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Biomedical subjects

F Achard

Publications and source records attributed to F Achard.

34 records · Page 2Linked to original sources
PubMed1989

[Coronary angioplasty in the treatment of threatening extension of myocardial infarction].

Recurrent angina with reversible ECG changes within days of a myocardial infarction is a serious clinical entity associated with a high incidence of reinfarction and death. In this study, we report a one-year experience of the treatment and outcome of patients presenting early post-myocardial infarction angina. Out of 32 patients who underwent coronary angiography, 3 were treated medically, 4 were operated upon and 25 had coronary angioplasty at the same time as coronary angiography with a 100 p. 100 immediate success rate. Four early reocclusions were redilated successfully. While in hospital 3 of these 32 patients had myocardial infarct extension (very moderate in 2 cases with CPK less than 500 and a patent artery), and there was no death. During an 8-month follow-up period there were 3 late deaths and 2 reinfarctions; 4 patients were operated upon and 4 were redilated. Thus, angioplasty has a high success rate in early post-myocardial infarction angina, enabling most patients to get through an unstable phase. In some patients, however, the course of the disease is marred by secondary adverse events.

Adult↗
PubMed1988

Long-term prognosis of medically treated patients with vasospastic angina and no fixed significant coronary atherosclerosis.

The clinical course of 48 consecutive patients with vasospastic angina and minor coronary atherosclerosis (no stenoses greater than 50%) was analyzed during an average follow-up period of 47 months. The study group consisted of 37 men and 11 women. Patients were treated with usual doses of calcium antagonists. One patient died (2%) and three had myocardial infarctions (6%). Seventy-one percent were asymptomatic or had infrequent angina; 13% had recurrences but had periods of remission lasting at least 10 months. Only 16% had persistent angina. None of the clinical or angiographic findings at the time of diagnosis were predictive of myocardial infarction or death, and they could not separate angina-free patients from those with recurrences. Thus, vasospastic angina without fixed coronary narrowing has a good prognosis despite the possibility of recurrences. However, there is a slight risk of myocardial infarction and death. This fact should be considered if there are plans to discontinue treatment.

Adult↗
PubMed1988

[A new procedure for the study and treatment of myocardial infarction in the acute phase: percutaneous coronary angioscopy].

The recent development of small diameter optical fibers, which are also very flexible allows us to realise percutaneous coronary angioscopy. First of all we visualized normal dog's arteries, bifurcations, origin of small branches; then we created and visualized intimal tears, dissections and experimental thrombi. The second part of this work consisted in applying this new technic in three patients who had an evolving myocardial infarction and an occluded right coronary artery. In all three cases a clot has been visualized, occluding the lumen of the artery. This small experiment shows that percutaneous angioscopy is a feasible, quick and save procedure. Its developments will be very important according to the development of percutaneous interventional therapies.

Animals↗
PubMed1986

Relationships between electromyographic ileal and colonic motility patterns in cats during fasting and feeding.

The relationship between ileal and colonic electromyographic motility patterns were investigated in six awake cats chronically fitted with subserosal electrodes implanted in the smooth muscles of the ileum and colon. Smooth muscle electrical activity (electromyogram) was recorded in both fed and fasted conditions under a 12-12 hours dark-light schedule. It consisted of electrical long spike bursts having two different patterns for each condition. Short sequences of three to five long spike bursts were propagated either aborally or orally from any part of the colon; they were most frequent during the interdigestive or fasting period and no relationship was observed between these long spike bursts and the electrical activity of the ileum. During the digestive or feeding period, the colonic activity was organized in long sequences of 10-15 long spike bursts, termed migrating spike bursts, which started near the caecal junction and propagated aborally to the distal colon. These migrating spike bursts were correlated with the ileal motility. This relationship demonstrated between ileum and colon after feeding is dependent upon the amount of food intake.

Animals↗
PubMed1985

[Differentiation of the effects of antispasmodic agents on the electromyogram of the sphincter of Oddi and the duodenum of the alert rabbit].

The electrical activity of the sphincter of Oddi and gastro-intestinal tract had been recorded on 21 negative atropineesterase conscious rabbits by means of chronically implanted electrodes located in the digestive wall. An analysis of the action of different spasmolytic and analgesic drugs was realized. Electromyograms of the sphincter of Oddi presented (a) isolated or in series spike potentials occurring independently of electrical activities of the duodenum (b) recurring spike potentials correlated with intestine spikes. The independent activity of the sphincter of Oddi was not controlled by the cholinergic system, contrary to the intestine-dependent activity (effect of the fempiverinium, atropine like drug). The pitofenone had inhibited the spike potentials of both the sphincter and intestine because its papaverinic effect. The noramidopyrine, analgesic drug without morphine-like effects, had induced activation and inhibition at low and high posology respectively.

