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Biomedical subjects

J Allal

Publications and source records attributed to J Allal.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Trapped popliteal vein and artery].

A report is made of 3 observations of vascular constrictions in the knee hollow of three young adults: two constrictions of the popliteal artery, one by abnormal insertion of a tendon of the gastrocnemius muscle and of the arterial passage, the other by a fibrous band surrounding the artery. In one observation, the disorder was revealed by acute ischemia of one limb. The third observation was of a sural phlebitis with secondary repetition at the constriction of the popliteal vein by Soleaire's arcade. In all cases examination using the Doppler effect, in baseline and especially dynamic position, gives a diagnosis and allows postoperative monitoring. Bilateral arteriography, both static and dynamic, allows a precise diagnosis to be given and reveals the extent of vascular lesions, which conditions the operative technique. Treatment is always surgical, with exploration of the contralateral side if a constriction is suspected, even if it is asymptomatic.

Adult↗
PubMed1986

[Cardiac manifestations of Lyme disease].

Three cases of Lyme's disease with cardiac involvement are reported. One patient had myocarditis complicated by symptomatic complete AV block and two patients had asymptomatic 1st degree AV block. There were no abnormalities on echocardiography. The cardiac changes occurred between the 18th and 40th day after the onset of the disease and persisted 10 days: however these conduction defects may vary within a few hours. A rapid and complete cure was obtained with antibiotic therapy.

Adult↗
PubMed1986

[Risk factors in the combination of myocardial infarction and carotid atheroma].

This study compares two groups of patients: Group I with 44 patients who suffered recent acute myocardial infarction and Group II: 40 control subjects. In both groups, 2D Doppler echocardiography was performed to detect carotid atheroma, to determine the respective roles of vascular risk factors for two sites of atherosclerosis. Carotid atheroma affected 73 p. 100 of subjects in Group I and 22.5 p. 100 in Group II. Carotid stenosis of more than 40 p. 100 was found mainly in hypertensive patients who presented with acute myocardial infarction, and in patients with left ventricular hypertrophy. Smoking was more frequent in Group I than in Group II (p less than 0.001) irrespective of the frequency of carotid atheroma (p less than 0.05). Hypercholesterolaemia only favoured carotid atherosclerosis after acute myocardial infarction (p = 0.01). We did not find any difference in the incidence of diabetes mellitus in the two groups of patients. Age analysis indicated that carotid atheroma occurred earlier in Group I than in Group II. An association between a dominant risk factor for coronary disease (smoking or hypercholesterolemia) was found in 9 patients, all of whom had severe bipolar atherosclerosis with multivessel coronary lesions and carotid stenosis.

Adult↗
PubMed1985

[Myocardial infarction with normal coronary vessels in young subjects. Apropos of 2 cases with an interval of 2 months in 2 brothers aged 32 and 34].

The authors report 2 cases of myocardial infarction with normal coronary arteries occurring at an interval of 2 months in 2 brothers aged 32 and 34. Following an episode of angina, the younger brother, a sportsman, but a smoker, developed an antero-septal infarct at rest, which was complicated by complete persistent right bundle branch block. Ventriculography and coronary angiography were normal. Induced spasm tests were not performed. The elder brother presented an infero-apico-lateral infarct on effort, without any prodromal syndrome, which was complicated by apical akinesia. Ventriculography revealed mitral prolapse. Coronary angiography was normal and the methylergometrine test was negative. In relation to this example of familial infarction with normal coronary vessels, the authors review the features of this type of infarction reported in the literature which predominantly occurs in young people. They discuss the principal points of interest, including the incidence, the criteria of definition based on the coronary angiography, the elements of the prognosis, the pathophysiological mechanisms and the possibility of a genetic predisposition.

Adult↗
PubMed1985

[Contribution of echocardiography and Holter monitoring to the diagnosis of occult sources of cerebral embolism].

112 echocardiographies and 91 long-term Holter recordings were performed looking for an emboligenic cardiac lesion in patients in sinus rhythm and free of any major carotid atherosclerosis. The results were evaluated in relation to the emboligenic potential of the lesions observed. 5 positive results were obtained (4.46%) on echocardiography (3 aneurysms of the interatrial septum, 1 myxoma and 1 endocarditis) and 10 positive results (10.99%) were demonstrated on the Holter monitor. Among the 45 (40.18%) echocardiographic anomalies capable of constituting a cardiac site of origin of emboli, there were 18 cases of dilatation or hypertrophy of the left chambers of the heart, 13 cases of calcification of the aortic valve, 8 cases of prolapse of the mitral valve and 8 cases of calcification of the mitral ring. Finally, 55.35 per cent of the echocardiographic examinations and 52.74 per cent of the Holter examinations were found to be normal. Although the yield of these examinations is low, the anomalies discovered were definitely responsible for the cerebral emboli and could only have been demonstrated by such investigations.

Adult↗
PubMed1985

[Cardiac insufficiency in infectious endocarditis].

