Biomedical subjects
Publications and source records attributed to F Barale.
During aorto-biiliac by-pass, patients with heart disease are exposed at many haemodynamic problems. Mixed venous oxygen saturation monitoring help anesthetist along clamping and unclamping periods. This study concerning 13 patients with pre-operative NYHA class II and III congestive heart disease, discusses therapeutic algorithm especially for choosing inotropic or vasodilatator drugs.
Explore the source record for details and available documents.
Morphine at very low dose gives a good post-operatory analgesia without major secondary effects. This study analyses retrospectively 285 spinal anaesthesia with hyperbaric 0.5% bupivacaine 0.2 mg.kg-1 and morphine 0.25 mg in adult urologic surgery. The analysis of enquiry in analgesic during the post-operatory period shows that in most cases (72%) the patients have supported the first 24 hours without any complementary analgesia; 28% of patients needs a complementary analgesia realized with 1 g of paracetamol. Intravenous morphinics have never been necessary in post-operative period. The analgesia was adequate for the patient's comfort, and it never mask a surgery complication. No respiratory complication appeared, even in 13 patients who needed intravenous morphinics in per-operative.
A retrospective study was carried out on anaesthetic records concerning spinal anaesthesia with hyperbaric bupivacaine 0.5% in urologic surgery. Three doses were utilised: slight (< 0.19 mg.kg-1), mean (0.19-0.21 mg.kg-1) or important (> 0.21 mg.kg-1) for two different levels: T12 or T10. Important doses may be involved excessive extension. Failures are perhaps more frequent with slight doses. Mean doses, 0.20 mg.kg1, seems to be recommended.
Acexamic acid is currently used to avoid pulmonary fibrosis in patients treated with bleomycim. It seems to be equally effective to prevent pulmonary fibrosis in adult respiratory distress syndrome. The complications of this therapy are hypercalcemia and hypernatremia.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors report a case of fatal pancytopenia associated with sulfamethoxazole-trimethoprim therapy in a patient with folic acid deficiency. The mechanism is a matter of speculation, but the most attractive view is that the inhibiting effect of trimethoprim on dehydrofolate reductase can involve pancytopenia in patients with folic acid deficiency.
Explore the source record for details and available documents.
Pneumothorax during operation is always clinically serious. The symptoms are usually sudden cyanosis, accompanied by cardio-vascular collapse and difficulty or even impossibility to ventilate owing to increased pressures of insufflation. Immediate or secondary bilateral pneumothorax is relatively common, then may appear associated complications such as subcutaneous emphysema or pneumo-mediastinum. Early diagnosis is necessary to apply simple treatment and avoid a course which may be rapidly fatal. The authors report 3 cases of pneumothorax during anesthesia and consider the clinical forms, the mechanisms and causes of this accident.
The authors report a rare case in which tetanus occurred with a pregnancy near term. In this particular case of pregnancy with risk for the fetus and mother associated with one another, curative treatment with monitoring of the state of the fetus and assisted respiration for the mother resulted in the birth of a live child who could be brought up normally and a cure for the mother without having to resort to caesarean section.
The authors thoroughly checked 71 reinterventions in abdominal surgery. They again found the importance of the factor of infection, respiratory, complications and oligoanuria. The overall percentage of deaths was 58 p. 100, age and associated defects made the prognosis worse.
A post-operative use of the calorico-nitrogenous mixture: Trivé 1000 was carried out in 25 patients after digestive surgery. The prescribed dose of this lipidic emulsion was 1,36 1 for an average period of four days. A study of the results led to establish the following facts:--a 55 p. cent increase in the nitrogen retention in comparison with a control series of ten patients and from (J o) the day of the intervention to (J F) the day when the treatment was stopped. Besides, the duration of the treatment did not seem to modify this balance, at least within the limits of the period of use. On the other hand, the quantity of EB 51 was a determining factor since 2000 ml were necessary to obtain a positive nitrogen balance (+ 0.96 g).--a very small rise in the amino-acid serous rate. It appeared in 14 patients and, supplied by EB 51, 3 other amino-acids increased their proportion spontaneously (Asp.--Gluc.--Tau.).--a reduction of the rate of 5 amino-acids, one of which, however, (Arginine) was being supplied by the drip. The variations were never statistically significant but for the Phenylalanine rate increase.--a non-systematic variation in the blood proteids that decreased as far as total proteids and albumin were concerned and that increased as far as globulins alpha1 and alpha2 were concerned.--Finally, no variations in the serous graphic record of lipid levels were noted, neither in the average of figures, nor in the analyses carried out after each bottle. Besides, it must be added that the tolerance of the product was excellent both on a general level (very few cases of intolerance: 4) and on the level of the plasma turbidimetry which did not reveal and chylomicrons except in one case. Therefore Trivé 1000 proved to be an interesting nutrient combinatin quite suited to a parenteral feeding because of its high caloric power. The necessity of a calories/g/nitrogen ratio from 100 to 200 corresponding to 2000 ml of EB 51 was once more evidenced. Therefore such a dose (for lack of a protein assimilation) allows for a nitrogen retention important enough to prevent an excessive consumption of the body proteinic reserves. Such doses are perfectly tolerated both on the general and metabolic levels (mainly on the lipometabolic one).
Explore the source record for details and available documents.
Based on data obtained from 260 patients ventilated through a mouth-piece, several notions concerning equipment and supervision requirements have become clear.--In our opinion, the indications should not be reserved for extremely severe patients; in their case cardiac complications are constant in spite of usual treatment. These patients, most often respiratory encephalopathic, are not very receptive to the "directions for use" of home assisted ventilation.--On the contrary, chronic hypoxia-hypercapnia, whatever its origin, accompanied by slight or transitory cardiac signs, has much more chance of being treated successfully.--The adaptation of the patient to the respirator before his release from the hospital must be worked out until a clinical and biological improvement can be obtained, at the risk of probable failure.--Supervision at home should disclose any alteration in the patient's clinical condition. It can only be carried out by the conjoined visits of the practicing doctor, nurse, technician, etc. The contacts between the practicing doctor and the hospital physician should be frequent. The ideal solution is systematic visits to the hospital.
Explore the source record for details and available documents.
In a large series of head-injured patients (132 cases), we have selected 30 patients (mean age 43 years) with only primary school education: they have been investigated with isotope cisternography and psycodiagnostic tests. 19 underwent neurosurgical procedures (6 extradural haematomas, 8 subdural haematomas, 5 cerebral lacerations). These investigations have been carried at least six months after the head injury. We have used for isotopic cisternography RISA and In111-DTPA. Raven's Progressive Coloured Matrices and Immediate Memory Tests were performed. Cisternographic pictures were classified as 1) normal, 2) with asymmetrical diffusion, 3) with ventricular reflux and were correlated with the neuropsychological data. We have found ventricular reflux in 10 patients (5 underwent surgical procedures), asimmetrical diffusion in 15 patients (11 operated); in 5 cases cisternographic pictures were normal. Neuropsychological tests give quantitative data about progressive mental deterioration, in full agreement with cisternographic results.