Doxapram and potential benzyl alcohol toxicity: a moratorium on clinical investigation?
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Benzyl Alcohol↗
Biomedical subjects
J Garcia
Publications and source records attributed to J Garcia.
[Screening of essential fatty acid deficiency in children. Respective value of the assay of fatty acids in total lipids and lipid fractions of the serum].
This study was carried out in metabolically stable infants aged from one to six months receiving artificial food. The lipid serum fraction presenting changes characteristic of essential fatty acid (EFA) deficiency was determined. A preliminary study (n = 13 samples) showed that analysis of total fatty acids (TFA) and of phospholipids (PL) was more discriminatory than analysis of free fatty acids (FFA), triglycerides (TG) or esterified cholesterol (EC). Comparison of TFA and PL (n = 25 samples) confirmed literature data; in particular, C18: 2 n-6 and C20: 4 n-6 decreased whereas C20: 3 n-9 increased. These changes were clearer and significantly greater (p less than 0.001) for C20: 3 n-9 and C20: 4 n-6 of the PL, but were also very significant for the TFA compared to healthy controls. The C20: n-9/C20: n-6 ratio was identical for all fractions. TFA analysis by gas-liquid chromatography is faster and less costly than analysis of lipid fractions and provides sufficient data for screening of EFA deficiency.
Chemical Fractionation↗
[Radiology of spondylodiskitis].
Current radiological techniques for the diagnosis of spinal osteomyelitis are plain-films (and tomography), scintigraphy, ultrasonography, computed tomography and magnetic resonance imaging. The authors describe the semiology of each one, define their respective limits and complementary character, and propose a strategy adapted to individual clinical situations.
Adult↗
[Multidisciplinary study of the prolonged treatment of involution osteoporosis using sodium fluoride with calcium, phosphate and vitamin D].
A multidisciplinary study on the prolonged treatment of involution osteoporosis with fluoride was performed on a homogeneous population of 31 women aged 51 to 75 years (mean 64 years). The selection criteria were the following: significant backache, vertebral compression fractures on X-rays, bone biopsy evidence of osteoporosis, and absence of other risk factors after a complete workup. The patients were treated for a period of 3 to 6 years (mean 4 years) with daily doses of 30 mg (10 mg 3 times) fluorides ion associated during the last 3 years with 500 mg calcium twice daily, 750 mg phosphate and 1000 units vitamin D daily. The study demonstrated a favourable effect of the treatment on the backache and that it was well tolerated in the majority of cases, the side effects being intermittent osteo-articular pains of the lower extremities due to the fluoride in 9 patients, and gastric intolerance to the phosphate in 7. X-ray follow-up showed slowing of the vertebral compressions after the first year of treatment, but no effect on fractures of the extremities. There was no evidence of alterations in parameters of mineral and bone metabolism, and in endocrine, hepatic, renal or hematological assays. Histomorphometric and biophysical examination of biopsies indicated that, although there was no significant increase in the quantity of mineralized bone under the treatment, there was a very significant improvement in the crystallinity of the mineral substance, thus enhancing the quality of the bone tissue and its resistance to pressure. This study is the first in which a catamnesis of the patients was undertaken, 28 of them having received a clinical and radiological examination 2 years after the end of therapy: a favourable evolution was observed in most of the cases, both in those patients treated for a period of 3 years and in those whose treatment had lasted for a longer period.
Aged↗
Testicular neoplasms in Hispanic brothers.
Two hispanic brothers developed nonconcordant testicular malignancies in an interval of 11 months. They represent the 36th report of familial testicular neoplasia. The problems deriving from poor patient compliance are documented.
Adult↗
Involvement of the anterior insular gustatory neocortex in taste-potentiated odor aversion learning.
When an odor conditioned stimulus (CS) precedes illness (unconditioned stimulus; UCS), rats acquire relatively weak odor aversions. Conversely, when a compound odor-taste (flavor) CS precedes illness, rats acquire robust aversions both to the odor and to the taste components of a compound flavor CS. Thus, tastes potentiate odor-illness aversions during toxiphobic conditioning. Such conditioning effects have been referred to as taste-potentiated odor aversion learning (POA). Previous neurobehavioral experiments have shown that the anterior insular gustatory neocortex contributes to conditioned taste aversion (CTA) learning. The present experiment examined the involvement of the anterior insular gustatory neocortex in CTA learning and POA learning. To that end, four distinct groups of rats received bilateral electrolytic lesion placements in the orbitofrontal neocortex, the "somatic" gustatory neocortex, the anterior insular gustatory neocortex or the posterior insular neocortex. Control animals received anesthesia only. Subgroups of animals thereafter received aversion conditioning using either an odor (almond) CS or a compound odor-taste (almond-saccharin) CS. Aversions to the almond odorant and/or saccharin tastant were evaluated during extinction. Results indicated that animals lacking orbitofrontal neocortex or posterior insular neocortex acquired normal CTAs and POAs. Animals lacking somatic gustatory neocortex exhibited impaired CTA learning, yet those animals showed normal POA learning. Lesions centered in the anterior insular neocortex impaired both CTA learning and POA learning. These results demonstrate that the insular gustatory neocortex is uniquely involved in the higher-order integration of odors, tastes and illness.
Animals↗
Taste discriminations in rats lacking anterior insular gustatory neocortex.
