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Biomedical subjects

F Artru

Publications and source records attributed to F Artru.

At least 55 records · Page 3Linked to original sources
PubMed1987

Brain-stem monitoring. I. A system for high-rate sequential BAEP recording and feature extraction.

A computerized system is proposed for the continuous automatic monitoring of BAEPs in the intensive care unit or in the operating room. A new adaptive optimal digital filtering technique has been developed to allow BAEP recording with 200-400 stimulations, i.e., within 10-20 sec only, every 2 min. This method permits a selective cancellation of the major artifacts as soon as they occur: electrical interference and myogenic activities which are commonly encountered in such environments. An algorithm for automatic peak detection (waves I-V) has been implemented, and the whole system has been evaluated in terms of reduction of the intra-individual variability of latencies and amplitudes. Some clinical examples of comatose patient monitoring are briefly presented to illustrate the performance and the reliability of the system.

Brain Stem↗
PubMed1987

Brain-stem monitoring. II. Preterminal BAEP changes observed until brain death in deeply comatose patients.

Preterminal BAEP changes were studied until brain death in 8 head-injured patients out of a series of 38 comas monitored by means of a system allowing high-rate sequential recording. Two different modalities of BAEP degradation were disclosed: (1) simultaneous latency increase of all components associated with a decrease of cerebral perfusion pressure (CPP), consistent with ongoing ischaemia of the posterior fossa; (2) deterioration of brain-stem components (waves III-V) with preserved or even enhanced wave I. The latter pattern was not consistently associated with any haemodynamic change and might be related to mechanical factors causing rostro-caudal deterioration of brain-stem function. The time course of BAEP degradation ranged from a few minutes to more than 10 h. In the case of slow preterminal evolution definitely pathological trends were identified even when individual BAEPs were still within normal limits. Such trends would have remained unnoticed in single BAEP records. Hypothermia and anaesthetic drugs were found to induce falsely alarming BAEP changes very similar to those seen during preterminal evolution. Our results suggest that continuous brain-stem monitoring could be helpful for management of comatose head-injured patients.

Blood Pressure↗
PubMed1986

[Brain toxoplasmosis: from a case disclosing AIDS. Recall of diagnostic, developmental and therapeutic elements].

The authors are studying from a personal case revealing an AIDS, and from bibliographical cases, the treated evolution of toxoplasmic encephalitis in immuno-depressed patients and the elements of the diagnosis. They are insisting on the interest of the brain biopsy, and on the importance of the inflammatory brain oedema. The therapy consists on sulfamides and anti-oedematous drugs. They are thinking that the corticosteroids must be avoided. The evolution of cerebral lesions, seen on the repeated computed tomographies is often good but the prognosis remains bad according to the immuno-deficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Post-traumatic-shock lung: postmortem microangiographic and pathologic correlation.

In post-traumatic-shock lung, increased pulmonary vascular resistance and pulmonary hypertension are prominent features. The explanation for them was sought by postmortem microangiography of the lungs of 17 patients dying of respiratory failure after trauma. The 10 patients with thoracic injury died earlier (1-8 days). Extravasation of contrast material due to alveolar capillary rupture was present in all but one specimen and occupied 20% of the sampled area. Pulmonary artery thrombi lay proximal to these extravasations. Hypovascular areas due to infection and hemorrhagic alveolitis were found in all patients and involved 40% of the surface area. The small pulmonary arteries were poorly filled and contained many microthrombi. Some patients had hematomas, cavities, and areas of interstitial edema occupying about 5% of the lung area and associated with compressed or occluded vessels. Several mechanisms including pulmonary trauma may be responsible for the antemortem rupture and obstruction of small blood vessels. In the post-traumatic-shock lung, small artery occlusion and compression are associated with pulmonary hemorrhage, infarction, and infection and are important contributors to perfusion abnormalities and respiratory failure.

Adolescent↗
PubMed1981

[Treatment of head injury coma with prolonged pentobarbital anaesthesia (author's transl)].

Forty-five patients in deep coma resulting from head injury were treated with pentobarbital in doses adjusted to maintain serum barbiturate levels between 15 and 25 mg/l and short burst suppression phases on EEG. Brain death occurred in 20%. The overall mortality rate was 60%, no death being attributable to treatment; 24% of the patients were able to resume active life. Patients with non-reactive pupils during the early phase of coma were compared with patients of similar ages and neurological symptoms non treated with pentobarbital. In treated patients the incidence of brain death was reduced by 50% and the mortality rate by 25% (p less than 0.05), without increase in deaths from intercurrent complications and in severe sequelae among survivors.

Adolescent↗
PubMed1981

[Pheochromocytoma and pregnancy. Report of two cases (author's transl)].

We found in the literature 119 cases of pheochromocytoma manifested during pregnancy and observed 2 personal cases. Pheochromocytoma and pregnancy show reciprocal influences. Unsuspected diagnosis is frequent and followed by a high maternal mortality. The tumor was surgically removed in 42 cases. There are two different attitudes: when diagnosed in early pregnancy, the tumor can be excised without delay although the foetal risk is high; when the diagnosis is made in the last trimester, foetal maturity has to be awaited to perform a combined caesarean section and excision of the tumor.

Adrenal Gland Neoplasms↗
PubMed1979

[Prevention of hospital-acquired infection. Efficacy of isolation procedures in a neurological intensive care unit (ICU) (author's transl)].

Isolation procedures were adopted after usual measures failed to control hospital-acquired infection in a neurological ICU. All patients with an intubation or a tracheostomy were treated in individual rooms following the rules of strict isolation. The circulation of contaminated equipments was strictly isolated from the rest of the ICU. The efficacy of this isolation policy was aasessed by comparing the rates of hospital-acquired infections during the year before and the year after its adoption. The rates of pulmonary infections and venous catheters infections were significantly reduced (p less than or equal to 0.001). The rates of septicemias and urinary infections were relatively unaffected. The mortality caused by nosocomial infections showed a 64% fall (p less than 0.001) which accounted for a 29% reduction in the overall mortality (p less than 0.05). The average stay in the ICU was shortened by 20% and antibiotics consumption declined by 64% leading to substantial savings of money. The activity of the ICU as reflected by the number of admitted patients was unaffected.

Adolescent↗