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Biomedical subjects

J F Enrico

Publications and source records attributed to J F Enrico.

At least 19 recordsLinked to original sources
PubMed1997

Cerebral thromboembolism after direct current cardioversion for pure atrial flutter.

The need for prophylactic anticoagulation before electrical cardioversion for atrial arrhythmias is clearly established in the case of atrial fibrillation. By contrast, such prophylaxis is not a current standard of care before cardioversion for pure atrial flutter, since this arrhythmia seems not to increase the risk of postcardioversion embolism. We present a patient who developed two cerebral embolisms 24 h after electrical cardioversion for pure atrial flutter. To our knowledge, this observation has not been previously reported.

Aged↗
PubMed1995

[Anaphylactic shock].

Anaphylactic shock is an unexpected, sudden and sometimes deadly event that attacks the patient in 75% of the cases without pre-existent history of allergy. In general, drugs, hymenopteric poisons and nutrients (according to the recent concept) are responsible. Beside the classical IgE-mediated anaphylactic shock there exists another anaphylactic shock, identical in its clinical picture and treatment but not in the mechanism of development. Epinephrine is the only effective drug in case of respiratory (bronchial asthma, laryngeal edema) or cardiovascular (hypotension, arrhythmias, hypovolemic shock) manifestation. It has to be administered as rapidly as possible.

Anaphylaxis↗
PubMed1995

[Nontraumatic coma in extramural practice].

After a short review on pathophysiologic mechanisms of comatose states and their complications, a cohort of 392 comatose patients (Glasgow Coma Scale < or = 8) hospitalized in intensive care is analyzed in order to estimate the relative frequency of the different causes of nontraumatic coma. Depending on pathology, the following practical, sequential procedure is recommended: at first, identification and treatment of disorders of vital functions, objective estimate of the severity of the coma and rapid diagnostic orientation with a targeted neurologic investigation; then, simple therapeutic interventions in order to treat reversible causes of a metabolic encephalopathy as well as immediate measures for neuroprotection (anticonvulsive and antihypotensive therapy, oxygen, etc.). An initial, adequate control of the comatose patient is mandatory in order to limit disabling cerebral complications.

Brain Diseases, Metabolic↗
PubMed1993

[Late post-traumatic pericardial effusion. Identification of promoting conditions and literature review apropos of 2 cases].

The authors report two cases of post traumatic haemopericardium discovered 18 days after a iatrogenic penetrating trauma (sternal puncture) for the first one, and 102 days after a fall with blunt thoracic trauma and multiple associated injuries, for the second one. After admission, the first case rapidly developed a severe tamponade requiring a pericardial drainage, of 420 ml of non coagulated blood. The second case, in spite of a volume of liquid of more than 1000 ml, showed only a fatigue and a dyspnea, without any sign of haemodynamic failure. A literature review allows to be more specific about the characteristics of the tamponade and the different mechanisms responsible for cardiac injuries connected to thoracic traumas. For many reasons, the cardiac damages and/or their complications are often misjudged, particularly in thoracic traumas associated with multiple lesions. Among the sequelae, pericarditis, with or without effusion, is particularly frequent and it is essential to systematically look for it before dismissing a patient who went through a thoracic trauma. As for the bone marrow sampling, the sternal puncture generates a great number of injuries and must be proscribed. The iliac crest puncture should take its place.

Aged↗
PubMed1993

[Myocardial lesion secondary to defibrillation. Literature review and practical implications].

A 39 years old patient was defibrillated during the acute stage of an inferior myocardial infarction. He presented an elevation of the ST segment in the right precordial leads immediately after resuscitation. The evolution of the electrocardiographic changes were characterised by the development of a septo-apical subepicardial necrosis, whose sequelae remained nine months after the initial event. In the absence of any stenosing lesion of the anterior interventricular coronary artery, this necrosis can be attributed to the electrical shocks. The close position of the defibrillator paddles on the thorax certainly played a determining role, exposing the underlying myocardial tissue to an excessive electrical intensity. The authors point out the importance of the technical modalities of defibrillation that are likely to ensure the best chances of success with a minimum of secondary myocardial damage.

Adult↗
PubMed1989

[Arrhythmogenic ventricular dysplasia or Uhl's disease?].

Uhl's anomaly and arrhythmogenic right ventricular dysplasia are characterized by an analogous morphologic lesion which can be attributed to a major or minor expression of the same genetic disorder. The clinical diagnosis of arrhythmogenic dysplasia is not always easily established. A 23-year-old patient is discussed who showed extrasystolic arrhythmia, electrocardiographic signs of myocardial impairment and syncopes, the latter proving fatal. The segmental absence of myocardial tissue in the right ventricle is associated with interstitial sclerosis of the left ventricular myocardium. Subsisting myocardial fibers might be at the origin of a conduction slowdown creating an intraventricular reentry mechanism. The diagnosis should be considered in young subjects, more frequently males, with some years' history of palpitations, malaise with or without syncopes, and nonspecific electrocardiographic signs such as retarded activation of right cavities (S wave in derivations I and V6, possible right bundle block) and, during ventricular tachycardia, signs of delayed activation of left chambers, a right axis or an extreme deviation to the left.

Adult↗
PubMed1989

[Prevention of recurrence of thromboembolic disease: maintenance of anticoagulant therapy].

Deep venous thrombosis and pulmonary embolism are frequently diagnosed in patients encountered in a primary-care practice. Poor prognosis is related to acute sudden death and to recurrent thromboembolic disease. Anticoagulant therapy with heparin followed by coumarin derivatives is highly effective in preventing such recurrences, but the intensity of anticoagulation must be strictly monitored. Treatment with heparin, sufficient to prolong the activated partial prothrombin time to 1.5 to 2.0 times the control, should be continued for five to ten days, and oral anticoagulation should be overlapped with heparin for four to five days. The recommended therapeutic range for the prothrombin time during coumarin therapy is an INR of 2.0 to 3.0. The duration of anticoagulant treatment must be tailored to the individual patient. Patients with slowly resolving risk factors must be treated for at least three months after an acute deep vein thrombosis and for six months after a pulmonary embolism. Patients with tumors, antithrombin III, protein C or S deficiency should be treated indefinitely.

Anticoagulants↗
PubMed1988

[Activities of intensive care units in 1986].

Based on a yearly evaluation carried out by the Swiss Society for Intensive Care Medicine and the Swiss Nurses Association, statistical reports for 1986 from 72 recognized intensive care units are presented.

Critical Care↗