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Biomedical subjects

C Richard

Publications and source records attributed to C Richard.

At least 325 records · Page 18Linked to original sources
PubMed1984

[Respiratory distress syndrome in necrotizing fasciitis of the hand].

A case is reported of acute respiratory distress syndrome occurring during septic shock complicating necrotizing fasciitis of the hand. It is emphasized that, although this kind of evolution is largely unknown, it is logical for this complicated infective pathology. As the presence of septic shock contraindicated the use of positive end-expiratory pressure, the evolution of the respiratory failure could only be of a fulminating nature, and the patient died.

Fasciitis↗
PubMed1984

[Not Available].

Explore the source record for details and available documents.

Canada↗
PubMed1984

Effects of captopril on pulmonary haemodynamics.

The effects of oral captopril on pulmonary haemodynamics were studied in two groups of 6 patients, one of subjects with chronic respiratory failure (PaO2 52 +/- 5.1 mmHg, PaCO2 54 +/- 2.1 mmHg), and the others with chronic heart failure and high plasma renin activity. Two potential mechanisms of its actions were assessed, namely inhibition of hypoxic vasoconstriction and inhibition of the possible effects of angiotensin II on the pulmonary circulation. There were significant (p less than 0.05) decreases in mean arterial pressure, pulmonary wedge pressure and in systemic arterial resistance associated with improvement in cardiac index in both groups. In the chronic respiratory failure group there was no change in blood gases, mean pulmonary arterial pressure or pulmonary vascular resistance. An increase in driving pressure (p less than 0.05) indicated that captopril had had no effect on pulmonary haemodynamics. In chronic heart failure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure were decreased by a similar extent, so that driving pressure and pulmonary vascular resistance were not changed. It is concluded that oral captopril did not inhibit hypoxic vasoconstriction, and that it modified pulmonary haemodynamics in chronic heart failure patients with high renin activity only as a consequence of reduction in systemic afterload.

Adult↗
PubMed1983

Enzymatic cleavage of pyroglutamyl-histidyl-dopamine, a TRH-related pseudo-peptide by porcine serum and brain hoimogenate.

The Pseudo-peptide (pGlu-His-Dopamine) was subjected to enzymatic degradation by porcine serum and brain homogenate. The digests were quantitatively analyzed by HPLC to provide evidence for liberation of pyroglutamic acid and dopamine in serum and of pyroglutamic acid in brain. The yield of liberation of pGlu is about 3% in serum digests and about 0.70% in brain digests after 3 minutes incubation. The time course of the yield of liberation of both pGlu and dopamine in serum digests is determined. The "stability in vitro" toward enzymes of serum and brain homogenate of a new type of drug based on the combination of peptidic fragment of TRH-(Thyrotropin-Releasing Hormone:pGlu-His-Pro-NH2) with a non peptide moiety (dopamine) is considered and discussed.

Animals↗
PubMed1983

Nosocomial infections by chlorhexidine solution contaminated with Pseudomonas pickettii (Biovar VA-I).

Over a period of 10 days, six patients in a cardiac intensive care unit developed Pseudomonas pickettii (biovar VA-I) septicaemia after installation of a venous catheter. The organism was also recovered from all the vials of the aqueous solution of 0.05 per cent chlorhexidine ('Hibitane') prepared with contaminated bidistilled water. There were no further cases of infection when the use of this water was prohibited.

Adult↗
PubMed1983

[Value of captopril in the treatment of systemic arterial and pulmonary hypertension with increased plasma renin in scleroderma].

The effects of the converting enzyme inhibitor captopril (Lopril) were studied in a 53 year old woman with acute exacerbation of scleroderma. In addition to her chronic symptoms of Raynaud's syndrome, the patient presented with severe hypertension, cardiac failure and oligoanuria. Right heart catheterisation with a Swan-Ganz catheter confirmed the systemic hypertension with cardiac failure, and also demonstrated precapillary pulmonary hypertension with raised pulmonary arterial resistance. The organic renal failure was an indication for renal biopsy which showed segmental and focal fibrinoid necrosis with microthrombosis and chronic ischemic changes. Due to raised plasma renin activity, treatment with captopril was instituted, leading to a rapid normalisation of systemic and pulmonary hypertension, the regression of cardiac failure and a transient improvement in the Raynaud's syndrome. The renal failure did not improve and the patient had to undergo chronic hemodialysis. These spectacular initial results should be interpreted in the context of the poor prognosis of acute exacerbations of scleroderma despite the encouraging data published recently after well-controlled antihypertensive therapy.

Adult↗
PubMed1983

O and H serotyping of Pseudomonas cepacia.

Procedures for the preparation, absorption, and titration of Pseudomonas cepacia O and H rabbit antisera are described. Seven O antigens (O1 to O7) for the slide agglutination test and five H antigens (H1, H3, H5, H6, and H7) for the agglutination and H immobilization tests were determined. Nearly 300 strains of P. cepacia isolated from hospitalized patients (a majority from Strasbourg hospitals) were serotyped. The use of P. cepacia serotyping as an epidemiological tool, especially in outbreak situations, was emphasized. Difficulties in obtaining monospecific H antisera are discussed.

