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Biomedical subjects

D Gambini

Publications and source records attributed to D Gambini.

At least 37 records · Page 2Linked to original sources

[Evaluation of post-infarction disorders of left ventricular contraction by echocardiography and scintigraphy of the cardiac cavities].

The comparison in 36 patients of two-dimensional echocardiography and scintigraphy of the cardiac cavities in the steady state with left cineventriculography selective for the evaluation of anomalies in left ventricular contraction post infarction shows good agreement between these techniques for the detection of major segmental anomalies, a higher sensitivity being found for echocardiography in dyskinesis. The overall rejection fraction calculated by two-dimensional echocardiography is correlated with the ejection fraction calculated in left cineventriculography (r = 0.57; p less than 0.001). The same is true of the overall ejection fraction obtained by cavitary scintigraphy (r = 0.62; p less than 0.01). The indices of residual myocardium in the anterior wall (IRM ant) and the posterior wall (IRM post) calculated in apical echographic section for the two cavities and in left cineventriculography (oblique anterior right) are also well correlated (IRM ant: r = 0.70 and p less than 0.001; IRM post: r = 0.46 and p less than 0.01). The determination of these parameters as well as the percentage of shortening of the left ventricular small axis measured by echocardiography TM, to the smallest value, permits a valid assessment of ventricular function and makes it possible to avoid coronaroventriculography when this function is too impaired.

Adult↗

[Induced coronary spasm: immediate revascularization by the opposite coronary artery. Use of myocardial scintigraphy].

The case reported analyses the instantaneous revascularisation distal to a coronary spasm by electrocardiography and thallium scintigraphy. The patient, a 48 year old man, had an 18 months history of spontaneous anginal chest pain sensitive to trinitrin. No electrocardiogrammes had been recorded during an attack. Coronary angiography was normal apart from a slight reduction in calibre of a dominant right coronary artery. Injection of 0.4 mg methylergometrine provoked an occlusive spasm of this artery after 4 minutes. At the same time the patient experienced angina and 4,5 mm depression of the ST segment, without ST changes in D3 and AVF, was observed. Opacification of the left coronary artery during spasme of the right showed retrograde revascularisation of the posterior interventricular artery which was reversed when the coronary spasm was terminated with trinitrin. Thallium scintigraphy was performed during another spasm provocation test four days later which gave identical clinical and electrical changes. A zone of hypofixation with blurred limits over the inferior myocardial wall was demonstrated. In the absence of ST elevation and of lacuna on myocardial scanning, the myocardial ischaemia induced by this occlusive spasm could not be considered to be total. Therefore the immediate revascularisation of the coronary artery in spasm seemed to have played the role of an effective collateral circulation.

Angina Pectoris↗

[Monitoring of extra- and intra-cellular compartment through total body impedance (author's transl)].

To evaluate the extra-cellular space, we measure the impedance (or resistance) of the extra-cellular electrolyte compartment with an alternating current at a fixed frequency of 5 kHz that can't pass through the cellular membrane. Total water is measured by the impedance to a current of 1 MHz which is conducted by extra and intra cellular hydro-electrolytic space. There is a good correlation between electrical impedance measurements and distribution of isotopic markers. The extra-cellular compartment was evaluated by diffusion of D.T.P.A. marked with 99mTc or with 111In and the total water by the diffusion of Antipyrin marked with 1,311 or 1,231. The findings indicate that there is not a significant difference between the results of the size of extra-cellular water measured by electrical impedance and D.T.P.A. diffusion (r = 0.75). Comparable results have been obtained in the determination of total water by electrical impedance measure and diffusion of Antipyrin (r = 0.90). We have also studied by method of electric impedance:--The state of hydratation in head injured patients and after pituitary surgery.--The lean body mass and hydro-electrolyte compartments in pregnancy. Electrical impedance measure seems to be a simple and reliable method to assess the hydric state of patients.

Adult↗

[Dynamic study of the coronary vascular bed by selective coronary scanning using hyperaemia].

