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Biomedical subjects

J Fabre

Publications and source records attributed to J Fabre.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Natural history of bronchiolo-alveolar cancer. Apropos of 38 cases].

Thirty-eight cases of bronchioloalveolar carcinoma were selected on anatomico-pathological criteria and analysed both radioclinically and histologically. At histology, this type of carcinoma is characterized chiefly by the growth of malignant cells along the alveolar walls. Cytology, which determines the nature of these cells (pneumocyte II or Clara cell), is not specific but remains important as regards phylogenesis. The course of bronchioloalveolar carcinoma gives a better understanding of its mode of propagation. Actuarial curves show that all patients with a diffuse carcinoma die very rapidly, whereas the survival rate of those who have localized lesions is 60% at 5 years. Moreover, the time required for dissemination to take place is long in assessable cases. This means that the condition should be diagnosed at an early stage on the presence of crepitant rales, on their air bronchogram at CT and on transparietal needle biopsy under CT. The chances are that early excision will result in cure.

Actuarial Analysis↗
PubMed1989

[Is thoracic actinomycosis underestimated? Reflections on 7 cases].

An analysis of 7 cases of thoracic actinomycoses were recorded over 25 years enabling a better appreciation of the radiological and clinical criteria: a low grade pneumonia with haemoptysis and an alteration in the general physical state, with pseudo-tuberculous radiological images or "pseudo-tumoral" with bronchograms and parietal wall disease. This clinical picture calls for endoscopic biopsies or biopsies under CT scanning for a study combining both histological and bacteriological diagnosis on appropriate culture media, enabling an exploratory thoracotomy to be avoided, the latter the classic method of diagnosis. This approach should reduce the number of pneumonias which are not confirmed bacteriologically which are sensitive to the usual antibiotics and determine better the true frequency of actinomycoses.

Actinomycosis↗
PubMed1989

[Evaluation of the central anticholinergic activity of antidepressants. Comparison of two experimental methods].

The anticholinergic effect of atropine, imipramine, clomipramine and metapramine was evaluated on oxotremorine induced trembling in the mouse as well as on contractions of the isolated guinea pig ileum induced by electrical stimulation of the mesenteric plexus. The ED 50 and IC 50 which expressed the anticholinergic activity of these substances, were found to be identifically distributed for both methods. Activity, in decreasing order was found to be: atropine much greater than imipramine greater than clomipramine greater than metapramine. There was a good correlation between results from the two methods (r = 0.97). The method using the stimulated guinea pig ileum would therefore seem suitable for characterisation of potential anticholinergic activity of a molecule.

Animals↗
PubMed1988

Accidental bromine exposure in an urban population: an acute epidemiological assessment.

In November 1984, because of an accident at a chemical plant, the population of a large area in the town of Geneva, Switzerland, was exposed to toxic bromine gas during several hours at concentrations above the short-term exposure limit. We describe the development of the disaster, the reactions of the fire brigade, the police and the first aid services as well as the breakdown of communications that occurred. On-the-spot epidemiological assessment of the exposed area and of the characteristics of the exposure syndrome was combined with the emergency care of 91 self-referred patients that were seen at the University Hospital. Follow-up was obtained one month later. The clinical course was moderate (eyes and upper airways irritation) and self-limiting in all cases. Immediate definition of the exposed population permitted effective follow-up. Such early evaluation could prove to be of crucial importance for managing more serious accidents of a similar nature.

Accidents, Occupational↗
PubMed1988

Comparison of the short-acting benzodiazepines midazolam and triazolam with placebo.

