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Biomedical subjects

H Lambert

Publications and source records attributed to H Lambert.

At least 109 records · Page 6Linked to original sources
PubMed1989

Phosphorus nuclear magnetic resonance evidence of abnormal skeletal muscle metabolism in chronic alcoholics.

Pathophysiologic events leading to rhabdomyolysis in alcoholics are not clearly understood. We examined 18 alcoholic patients (10 with and 8 without a recent history of rhabdomyolysis) and 15 healthy non-alcoholic volunteers by phosphorus nuclear magnetic resonance spectroscopy of thenar eminence muscle. At rest, phosphocreatine, ATP, and pH levels were similar in patients and control subjects. During aerobic exercise, phosphocreatine utilization was greater, pH fell more slowly, and maximum acidosis was less in alcoholics with previous rhabdomyolysis than in control subjects. During ischemic exercise, both patient groups exhibited a significantly slower and smaller decrease in pH than did control subjects. These findings are consistent with impaired muscular glycolysis or glycogenolysis in both alcoholic groups. This metabolic myopathy may contribute to the onset of acute rhabdomyolsis.

Adult↗
PubMed1989

Calcium channel blockade prevents postsurgical reformation of adnexal adhesions in rabbits.

Prevention of postoperative adhesion formation is a subject of concern to the reproductive surgeon. We developed a model to test the efficacy of calcium channel blockade-mediated adhesion prophylaxis after lysis of established pelvic adhesive disease. New Zealand White rabbits received a standardized primary adhesiogenic traumatic lesion to the left uterine horn. One week later, a laparotomy was performed for evaluation (prescore scale: 0 = no adhesions to 4+ = severe) and subsequent lysis of adhesions. Before operative closure, animals were allocated randomly to intraperitoneal treatment with either verapamil 2.5 micrograms/kg/hour or vehicle, delivered by mini-osmotic infusion pumps over the course of 200 hours. Seven days later, the animals were sacrificed and evaluated blindly for extent of adhesion reformation (postscore). Prescores for verapamil and control rabbits were not significantly different (3.3 versus 2.9). Verapamil-treated animals formed considerably fewer adhesions than did controls after adhesiolysis (postscore 0.5 versus 3.5; P less than .001). These data demonstrate a marked inhibition of adhesion reformation after lysis of pelvic adhesions under the influence of verapamil.

Adnexal Diseases↗
PubMed1988

The use of calcium channel blockade for the prevention of postoperative adhesion formation.

Prevention of postoperative adhesion formation is an issue of fundamental concern to the reproductive surgeon. The disappointing results of current adjunctive regimens have prompted a search for more potent antiadhesion therapies. Administration of nifedipine hydrochloride, a prototypical calcium channel blocking agent, to hamsters receiving a standardized traumatic lesion of the left uterine horn significantly inhibited primary adhesion formation as compared to control animals. These preliminary results suggest that calcium channel blockade may have the potential to favorably influence events related to peritoneal repair; further study of these agents as surgical adjuvants in the treatment of chronic pelvic adhesive disease is indicated.

Animals↗
PubMed1988

[Treatment using plasma exchange of massive acute hemolysis. 15 cases].

Fifteen patients admitted to an intensive care unit for massive acute hemolysis (MAH), defined by a free hemoglobinemia of more than 60 mumol/l, were treated by plasma exchange (PE) after a mean period following onset of 48.5 39 hours. The aim of plasma exchange therapy was to obtain early purification of hemoglobin and other substances released by red cell lysis and to prevent serious complications of MAH such as shock and RVHF or acute renal failure. Treatment by PE produced a decrease in initial hemoglobinemia of 76%, this level then remaining stable. The PE also appeared effective in the prevention and treatment of shock and RVHF, but much less so for installed acute renal failure. Comparison of results with those of a previous series of 16 patients with MAH treated by exsanguino-transfusion showed that PE was more effective, simpler to perform and less aggressive for early treatment of MAH, if rigorous conditions are applied.

Adult↗
PubMed1987

The effect of peritoneal fluid from patients with endometriosis on murine sperm-oocyte interaction.

It has been demonstrated that PF contains some factor or factors that interfere with effective gamete interaction as determined by an in vitro animal assay. PF from patients with mild endometriosis has an increased activity of this substance and/or additional inhibitory factors. In endometriosis, this peritoneal fluid factor or factors appear to be filterable and to a significant degree heat-labile. This observation may be of importance in explaining subfertility associated with early stages of endometriosis.

Animals↗
PubMed1987

[Asphyxic pulmonary edema caused by upper airway obstruction in adults].

A case of pulmonary oedema following acute pharyngo-laryngeal obstruction is reported. The case is compared with the results of the literature. The haemodynamic data suggested a non-cardiogenic effect, with low pulmonary arterial occlusion pressure of 1 mmHg and right-to-left shunting. Positive end-expiratory pressure was used with success. The mechanisms underlying such oedema are not well known, and may include disturbances in the balance of transpulmonary forces or hypoxia. However the outcome is usually favourable.

