Search PubMedSearch

Biomedical subjects

J Fabre

Publications and source records attributed to J Fabre.

At least 19 recordsLinked to original sources

Technetium labeling of bi, tri and tetradentate ligands derived from 2-aminocyclopentene-1-dithiocarboxylic acid: characterization and biodistribution of their oxo and nitrido 99mtechnetium complexes.

We have synthesized and characterized seven ligands derived from 2-aminocyclopentene-1-dithiocarboxylic acid with different donor sets (SN2-, SNO2-, SNN2-, SNNO3- and SNNN3-) and different substituents on the sulfur moieties-SR (with R = H, CH3 or C2H5O(CH3)CH). With five of these ligands technetium nitrido complexes have been obtained with high yields (over 95%) using rather harsh conditions (pH = 1, temperature > or = 80 degrees C), whereas for technetium oxo complexes similar high yields were only obtained with two ligands but with mild conditions (pH = 7-8, temperature approximately equal to 50 degrees C). Changing an OH group for an NH2 has a drastic effect upon labeling yields. The possibility of complexing ligands as either oxo (TcO)3+ or nitrido (TcN)2+ derivatives increases the number of available labeled agents with different overall change and consequently with different biological behavior.

Animals

Results of heart-lung transplantation in children with cystic fibrosis.

Children with cystic fibrosis represent the largest group referred for, and undergoing, heart-lung transplantation at our institute. Between June 1988 and July 1993, 76 patients were accepted for transplantation, of whom 25 were transplanted, while a further 36 died waiting. Those transplanted ranged from 5-18 years of age and included 13 males and 12 females. Organs were used from donors matched by ABO blood group, size and cytomegalovirus (CMV) status. Post-transplant maintenance immunosuppression comprised cyclosporin A, azathioprine and prednisolone. Anti-thymocyte globulin and high dose methylprednisolone were given peri-operatively and for acute rejection episodes. Actuarial survival was 67% at 1 year, 61% at 2 years and 54% at 3 years. Obliterative bronchiolitis (OB) has occurred in 13 patients (52%) and was the major cause of mortality and morbidity. In three patients, OB was associated with the development of tracheal anastomotic stenosis. Other complications included diabetes mellitus (n = 9), pancreatitis (n = 1) and hypertension (n = 8). Despite these problems, those surviving the first year post-transplant showed a mean FEV1 of 71% (compared to 29% pre-transplant) and enjoyed an overall improved quality of life.

Actuarial Analysis

Colonic transit in soccer players.

To evaluate the effects of exercise on colonic function, we measured total and segmental transit times in 11 male soccer players and nine male radiology student technicians. Diet was kept constant in all subjects, who maintained their normal activities. For the soccer players, normal activities included 15 h of training and one match each week. Transit times were measured with radioopaque markers, using the multiple-ingestion, single-radiograph technique. No overall difference in large bowel transit was observed between the two groups. Right colon transit was considerably slower in the soccer players, whereas left colon and rectal transit were slightly accelerated. We conclude that an intensive sport activity only modifies regional differences in large bowel function. This may be of importance in extreme conditions, such as those experienced by marathon runners. Data should be obtained before prescribing exercise to treat constipation.

Adult

Recurrent renal salt wasting in a child treated with carboplatin and etoposide.

BACKGROUND: Nephrotoxicity of carboplatin is rare, especially in children with normal renal function. A 3-year-old boy had localized esthesioneuroblastoma and received 2 courses of carboplatin (200 mg/m2/day during a 1-hour infusion for 3 consecutive days) associated with etoposide (150 mg/m2/day after carboplatin). Because of a good tumor response, a second course was given 21 days later. Complete surgical excision and local irradiation were performed. However, the tumor recurred a few months later, and the patient subsequently died of the disease. METHODS: Renal function initially was assessed by standard baseline chemistry and technetium-panetetic acid (Tc-DTPA) clearance. Follow-up included ionic controls and tubular exploration during the episodes of hyponatremia. RESULTS: Hyponatremia occurred 4 days after completion of the first course and resolved after intravenous supplementation. It recurred 20 days after the second course despite salt and magnesium prehydration and posthydration and resolved 17 days later. No glomerular dysfunction was noticed. The association of urinary bicarbonate loss with elevated N-acetyl-beta-glucosaminidase suggested a proximal tubular damage. CONCLUSIONS: Standard doses of carboplatin may lead to recurrent renal salt wasting in children with initially normal renal function.