Advantage may be taken of the hyperaemic response to the iodine contained in the contrast medium injected during coronary angiography to assess the functional value of the coronary tree using radioactive microspheres. This series comprises 73 selective coronary scans performed in the resting state (113 m In marked microspheres) and during the hyperaemic phase (99 m TC marked microspheres) in 70 patients. A positive hyperaemic response distal to severe truncular stenosis indicates a good distal arteriolar bed and collateral circulation for aorto-coronary bypass grafting. After aorto-coronary bypass (23 cases), the hyperaemic response gives an indication of the functional value of the revascularised myocardium. In 71% cases, the results correlate well with the measurement of the peroperative blood flow through the graft. It is usually positive when the bypass graft is implanted with good distal arterial run off.

Adult↗

[Study of the coronary arteriole bed at rest and during hyperemia by selective coronary scintigraphy with labeled microspheres].

The hyperemic response induced by the tri-iodinated contrast agent injection for coronarography assesses functional value of the arteriolar areas of coronary distribution. The intracoronary injection of two kinds of micropheres labeled with gamma emitter radionuclides of different levels of energy (99m-Technetium and 113m-Indium) provides comparison of the studied areas-scintigraphies at rest and during hyperemia.

Arterioles↗

[Quantitation of mitral and aortic regurgitation using the effective systemic ejection fraction measured by radiocardiography and scintography of the cardiac cavities].

Comparison between the effective systemic ejection fraction defined by radiocardiography and cardiac chambers scanning, and the whole left ventricular ejection fraction calculated by cineangiocardiography allows an accurate assessment of mitral and aortic regurgitation extent. In case of both mitral and aortic insufficiency, each regurgitation can be quantitatively dissociated by means of the aortic isotopic dilution curve recorded at the same time as the radiocardiogram.

Aortic Valve Insufficiency↗

[Selective coronary scintigraphy using labelled microspheres].

Selective intracoronary injection of microspheres labelled with radioactive substances which emit gamma rays with different energy levels (Indium 113 m and Technetium 99 m) allows us to explore by scintigraphic methods the areas of distribution of the two coronary arteries. Having been carefully calibrated, the particles are injected in limited numbers, and block the precapillary arterioles, where they gradually diminish in number. Scintigraphic examination is carried out in various projections (anteroposterior, left anterior oblique and right anterior oblique) immediately after coronary arteriography. Coronary scintigraphy allows us to establish the integrity of the distribution network of a coronary trunk which appears normal on coronary arteriography, to visualise the diminution of flow caused by a stenosed but patent trunk, and to visualise the extent of the collateral circulation and the quality of revascularisation achieved by an aorto-coronary bypass operation.

Angina Pectoris↗

[Role of pharmacovigilance center in information for the public on drugs. Experience in Marseille on 9 month].

We analyzed the role of the Marseille pharmacovigilance center (working in collaboration with the local poison treatment center) in informing the general public on medicinal drugs. Over a 9-month period, the center received 115 requests from members of the public for information. 82.6% of callers were not members of the health professions and wanted information for themselves (61.7%, 67.6% women) or their children (26.08%). The questions mainly involved drug interactions (28.7%), side-effects (26%) and precautions for use in particular circumstances (20%). 178 proprietary drugs (47 of which had been bought over the counter) were mentioned. The main therapeutic classes were neuropsychiatric drugs (n = 41), cardiovascular drugs (n = 17) and analgesics (n = 16). A number of communication difficulties and problems of a deontological nature were encountered. Full information was provided in every case, together with advice on prevention to about half the callers.

Adverse Drug Reaction Reporting Systems↗

What is the pathogenetic role of antiphospholipid antibodies?

The association between antiphospholipid antibodies (aPL) and arterial or venous thrombosis, fetal loss and thrombocytopenia defines the so-called "antiphospholipid syndrome" (APS). Despite serial studies in recent years, a clear pathogenetic mechanism(s) has not yet been demonstrated. Several authors have investigated the interaction between aPL and the membranes of blood cells (endothelial cells and platelets) involved in coagulation. aPL is also thought to affect the balance between the procoagulant and anticoagulant states by interacting with plasma or tissue cofactors. Finally, the strong association between aPL and experimental animal models of fetal loss supports a direct pathogenetic role for aPL in inducing a poor pregnancy outcome in APS women.

Abortion, Spontaneous↗