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Biomedical subjects

J Brun

Publications and source records attributed to J Brun.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Prolonged mechanical nasal ventilation. Apropos of 27 case of myopathy].

We report the results of a retrospective study of a group of 27 patients with a myopathy who were ventilated at home using a nasal mask over a period of 5 years. Twelve patients were ventilated in a preventive fashion before any orthopaedic surgical intervention and 15 out of necessity because of respiratory failure and/or hypercapnia. There was a statistically significant improvement in the PaO2 while the PaCO2 remained stable. The vital capacity (CV) was unaltered. Side effects were relatively frequent but did not lead to this method of ventilation being stopped. One patient died from a very advanced cardio-myopathy after having stopped his own assisted ventilation. Another patient died at home of bronchial congestion. One patient had a tracheotomy after 3 years of ventilation. The treatment was judged overall as positive amongst the 19 patients who responded to a questionnaire anonymously. We are able to confirm the efficacy of this mode of ventilation by the nasal route as much therapeutically as prophylactically, which is against the recently reported results in a multi-centre study.

Adolescent↗
PubMed1991

[Massive hemoptysis ten days after bronchial extraction of an accidentally inhaled tablet of ferrous sulfate].

Fatale haemoptysis occurred as a result of circumferential caustic erosion to the right intermediate bronchus caused by a tablet of ferrous sulphate which remained in contact for 4 days. The necrotic process continued, after removal of the foreign body, in the bronchial wall and its vessels. We suggest local bronchial lavage with 1% bicarbonate saline during extraction of the tablet and subsequent follow-up fibroscopies. The discovery of a necrotic ulceration of the bronchus requires strict medico-surgical surveillance in order to rapidly intervene under cover of selective intubation when necessary.

Accidents, Home↗
PubMed1991

[Myocardial infarction and vinorelbine. Report of a case].

The authors report a case of a patient dying as a result of a myocardial infarction which was probably related to the administration of vinorelbine, the vinca alkaloid recently introduced into the treatment of non small cell bronchial cancers.

Antineoplastic Agents↗
PubMed1991

Direct radioimmunoassay of 6-sulfatoxymelatonin in plasma with use of an iodinated tracer.

We describe here a direct a radioimmunoassay (RIA) for the determination of 6-sulfatoxymelatonin (aMT6s) in plasma, with iodinated aMT6s as tracer. The aMT6s antiserum was raised in rabbit by immunization with a bovine serum albumin conjugate, giving negligible cross-reactivities for related compounds. The low limit of detection (15 pmol/L) allowed a direct assay that required only a 100-microL plasma sample. Dilutions of plasma and of synthetic aMT6s gave the same parallel response in the RIA. A preliminary study showed a circadian variation in healthy volunteers, with mean concentrations ranging from 52 (at 1600-2100 h) to 378 pmol/L (at 0400 h), whereas this rhythm was abolished in pinealomectomized patients. After administration of melatonin orally, or by infusion, the aMT6s concentrations in plasma concorded with previous data on aMT6s production and pharmacokinetics, with aMT6s being cleared from plasma more slowly than melatonin. This assay should have practical application in the development of new pharmaceutical formulations that minimize the hepatic metabolism of melatonin.

Adult↗
PubMed1990

[The patients' and referring physicians' evaluation of the benefit of examination by a specialist].

60 patients and their referring general practitioners were asked to evaluate the benefit of examination by a rheumatologist in an out-patient clinic. A large percentage of the patients (73%) and of the GPs (89%) were satisfied with the outcome of the examination, even though only 29% of the patients and 37% of the GPs thought that the advice given by the specialist had helped. A majority (60%) of the patients would have liked to have received more information from the specialist, about the diagnosis, and 49% patients claimed that they had not been given any advice on treatment. The results of this study will lead to a change in how we inform patients about diagnosis and treatment in our out-patient clinic.

Ambulatory Care Facilities↗
PubMed1990

Pharmacokinetics of melatonin in man after intravenous infusion and bolus injection.