Agglutination Tests↗
PubMed1983

Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock.

In eight mechanically ventilated patients in cardiogenic shock, we assessed the hemodynamic effects of an infusion of dopamine and dobutamine and evaluated its role in preventing the deleterious effects of administering each amine alone. Each patient received three infusions in a randomly assigned order: dopamine, 15 micrograms/kg/min; dobutamine, 15 micrograms/kg/min; and a combination of dopamine, 7.5 micrograms/kg/min, and dobutamine, 7.5 micrograms/kg/min. Stroke volume index increased similarly with the three infusions, but dopamine alone increased oxygen consumption (p less than 0.05 vs dobutamine alone and dopamine-dobutamine combined). The dopamine-dobutamine combination increased mean arterial pressure (p less than 0.05 vs dobutamine), maintained pulmonary capillary wedge pressure within normal limits (p less than vs dopamine), and prevented the worsening of hypoxemia induced by dopamine (p less than 0.05). The dopamine-dobutamine combination appears to be useful in the management of mechanically ventilated patients in cardiogenic shock.

Aged↗
PubMed1983

[Acute poisoning caused by beta blockers in the adult. Apropos of 7 cases].

Although rare, acute poisoning with beta-blockers can be serious. Including the four personal cases of the authors, 40 cases of propranolol overdose have been published, with 8 deaths. Hypoglycaemia was not reported, but the association with alcohol can be very serious. One case of bronchospasm and one case of acute pulmonary oedema have been reported. Bradycardia is not the rule and widening of the QRS complex was reported in 4 cases. The other cases published are: 1) 10 cases with oxprenolol (including 5 cases of coma and 4 deaths), 2) 9 cases with acebutolol (2 deaths) including 5 with studies of the kinetics of the product (1 personal case), 3) 7 cases with pindolol (no bradycardia, good prognosis), 4) 6 cases (1 personal) with metoprolol (4 cases of massive ingestion with 1 death), 5) 3 cases with alprenolol (1 death), 6) 4 cases with sotalol (2 cases of turned apex, 1 death), 7) 1 case with atenolol. The authors discuss the practical management. They stress that glucagon is a much better form of treatment in severe cases than isopropylnoradrenaline, and that the crucial period is in the first few hours after the ingestion of the beta-blockers, i.e. usually before the patient's arrival at the hospital. The effectiveness of endocavity stimulation has not been demonstrated.

Acebutolol↗
PubMed1983

[Isolation, identification and clinical significance of species of the Flavobacterium genus].

Strictly aerobic Gram negative bacteria are found more and more often in human pathological specimens and in the environment. Amongst these bacteria, Flavobacterium poses problems of bacteriological diagnosis as their precise taxonomy is still recent. In this study, conducted on 321 strains of Flavobacterium from various sources, but essentially from patients in the intensive care unit, the authors define the methods and features of identification and the clinical significance of the species of the Flavobacterium genus. One species is particularly important in medical bacteriology, Flavobacterium meningosepticum which can cause septicaemia and neonatal meningitis which are difficult to treat.

Anti-Bacterial Agents↗
PubMed1983

[Evaluation of functional myocardial recovery after emergency revascularization by intracoronary fibrinolysis in the acute infarct period].

An angiographic study was carried out to evaluate myocardial recovery in 50 patients who had undergone coronary angiography in the first six hours of myocardial infarction with the object of attempting emergency revascularisation by a selective intracoronary infusion of streptokinase. Left ventriculography performed before initial coronary arteriography and 2 to 10 weeks later was compared. The ejection fractions and two indices obtained by quantitative analysis of regional contractility, the surface (SHK) and extent (EHK) of the ischemic zones were calculated. The patients were divided into two groups according to results: Group I, 25 patients with patent arteries at the second control, and Group II, 25 patients not revascularised or with a reobstructed artery at the second angiographic control. In Group I, the ejection fraction remained stable (47 +/- 11 p. 100 to 48 = 10 p. 100 N.S.) but SHK (13 +/- 6 cm2 to 10 +/- 5 cm2, p less than 0,01) and EHK in percentage of ventricular circumference (48 +/- 12 p. 100 to 42 +/- 11 p. 100, p less than 0,05) fell significantly. In Group II, the ejection fraction fell (55 +/- 9 p. 100 to 44 +/- 11 p. 100, p less than 0,001) whilst SHK (7 +/- 4 cm2 to 11 +/- 5 cm2, p less than 0,001) and EHK (34 +/- 11 p. 100 to 43 +/- 14 p. 100, p less than 0,001) increased significantly. These results show that revascularisation may result in significant functional myocardial recovery and, consequently, that some ischemic myocardium can be salvaged in these patients.

Cardiac Catheterization↗
PubMed1983

[Fatal pulmonary embolism with a normal PaO2].

A case of massive pulmonary embolism confirmed by angiography and necropsy, without arterial hypoxemia (PaO2 = 109 torr while the patient breathing room air) was reported. The onset of hypoxemia and increase in venous admixture secondary to cardiac output improvement with dobutamine was discussed.

Aged↗