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Biomedical subjects

G Boulard

Publications and source records attributed to G Boulard.

At least 109 records · Page 6Linked to original sources
PubMed1985

[Spontaneous subarachnoid hemorrhage. Plea for a standard evaluation system].

There is no univocal grading of subarachnoid hemorrhage by ruptured intra-cranial aneurysms. Three systems are commonly used: Botterell's, Hunt's and Hess's, Nischioka's. Besides, many surgical teams use modified or derived systems. It is this very difficult to compare series of patients whose grading has not been made, using the same criteria. The authors propose to make a unique system of grading with new criteria of clinical evaluation.

Humans↗
PubMed1983

[Effects of synthetic ACTH on plasma cortisol and aldosterone in neurosurgery].

Cerebral oedema, present or potential, is a predominant medical complication of neurosurgery. Its physiopathology and treatment can be in part linked to adrenal activity (aldosterone and sodium balance; cortisol and hormone treatments). In 25 non-comatose patients presenting with a tumoral or vascular neurosurgical condition, plasma cortisol and aldosterone levels were measured by radioimmunoassay, always at the same time (07 h), before any investigations or treatment were carried out, the patient being at rest. Cortisol levels were increased in more than half the patients (n = 14; 44.11 +/- 3.4 micrograms X 100 ml-1; p less than 0.001); aldosterone levels were high in one third of the patients (n = 8; 304.29 +/- 57 micrograms X ml-1; p less than 0.001). 17 of these patients were studied according to the protocol of the synthetic ACTH test during the first four days of their receiving 1 mg X 24 h-1 synthetic ACTH. The expected therapeutic effect on cortisol was not obtained in all cases, and the stimulation of aldosterone release was important and prolonged.

Adrenocorticotropic Hormone↗
PubMed1983

The use of hepatitis B vaccine as booster for donors immune to HBV for the production of hepatitis B immunoglobulin (HBIG).

Forty nine blood donors immune to HBV volunteered to receive a single dose of hepatitis B vaccine (HEVAC B from Institut Pasteur Production). The initial mean level of anti-HBs was 20 IU/ml (from 5 to 75 IU/ml). The maximum level was observed at the consecutive plasma donation usually 1 month and a half after the vaccine injection. The mean maximum level was 188 IU/ml (from 7 to 800 IU/ml) i.e. an increase of 9 times the initial level. Six donors developed a very weak immune response (inferior to twice the initial level). In the 43 others, anti-HBs levels remained higher than initial level 6 months after the vaccine injection. One year later (study conducted in 25 subjects) 56% had anti-HBs levels superior to 3.6 to 16 times the original level. Such booster responses are of considerable practical importance for increasing anti-HBs titers in human donors for producing HBIG.

Adult↗
PubMed1983

[Treatment of ventriculitis caused by Staphylococcus epidermidis on equipment with the combination of fosfomycin and an aminoglycoside. Course of ventricular levels of fosfomycin].

Five patients (4 adults and 1 child) with cerebrospinal fluid shunt infections caused by Staphylococcus epidermidis were successfully treated by fosfomycin combined with an aminoglycoside. Fosfomycin was given intravenously over 4 hours 3 times a day. The antibiotic dose was 12 g/day for adults and 200 mg/kg/day for the child. In 3 patients with an external CSF drainage system, serum and ventricular fluid samples were obtained before and after one infusion during 10 days. The serum concentrations varied greatly (48,12 +/- 31,47 and 115,07 +/- 46,5 micrograms/ml. However the drug levels in ventricular fluid were constant and similar for the 3 patients (24,48 +/- 10,28 à 27,87 +/- 8,58 micrograms/ml), well above the MICS (1 and 2 micrograms/ml).

Adolescent↗
PubMed1983

[Electrocardiographic anomalies in subarachnoid hemorrhage].

An electrocardiographic study was undertaken in 100 patients with subarachnoid haemorrhage to try and establish a relationship between the clinical state of the patient and the ECG abnormalities. Cerebral angiography was performed in 95 cases showing 1 or more aneurysms in 68 cases and an angioma in 6 cases. Twenty one patients had no cerebrovascular abnormality. Routine ECGs were recorded on admission and were abnormal (Lipman and Massie's criteria) in 80 p. 100 of cases. The commonest changes were T-wave inversion (34 cases), bradycardia (32 cases), abnormal U-waves (28 cases) and prolongation of the Q-T interval (21 cases). Only 2 patients had giant T waves of normal polarity. Intraventricular conduction defects were more common (12 cases) than atrioventricular block (3 cases). Ten patients had sinus tachycardia and ventricular extrasystoles were observed in 5 cases. The patients were divided into two groups according to severity of their clinical state: Group A (52 patients) without changes in the level of consciousness, and Group B (48 patients) with disturbed levels of consciousness. The incidence of bradycardia and T-wave inversion in the two groups was compared by the Chi-squared test. Bradycardia was commoner than T-wave inversion in Group A (52 p. 100 and 19 p. 100 respectively). This finding was the contrary to what was observed in Group B where 10 p. 100 of patients had bradycardia (p less than 0,0005) and 50 p. 100 had T-wave inversion (p less than 0,005). The ECG changes were of prognostic value. The survival rate in patients with T-wave inversions was 85,7 p. 100 (p less than 0,001). The presence and site of the cerebrovascular abnormalities were not related to the ECG changes and no correlations were found between electrolyte changes and the ECG appearances.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1982

[Use of hepatitis B virus vaccine in volunteer donors already immunized against this virus].

Forty nine blood donors immune to HBV have been volunteers to receive a single dose of hepatitis B vaccine (Hevac B from Pasteur Institute Production). The initial mean level of anti-HBs was 20 IU/ml (from 5 to 75 IU/ml). The maximum level was observed at the consecutive plasma donation usually 1 month and a half after the vaccine injection. The mean maximum level was 188 IU/ml (from 7 to 800 IU/ml). i.e. an increase of 9 times the initial level. Six donors have developed a very weak immune response (inferior to twice the initial level). In the 43 others, anti-HBs levels remained higher than initial level 6 months after the vaccine injection. One year later (study conducted in 25 subjects), 56% had anti-HBs levels superior to 3.6 to 16 times the original level. Such booster responses are of considerable practical importance for increasing anti-HBs titers in human donors for producing HBIG.

Adult↗
PubMed1982

[Anesthesia for carotid surgery with clamping under residual carotid pressure control].

Carotid endarterectomy with clamping is performed in 50 patients. Internal carotid artery stump pressure is measured in all cases after clamping at the beginning of the operation. In 35 patients, an increase of systolic pressure is observed which allows a stump pressure more than 70 mmHg in 29 patients. In 15 patients, systolic pressure decreases and a stump pressure more than 70 mmHg is observed in two patients. When the stump pressure is more than 70 mmHg, the clamping is maintained. When the stump pressure is low, the clamping is stopped. A perfusion of Metaraminol increases systolic pressure in all cases: stump pressure is measured again after a second clamping. In 17 cases out of 19, stump pressure increases more than 70 mmHg and the clamping is maintained. In the two cases with a low stump pressure, a shunt is used during intervention.

Aged↗