The pharmacokinetics of melatonin during the day-time has been studied in 4 healthy subjects after a bolus i.v. injection of 5 or 10 micrograms/person and after a 5 h infusion of 20 micrograms per person in 6 healthy subjects. In addition, a pinealomectomized patient whose nocturnal plasma melatonin had been abolished was investigated after the i.v. infusion--once during the night and once during the day. The clearance of melatonin from blood showed a biexponential decay. The pharmacokinetic parameters in the two studies were similar, except for the disappearance rate constant beta and the apparent volume of distribution at steady-state (Vss). Supplementary peaks or troughs were superimposed on the plateau and the falling part of the profile. They were not due to stimulation of endogenous secretion, because they were also seen in the pinealomectomized patient. During the melatonin infusion, the plasma hormone level reached a steady-state after 60 and 120 min, and when it was equal to the nocturnal level. The infusion regime may be valuable in replacing blunted hormonal secretion in disease states.

Adult↗
PubMed1990

Optimal felodipine dose when combined with metoprolol in arterial hypertension: a Swedish multicenter study within primary health care. Swedish General Practitioner Felodipine Study Group.

In a multicenter study comprising 23 Swedish primary health care centers, felodipine extended-release (ER) tablets in doses of 5, 10, and 20 mg were compared double-blind with placebo when given in addition to metoprolol controlled-release (CR) tablets 100 mg. All medication was given once daily in the morning. Altogether, 251 hypertensive patients with a diastolic blood pressure greater than 95 mm Hg after 4 weeks of treatment with placebo in combination with metoprolol CR 100 mg were randomized to four parallel groups. After 4 weeks of treatment, there were significantly greater reductions in blood pressure with all doses of felodipine ER than with placebo, both 2 and 24 h after intake of the tablets. Twelve patients were withdrawn because of adverse reactions. Of these, one patient was taking placebo, one 5 mg of felodipine ER, four 10 mg of felodipine ER, and six patients 20 mg of felodipine ER. When combined with metoprolol, 5 mg of felodipine ER seemed to be less effective than higher doses, but was very well tolerated. Adding 10 mg of felodipine ER to the basal metoprolol appeared to be optimal if both the effect and adverse reactions were taken into consideration.

Adult↗
PubMed1989

The effects of melatonin and pinealectomy upon local cerebral glucose utilization in awake unrestrained rats are restricted to a few specific regions.

The effects of the infusion of melatonin (MT) and/or of pinealectomy upon glucose utilization in anatomically discrete regions of the brain of freely moving rats have been studied by the quantitative autoradiographic 2-deoxy-D-[1-14C]glucose technique. The experiments were made from 14.00 to 16.00 h, when MT is normally not secreted by the pineal gland, in order to compare the local cerebral glucose utilization (LCGU) response to MT from animals with long-term (pinealectomized) or short-term (pineal intact) absence of MT secretion. The majority of the 98 brain areas examined showed no change in LCGU after MT administration and/or pinealectomy. Pinealectomy increased the LCGU in the median mammillary nucleus only, whereas following MT administration, an increase in LCGU was observed in 3 cerebral regions of intact rats (paraventricular nucleus of the hypothalamus, nucleus of the solitary tract, choroid plexus of the third ventricle) and in 5 cerebral regions of pinealectomized rats (paraventricular nucleus of the hypothalamus, nucleus of the solitary tract, choroid plexuses of the lateral ventricles, third and fourth ventricles). Except for the choroid plexuses of the fourth ventricle, there was no difference in LCGU response to MT between pinealectomized and intact animals. This does not favor the hypothesis of receptor supersensitivity under the conditions of this experiment. Our results suggest that the hypothalamus, nucleus of the solitary tract and choroid plexuses represent a neural substrate through which MT could influence the activity of the central nervous system when administered at a low dose under near-physiological conditions.

Animals↗
PubMed1989

Nocturnal plasma melatonin levels in migraine: a preliminary report.

We determined by radioimmunoassay plasma melatonin levels on blood samples drawn at 11 p.m. in migraine patients and control subjects. Ninety-three cephalalgic outpatients (75 females, 18 males) were compared to a control group (24 females, 22 males) matched according to age. Patients were divided into subgroups presenting common migraine (n = 38); ophthalmic migraine (n = 12); and tension headache associated with ophthalmic or common migraine (n = 24), and associated depressive status (n = 19). Statistical analysis revealed a decrease in plasma melatonin levels for the entire migraine population, compared to the control one, and a heterogeneity in both controls and patients; this heterogeneity was found mainly in the depressive and tension headache subgroups. When the migraine population--from which the depressive patients were excluded--was divided into male and female subgroups, a decrease in plasma melatonin levels was observed only for the female subgroups. Results are discussed with reference to the role of the pineal gland in the synchronization of the organism with the environmental conditions.

