Search PubMed⌕ Search

Biomedical subjects

C Perret

Publications and source records attributed to C Perret.

At least 235 records · Page 13Linked to original sources
PubMed1980

[Acute respiratory distress syndrome after mycoplasma infection].

The natural and treated course of Mycoplasma pneumoniae is generally satisfactory. Only a few cases with fatal outcome have been reported, mainly in immunosuppressed and debilitated patients. The case is reported of a healthy young woman admitted with acute respiratory failure, who developed diffuse interstitial fibrosing pneumonia followed by refractory hypoxemia. The diagnosis of Mycoplasma pneumoniae pneumonia was at first suspected from an elevated specific titer in the standard complement fixation test, and then confirmed in the immunofluorescence study by the presence of granular deposits (mycoplasma) in the macrophages of lung tissue. The functional impairments associated with this unusually malignant evolution are discussed.

Adult↗
PubMed1980

[Hemodynamics during septic shock].

Septic shock usually induces a hyperdynamic state characterized by normal or high cardiac output, associated with a fall in peripheral resistances which is responsible for arterial hypotension; when the evolution is prolonged it usually leads to a low output syndrome with elevated peripheral resistances, suggesting the hemodynamic pattern of hypovolemic shock. All intermediate situations can be observed within these extremes. The hyperdynamic state corresponds to a decrease in aortic impedance, which is indirectly related to the effects of endotoxin on vascular bed. The low output syndrome is more usual at the advanced stage and corresponds to the intervention of associated factors such as progressive hypovolemia and/or myocardial dysfunction. In certain cases--e.g. peritonitis--septic shock is immediately associated with hypovolemia. Many hypotheses have been advanced to explain the circulatory, cardiac and metabolic effects of septic shock. The effect of kinines on the circulation appears to predominate but there are still many unanswered questions concerning the real sequence of events. Hemodynamic monitoring is of great advantage in identifying the type of circulatory distortion, determining its severity, guiding therapy and evaluating its effects.

Adult↗
PubMed1980

Intraventricular conduction disturbances in acute myocardial infarction: short- and long-term prognosis.

Short- and long-term prognosis were analysed in 59 patients admitted in the coronary care unit with an acute myocardial infarction, complicated with acute intraventricular (IV) conduction defects. In-hospital mortality of patients with IV conduction disturbances was more than twice (30%) the mortality of patients without IV conduction defects (13%; P less than 0.001). Mortality rate was very high among patients with all forms of incomplete trifascicular block or complete right bundle-branch block. Among survivors of the group with conduction defects, late death rate was significantly higher than in survivors of the group without IV blocks (25 vs 8%; P less than 0.01). Short-term prognosis of conduction defects in myocardial infarction depends on the extent of the necrosis. The conflicting results in long-term prognosis could be ascribed to variations in patient material and to different criteria used to define the acute nature of a block. Lastly the variable prognosis could correspond to differences in the site of the lesions within the conduction pathway.

Arrhythmias, Cardiac↗
PubMed1979

[Massive heroin intoxication. Hemodynamic studies].

Acute hemodynamic changes during heroin overdose have not been frequently reported. We observed 2 male patients aged 24 and 21 years admitted in coma and shock and presenting severe mixed acidosis, with, respectively, pH 6.80, PaCO2 72 mm Hg, PaO2 70 mm Hg, BE -18 mEq/l, lactic acid 16.5 mmol/l, and pH 6.86, PaCO2 94 mm Hg, PaO2 46 mm Hg, BE -16 mEq/l, lactic acid 5.45 mmol/l. The hemodynamic data of the first patient showed a low output failure state associated with high filling pressures, suggesting biventricular heart failure. In the second case, clinically and radiologically marked pulmonary edema was associated with a hyperdynamic state and moderately elevated pulmonary artery pressure, but normal pulmonary capillary pressure. The possible pathophysiological mechanisms of those different, hemodynamic patterns are discussed.

Acidosis↗
PubMed1979

Haemodynamics in phaeochromocytoma. A report of 2 cases.

The haemodynamic measurements made in two cases of proved phaeochromocytoma are described. In both the systemic vascular resistance (SVR) was markedly increased and was associated with a decreased preload. In one case, phentolamine infusion, when lowering the SVR, produced a marked decrease in the cardiac index resulting in a state of hypovolemic shock. This was successfully treated by the administration of plasma expanders. The data tend to indicate that haemodynamic measurements in cases of phaeochromocytoma could be both of diagnostic and therapeutic interest.

Adrenal Gland Neoplasms↗
PubMed1978

Messages conveyed by descending tracts during scratching in the cat. II. Activity of rubrospinal neurons.

(1) The activity of rubrospinal (RS) neurons giving axons to the lumbosacral spinal cord was recorded during actual and fictitious8 scratching in thalamic cats. (2) During both actual and fictitious scratching, the discharge frequency of many RS neurons was rhythmically modulated. Different neurons were active in different parts of the scratch cycle, but most neurons were active in the flexor phase. (3) The discharge frequency within the bursts during fictitious scratching was, on the average, equal to that during actual scratching. Immobilization usually resulted only in a small displacement of the burst position in the scratch cycle. Therefore, rhythmical modulation of RS neurons is determined mainly by central mechanisms and not by a rhythmical sensory input. (4) In decerebellate cats, the overwhelming majority of RS neurons had no rhythmical modulation. Very weak modulation was found only in a few neurons. (5) Transection of the ventral spinocerebellar tract (VSCT) resulted in considerable reduction or complete cessation of rhythmical modulation in RS neurons during fictitious scratching. On the contrary, transection of the spino-reticulocerebellar pathway (SRCP) resulted in just a small decrease of modulation. Therefore, of the two pathways (the VSCT and SRCP) transmitting messages about intraspinal processes to the cerebellum during scratching2,3, the VSCT is of major importance for modulating RS neurons.