Antineoplastic Combined Chemotherapy Protocols

Evaluation of a cardiopulmonary preservation method for heart-lung transplantation.

This study was designed to examine whether concomitant administration of anti-free radicals with donorcore cooling on cardiopulmonary bypass (CPB) and hypothermic storage of the heart and lung, could provide successful extended cardiopulmonary preservation. Fourteen sheep heart-lung blocks harvested after core-cooling and cardioplegic arrest were preserved at 4 degrees C for 8.5 hr. Before and during CPB, the animals were perfused with Prostaglandin E1 (PGE1), superoxide dismutase (SOD), catalase (CAT) and deferoxamine (DEF). Cardioplegic arrest was induced with St. Thomas' Hospital solution (Plegisol) to which SOD, CAT and DEF had been added. The preservation solution consisted of Plegisol modified by the addition of K-lactobionate, raffinose, mannitol, SOD, CAT, DEF, a phosphate buffer and penicillin. Histological examination performed on 3 donor heart-lung blocks before and after CPB and cardioplegia, then immediately following cold storage, produced no clear evidence of structural damage in cardiac myocytes and lung parenchyma. Eleven donor organs were therefore transplanted in size-matched recipients with a total mean ischemic time of 12 hr. The combined administration of SOD, CAT, DEF, insulin and glucose during the initial period of reperfusion had no beneficial effect on cardiopulmonary performance. A progressive fall in Pa O2 and mean aortic pressure was observed post-operatively in the 7 animals that were weaned from CPB. Five of them died within 3 to 5 hr after CPB weaning, the remaining 2 animals died of cardiac arrest within the fourth hour. The results of this experiment seem to indicate that: 1. better organ function and improved survival could have been obtained if the duration of anti-radical treatment had been prolonged after reperfusion and, 2. physical manipulation of the donor grafts during harvesting and transplantation may have been partly responsible for the poor post-transplantation cardiopulmonary performance.

Animals

[Nutrition of children and adolescents engaged in high-level sports activities].

Young high-level athletes are frequently exposed to deficiencies, the most frequent origin of which is dietary. Supervision must be clinical, biological and dietary. Recommendations should be made individually, based on the nature and intensity of the exercise, and are calculated from the recommended supplements for the paediatric population. Protein, glucid and lipid supplements must represent approximately 12, 60 and 28% of the daily energetic intake respectively, the glucid ratio reaching 70% under certain conditions of prolonged exercise. Liquids must be controlled when exercise takes place in a warm atmosphere because young athletes are rapidly exposed to dehydration, the osmolarity of the selected drink being below 250 mosm/l. Mineral and vitamin supplementations are recommended. For minerals, perspiration losses may be associated with dietary deficiency. Possible vitamin deficiencies concern B1, B2, B6, B9, B12, C and D vitamins. The daily mineral supplements are estimated at 10 mg for iron, 5 mg for zinc and 1 mg for copper, and have to be prescribed in regular treatment after biological control.

Adolescent

[Therapy compliance. A matter of concern in clinical medicine].

Approximately one half of the patients takes prescribed medications irregularly or omits these altogether. On the basis of our own observations and published reports we analyze the factors influencing compliance. The motivation of the patients plays a decisive role, it is rooted in the meaning the patient gives to his existence, to where the strength of his family bonds and the confidence in the care-taking persons lays as well as the possibility to express himself which is most important. The better guidance and training of the doctors in the difficult task of strengthening such motivation may contribute to substantially improve this situation.

Adult

The influence of patient and physician gender on prescription of psychotropic drugs.