The aim of this study of 101 cases of infective endocarditis was to determine the factors predisposing to cardiac failure, the prognostic factors of this complication and the therapeutic implications. A significant (p less than 0.05) Chi square test was the statistical reference. Fifty-two per cent of patients developed cardiac failure which was biventricular in 48 p. 100 of cases and the presenting symptom in 64 p. 100. The mean age of the patients with cardiac failure was 56.6 years with a clear male predominance. In 48 p. 100 of cases, cardiac failure complicated a pre-existing cardiac lesion which was usually acquired (84 p. 100). The commonest condition was valvular insufficiency of the aortic and mitral valves (70 p. 100 of cases with cardiac failure). Severe cardiac failure was observed more frequently and earlier in aortic than in mitral regurgitation. The commonest infecting organism was the streptococcus (53 p. 100 of cases with cardiac failure) and the most frequent presumed portal of entry was dental (25 p. 100). Arrhythmias were observed in 51 p. 100 of patients in cardiac failure, the commonest being atrial fibrillation (34 p. 100) complicating mitral valve disease in 56 p. 100 of cases; 17 p. 100 of arrhythmias were ventricular. Conduction defects were observed in 26 p. 100 of cases with cardiac failure, 55 p. 100 of which had aortic valve disease. Valvular vegetations were demonstrated by echocardiography in 43 p. 100 of cases with cardiac failure. Valve replacement had to be performed for resistant cardiac failure in 13 p. 100 of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Intravenous labetalol in normotensive coronary patients. Effects on hemodynamics and myocardial metabolism].

The haemodynamic and myocardial metabolic effects of intravenous Labetalol were studied in 7 normotensive coronary patients with at least one significant stenosis on the left anterior descending artery. The study consisted of 5 successive observation periods: basal (I); during atrial pacing at the theoretical maximal heart rate or when anginal pain occurred (II); return to basal conditions (III); 20 minutes after an injection of 1.5 mg/kg of Labetalol over 3 minutes into the pulmonary artery (IV); during repeat atrial pacing at the rate achieved during phase II (V). There was no significant difference between phases I and III except for a slightly faster heart rate in phase III. The effects of Labetalol were assessed by comparing the results during phases III and IV between phases II and V and by analysing the variations between phases I, II, IV and V. In comparison with basal conditions (phase III), Labetalol (phase IV) induced a slight decrease in cardiac output (p less than 0.05), a decrease in aortic pressure and systemic arterial resistances (p less than 0.01) and of the double product. Coronary sinus flow did not change but myocardial oxygen consumption fell by an average of 11% (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Current aspects of infectious endocarditis. Review of 101 cases].

One hundred and one cases of infectious endocarditis were reviewed, from 1966 to 1982. The mean age of the patients was 56.3 +/- 15 years. There was a marked predominance of men (70.2 p. 100); the commonest portal of entry was dental (45.9 p. 100); the number of iatrogenic portals of entry and cases of endocarditis on prosthetic valves has been increasing in recent years. Blood cultures were positive in 83 p. 100 of cases; the commonest responsible organism was the non-D streptococcus (31 p. 100 of cases) followed by the D streptococcus (18.8 p. 100), the staphylococcus aureus (17.8 p. 100), and the staphylococcus epidermidis (2.9 p. 100). Gram-negative bacilli were isolated in 9.9 p. 100 of cases. Rare and slow growing organisms have been isolated since 1977. Echocardiography was then introduced and helped the diagnostic in 70 p. 100 of cases. Circulating immune complexes were measured in 25 patients and were found to be raised in 14 cases (56 p. 100). The commonest complication was cardiac failure (43 p. 100) which led to valve replacement in the acute phase in 14 p. 100 of cases. The occurrence of cardiac arrhythmias was a poor prognostic factor. The other complications were neurological (15 p. 100), renal (10 p. 100), embolic (19 p. 100), and pulmonary (9 p. 100). The mortality rate in the acute phase was 30 p. 100 and the probability of a five year survival was 54 p. 100.

Adult↗
PubMed1985

[Quantification of carotid atheroma, by vascular ultrasonics and spectral analysis, after myocardial infarction. Apropos of 80 cases].

A prospective study of carotid artery atheroma by vascular echotomography and spectral analysis was performed in 40 patients with myocardial infarction and 40 control subjects. Carotid artery atheroma was commoner in the group of patients with myocardial infarction (72.5% +/- 6.8%), earlier (9 years), more commonly bilateral (37.5% +/- 7.6%) and more stenotic (32.5% +/- 7.4%) than in the control group (p less than 0.000a, p less than 0.0001 and p less than 0.002, respectively). The severity of carotid artery atheroma correlated with the site of coronary artery disease; the following significant relationships were found: stenosing 40% and/or bilateral carotid atherosclerosis and left anterior descending disease (p less than 0.02); carotid atherosclerosis and double or triple vessel disease (p less than 0.05). The authors conclude that detection of carotid artery atheroma after myocardial infarction is valuable for two reasons: it gives an indication as to the severity of the coronary disease; carotid endarterectomy may be considered at the same time as coronary artery bypass surgery.