Animals↗
PubMed1978

[Short and long-term prognosis of intraventricular conduction disorders in the acute stage of myocardial infarct].

The short- and long-term prognosis of acute intraventricular (iv) conduction defects is analyzed in 59 patients admitted to the coronary care unit with acute myocardial infarction. In-hosptial mortality of patients with iv conduction disturbances was more than twice (30%) the mortality of patients without iv conduction defects (13%; p less than 0.001). Mortality was very high among patients with all forms of incomplete trifascicular block or complete right bundle branch block. Among survivors of the group with conduction defects, the late death rate was significantly higher than in survivors of the group without conduction disturbances (25% and 8% respectively: p less than 0.001). The short- and long-term prognosis of acute conduction defects in myocardial infarction depends on the extent of necrosis. Permanent endocardial pacing is therefore indicated only among patients whose death risk is related to conduction disturbances.

Acute Disease↗
PubMed1977

[Acid production and the need for bicarbonate in diabetic acidosis].

In a study of 54 patients with diabetic keto-acidosis with pH on admission less than or equal to 7.1, the amount of bicarbonate (HCO3-) necessary to correct the acidosis is compared to the amount predicted by the formula HCO3- (MEq) = 0,3 X body weight (kg) KG) X delta base excess (mEq/l). HCO3- requirements vary widely among patients. In addition, whenever HCO3- is given within 1-2 h the requirement may be inferior to the value calculated, whereas with slow HCO3- infusion it can be twice or three times the amount calculated. Variable HCO3- needs among subjects, and increased needs with time, are due to acid production which may exceed 100 mEq/h, especially in young patients. The amount of HCO3- required is determined not only by the severity of acidosis but also by net acid production, which may vary widely. The assessment of acid-base balance during treatment is useful in evaluating the amount of acid produced and hence the precise need for HCO3- replacement.

Acid-Base Equilibrium↗
PubMed1976

[The value of alkalizing treatments in severe diabetic keto-acidosis].

In 37 diabetic patients with severe acidosis (pH less than 7.0; [HCO3-] less than 5.0 mMol/l), administration of insulin was preceded by a rapid infusion of molar sodium bicarbonate in order to obtain partial correction of acidosis (pH approximately 7.20). 31 patients survived (83,8%); 6 patients died in cardio-circulatory failure associated in two cases with acute pulmonary edema. Initial administration of bicarbonate appears to be beneficial in preventing the deleterious effects of prolonged severe acidosis, such as cardiac arrhythmias, shock or acute pulmonary edema. Furthermore, partial correction of acidosis decreases the total dose of insulin necessary to compensate hyperglycemia and thereby reduces the danger of late hypoglycemia. This treatment calls for frequent checks on acid-base status and serum potassium. In most cases hypokalemia develops, but can be easily corrected by administration of potassium chloride. Normalization of arterial pH by bicarbonate infusion is not recommended in view of the development of late hypernatremia and metabolic alkalosis.

Acid-Base Equilibrium↗
PubMed1976

Central generation of locomotion in the spinal dogfish.

After a transection of the spinal cord a dogfish performs continuous swimming movements with a phase lag between adjacent segments. It is shown that the intersegmental coordination remains after an extensive dorsal root transection as well as after curarization. In the former case the motor activity was recorded electromyographically in several segments along the body, in the latter case the intersegmental coordination was evaluated by recording the efferent activity in different ventral roots along the body. It was concluded that a spinal central network can account for the phase lag observed between successive segments during swimming. It was also shown that the efferent activity from parts of the spinal cord with no dorsal roots intact could be influenced by peripheral stimuli such as pressure on the pelvic fins; this result suggests that some afferent fibres reach the spinal cord via the ventral roots.

Animals↗
PubMed1975

Haemodynamic response to slow plasma volume expansion in uncomplicated myocardial infarction.

Left ventricular performance in 16 patients with uncomplicated acute myocardial infarction (AMI) has been estimated, by measuring the haemodynamic response to a moderate increase in left ventricular filling pressure (LVFP), obtained by an espansion in blood volume with a slow infusion of 250 ml of plasma. In 9 cases the infusion was repeated. This represents a total of 25 tests. In 17 tests (group A) cardiac index (CI) and left ventricular stroke work index (LVSWI) did not increase significantly and sometimes decreased. In 8 tests (group B) The same plasma volume expansion (PVE) induced a moderate but significant increase in CI(p less than 0.001) and LVSWI (p less than 0.001). A higher incidence of inferior wall infarction was present in group B. Control CI and LVFP did not differ between the two groups and there was no correlation between the initial LVFP and the type of response to PVE. For the same volume load, the increase in pulmonary capillary wedge pressure (CWP) showed large individual variations (+1 to +8 mm Hg). As a general rule when CI improved, the increment in CWP was minimal (+1 mm Hg). It is concluded that there is no unique optimal LVFP and that PVE must be carefully monitored, in all cases.

Adult↗