Adult↗
PubMed1987

[Physiopathological approach to pathological hyperlactatemia in the diabetic patient. Value of blood metformin].

Type B lactic acidosis, or pathological hyperlactatemia (PHL), is defined by an arterial lactate level greater than 5 mmol X l-1. It is a known and severe complication of diabetes mellitus treated with biguanide hypoglycaemic agents, particularly phenformin which was taken off the French pharmaceutical market in 1977. Metformin, which remains the only biguanide hypoglycaemic agent currently prescribed in France, may also lead to this complication. However it does so less frequently and mostly in the diabetic presenting with renal failure. A few well studied cases showed that PHL could be correlated with excessive metformin blood levels, i.e. a toxic mechanism. In order to find out whether this toxic mechanism was the real cause of PHL in diabetics treated with metformin, a systematic study of metformin blood levels was carried out in 20 such patients. They had all been admitted to a critical care unit presenting with PHL. The results of this study led us to distinguish between two groups of patients. The seven patients of the first group had high metformin blood levels (4.3 to 65.8 micrograms X l-1). In these, renal excretion or extrarenal dialysis lowered or normalized their hyperlactatemia, and six of the seven recovered from PHL. In the second group, with thirteen patients, metformin blood levels were within the normal therapeutic range (0.225 to 3 micrograms X l-1) for seven patients and close to zero for the other six. This second group received the same treatment as the first one. Only three patients recovered, the others all died.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis, Lactic↗
PubMed1987

Herpes oesophagitis in a healthy 8 year-old.

An 8 year-old, immunocompetent child developed a severe acute herpetic oesophagitis in the absence of oropharyngeal lesions. Intravenous treatment with the antiviral drug, acyclovir, relieved symptoms within 24 hours.

Acyclovir↗
PubMed1987

[Thrombogenic thrombopenia related to heparin. Clinical, biological and therapeutic results. Apropos of 32 cases].

Heparin induced thrombocytopenia is characterized by often dramatic evolution of thrombotic arterial and venous complications. These occurred or are worsened in curative or preventive heparin therapy and the treatment remains delicate. The authors report 32 observations of thrombocytopenia complicated with thromboembolic events; seven deaths are to mention. The tests of platelet aggregation with standard heparin and platelets poor patient's plasma confirm the diagnosis in 28 cases of 30 very early studied and in 2 cases around the 6th day only after the stop of standard heparin. The choice of anticoagulant therapy is carried out the negative tests of platelet aggregation with low molecular weight heparin (L.M.W.H.) (CY 216, CY 222 Choay, PK 10109 Pharmuka). In L.M.W. heparin therapy, clinical and biological improvement is obtained in 26 cases of 30 treated cases. In three cases, the rapid climbing of platelet countings is not present although negative tests of platelet aggregation with selected L.M.W.H. In one case, after a initial climbing of platelet countings, the thrombocytopenia recurs rapidly with L.M.W. heparin after a operation. The immediate or secondary passage with K-antivitamins, platelet antiaggregant stabilized medium and long term's evolution.

Adult↗
PubMed1987

[Use of a low molecular weight heparin, CY 222, in the treatment of consumption coagulopathy].

UNLABELLED: Among the different treatments used for consumption coagulopathies, the most contested is classical heparin because of the risk of worsening of a hemorrhagic syndrome. A low molecular weight heparin was evaluated to determine possible improvement of this risk. METHODS: Treatment with CY 222 (Choay) was administered over 2 years to 29 patients (mean age 40 years, range 15-74) with coagulation coagulopathies. Diagnosis was based on the presence of 3 of the following 5 signs: platelets less than 150,000/mm, fibrinogen less than 2 g/l, QT less than 50%, ethanol test positive, PDF greater than 20 micrograms/ml. Etiology could be classed in 3 groups: gravido-puerperal (12 cases), medical disorders (15 cases), post-traumatic (2 cases). Dosage was 150 U/kg every 18 hours subcutaneously. The usual symptomatic treatment included: transfusion of red cells, frozen fresh plasma, platelets and antithrombin III as necessary. A hemorrhage syndrome was present in 16 cases. The course of the disease was evaluated on clinical findings and surveillance of hemostasis parameters; anti-Xa activity was determined in 15 patients. RESULTS: Hemorrhage was arrested and biological values normalized in 22 patients (76%) including 15 (52%) survivors. In the 7 cases where the coagulopathy was not improved, the hemorrhagic syndrome persisted in 4. In the 22 successful outcomes, the hemostasis was corrected within 48 to 72 hours, with the exception of the thrombopenia, which persisted up to the 6th day. Mean anti-Xa activity was 0.32 +/- 0.16 anti-Xa U/ml. CONCLUSION: Results of this preliminary, non-randomized study show CY 222 to be as effective as heparin in the treatment of consumption coagulopathies.

Adult↗