The hypnotic effect of midazolam (Dormicum, 15 mg) and triazolam (0.5 mg) were compared with each other and with a placebo. Their effects on the quality of dreams and of morning awaking were also evaluated. 30 out-patients were included in a double-blind cross-over study for a period of 11 consecutive nights in which the order of the drugs was randomized according to the Latin squares method. The active substances and the placebo were each administered in 3-night blocks separated from each other by an intercalary placebo night. On waking each morning the patients answered a questionnaire concerning the previous night. Some of the responses were recorded on a visual analogue scale. Midazolam and triazolam significantly decreased the latency of onset of sleep and the number of nocturnal and premature morning awakenings. The patients' overall impression of their night was better under the active drugs than under placebo. However, there were no differences between placebo and the benzodiazepines as far as side effects or the quality of dreams and of morning awakening were concerned. The two drugs had an identical effect on sleep latency, but under midazolam the patients woke more frequently during the night and slightly earlier in the morning, suggesting that the duration of action is shorter. The intercalary placebo nights were better after 3 nights of placebo than after 3 nights of benzodiazepine. This rebound effect was more marked after triazolam than after midazolam. In conclusion the two benzodiazepines were both effective and well tolerated but midazolam is slightly shorter acting and has slightly less rebound effect than triazolam.

Adult↗
PubMed1987

Cholinesterase activities in resected bowel specimens from children with Hirschsprung's disease.

We have measured acetylcholinesterase (AChE) and the butyrylcholinesterase (BChE) activities along strips of resected bowel specimens from thirteen children with Hirschsprung's disease. The AChE activity was variable along the length of the resected bowel, while the BChE activity remained constant. By contrast, the AChE/BChE ratio decreased rapidly to low levels when ganglion cells were present. We suggest that this ratio can be used to determine the normal segments of the bowel, to specify the anatomic forms (i.e. rectal or rectosigmoid) and may be useful in determining the anastomotic level.

Acetylcholinesterase↗
PubMed1987

The diagnostic value of acetylcholinesterase/butyrylcholinesterase ratio in Hirschsprung's disease.

Aganglionosis of large bowel (Hirschsprung's disease; HD) is associated with higher acetylcholinesterase activity (AChE activity). Occasionally, especially in the neonatal period, the AChE activity may not be of diagnostic value. The authors previously reported that simultaneous estimation of butyrylcholinesterase activity (BChE activity) and the determination of AChE/BChE ratio may have discriminatory diagnostic value. They extended this finding to 31 cases of HD, in 16 of which resected tissue was available for study. All cases had histologic confirmation of aganglionosis. The AChE/BChE ratio was found to be higher than 2.0, with the exception of a case in which the biopsy weight was low (i.e., less than 3 mg), even when the AChE activity was normal or borderline. The estimation of AChE/BChE ratio is easy, rapid, and, in the author's experience, of discriminatory diagnostic value.

Acetylcholinesterase↗
PubMed1986

[Ordering laboratory tests: their quantity and causes of variations among physicians].

To establish whether some physicians contribute more than others to the alarming increase in laboratory related expenditure, 317 consecutive medical files established by 10 residents of an outpatient clinic were analyzed. The expense incurred in establishing a diagnosis varied, according to the physicians involved, by a factor of 4.9 for back pain and 2.6 for acute respiratory illness. The difference is even more striking when the various types of investigation are analyzed (blood count, ESR, X-rays). It is therefore possible to group physicians according to their individual tendency to order tests. This classification is not related to age, sex, former professional experience or sub-specialty in internal medicine. There is a significant correlation (Spearman's test) between this classification and the approach to medicine, as evidenced by analysis of the content of an interview on medical practice. These interviews were conducted double blind, recorded and transcribed to determine psychological traits. Physicians who order a large number of tests are characterized by a high index of uncertainty, as evidenced by the large number of hesitant expressions and a tendency to cut the interview short, showing off to compensate for lack of self-assurance, depersonalized reference to patients, few references to the interviewer, difficulty in establishing a true dialogue. These characteristics can be considered to form a coherent entity which shows that even the material aspects of medical practice are strongly influenced by the physician-patient relationship.

Attitude of Health Personnel↗
PubMed1986

[Bromine cloud in Geneva. Epidemiologic study of the short-term effects on a population sample].

