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Biomedical subjects

G Janvier

Publications and source records attributed to G Janvier.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Hemodynamic changes caused by laparotomy during aorto-iliac surgery].

A haemodynamic study was carried out on 53 patients undergoing elective surgery of the abdominal aorta in order to assess the haemodynamic changes consequent to abdominal manipulations prior to aortic clamping. Surgery was carried out under general anaesthesia and ventilation was controlled. The following parameters were monitored: mean arterial pressure (Pa), cardiac index (CI), systolic index (SI), systemic vascular resistances (Rsa), pulmonary vascular resistances (Rpa), heart rate (fC). Cutaneous circulation was monitored using a photoplethysmographic transducer. The following haemodynamic pattern was seen as the peritoneal cavity was opened and traction on the mesentery was applied: CI +40.7%; fC +28.61%; SI +9.85%; Rsa -39.16%; Rpa -28.43%; Pa -15.7%. The recording of the facial cutaneous photoplethysmographic wave showed an increase of 50%. In some extreme cases, a state of cardiovascular collapse with marked cutaneous erythema strongly resembling anaphylactic shock ensued. The physiopathology of these cardiovascular reactions is unclear, but the haemodynamic pattern as well as the cutaneous vasodilation suggest a stimulation of both vagal and sympathetic nervous systems and the release of vasoactive substances into the general circulation.

Adult↗
PubMed1987

Treatment of deep venous thrombosis with a very low molecular weight heparin fragment (CY 222).

Thirty patients presenting with phlebographically confirmed deep venous thrombosis were treated with a very low molecular weight heparin fragment (CY 222) in an open and prospective phase-2 trial. A uniform dosage of 750 IC anti-factor Xa units/kg/day was administered subcutaneously for 10 days or more to patients whose thromboses were categorized as postsurgical (17 cases) or medical (13 cases). The clinical symptoms of venous thrombosis diminished in 93% of the patients overall. The extent of vascular clearing was assessed by an original scoring system which compared the pre- and posttreatment phlebographies. The effect of treatment was globally rated 'very good' (more than 75% lysis) in 37% of the patients, 'good' (about 50% lysis) in 40% and 'poor' (0-25% lysis) in 17%; the phlebographic thrombosis worsened in 6.6%. Little change occurred in laboratory tests exploring thrombolysis, but a strong anti-factor Xa activity was detected.

Adolescent↗
PubMed1987

[CY 222, a very low molecular weight heparin, in the curative treatment of deep venous thrombosis. Apropos of 95 cases. Clinical and phlebographic results].

Efficacy of a very low molecular weight heparin, CY 222, in the treatment of deep venous thrombosis of lower limbs was evaluated in a prospective clinical trial instituted in November 1984. CY 222 was administered as subcutaneous injections of 0.03 ml.kg-1 daily (750 anti-Xa U.kg-1.d-1) as 3 divided doses over a minimum of 10 days. Efficacy was rated as a function of clinical and phlebographic criteria. The group of 95 patients treated was a heterogenious one: 38% medical, 62% surgical, and 48% of the total group had partial interruption of vena cava previous to study. The period between first clinical manifestations of the deep thrombosis and therapy varied between one day and 3 months (mean: 1 1/2 days). Clinical symptomatology significantly and globally regressed in 88% of the patients. Comparisons between phlebographic findings at start and end of treatment are expressed using Arnesen's score (cf. table).

Drug Evaluation↗
PubMed1987

[Duodenopancreatic injuries. Diagnostic and therapeutic considerations apropos of 25 cases].

A review of a homogeneous series of 25 cases of duodenopancreatic injuries emphasizes the serious nature of the lesions operated upon at the acute pancreatitis stage. An early diagnosis of these duodenopancreatic lesions is essential since they are often included in the context of multiple injuries. Principal diagnostic difficulties arise in lesions due to contusion without associated intra-abdominal injuries. In these cases ultrasound and CT scan imaging provide valuable data, particularly the latter exploration which is 89% reliable in demonstrating pancreatic morphology. Treatment differs as a function of presence of isolated or combined duodenal and pancreatic lesions and of lesional type. It should be as conservative as possible, although exeresis for lesions of body and tail of pancreas is currently performed more frequently.

Adolescent↗
PubMed1987

[Diagnostic and therapeutic angiography in severe retro- and subperitoneal hematomas].

This study of the value of arterial angiography was carried out in 22 patients with serious retroperitoneal hemorrhage. In the first instance, this investigation determines the number of hemorrhages, their sites and flows. Later on it can be used to evaluate the volume of the hemorrhage and its effect on vascularisation of the abdominal viscera so that an initial prognosis can be made. At a later stage it also provider valuable date when setting up an appropriate selective embolisation based on the number of sites involved.

Abdominal Injuries↗
PubMed1986

[Peroperative autotransfusion].

Between April 1976 and December 1984, 297 patients underwent major elective and emergency surgery using intraoperative autotransfusion (Bentley ATS unit). An amount of 732 l of blood was reinfused, representing 61% of the total intraoperative blood transfusion. Thanks to this method, an average 2.46 l of blood per patient was spared, with a range of 0.9 to 6 l according to the type of surgery (elective or emergency). Twelve accidents are reported, including four bradycardias (less than 45 b X min-1), two air emboli and six haemorrhages due to an excess of anticoagulation. These complications were related either to poor technique (too great a transfusion output) or insufficient blood anticoagulation control. Simplicity of use and high transfusion output of the device adapted to the blood loss are the advantages of intraoperative autotransfusion.

Adult↗
PubMed1985

[Pleural clot ablation and fibrinolytic agents].

Two patients presenting with an important intrapleural clot with cardiorespiratory repercussions were given in situ thrombolytic treatment after drainage with a suction tube had failed. The first patient was treated immediately after thoracophrenolaparotomy for hepatic surgery. Dissolution of the clot was obtained with two local injections of urokinase (450,000 IU). The second patient was treated on the tenth day of a recurring post-traumatic clot, with urokinase (75,000 IU, then 225,000 IU) each day. In addition, this patient received lys-plasminogen locally (15 mukat, then 30 mukat). Dissolution of the clot was complete within five days. Clinical tolerance was excellent and there was no effect on the usual clotting studies. This study confirms previous findings, and underlines the usefulness of this method and its lack of adverse effects, even immediately postoperatively.

Adult↗
PubMed1983

[Paradoxical systemic emboli. 5 case reports].

Paradoxical systemic embolism by venous emboli in the arterial circulation can be explained by a right-left shunt. In 5 patients, the diagnosis of paradoxical emboli was definite in three cases, and suspected in two others. Venous, arterial and cardiac angiography define the anatomical criteria which alone can confirm the diagnosis. The introduction of a caval filter can prevent recurrent emboli which has a serious prognosis.

Angiography↗