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Biomedical subjects

F Saulnier

Publications and source records attributed to F Saulnier.

51 records · Page 3Linked to original sources
PubMed1989

The association between the neuroleptic malignant syndrome and malignant hyperthermia.

The neuroleptic malignant syndrome (NMS) is an uncommon but dangerous complication of treatment with neuroleptic drugs. A primary defect in skeletal muscle has been suggested in view of similarities in the clinical presentations of NMS and anaesthetic-induced malignant hyperthermia (MH). The in vitro halothane-caffeine contracture tests are the most reliable method of identifying individuals susceptible to MH. The aim of this study was to define if a relationship exists between NMS and MH susceptibility. Hence, the in vitro halothane and caffeine contracture tests were performed on muscle tissue obtained from eight NMS, ten MH-susceptible and ten control patients. The results, which are expressed in accordance with the criteria of the European MH Group, defined the eight NMS subjects as MH non-susceptible. The response to halothane and caffeine exposure of skeletal muscle from NMS and control subjects was the same and significantly different from that of muscle from patients susceptible to MH. Furthermore, muscle from subjects in NMS and control group responded similarly to increasing concentrations of chlorpromazine. These results do not point towards an association between NMS and MH.

Adult↗
PubMed1988

A comparison of three severity score indexes in an evaluation of serious bacterial pneumonia.

Two non specific severity scoring systems, acute physiological score (APS) and simplified acute physiological score (SAPS) are compared with a specific index (Sc) in an evaluation of 96 ICU patients with "serious" bacterial pneumonia. The three scores were measured during the first 24 h following ICU admission. There is a good correlation between APS, SAPS or Sc. Accuracy and efficiency of the non specific scoring indexes and Sc are similar. There is no statistical difference in sensitivity, specificity, positive and negative predictive values, receiver operating characteristic curves of the three indexes. Simple and reliable non specific index such as SAPS, valid for a variety of pathologies, can be used in an evaluation of mortality and comparative studies of groups of patients with serious bacterial pneumonia.

Adolescent↗
PubMed1986

[An unusual cause of right-left shunt: anastomosis of the left superior vena cava with the left atrium].

We report the case of a 73 year old man presenting with severe hypoxaemia due to an anatomical right to left shunt from a persistent left superior vena cava (VCSG) anastomosing with the left auricle. This was fortuitously discovered while placing a left sub clavicular catheter; the diagnosis of the VCSG draining into the left auricle was confirmed by superior phlebography and CT scanning. The discovery of this shunt after a pulmonary embolus suggested to us that the rise in venous pressure secondary to the embolus led to both clinical symptoms and hypoxaemia from the shunt, which had until then been clinically silent. No surgical treatment was performed.

Aged↗
PubMed1985

Acute carbon monoxide poisoning. Risk of late sequelae and treatment by hyperbaric oxygen.

The indications for hyperbaric oxygen therapy (HBO) in the treatment of acute carbon monoxide (CO) poisoning are discussed far too little in the literature. Depending on the author reasons for referral to a hyperbaric center include the carboxyhemoglobin level, change in state of consciousness or neurological abnormalities. In our opinion, HBO should be used on much wider indications than is usual, not only because of the rapid relief from symptoms it provides but mainly because it may prevent severe delayed sequelae. During a period of 9 months 230 patients with CO poisoning were admitted to our intensive care unit; 203 were treated with HBO and 27 with normobaric oxygen. Our indications for HBO treatment were: coma, pathological neurological findings or loss of consciousness during CO exposure irrespective of normal clinical findings on admission. Four patients died and the others were discharged 12 hours to 25 days after the incident. Seven patients had minor neurological problems within two weeks of discharge and which disappeared within one month. Two patients were re-hospitalized for neuropsychiatric sequelae and recovered in 3 and 6 months respectively. Neither the clinical status upon admission nor COHb predicted the outcome of the poisoning. Referral to a HBO center should be considered when: --the patient is comatose --there are abnormal clinical findings --patients have been unconsciousness during exposure, irrespective of whether they are conscious on admission and have normal clinical status.

Acute Disease↗
PubMed1984

[Conduction disorders in infarction. Prognosis and therapeutic impact].

The natural history of conduction disorders in infarction and their prognostic significance are now well known and determine the choice of treatment. In the acute phase of inferior infarction without bundle branch block, temporary pacing is only indicated in cases with poor clinical tolerance or with a bradycardia of less than 50. Prophylactic pacing, on the other hand, appears to be necessary in cases of anterior infarction with branch block, at least in the high risk group in which the block is recent and bifascicular. In this case, the pacemaker is only permanent in cases of high degree atrio-ventricular block in the acute phase. The subsequent prognosis of anterior infarction with branch block and without high degree atrio-ventricular block in the acute phase carries a high incidence of sudden death. Primary delayed ventricular fibrillation during the first eight weeks seems to be the cause for this sudden death. Prolonged hospital surveillance of these patients would appear to be indicated.

