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Biomedical subjects

D Desaulniers

Publications and source records attributed to D Desaulniers.

34 records · Page 2Linked to original sources
PubMed1985

[Rehabilitation after aorto-coronary bypass and return to work].

In Quebec, deceptively few patients who have successfully undergone coronary artery bypass have been returning to work. Those aged 55 to 64 years, blue collar workers or those who were off work for 13 weeks or more were likely not to return to work after surgery. From Jan. 1, 1983, all patients aged 64 years and younger, who successfully underwent coronary artery bypass grafting were invited to attend a 6-week rehabilitation program, starting 6 weeks after operation. The aim of the program was to improve the rate of return to work through a low-intensity physical activity course (60% to 70% maximal working capacity and calisthenics ). Up to Mar. 31, 1984, 68 patients had participated in the program. The proportion of patients returning to work was significantly (p less than 0.01) improved and the trend was observed in all age groups, and for all types of employment and length of time off work before operation.

Adult↗
PubMed1984

Vigorous physical training after aortic valve replacement: analysis of 10 patients.

Improved prosthetic aortic valves have reduced the incidence of complications to a point where it can be hypothesized that functional class I subjects after aortic valve replacement (AVR) should adapt to a vigorous training program without a significant increase of hemolytic activity or clinical signs of prosthesis malfunction. To test this hypothesis, 10 men (mean age 52 years) who had undergone AVR (7 Björk-Shiley and 3 Lillehei-Kaster) were submitted to an 8-week training program on ergometer, 3 times/week, from 60 to 80% of individual maximal heart rate. Ten other men who had undergone AVR but did not participate in the training program were control subjects. The exercise program produced significant improvements in posttraining maximum tolerated ergometer work load (210 kpm, p less than 0.001), in maximum total body oxygen consumption (5 ml/kg X min-1, p less than or equal to 0.01) and in double product at submaximal work load (-5,126, p less than or equal to 0.01). After training, hemoglobin decreased by about 1 g% (p less than or equal to 0.05) and hematocrit, reticulocyte counts and haptoglobin did not change significantly. Serum LDH and serum AST did not increase. Pre- and post-training echocardiograms did not show detectable alterations. Thus, patients with AVR who are in functional class I can adapt to a physical exercise program without significant adverse effects.

Aortic Valve↗
PubMed1981

Does pericardial drainage decrease the frequency of postpericardiotomy syndrome?

The postpericardiotomy syndrome occurs in 10% to 40% of patients who undergo open-heart surgery. Its frequency is reportedly decreased when pericardial drainage is used. To challenge this, 50 consecutive patients (1 was disqualified) were randomly assigned to two groups: one in which only the anterior mediastinum was drained (group 1) and the other in which the anterior mediastinum and posterior pericardium were drained (group 2). The surgical procedures performed were: coronary artery bypass grafting in 14 patients, valve surgery in 23 and repair of congenital defects in 12. The two groups were similar with respect to age and the volume of blood drained. Significant differences were found only for the duration of bypass and volume of blood given. At 7 to 10 days there were no differences in the frequency of fever, thoracic pain or presence of arthralgia. Findings were similar in both groups for leukocyte count, sedimentation rate, serum lactic dehydrogenase value and for the frequency of positive blood, urine and sputum cultures. Six patients (three in each group) had a postpericardiotomy syndrome that required steroid treatment and prolonged hospitalization for 10 more days. However, none had postpericardiotomy syndrome complicating coronary artery bypass surgery. None of the patients had cardiac tamponade. This study demonstrates that pericardial drainage has no effect on the frequency of postpericardiotomy syndrome and appears to be unnecessary after open-heart surgery.

Cardiac Surgical Procedures↗
PubMed1980

[Views of patients after open heart surgery].

Twenty patients, selected at random, were followed up by means of interviews and questionnaires before and after open-heart surgery. Nine were professional or business people, two were office clerks, four were manual labourers and five were unemployed. The operative procedures consisted of valve replacement in eight patients, aortocoronary bypass in nine and correction of congenital cardiopathy in three. Anxiety factors before the operation centred around the fear of death (55%), invalidity (15%) and convalescence (10%). No anxiety was found in 20%. The family proved to be a negative factor in 31%, especially in wives of professionals. In the intensive care unit, 47% of patients complained of the noise and 26% of the nursing during the night shift; only 21% complained of pain. More than 70% of the patients appreciated the support of the interviewer, and especially the continuity of the follow-up throughout the hospital and convalescence phases.

Adolescent↗
PubMed1978

Value of a cinefluoroscopic assessment of the Lillehei-Kaster prosthetic heart valves.

In order to assess the functioning of the pivoting disc of the Lillehei-Kaster prosthetic valve, a cinefluoroscopic technique using multiple angulations was developed. The disc was detected in 240 (99%) of the 242 valves studied (126 aortic, 107 mitral, and nine tricuspid valves). The maximal-opening angle of the disc was measured in 75% of the aortic but only 20% of the mitral valve prostheses in the 182 valve studies in which this was attempted. Prosthetic dysfunctions were suspected clinically in three aortic and three tricuspid valves and confirmed with the cinefluoroscopic technique. This cinefluoroscopic approach constitutes a rapid, noninvasive, and sensitive evaluation of the function of the Lillehei-Kaster prosthetic valve in the aortic position.