Adult↗
PubMed1988

Effects of a four-day nocturnal melatonin treatment on the 24 h plasma melatonin, cortisol and prolactin profiles in humans.

An oral preparation of melatonin was administered daily at 22.00 h to 6 healthy volunteers during summer on 4 consecutive days (days 1-4). The daily dose was 8 mg of melatonin as a single. Three 24-h melatonin, cortisol and prolactin profiles were determined in plasma by radioimmunological methods: 1) before treatment (day 0); 2) the first day after the 4-day treatment had been stopped (day 5), 3) the third day after withdrawal of this treatment (day 7). For the melatonin rhythm, an advanced phase was observed at day 7 vs day 0, whereas the amplitude and the mesor were not modified, whatever the day. For the prolactin profile, a significant increase as compared with the control day (day 0) was detected only at day 7 between 19.00 and 21.00 h. No modification was recorded for the plasma cortisol secretion. These results suggest that melatonin, when administered at a high dose over a short period, can influence the endocrine rhythms, and especially its own endogenous secretion. This effect must be investigated over several days after the treatment has ended.

Adult↗
PubMed1988

[Neoplastic pulmonary embolism. Apropos of a case diagnosed by transbronchial pulmonary biopsy].

The authors report a case of micro-pulmonary emboli of malignant cells observed in a 58 year old lady who had been submitted to a mastectomy for cancer 18 months before, followed by chemotherapy for six months. The patient entered into the terminal phase of her disease with dyspnoea which became rapidly incapacitating leading to her death ten weeks later, in spite of heparin therapy and chemotherapy. The diagnosis was furnished by a transbronchial biopsy. However, the discovery of a mobile mass in the right ventricle raised the question as to the source of the micro-emboli.

Adenocarcinoma↗
PubMed1988

[Hypersensitivity pneumopathies ("bird fancier's lung") in children. Diagnostic value of bronchoalveolar lavage].

A current view of "pigeon fancier's lung" in children is reported through a familial case presenting as a severe denutrition in a 9 year-old boy. Cellular and biochemical analysis of broncho-alveolar lavage fluid is essential to proper diagnosis. Treatment is based upon the eviction of inhaled antigenic organic materials issued from pigeon's droppings, corticosteroid treatment being only additional. Pulmonary fibrosis is a rare but possible complication in the outcome of the disease.

Adrenal Cortex Hormones↗
PubMed1987

Effects on the patterns of melatonin and cortisol in cluster headache of a single administration of lithium at 7.00 p.m. daily over one week: a preliminary report.

Cluster headache represents a primary headache disorder. The major characteristics of cluster headache are the seasonal frequency and the occurrence of symptoms during night time. A significant decrease in nocturnal melatonin levels and an advanced phase associated with a shift in cortisol acrophase has been described. The effect of lithium on nocturnal melatonin and cortisol secretion was examined in the present study. Preliminary results indicate that Lithium delaises rhythms in cluster head-ache.

Adult↗
PubMed1987

Urinary melatonin, LH, oestradiol, progesterone excretion during the menstrual cycle or in women taking oral contraceptives.

Nocturnal urinary excretion of melatonin, LH, progesterone and oestradiol was measured by radioimmunoassay in nine normal women during a complete cycle. In addition, these hormonal excretions were studied in two women taking an oral contraceptive. A high within-subject coefficient of variation was observed for melatonin excretion in the two groups. In the nine normal cycling women, melatonin excretion was not decreased at the time of ovulation, but was significantly increased during the luteal phase compared with that of the follicular phase (P less than 0.01). These data are consistent with a positive relationship between melatonin and progesterone during the luteal phase. In the two women under an oral contraceptive, melatonin excretion was found within the same range as for the other nine. The results are discussed in terms of pineal investigation in human.

Adult↗