Ampulla of Vater↗
PubMed1985

[Electromyographic profile of the human jejunum after abdominal surgery].

The purpose of this work was to describe the electromyographical profile of the jejunum observed after various types of abdominal operations. The electromyogram of the first 140 centimeters of the small intestine was recorded on a continuous basis by an intraluminal tube between the 6th and 20th day after abdominal surgery in twenty patients. Results allow us to describe a profile of the patient's intestinal electromyogram after abdominal surgery. It was characterized by three consecutive periods: a) early reappearance of migrating myoelectric complexes occurring during the first period; b) a very short second period beginning immediately before the expulsion of gases; during this period the electrical activity fluctuated and appeared disorganised; c) finally, during the third period, after gas expulsion, peristaltic rushes were associated with normalized migrating myoelectrical complexes. Both early and permanent migrating myoelectrical complexes characterize the normal postoperative period. Continuous linear integration of the jejunal electromyogram might be a useful tool for the monitoring of postoperative intestinal motility as a routine procedure.

Abdomen↗
PubMed1983

Coronary spasm and thrombosis associated with myocardial infarction in a patient with nearly normal coronary arteries.

A 37-year-old man presented with an evolving inferior myocardial infarction. Coronary angiography performed within 3 hours after the onset of the pain showed spasm of the right coronary artery and the presence of intracoronary thrombi. After resolution of spasm and the disappearance of thrombi, angiography revealed nearly normal coronary arteries. An ergonovine test was positive when the patient was not taking medication and became negative when he was taking diltiazem. The course was uncomplicated, and after 9 months the patient is free of angina.

Adult↗
PubMed1983

[Experimental study in anesthetized dogs of the harmful effects of coronary microemboli and their prevention by drugs].

The present experiments have been performed in anesthetized dogs. They have allowed to determine the nocivity of air microembolus introduced directly in the circumflex branch of the left coronary artery. It has been suggested that to reduce post-operative disease due to microembolus at the end of an extracorporal circulation it is necessary to forbid the injection of isoprenalin and to realize a perfusion of papaverine.

Animals↗
PubMed1982

Increased exercise tolerance and reduced electrocardiographic ischemia with diltiazem in patients with stable angina pectoris.

Diltiazem is a calcium slow-channel blocking drug that may be effective in the treatment of chronic stable angina pectoris. To evaluate the therapeutic efficacy 3 hours after a single oral dose of 120 mg, 12 men with chronic stable angina pectoris performed a maximal exercise test on a bicycle ergometer after ingesting either placebo or diltiazem administered in a double-blind fashion. During submaximal exercise at a fixed work load, diltiazem decreased the average heart rate response from 119 +/- 17 to 107 +/- 14 beats/min (p less than 0.01), systolic blood pressure from 182 +/- 15 to 175 +/- 15 mm Hg (p less than 0.05) and the rate-pressure product from 21.8 +/- 4.2 to 18.8 +/- 3.2 x 10(-3) units (p less than 0.01). The average submaximal work load at which significant ST-segment depression (0.1 mV) first appeared was increased from 355 +/- 142 to 525 +/- 143 seconds (p less than 0.01) after diltiazem. At peak exercise after diltiazem, the average depth of ST-segment depression in any one lead and the extent of myocardial ischemia observed in all 12 ECG leads were decreased (p less than 0.01), even though the average work load was increased by 29% (p less than 0.01). Peak heart rate, systolic blood pressure and rate-pressure product were similar with placebo and diltiazem. The plasma diltiazem concentration was 13.9 +/- 29 ng/ml 3 hours after ingestion and was significantly (p less than 0.05) related to the increased time to the onset of important ST-segment depression (r = 0.65) and to the decrease in the extent of myocardial ischemia observed in all 12 ECG leads (r = -0.61) compared with placebo. Thus, diltiazem is effective in treating chronic stable angina pectoris. It decreases myocardial oxygen requirements during upright exercise and appears to increase myocardial oxygen delivery.

Angina Pectoris↗
PubMed1980

[Study of the mechanism of an atrial pause using endocavitary recording of the sinus node potential in man].

