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Biomedical subjects

D Grimaud

Publications and source records attributed to D Grimaud.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Physiopathology of continuous enteral feeding. Application to several major digestive system disease syndromes].

The first chapter looks at the advantages of continuous oral feeding (COF) over conventional oral feeding, from a physiological and physiopathological point of view. From this discussion the indications and contraindications for this type of feeding are drawn. Then a few major diseases of the digestive tract are examined: diseases of the bile salts, intra-luminal bacterial proliferation, acute bacterial diarrhoea, isufficiency of exocrine pancreatic secretion. In each case the use off continuous oral feeding is suggested.

Bacteria↗
PubMed1979

[Acute pancreatitis during "diabetic lipemia": unusual disclosure of insulin-dependent diabetes (author's transl)].

A case of diabetic lipemia is reported in a 27 year-old man admitted for acute pancreatitis. Initial investigations revealed gross hyperlipoproteinemia and ketoacidosis. Hyperlipoproteinemia was progressively corrected up to normalization in four weeks under insulin-therapy; the metabolic control of diabetes was obtained in parellel. This feature is caracteristic of "diabetic lipemia". The following sequence could be suggested: onset of diabetes, occurence of diabetic lipemia and then acute pancreatitis.

Acute Disease↗
PubMed1978

[Pulmonary oedema after late revascularisation of the lower limbs (author's transl)].

In the two cases reported, pulmonary oedema developed immediately following revascularisation of the lower limbs after prolonged ischaemia. Without it being possible to formally exclude the possible role of a haemodynamic factor, the authors suggest the hypothesis of a predominantly lesional mechanism. The "reconnection to the circuit" is the provoking factor in this oedema, the alveolo-capillary membrane being previously altered by the prolonged ischaemia, infection and massive transfusion. The pulmonary manifestations would seem to enter within the classification of somatolysis.

Adolescent↗
PubMed1978

[Study of a new respiratory analeptic: injectable almatrine. Apropos of 22 cases of acute hypoventilation: respiratory activity and electroencephalographic control].

2620 is a respiratory analeptic which acts by stimulation of peripheral chemoreceptors. It was administered intravenously in 22 patients in acute respiratory insufficiency. Doses during the first hour varied between 0.7 and 3 mg/kg. A careful study of the effects on respiration showed a significant increase in minute ventilation without any proportional increase in frequency for doses of between 1.7 and 3 mg/kg. Continuous recording of the electroencephalogram over a period of one hour revealed no convulsant effect even in particularly vulnerable patients. In seven patients, tracings showed a change in the sense of increased consciousness which corresponded with the clinical course of the diseases responsible for the state of hypoventilation.

Acute Disease↗
PubMed1977

[Metabolism of glucides and polyols and disorders of their utilization].

The first part of this report is devoted to a description of the metabolic pathways of the principle carbohydrates and polyols. The second part is concerned with the utilisation of these energy-providing substrates, when used in parenteral alimentation. Notions emerge of "total clearance" and of coefficient of utilisation in relation to the rate of administration for each of them. Finally, the third part deals with disturbances of carbolydate and polyol metabolism during stress and diabetes and the possiblilities of the development of hyperlactatemia according to the substances used or the pathological circumstances encountered. A table attempts to summarise the potential complications in comparison with all the substrates used in parenteral alimentation.

Blood Glucose↗
PubMed1977

[Three cases of coma during parenteral alimentation].

Three cases of coma occuring during parenteral alimentation are presented. The common factor was that they occurred during the phase of realimentation in patients with severely impaired nutrition. In two cases out of three, the coma marked the beginning of the absolute or relative anabolic period. They were studied clinically, biologically and electrically. In one case only, major hypophosphataemia was discovered (2mg/l). Of the three patients, one only died 4 days after the onset of coma, whilst clinical and biological characteristics had returned to normal.

Coma↗
PubMed1976

[Study of pressure and FeCO2 during ventilation by injection (preliminary note)].

This study, carried out in nine patients, attempted to judge the efficacy and possible inocuity of ventilation by injection (jet ventilation), firstly on capnography and. secondly, on recordings of intra-tracheal pressure. The frequency of six jets per minute, is that which, under the conditions of the trial, ensures the best removal of CO2 and the maintenance of stable CO2 levels in the trachea. Although pressures recorded in the airways varied between 15 and 40 torrs, the finding of very high peaks of pressure in certain cases, makes the authors somewhat reserved concerning the security of the method when the free reflux of gas is liable to be inhibited.

Bronchoscopy↗
PubMed1976

[Correction of the alphamimetic effects of metaraminol by nicergoline].

