Search PubMed⌕ Search

Biomedical subjects

J B Bouhour

Publications and source records attributed to J B Bouhour.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Strategy of the medical treatment of angina pectoris].

The first objective is to correct any existing coronary risk factors but this must be achieved with discrimination. Smoking should be strictly forbidden, hypertension reduced and a more active life style encouraged. However, a more nuanced approach should be adopted towards dietetic problems, obesity and disorders of lipid metabolism. It is also very important to teach the patient to use glyceryl trinitrate correctly in the double objective of relieving pain as quickly as possible and of preventing pain by using it in certain critical situations. Clinical practice shows that patients often use glyceryl trinitrate too sparingly. When these general measures have been settled, treatment must be adapted to each particular situation. The patient's age, the frequency of attacks, trigger factors, the repercussions of the disease on the patient's life all have to be considered before deciding on the individual's treatment. In younger patients, a controlled exercise ECG is essential for selecting patients for surgery. The drugs of choice for stable angina are the betablockers which have been shown to be effective and well tolerated. When this group of drugs cannot be used or is ineffective, other major anti-anginal drugs may be chosen according to the individual terrain and their known secondary effects.

Adrenergic beta-Antagonists↗
PubMed1983

[Comparison of the cardiotoxicity of adriamycin and aclacinomycin A in the rat. Optical and electron microscopic study].

Adriamycin (ADM) is a very effective antimitotic agent but its use is limited by its cardiotoxicity. New anthracycline drugs such as aclacinomycin A (ACMA) have been developed and have to be compared with ADM after chronic experimental intoxication. Three groups of randomised rats were compared: the ADM group receiving 2 mg/kg/week X 13 by intraperitoneal injection; the ACMA group receiving 4 mg/kg/week X 13 and a control group: 7 rats. The rats were autopsied at the 20th week. The heart was stopped in diastole and fixed by aortic retroinfusion of glutaraldehide for electronic microscopy (EM). In the ADM group, mean weight fell from the 4th week and mortality was 11/16 at 20 weeks. Voluminous haemorrhagic ascites was associated with peritoneal fibrosis in 12/16. Cardiac failure was observed in 4 cases but on light microscopy (LM) myofibril degeneration was constant and focal without sarcoplasmic reticulum or mitochondrial changes on EM. In the ACMA group the loss of weight occurred at 10 weeks and mortality due to toxicity was nil. There was no cardiac failure; myocytolysis was absent on LM and slight in 4/13 cases on EM with a moderate dilatation of the sarcoplasmic recticulum and presence of numerous residual bodies in the striated skeletal fibres in 5/15 cases. In this study, the ACMA had very little cardio and general toxicity in comparison with ADM. The technique of fixing the heart by retrograde infusion prevents, as far as possible, artefacts on EM affecting mainly the mitochondria.

Aclarubicin↗
PubMed1983

[Endomyocardial biopsy as a method of surveilling adriamycin cardiac toxicity. 28 biopsies in 26 patients].

The aim of this study was to evaluate the role of endomyocardial biopsy in the surveillance of toxic, latent cardiomyopathy secondary to adriamycin (ADM) therapy, and to assess its value by comparison with non-invasive investigations such as echocardiography. Twenty six patients underwent endomyocardial biopsy and echocardiographic measurement of the fractional shortening of the left ventricular internal diameter after a total dose of 150 to 520 mg/m2 of ADM. Interstitial fibrosis was observed in 8 of the 20 interpretable cases on light microscopy (6 moderate, 2 severe). There were no cellular changes. Slight focal myofibril degeneration was observed in 8 cases, and vacuolisation corresponding to mild dilatation of the sarcoplasmic reticulum was observed in 9 cases out of the 22 technically interpretable cases on electron microscopy. In contrast to the findings of interstitial fibrosis, cellular degeneration correlated significantly with the total dose of ADM (p less than 0,01). We conclude that this histological study confirms the fact that myocardial changes are rare and slight with doses of less than 520 mg/m2 of ADM and that non-invasive techniques are adequate for follow-up until this dose is reached.

Adult↗
PubMed1982

[Complications of myocardial infarction between the 2d and 4th week].