Arrhythmias, Cardiac↗
PubMed1983

[Acute pulmonary edema in carbon monoxide poisoning. Prognostic effect].

285 patients affected by carbon monoxide poisoning were admitted in our intensive care unit over a period of two years (from july 1980 to july 1982). 18 patients had a pulmonary edema (P.E.). The occurrence of P.E. was more frequent when coma was grade 2, 3 or 4 (p less than 10(-3]. The acute physiologic score (weighting of physiologic measurements) as proposed by Knauss is higher in patients with P.E. (p less than 10(-2]. However death is never due to P.E.; about 54 patients with coma, 5 died; death is related to neurologic aggravation. Neurologic sequelae are not related to the occurrence of P.E. but to a delay in hyperbaric oxygen therapy. These date show that prognosis of carbon monoxide poisoning is related to neurological status and is not influenced by the occurrence of P.E. when correctly treated and when hyperbaric oxygen therapy is early realized.

Carbon Monoxide Poisoning↗
PubMedDate not supplied

A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study.

OBJECTIVE: To develop and validate a new Simplified Acute Physiology Score, the SAPS II, from a large sample of surgical and medical patients, and to provide a method to convert the score to a probability of hospital mortality. DESIGN AND SETTING: The SAPS II and the probability of hospital mortality were developed and validated using data from consecutive admissions to 137 adult medical and/or surgical intensive care units in 12 countries. PATIENTS: The 13,152 patients were randomly divided into developmental (65%) and validation (35%) samples. Patients younger than 18 years, burn patients, coronary care patients, and cardiac surgery patients were excluded. OUTCOME MEASURE: Vital status at hospital discharge. RESULTS: The SAPS II includes only 17 variables: 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables (acquired immunodeficiency syndrome, metastatic cancer, and hematologic malignancy). Goodness-of-fit tests indicated that the model performed well in the developmental sample and validated well in an independent sample of patients (P = .883 and P = .104 in the developmental and validation samples, respectively). The area under the receiver operating characteristic curve was 0.88 in the developmental sample and 0.86 in the validation sample. CONCLUSION: The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis. This is a starting point for future evaluation of the efficiency of intensive care units.

Adult↗
PubMedDate not supplied

[Hemodynamic and respiratory effects of enoximone in acute respiratory insufficiency of chronic obstructive bronchopneumopathy].

Hemodynamic effects and gas exchange were studied in twenty COPD patients undergoing mechanical ventilation before and 30 and 60 minutes after an intravenous administration of 1 mg/kg enoximone. Enoximone decreased significantly pulmonary arterial pressure and pulmonary vascular resistances without significantly decrease of systemic vascular resistances 60 minutes after a slight dose of 1 mg/kg. Right ventricular ejection fraction increased; O2 arterial pressure, CO2 arterial pressure, intrapulmonary shunt remained unchanged. We concluded that enoximone induced pulmonary vasodilation in patients with decompensated COPD and increased right ventricular function without deleterious effects in gas exchange.

Acute Disease↗
PubMedDate not supplied

[Nursing care evaluation, how to measure it and why?].

Quality of care assessment is based on three main prerequisites: to describe precisely patients or case-mix, to measure the level of care, to evaluate the outcomes and finally to consider the relationships between these parameters. Indicators to measure the level of nurses' workload have been developed from different concepts and methodologies: The range of nurses' activities is very wide, such as cares achieved in the presence of patient, cares achieved after medical prescription or specific nurse cares, administrative tasks, research activities, etc. Indicators may take into account a more or less important part of this field, but most of them are usually focused on patient's care. The value of each parameter may be a calculated coefficient or a time unit. If one considers the time as the best unit to measure the intensity of work, it is also an underlying concept to differentiate the actual time, obtained by timing, from the required time, necessary to achieve correctly the action. In the same way, required cares are also the best to consider. Indeed measuring required time for required cares is necessary to reach quality aim. The nurses' workload may be directly calculated with a specific indicator or indirectly estimated from a severity or disability scoring system. The selection of the indicator depends of the purpose of the evaluation process. If the question is to improve and develop quality of care and professional practices, the indicator has to take into account the required cares. The PRN system (Project de Recherche en Nursing) developed in Canada is probably the reference indicator. However this score is complex and cannot be daily used.(ABSTRACT TRUNCATED AT 250 WORDS)

France↗