Aortic Valve↗
PubMed1978

Fibrolipoma of the mitral valve in a child. Clinical and echocardiographic features.

Echocardiographic examination, performed in a 12-year-old boy who had signs of mitral regulation, showed the presence of an abnormal mass of echoes in the left atrium and mitral orifice. These were initially interpreted as representing an atrial myxoma. Surgical exploration showed that the tumor originated from the posterior leaflet of the mitral valve, and, microscopically, the lesion was diagnosed as a fibrolipoma. The clinical and echocardiographic features of this unique type of cardiac tumor are discussed.

Child↗
PubMed1978

[Segmental replacement of thoracic aorta with autologous pericardium during growth (author's transl)].

Surgical treatment of coarctation of the aorta in the newborn often recurs during childhood. As a means of avoiding this complication segmental replacement of the thoracic aorta with autologous pericardium was evaluated. The isthmic aorta of seven mongrel puppies was replaced by a tubular live pericardial autograft. Between 5 and 36 months (average 15) after surgery, the status of the graft was evaluated by hemodynamic, angiographic, macroscopical and histological studies. Growth of the graft was appreciated by comparing its diameter to that of the descending aorta DG/DA. No pressure gradient across the graft was noted. No significant structure of the graft was observed. The internal surface of the graft was smooth, and the wall, slightly thinner than that of the aorta showed no aneurysm. The diameter of the graft was increased (DG mean 37 %) proportionally to the increase of the aorta (DA mean 36 %). Histologically the graft was endothelialized, the wall was thickened and made up of concentric collagen fibers, live fibroblasts and muscular cells. These results show that during the first months of life, the isthmus of the aorta can be replaced by an autologous pericardial graft which will follow the growth of the normal aorta and adapt to its hemodynamic regimen.

Animals↗
PubMed1977

[Left atrial myxoma: a surgical emergency. Apropos of 2 cases].

This study reports on two more cases of left atrial myxoma. They were two women with embolic manifestation for several years and in whom the diagnosis was not clinically considered. It was made by echocardiography. Emergency surgery was applied in both cases one of whom without hemodynamic study. The presence of a recent brain embolism did not seem to us to be a contraindication to this surgery. In both cases the tumoral pedicle was implanted on the posterior wall of the left atrium, an unusual location.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Interactions between endosulfan and dieldrin on estrogen-mediated processes in vitro and in vivo.

There is growing concern that estrogenic chemicals, both natural and human-made, may be causing a variety of reproductive disorders in wildlife and human populations. Recent in vitro data suggest that the interaction between some weakly estrogenic organochlorines, dieldrin, endosulfan, toxaphene, and chlordane, causes a synergistic increase in their estrogenic potency, an effect due to joint action on estrogen receptors (ER). As these studies were conducted using models of estrogen action derived from cells that are not physiologically controlled by estrogens, the relevance of these findings to human health are not clear. The present studies were conducted to examine the interaction between endosulfan and dieldrin in the activation of ER in or extracted from mammalian cells. Endosulfan and dieldrin showed no synergism in displacing 3H-E2 from rat uterine ER or in inducing the proliferation of MCF-7 breast cancer cells, an estrogen-dependent response. Furthermore, endosulfan (0.1 mg per animal per d) or dieldrin (0.1 mg), alone or in combination, injected intraperitoneally daily for 3 d, did not stimulate any uterotrophic activity nor had any effect on pituitary prolactin or other endocrine-related endpoints in immature female rats. These studies demonstrate that these weakly estrogenic compounds do not interact in a synergistic fashion in binding to ER or in activating ER-dependent responses in mammalian tissues or cells. Thus, these results suggest that coexposure to these weakly estrogenic environmental contaminants likely will not cause human reproductive toxicity related to estrogen action.

Animals↗
PubMedDate not supplied

Reproductive and thyroid hormone levels in rats following 90-day dietary exposure to PCB 28 (2,4,4'-trichlorobiphenyl) or PCB 77 (3,3'4,4'-tetrachlorobiphenyl).

Subchronic exposure to the PCB congener 77 (PCB 77) and 28 (PCB 28) was previously shown to induce histological changes in the thyroid and in the brain biogenic amines levels, suggesting possible effects on thyroid and reproductive hormone levels. Thus, the effects of a 90-day dietary exposure to PCB 28 or 77 on luteinizing hormone, follicle-stimulating hormone, and testosterone concentrations were studied in male rats, as well as the levels of thyroid-stimulating hormone, thyroxine (T4) and uridine diphosphate-glucuronyl transferase (UDP-GT) activity in both genders. Weanling Sprague Dawley rats were randomly distributed into groups of 10 rats and were fed, for the next 13 weeks, purina lab chow containing 50, 500, 5,000 or 50 000 ppb of PCB 28 or 10, 100, 1000, or 10 000 ppb of PCB 77. The serum concentrations of T4 were decreased in rats of both sexes receiving 1000 ppb or more of PCB 77, and was associated with an increased activity of UDP-GT which reached significance only in the females. There was a tendency for the highest dose of PCB 28 also to decrease serum T4 concentrations in the female rats. None of the PCB treatments significantly altered gonadotropin, TSH, or testosterone concentrations. These results suggest that thyroid functions may be more susceptible or adapt less readily than the pituitary gland and the testes to endocrine disruption caused by PCB congeners.

Animals↗