The complications of myocardial infarction after transfer from the Coronary Care Unit on the 6th day were analysed bu a retrospective study of 3,460 computerised case reports (1973-1980). The mortality rate was 6% (1/3 of hospital deaths) in the period from the 7th day to discharge from hospital (14th to 30th day). Cardiac arrest as not uncommon (20% of all cardiac arrests) but the prognosis was better thn during the initial phase (p less than 0.05) as the mechanism was more commonly ventricular fibrillation or tachycardia (p less than 0.05). This series was compared with a similar population from 1970-1973; an improvement was observed in global hospital mortality (27% previously compared to 17%, in the study series, p less than 0.001). As the population were comparable, this phenomenon seems to be related to better treatment of shock and cardiac failure and the advances in cardiac surgery during the initial phase of infarction. Thd commonest mechanical complication was ventricular aneurysm; its occurrence does not influence the vital prognosis during this period. The incidence of cardiac arrest and death due to cardiac failure is not negligible after the first week of myocardial infarction. Therefore, we do not believe that the hospital period should be reduced after myocardial infarction. Special training of the nursing staff is essential for the successful treatment of these complications. The global prognosis could be improved by the rehabilitation of digitalis therapy and the introduction of new sympathomimetic amines in the acute phase of myocardial infarction.

Adult↗
PubMed1980

[Exercise testing in probable primary hypokinetic cardiomyopathies].

50 patients with primary congestive cardiomyopathy underwent one or several exercise tests at yearly intervals in order to evaluate exercise capacity and to assess the prognosis. Three parameters were studied: the workload, the elevation of the systolic blood pressure (SBP) on exercise and the appearance of premature ventricular beats (PVB) on exercise or during the recovery phase. The results show that when the work loads > 120 watts, an elevation of SBP greater than or equal to 50 mmHg and the appearance of less than 3 PVB per minute were compatible with a moderate degree of physical exertion. On the other hand these same poor prognostic factors were associated with a higher mortality rate after 20 months follow-up.

Adult↗
PubMed1978

[The heart and drug poisoning, excluding cardiologic treatments].

When considered strictly from the viewpoint of actions on the myocardium, the number of drugs falling into this category is limited, but the resulting conditions may be serious. The prototype for cardiac toxicity is the group of antimitotic drugs (adriamycin or daunomycin). If these drugs are used; frequent and careful follow-up is necessary, the dosage at which the drug becomes cumulative must be known; and patients with a pre-existing cardiac condition must be exluded from treatment. Above all, it is essential not to wait until asystole occurs, but to try to prevent such occurrences by monitoring the patient electrocardiographically. A part from these drugs, recent articles in the literature suggest that similar care should be taken when prescribing emetine and lithium salts. There is insufficient information about other drugs which may have a certain degree of cardiotoxicity. For this reason, it is most important to gather information on accidents and reaction during treatment.

Daunorubicin↗
PubMed1978

[Secondary coronary fistulas].

These fistulae are very rare: 8 to 11 p. 100 of all coronary fistulae. Three types are recognised: right coronaro-ventricular, left coronaro-ventricular, and coronao-pulmonary. The two first types are found most frequently in association with a sigmoid atresia on the orifice, and with ventricular hypoplasia in the presence of a functional atrio-ventricular valve. The fistula then serves as a means of ventricular ejection. Of the secondary fistulae, the right coronaro-ventricular type is the most common (73 p. 100). The authors have found 30 cases in the published literature, and add 2 of their own. They have also reviewed the clinical features and the findings on coronary arteriography and post mortem studies on such fistulae. They discuss their etiology, pathogenesis, and physiopathology. Surgical correction involves repairing the fistula in one stage. Fistulae of the left coronaro-ventricular type are exceptions to this rule (9 p. 100), as they are always associated with a rapidly fatal hypoplasia of the left side of the heart. Coronaro-pulmonary fistulae (18 p. 100) are usually found in association with extreme forms of Fallot's tetralogy, and a relatively simple surgical correction can form part of the total correction of the tetralogy.

Coronary Vessel Anomalies↗
PubMed1977

[Study of the association between aortic coarctation and congenital mitral insufficiency (excluding atrioventricular canals)].