There is a wealth of evidence that more psychotropic drugs are prescribed to female than to male patients. We studied the psychotropic drug prescription of 15 male and 9 female physicians to 2493 patients in the Ambulatory Care Clinic of a University hospital. The relative odds (RO) of benzodiazepine prescription to a female compared to a male patient was the same when the physician was a male or a female (adjusted RO: 1.8; 95% CL: 1.5-2.1). But female patients were significantly more likely to be prescribed psychotropic drugs of all types from a female than from a male physician (adjusted RO: 1.3; 95% CL: 1.0-1.7). Information on patient diagnosis or on severity of symptoms would be needed to determine whether the present results reflect gender differences in medical care needs, overprescription of psychotropic drugs to females or underprescription of psychotropic drugs to males.

Attitude of Health Personnel

On the determinants of persistent gambling behaviour. I. High-frequency poker machine players.

Persistent gambling was studied as a function of the reinforcement of arousal and winning during normal poker machine playing sessions. Play rate, heart rate, winnings, subjective excitement and expectations of winning were recorded for five male and five female high-frequency players. Autoregressive regression analysis indicated that wins affect play rate for up to three minutes, while effects of the other variables were inconsistent. Markov chain analysis confirmed that wins smaller than 50 credits tend to elevate play rate, while larger wins cause a breakdown in the otherwise very regular rate of play. Results are discussed in relation to the development of impaired control of gambling behaviour.

Adolescent

[Cardiac sarcoma disclosed by hypereosinophilia].

A 48 year old woman presented peripheral eosinophilia and neurologic symptoms which were related to a right parietal hypodense lesion. Further investigation led to the discovery of a left atrial cardiac tumor which had been incompletely resected and diagnosed as sarcoma. Eosinophilia than decreased. Two months after cardiac surgery, intracranial hypertension appeared and another expansive cerebral mass was discovered on CT scan. The patient was treated by radiotherapy. Two years later, the patient presented left abdominal pain. An increase of eosinophilic rate was noted. Abdominal CT scan revealed an heterogenous mass in the spleen. Splenectomy was performed and the tumor was diagnosed as a metastasis of the cardiac sarcoma. This case illustrates a rare tumor which is distinctive by its clinical signs: peripheral eosinophilia and neurologic signs. There were no cardiac symptoms. The clinical evolution was good after more than two years from initial diagnosis. This implies that a surgical attitude is recommended in such cases.

Eosinophilia

[Between nihilism and fanaticism: the ethics of prevention].

Opinions diverge on the ethics of preventive medicine. A balance needs to be struck between nihilism (doing nothing) and fanaticism (doing too much). The authors consider the ethical aspects of preventive medicine from the practising physician's viewpoint. Various aspects can be identified: SCIENTIFIC AND METHODOLOGICAL: Like any medical act, preventive practice relies on good scientific data. The epidemiologic studies should be clinically relevant and their recommendations must be interpreted critically before being incorporated into clinical practice. It should not be forgotten that we are dealing with patients and their behaviour. Tactful dialogue and personalized intervention are essential. DEONTOLOGICAL: Modern medicine is oriented toward health maintenance and promotion, thus including prevention. Although the community has drawn obvious benefits from preventive practices such as the use of vaccines, prevention must not be allowed to become a medical tyranny. Respect for the individual should remain its central concern. ETHICAL: The "meaning of life" must not be forgotten. Factors such as quality of life should always be kept in mind in measuring the benefits of prevention. By providing objective information and tailored counselling, the aim of prevention is to encourage expression of the individual's own responsibility for her/his own health. FINANCIAL: Preventive medicine is not covered by health insurance schemes. Cost-benefit analysis should consider not only the economic aspects of prevention but also its positive impacts on the entire social field. SOCIAL AND CULTURAL: The findings of epidemiologic studies must be adapted to precise socio-cultural environments. In our culture, for example, caregivers should be the first to practise what they preach. It must also be remembered that at the present time the basic preventive measures are still not accessible to everyone.

Culture