The aim of this clinical study was to determine the electrophysiological mechanism of spontaneous atrial standstill, defined as a sudden lengthening of the trial cycle to over 10 p. 100 of its basal value, by recording the sinus node potential by endocavitary electrocardiological techniques. Satisfactory recordings of the sinus potential were obtained for the study of 65 atrial pauses recorded in 31 patients (18 without sinus node dysfunction and 13 with sinus node disease). It was shown that atrial pauses, shorter than two basal atrial cycles correspond to a moderate slowing of the sinus rhythm and to a sometimes very significant lengthening of the sinoatrial conduction time when sinus rhythm resumed. Pauses longer than two basal atrial cycles were always due to sinoatrial block which sometimes occured in patients with clearly individualised sinus activity, and sometimes with a slow continuous sinus activity. The sinus period did not change during these long pauses and sinoatrial conduction was normal when sinus rhythm resumed. The increased duration of the sinus potential, a constant finding during these pauses, is related to an intrasinusal conduction defect. This suggest that the primum movens of sinoatrial block is intrasinusal block which prevents rapid recruitment of a sufficient number of elemental sinus potentials so that the resultant potential becomes subliminal and therefore incapable of passing the sinoatrial junction. Short-lasting atrial pauses with a normal response to extrastimulus or atrial stimulation and characterised electrophysiologically by an increased sinoatrial conduction time without block of the sinus potential may be opposed to long atrial pauses with the pathological response of sinus node dysfunction characterised electrophysiologically by block of the sinus impulse. In practice the ability to induce a long pause by atrial stimulation (sinoatrial block) revealing latent disease of intrasinusal or sinoatrial conduction, may constitute an essential physiological sign of sinus node dysfunction.

Electrocardiography↗
PubMed1979

[Identification of the sinus potential in man by endocavitary electrocardiography. Identification criteria, preliminary results].

The potential of the sinus node was recorded in 24 patients by endocavitary electrocardiography using the same equipment as for usual electrophysiological investigation. The sinus node potential is a slow wave which starts progressively, has a rounded peak and precedes the endocavitary atrial activation and the surface P wave, and is relayed at an acute angle to the high amplitude deflection of atrial depolarisation. In some specially selected recordings it is easy to confirm the sinus origin of this slow wave where its preatrial position may be defined by the fixed relation of the S-P interval and by the variability of the T-S interval. Usually it is necessary to use technical manoeuvres (vagal stimulation, premature atrial stimulation) to demonstrate the preatrial behaviour of a potential thought to be of sinus origin. The variability of the sinus potential and the apparent sinoatrial conduction time, is suggestive of a physiological instability of the intrasinus pacemaker. The sinoatrial conduction time measured directly does not seem to exceed 140 ms in normal subjects.

Arrhythmias, Cardiac↗
PubMed1975

[Pulmonary embolism and preventive anticoagulant treatment in hospitalized elderly patients. Statistical study of their respective risks].

Pulmonary embolism and preventive anticoagulant therapy of ederly patients in hospital. Statistical survey of their respective risks. The incidence of pulmonary embolism as a cause of death seems the higher as its strikes old people (above 60) affected by cardiovascular diseases and who are bed tied; the interest of preventive anticoagulant treatment (PAT) remains controversial. This matter has been studied over a period of 5 years from the files of a geriatric cardiology department; 455 anatomo-clinical documents have been set up. This survey confirms the frequency of mortality by pulmonary embolism (23,9 %) and its diminution under long-term preventive anticoagulant treatment 6,6 %). The anticoagulant therapy does not increase the risk of haemorrhagic accidents, from the point of view of frequency, but slightly increases it if one considers the number of days spent in hospital. As a conclusion, the preventive anticoagulant treatment seems positive insofar as contra-indications are strictly observed, in particular the digestive ones. The mechanism of some hemorrhagic accidents with or without PAT remains sometimes difficult to explain.

Aged↗
PubMedDate not supplied

[Impact of therapeutics on sex. Value of measurements of quality of life].

Quality of Life is a new clinical dimension with the objective of evaluating the impact of a disease or of a treatment on patients well being. Quality of life is a measure of increasing interest. It is a global and cumulative measure, relevant for the evaluation of the therapeutic benefit of a treatment. It can be measured through "specific" or "generic" tools. Very few experimental literature exploring the impact of pathologies over the sexual sphere exists today. Only generic scales have been used, because no specific scale has been developed up to now. The impact of certain pathologies such as depression or diabetes has been documented, but very little objective information exists concerning the sexual repercussion of the chronic use of drugs (anti depressive, anxiolytics). Sexual quality or life as a risk factor for disease development is also dimension that has been explored, but only superficially. In a general way, no evidence exists concerning a reel correlation link between pathologies, treatments and sexual quality of life and this specific dimension of the quality of life still remains to be explored further.

Drug Therapy↗