Coarctation of the aorta is accompanied by congenital mitral incompetence in 3% of cases, and this combination worsens the prognosis. A series of 23 cases is reported, and the treatment analysed. In 6 cases only medical treatment was used, either because death was rapid or, on the contrary, satisfactory progress made it possible to wait for the normal age for resection and suture of the coarctation. In one case the severity of the mitral incompetence required early valvular replacement, while the minimal coarctation was ignored. Usually (16 cases) a Crafoord operation is carried out as a first stage, and of the 13 children still alive, 8 had their mitral incompetence improved or stabilised; but in 5 it became worse, requiring mitral valve surgery from 1 to 7 years later. Post mortem study showed the multiplicity of mitral lesions present, and explains the difficulty of mitral 'plasty' operations, which are the best solution in children.

Adolescent↗
PubMed1977

[Multinodular hepatic angioma: a rare cause of neonatal asystole. A case and review of the literature].

The clinical findings in a case with a diffuse multinodular type of angioma of the liver are reported. The clinical picture was typical: the appearance after the first week of a severe congestive failure mimicking a congenital heart disorder, of the left to right shunt type, with gross hepatomegaly of the "vascular" type with a systolo-diastolic murmur, but with no cutaneous evidence of angioma. The very severe prognosis during the first months of life of patients with this malformation, as illustrated by the 58 deaths out of the 78 cases reported in the literature, indicated ligature of the hepatic artery before the age of one month. The satisfactory outcome (with a nine months follow-up) for this case, as for the three other operated cases in the literature, leads us to conclude that this operation is indicated after a detailed arteriographic examination has been made, and provided that the other anatomical conditions are favourable.

Arrhythmias, Cardiac↗
PubMed1976

[Myocardial biopsy in congestive myocardiopathies of apparently primary origin].

38 patients with congestive cardiomyopathy of apparantly primary origin had a myocardial biopsy. The histology of the fragment of myocardium was studied both by light microscopy and electron microscopy. The results were compared with those from 3 "control" cases and with 16 cases of congestive asystole secondary to a known cause. The non-specific patternss which were observed were of 3 types: patterns of degeneration, pattern of hypertrophy, and interstitial fibrosis. Chronic alcholism had no modifying effect on the ultrastructure. Finally, the group in which the morphology was altered had a higher mortality, but the prognostic significance of the degree of severity of the morphological change must be treated with caution in each individual case.

Adolescent↗
PubMed1976

[Phonomechanograms of patients with the Bjork aortic valve prosthesis].

A survey, with consecutive phonocardiograms, of the function of 75 Björk aortic valve prostheses has enabled us to examine the basic components of the opening and closure sounds of this type of replacement; these are usually made up of multiple components in varying combinations. This diversity underlies the importance of an early postoperative recording to act as a baseline. In addition, 2 cases of malfunction presented with only the classical phonocardiographic changes.

Aortic Valve↗
PubMed1976

[Endomyocardial biopsy. Innocuousness and clinical value. A 5-year experience].

The authors present their experience of the endomyocardaial biopsy procedure by Konno's technique; they have carried out 180 biopsies in 94 subjects. When the person taking the biopsy is experienced, the procedure is trouble-free, and yields tissue fragments of good quality which are suitable both for histological study and for study of ultrastructure. Biopsies from 47 cases of primary congestive cardiomyopathy have formed the basis of a precise histological study, and have been compared with the findings of a control group comprising various cardiac defects and three normal hearts. The diagnostic and prognostic value of the method are discussed.

Biopsy↗
PubMed1975

[Long term prognosis after circulatory arrest].

24 PATIENTS HAVING SURVIVED MORE THAN 18 MONTHS AFTER AN EPISODE OF CIRCULATORY ARREST WERE EXAMINED WITH THE AIM OF ASSESSING THE PSYCHOLOGICAL REACTIONS TO SUCH AN INCIDENT. The results obtained were encouraging, since immediately after the circulatory arrest there were only monor troubles reflecting the simple bringing into action of defence mechanisms. Long term adaptation was deemed excellent in 80 p.cent of cases which should, nevertheless, lead to any underestimation of those sequelae which, though happily rare, are highly incapacitating.

Adaptation, Psychological↗