In this work, the authors are studying the cardio-vascular effects of nicergoline. To do so, the drug is made to compete with metaraminol whose dominant alphamimetic effects are known. This experimentation was performed in 7 patients in coma stage III or IV and whose vascular receptors were active. Those 7 patients were submitted continuous metaraminol perfusion and a steady state vasoconstriction was thus obtained. A single intravenous injection of 10 mg nicergoline resulted in vasodilation with a fall in vascular resistance and a moderate fall in mean blood pressure. Cardiac output remained unchanged. This work confirme thus the alphasympatholytic effects of nicergoline.

Blood Pressure↗
PubMed1975

[The utilization of EB 51 in parenteral feeding. Clinical, biological and anatomopathological control. Statistical study on 30 patients].

Two groups of patients (comas of central origin and serious digestive undernourished) were submitted to an exclusive or a supplementary parenteral feeding for a short or a long period of time totaling over 500 days. The catheter was placed (in 80 p. cent of the cases) in a deep vein and was tunnellized. EB 51 (Trivemil) used in those 30 patients gives amino-acids, lipids and glucides. The caloric intake was completed by 30 p. cent glucose solutes. If the average caloric intake was 3.000 calories per day, it was often above that figure since the feeding was combined with a nutri-pump enteral feeding for 60 p. cent of the days. The clinical tolerance was quite good. On a biological level, in addition to classic investigations, 40 analytic graphic records of lipid levels were made, as well as a quantitative analysis of serous triglycerides and lipurias, a study of sorbitol and 500 nitrogen balances combined with 150 chromatographies on the acidaminuria column. An hepatic biological control was also made (amnoniemia, transaminases) as well as a quantitative analysis of lactates, pyruvates and minerals: iron-phosphorus-magnesium. Some of the results were checked by statistical studies. No serious anomaly was detected. Lung and hepatic biopsies carried out upon 9 patients did not apparently reveal any lipidic overloading. The clinical and the biological investigation show that this complete nutriment is perfectly tolerated and assimilated.

Amino Acids↗
PubMed1975

[Pulmonary edemas of drownings].

Patients who are victims of near drowning in fresh water or salt water very frequently have acute edema of the lung which occurs either immediately, or after a free interval of variable duration. The mechanism of this edema is explained, in near drowning in salt water, by the hyperosmolarity of the alveolar fluid leading to a seeping of plasma from the capillaries in the alveoli. In the case of near drowning in fresh water, it is on the contrary the inhaled liquid which passes into the circulation, therby leading to immediate hypervolemia, but this overload is only transitory and is not responsible for the pulmonary edema which occurs later is not accompanied by a rise in pulmonary capillary pressure. It is therefore a lesional edema as is certified by the anatomopathological modifications found in the lungs of drowned patients. Therapeutic management must therefore take into consideration this physiopathology of acute edema of the lung in the drowned.

Drowning↗
PubMedDate not supplied

[Evaluation of the activities and value of allergo-anesthetic consultation at the University Hospital Center of Nice 1985-1991].

Life-threatening accident during anesthesia scarcely happen but the consequences may be dramatic. We report our experience of an allergo-anesthesia consultation created since 1985 in Nice hospital. 452 patients have been investigated: 1) 109 for life-threatening anaphylactic and anaphylactoid drug reactions. They have been investigated by: skin tests intradermal reactions (IDR) and prick tests with substances used during anesthesia (drugs and latex) and for all the muscle relaxants; the radioabsorbent test (RAST) for the muscles relaxants, propofol and latex; the human basophilic degranulation test (HBDT) for all the other drugs. We used the imputability decision table to classify the reactions. When anaphylaxis diagnosis was established (14) an "allergy card" was given to patients which identified the drugs to which they had a positive reaction. 62 patients have presented an anaphylaxis: 57 due to muscle relaxants (37 due to suxamethonium), 4 to latex and 1 to a gelatin. Patients were subsequently contacted and 50 of the 58 have responded. 18 of these patients have received 22 new anesthesias. Without exception, the advises to avoid a drug have been followed, 17 patients have a positive reaction to a muscle relaxant. In four of these, another muscle relaxant (skin test negative) was used without any trouble. For the other 13 who had shown a cross reactivity, all the muscle relaxants had been rejected and another anesthetic technique have been used: local anesthesia (3 cases), epidural (2 cases) associated or not with narcotics (propofol, midazolam), general anesthesia (propofol, midazolam, droperidol, phenoperidine). These drugs were all skin test negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaphylaxis↗