Arteriosclerosis↗
PubMed1985

[X-ray computed tomography and primary thoracic seminoma].

The primitive thoracic seminoma is a rare tumor. Given their low frequency, these tumour have rarely been the object of C.T. exploration. It determines the compressive effect on neighbouring organs, the volume and extensive character of the tumor. C.T. exploration allows proper surveillance after therapeutic.

Adult↗
PubMed1985

[Cardiac manifestations of chronic atrophic polychondritis].

The authors present a case of chronic atrophic polychondritis with cardiovascular complications, consisting of aortic incompetence due to dilatation of the aortic ring associated with an aneurysm of the ascending aorta and a first degree atrio-ventricular block occurring six months after the onset of the disease. The progression towards heart failure resulted in the replacement of the ascending aorta and of the aortic valve. The authors discuss the cardiovascular complications of this disease.

Aorta↗
PubMed1985

[Diagnosis and echocardiographic course of infectious endocarditis in obstructive cardiomyopathy].

A typical case of advanced obstructive cardiomyopathy in a young subject was revealed by Streptococcal mitral valve endocarditis and was diagnosed by one and two dimensional echocardiography, which revealed a pedunculated vegetation on the large mitral valve and rupture of the chordae of the small mitral valve. This was complicated by biventricular heart failure, peripheral arterial embolism in the leg due to migration of the vegetation which disappeared on the repeat echocardiography and pulmonary embolism with arterial clot emboli due to heparin-induced thrombocytopenia. This condition resolved without requiring cardiac surgery. Patients with obstructive cardiomyopathy should be treated routinely with prophylactic antibiotics, particularly when dental treatment is required. Echocardiography has become an essential examination in the diagnosis of this disease and its complications, especially in cases with infectious endocarditis.

Adult↗
PubMed1985

[Cardiac complications of infectious endocarditis].

Factors predisposing to cardiac complications and influencing hospital survival, were analysed in a retrospective study of 101 cases of infective endocarditis. Heart failure occurred in 52 p. 100 of our patients. A significantly greater incidence of heart failure was observed in endocarditis with no preexisting heart disease (p less than 0.01), aortic and mitral valve involvement (p less than 0.01), staphylococcus aureus infections (p less than 0.05), arrhythmias (p less than 0.001), and conduction disturbances (p less than 0.01). Significantly more patients with congestive cardiac failure died in hospital (51 p. 100) than those without congestive cardiac failure (17 p. 100) (p less than 0.001). Severe heart failure before treatment (p less than 0.05), streptococcus D endocarditis (p = 0.05), supraventricular arrhythmias (p less than 0.05), and intracardiac conduction disturbances (p less than 0.05), significantly increased the hospital mortality in patients with congestive heart failure. Electrocardiographic findings revealed arrhythmias in 34 p. 100 of cases, more commonly with mitral valve involvement (71 p. 100) and 52 p. 100 died in hospital. The development of intracardiac conduction disturbance during the course of 18 cases of endocarditis (aortic valve in 11 cases) was associated with a hospital mortality rate of 60 p. 100. The incidence of pericarditis and pulmonary embolism was 4 and 7 p. 100 respectively, and all patients died in hospital. Acute inferior myocardial infarction compatible with coronary embolism was suspected in one patient. Early cardiac valve replacement improved the hospital survival in patients with cardiac complications of infective endocarditis.

Adult↗
PubMed1984

[Infectious endocarditis in the elderly].

Thirty three cases of infectious endocarditis in patients over 65 years of age (mean age: 72,5 years) observed between 1966 and 1982, were analysed; there were 22 male and 11 female patients, a male predominance of 67%. The data was compared with 68 cases of patients aged less than 65 years of age (mean age: 48,4 years; 49 male and 19 female patients, a male predominance of 72%) treated during the same period. In the patients over 65 years old, compared to those under the age of 65, we observed that: the previous condition of the cardiac valves was more commonly unknown (39% compared to 21%), rheumatic valvular disease was rare (12% of cases), the diagnosis was not delayed, the reason for hospital admission was usually a complication (30% compared to 7%), the two cardinal signs (pyrexia and a cardiac murmur) were always present, as in the younger age group, the urinary tract was the only commoner site of primary infection, the blood cultures were as frequently positive in both groups (79% compared to 85%), in cases with negative blood cultures, antibiotics had not always been given beforehand, but this was commoner than in the younger age group, the causal organisms and usual biological changes were unremarkable, echocardiography, often more difficult because of the high incidence of valvular thickening, remained a valuable tool for diagnosis and management, cardiac failure was more common (55% compared to 37%) as were neurological complications (24% compared to 10%) and renal failure, mortality was greater (39% compared to 25%) and higher in both groups in patients with aortic valve disease and infection with staph-aureus.

Aged↗