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Biomedical subjects

E Mortier

Publications and source records attributed to E Mortier.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Corynebacterium diphtheriae endocarditis complicated by septic arthritis and cerebral abscess].

The authors report a rare case of the mitis type Corynebacterium diphteriae endocarditis on a prosthetic valve complicated by septic arthritis and cerebral abscess. The authors underline the importance of regular transoesophageal echocardiographic control and underline the diagnostic value of ultrafast computed tomography for the diagnosis of aortic annular and interventricular septal abscesses in patients with mechanical prosthetic valves.

Arthritis, Infectious↗
PubMed1995

Monostotic Paget's disease involving the calcaneus. Diagnostic and therapeutic problems. Two case-reports.

The authors report the cases of two patients who had chronic incapacitating heel pain unresponsive to standard therapy. They were both found to have Paget's disease of the calcaneus. The diagnosis was difficult because the typical roentgenological changes required time to develop and because no other sites were involved. Local corticosteroid injections, elimination of weight-bearing, and standard analgesic therapy were ineffective. Bisphosphonate therapy (pamidronate) given as intravenous infusions ensured prompt lasting pain relief, making ambulation possible.

Calcaneus↗
PubMed1995

[Fever with normal sedimentation rate. 30 cases].

Thirty patients (19 females, 11 males), with a mean age of 42 +/- 21 years, who presented a fever associated with a normal sedimentation rate prospectively studied. Mean fever duration at admission was 11 days (range: 1-90). Diagnosis included bacterial (12 cases) or viral (9 cases) infections, malaria (2 cases), systemic disease (2 cases), abnormal temperature control (2 cases) and lymphoma (1 cases). One patient simulated fever, and in the remaining case fever was of unknown origin. Identified factors implied in the mechanisms of normal sedimentation rate were: intravascular disseminated coagulation (5 cases), haemolysis (5 cases), late increase of inflammatory proteins (8 cases), red blood cell abnormalities (7 cases), cryoglobulinaemia (1 cases). This study suggests that the striking association of fever and normal sedimentation rate should lead clinicians to look for plasma and red blood cell abnormalities after ruling out a non inflammatory febrile disorder.

Acute-Phase Proteins↗
PubMed1995

Evaluation of morphine for patient controlled analgesia with the Infusor system after opiate-free locoregional anesthesia for osteotomy of the foot.

Efficacy and safety of a PCA protocol, without loading dose or background infusion, was investigated in 40 consenting patients after osteotomy of the foot. All patients had intrathecal lidocaine 5% 1.8 ml preoperatively. Postoperative pain relief was provided with morphine from a Baxter Travenol infusor with PC module. The morphine concentration was 2 mg/ml or 3 mg/ml. In order to reach the analgesic blood concentration as quickly as possible, the patients were instructed to start PCA from the very first moment pain occurred. The patients breathed room air. The nursing staff evaluated respiratory and cardiovascular parameters, pain and side effects. Although mean VAS scores were higher than 3 in the early postoperative phase, no supplementary analgesics were required. One patient had urine retention. One patient had a drop in blood pressure at the start of morphine, which was quickly restored with the administration of colloids. Oxygen saturations were lower (SpO2 < 95%) the first hours postoperatively, especially at the first assessment where no morphine was administered. Pain or relative hypovolaemia could be an explanation. Dry mouth and sleepiness were the most frequently reported side-effects, followed by dizziness, vomiting and nausea. Sweating and itching were less frequently reported. The occurrence of the side effects was the highest during the first postoperative day. We conclude that even when morphine is used in PCA without loading dose or background infusion after opiate-free locoregional analgesia, close monitoring is necessary for at least 5 hours.

Adolescent↗
PubMed1994

Methane accumulation during closed-circuit anesthesia.

When using the closed-circuit PhysioFlex apparatus for ventilating patients with an O2/air mixture during total intravenous anesthesia (TIVA) for gynecologic laparoscopy, we noticed that the built-in infrared analyzer indicated unexpected values for halothane. In 10 ASA grade I or II patients, the breathing gases were analyzed at the end of the ventilation for the presence of methane, which could be traced in all patients. Mean concentration was 861 ppm after a mean closed-circuit anesthesia time lasting 78 min. The unexpected halothane concentration at the time of gas sampling indicated an average of 1.0%. The anesthetic vapor analysis by infrared absorption is clearly disturbed by the presence of methane.

Adult↗
PubMed1993

[Liver and liver segment transplantation in adults and children. Experiences with the first 50 cases].