In November 1984, due to an accident at a chemical plant, toxic bromine gas spread into the town of Geneva, Switzerland, at concentrations over five times the maximal admissible concentration (MAC). Monitoring of atmospheric brome concentrations allowed the determination both of the duration of exposure and the geographical area concerned. Description of the immediate measures taken at the time of the accident illustrates how mass panic reactions can be generated or controlled, and clearly shows the vital importance of an effective communication network: it was lacking in this case and caused further insecurity for the population and isolation of the hospital. Immediate and systematic data collection enabled us to carry out an "acute" epidemiological survey of the accident. It is the first report of mass bromine intoxication in the medical literature. 91 patients with symptoms of bromine exposure were seen in the outpatient and casualty departments of the cantonal Hospital, but the clinical course was mild and self-limited in nearly all cases. One patient was admitted for 24 hours. The most common symptoms were upper respiratory tract symptoms, cough and headache. In 20-30% of cases these pesisted for more than three days, and sometimes up to one month. Recording the location of patients at the time when their first symptoms occurred made it possible to define the exposed area with precision. When the initial data collected in this "acute" fashion is reliable, it should be possible to undertake more elaborate epidemiological studies at a later stage if necessary.

Accidents, Occupational↗
PubMed1986

Effects of bopindolol on renal function.

The effect of the long-acting beta-blocking agent bopindolol on renal function was assessed in 10 healthy normotensive volunteers and 10 hypertensive patients. The subjects received 1 mg bopindolol at 8 p.m. for 21 days. The following determinations were made at 8 a.m. on recumbent, fasting subjects before day 0 (D0) and 12 h after day 1 (D1) the first dose of bopindolol, and on the 21st day of treatment (D21): blood pressure (diastolic = DBP), glomerular filtration rate (GFR) and renal plasma flow (RPF) as reflected by the plasma disappearance of 51Cr-EDTA and 125I-hippuran, plasma concentrations and 2- and 24-h urinary excretion of electrolytes, creatinine, and proteins and osmolality of the urine. Plasma renin activity was assessed on standing subjects. Following bopindolol administration GFR, RPF, and filtration fraction remained stable, in spite of a fall of DBP from 80 +/- 7 to 76 +/- 4 and to 72 +/- 9 mm Hg in normotensives (p less than 0.05) and from 106 +/- 11-96 +/- 10 and to 91 +/- 8 mm Hg in hypertensives (p less than 0.05) on D1 and D21, respectively. The drops in DBP at D1 correlated weakly with the pretreatment renin levels (p = 0.074, p less than 0.05). All the other variables remained stable, including diuresis, free water clearance, and fractional sodium excretion. It is concluded that in contrast to many other anti-hypertensive drugs including several beta blockers, bopindolol does not reduce renal function during short- or medium-term treatment in normal volunteers or hypertensive patients.

Adolescent↗
PubMed1986

[Continuous ambulatory enteral feeding in hospitalized adults: prospective experience in 98 patients].

The goal of this study, which describes a personal technique of continuous enteral nutrition (CEN) in hospitalized adults on an ambulatory basis, was: to prospectively evaluate, over a 2-year period, its efficacy and tolerance in 98 patients requiring CEN for at least 15 days; to compare its efficacy and tolerance with those of conventional non-ambulatory CEN on a prospectively randomized basis in 16 patients. Ambulatory CEN was given at the rate of 35-45 kcal/kg/d (lipids: 35 p. 100; carbohydrates: 45 p. 100); during day-time, a portable system, including pump, tubes and low-viscosity nutrient solutions, allowed ambulation. Ninety-eight consecutive patients with a minimal level of physical autonomy were treated for intestinal (n = 47), pancreatic (n = 20), esophagogastric (n = 17) diseases, or for malnutrition of other causes for an average of 38 days (15 to 141). The average weight gain (m +/- SD) was 1.2 +/- 5.5 p. 100 of ideal body weight (IBW) and the average nitrogen gain was 0.7 +/- 3.8 g/24 h; weight gain proved significantly lower in patients with inflammatory bowel disease receiving steroids. The clinical tolerance proved excellent, except for 5 cases of transient diarrhea and 9 cases of reposition of the nasogastric tube. A decrease in cholesterolemia below 3.9 mmol/l was noted in 25 p. 100 of patients during CEN. No significant difference between ambulatory and non-ambulatory CEN was observed in terms of evolution of body weight and other anthropometric variables, nitrogen balance, albuminemia, and oxygen consumption; conversely, the CEN experience, evaluated by patients on analogical visual scales, was significantly better endured in the ambulatory group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