The experience with 50 liver transplants performed in 42 patients within a 16 months period is reviewed. There were 15 transplantations in 12 children and 35 in 30 adults. The series was analysed regarding the source of transplant, i.e. living related (LR) n = 2 or cadaver (CAD) n = 48, graft size i.e. full size (FS) n = 34, reduced size (RED) n = 12 and split grafts (SG) n = 4. Regarding the preservation time or operating time there was no statistically significant difference between the groups. The overall function rate was 88%, 94% for FS and 73.4% for the remaining partial grafts (RED and SG). The difference was not significant (p = 0.062). Biliary leakage occurred in one (2%) reduced graft. Hepatic artery complications (kinking, intima dissection) were encountered in two (4%) patients receiving a FS. It is concluded that the use of partial liver grafts is a safe procedure to alleviate organ shortage while preservation time and operating time are not prolonged as compared to the transplantation of full size grafts.

Adolescent↗
PubMed1989

EEG and SEMG monitoring during induction and maintenance of anesthesia with propofol.

Propofol has been used as IV induction (2 mg/kg) and maintenance agent (150 micrograms/kg/min and 100 micrograms/kg/min after 30 min), combined with N2O/O2 in 16 premedicated (atropine 0.5 mg, Thalamonal 2 ml IM) and mechanically ventilated patients, having ear surgery or arthroscopy. Cranial biopotentials were analysed by 2 different techniques: 1. The Anesthesia and Brain Activity Monitor (ABM Datex) providing the zero crossing frequency (ZXF) as a value for the mean frequency of the EEG signal during a considered time interval, the mean integrated voltage (MIV) as a mean value of the amplitude of the same EEG signal and the spontaneous electromyography of the frontal muscle (SEMG). 2. The EEG trend monitor (rough signal, spectral analysis (S.A.), procentual display). The EEG changes, recorded during propofol anesthesia, are comparable with both techniques. Induction is characterised by a decrease in ZXF, caused by a procentual increase in the low frequency bands (the delta band represents more than 80% of the total power). During the perfusion period an increase in the power of the alpha band (10% to 40%) and a decrease in the delta band is noticed. The ZXF regains its original value. At the end of the procedure the ZXF increases (beta band to more than 30%). A correlation was looked for between the EEG changes and the propofol blood concentrations. The higher the propofol blood concentrations, the more pronounced the low frequency bands. The appearance of beta waves or a ZXF greater than 10 Hz indicates pending arrousal.

Adolescent↗
PubMed1989

[A comparison of hemodynamic changes with sufentanil-O2 and fentanyl-O2 anesthesia for coronary bypass grafting].

Hemodynamic changes were investigated in twenty patients undergoing coronary artery bypass grafting. Thirteen patients received sufentanil-O2 anesthesia and seven patients had fentanyl-O2 anesthesia. Systolic, diastolic, as well as mean arterial blood pressures, heart rate and rate pressure product (RPP) were measured before and after intubation, one minute after skin incision, and one minute after sternotomy. The sufentanil group received 3-5 micrograms.kg-1 of sufentanil for induction and a continuous infusion of 2.5-5.0 micrograms.kg-1.hour-1. The fentanyl group received 10 to 20 micrograms.kg-1 for induction and a continuous infusion of 12.5 micrograms.kg-1.hour-1. In sufentanil group, a decrease of systolic as well as mean arterial pressure, heart rate and RPP was observed following induction. These results showed effective blocking of the sympathetic reflex by sufentanil. In the fentanyl group, immediately after intubation, an increase in systolic pressure, mean pressure, heart rate and RPP was observed. Particularly RPP increased to more than 12000 at this moment. Diastolic pressure was not significantly changed in each group. Stable hemodynamic parameters with no ST-T change were noticed during surgical procedure in each group. We conclude that sufentanil is a superior narcotic agent than fentanyl for the patients undergoing CABG, and it effectively blocks sympathetic reflex activity.

Aged↗
PubMed1989

A contribution to the monitoring of neuromuscular blockade: an evaluation of the Datex Relaxograph.

The Datex Relaxograph is a neuromuscular transmission monitor, which measures the degree of neuromuscular blockade during anesthesia. In order to evaluate the reliability of the Relaxograph, results, obtained with this apparatus, were compared with simultaneous mechanical measurements obtained with the Myograph 2000 (Biometer). Although there was a good correlation between the two throughout the study, a shift towards mechanical responses was observed in all cases. Subsequently, the Relaxograph was used to evaluate atracurium and vecuronium when given accordingly to the priming principle. Results show that neither drug offers major clinical advantages over the other. In a third study, a new bolus-constant infusion regimen of atracurium was evaluated. Results show that it produces a predictable and stable neuromuscular blockade.

Adult↗