Previous neurobehavioral investigations have demonstrated that the anterior insular gustatory neocortex (AIGN) mediates taste-illness learning. The present experiment evaluated taste discriminations in rats lacking AIGN. Two groups of rats received distinct surgical treatments. One-half of the animals received bilateral electrolytic lesion placements in the AIGN: Remaining animals received anesthesia and scalp incisions only. Following postoperative recovery animals received standard two-bottle preference tests with various concentrations of sucrose to evaluate gustatory reactivity. Animals thereafter received two-bottle discrimination tests with selected sucrose concentrations. At the conclusion of preference tests and discrimination tests with sucrose, preference tests and discrimination tests were conducted with sodium chloride. Following those tests animals received taste aversion conditioning to determine whether or not AIGN lesions impaired taste-illness learning. Results of two-bottle taste tests indicated that AIGN lesions do not obviously alter taste reactivity nor taste discriminations to preferred concentrations of sucrose and NaCl. Anterior insular lesions did, however, impair normal taste aversion learning. These results, in combination with those of previous investigators, provide further evidence that the AIGN preferentially contributes to taste learning functions.
Animals↗
Olfactory responses in the gustatory area of the parabrachial pons.
Electrophysiological responses to olfactory and gustatory stimuli were recorded in the same neural elements in the parabrachial nuclei (PbN) of rats under Flaxedil. Responses to olfactory stimuli varied in temporal pattern and magnitude from responses to gustatory stimuli. Intravenous infusion of Nembutal while recording from one unit appeared to alter the pattern of responsiveness across stimuli. Most importantly the response to one olfactory stimulus (vanilla) was eliminated by this procedure. Olfactory-gustatory elements were located in the lateral portion of the taste-responsive area of the PbN, just below the brachium conjunctivum. These results suggest that the PbN receives input from both olfactory and gustatory pathways and that these pathways may converge on the same neural elements within the PbN. This convergence may be part of a neurophysiological substrate for the perception of flavor.
Administration, Oral↗
Management of aortic arch aneurysm using profound hypothermia and circulatory arrest.
The cases of 9 patients with aneurysms involving the aortic arch, repaired under profound hypothermia (average, 15.5 degrees C) and circulatory arrest, are presented. Five patients underwent elective operation and 4, emergency operation. Arch resection and graft replacement were done in 7 patients. Two patients with infected pseudoaneurysms of the aortic arch received patch grafts. There were 2 deaths (22%) from coagulopathy and decerebration. Seven patients are alive and well 18 to 45 months following repair. The combination of profound hypothermia and circulatory arrest appears to be a promising solution to a difficult problem.
Adult↗
Electrocardiographic and vectorcardiographic study of interatrial conduction disturbances with left atrial retrograde activation.
From 81,000 ECGs we collected 83 cases that fulfilled the criteria of Interatrial Conduction Disturbances with Left Atrial Retrograde Activation (IACD-LARA) (P +/- in II, III and VF with P width greater than or equal to 120 msec.). We present the detailed study of 35 cases with surface ECG and VCG and 29 cases with orthogonal ECG leads. The results are then compared against two control groups: with cardiopathy (30 cases) and without cardiopathy (25 cases). The prevalence of IACD-LARA was nearly 1% globally, and 2% among patients with valvular heart disease. The diagnostic criteria for IACD-LARA are: 1) ECG: P +/- in II, III and VF with P greater than or equal to 120 msec. with open angle (usually greater than 90 degrees) between the first and the second part of the P.2) Orthogonal ECG: P +/- in Y lead with a negative mode greater than 40 msec. 3) VCG: More than 50 msec. above the X or Z axis, duration of the P loop greater than or equal to 110 msec., open angle between the two parts of the P loop in both frontal (131.3 degrees +/- 32.3) and right sagital planes (171.2 degrees +/- 15.1), and presence of notches and slurrings in the last part of the P loop.
Adult↗
Auscultatory and echocardiographic features of mobile left atrial thrombus.
Free floating ball thrombus of the heart is a rare disorder that usually involves the left atrium, particularly in association with mitral stenosis and atrial fibrillation. The diagnosis of ball thrombus is suspected clinically when there are auscultatory changes in the intensity of the murmur of mitral stenosis. Two-dimensional echocardiography is especially useful in the diagnosis of this condition. By combining phonocardiographic recordings with both M-mode and two-dimensional echocardiography, attenuation and disappearance of the murmur were demonstrated as the mobile thrombus randomly drifted into the mitral valve orifice. Reappearance of the cardiac murmur was noted as the thrombus was expelled from the orifice. This study, combining simultaneous phonocardiography and two-dimensional echocardiography, identifies for the first time the relation between thrombus movement into the mitral aperture and changes of the murmur of mitral stenosis.
Echocardiography↗
Haemodynamic effects of molsidomine in patients with severe chronic coronary disease.
The haemodynamic effects of a single dose of intravenous molsidomine were assessed in 12 patients with severe coronary disease. The investigation was carried out at rest during angina induced by pacing and after molsidomine during pacing at the rate at which angina had been produced. During angina, left ventricular systolic and end-diastolic pressure rose, left ventricular stroke work fell and coronary flow and myocardial oxygen consumption increased by 58.3% above the control levels. After the administration of molsidomine, atrial stimulation was not followed by angina and there were no significant changes in systolic blood pressure. Left ventricular end-diastolic pressure fell sharply and coronary flow and myocardial oxygen consumption were only 38% and 33% higher, respectively, than the control levels. The beneficial effects of molsidomine in ischaemic heart disease, therefore, are the result of peripheral vasodilation which, by reducing the preload and afterload, lowers the oxygen requirements of the myocardium and thus increase the threshold for angina. A direct action on the coronary network can not be excluded but if such an action does exist it must be very small in the light of the marked systemic effect.
Adult↗
Mothers' views of continuous electronic fetal heart monitoring and intermittent auscultation in a randomized controlled trial.
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Clinical Trials as Topic↗
A general theory of aversion learning.
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Afferent Pathways↗
Magnesium excretion in idiopathic hypercalciuria.
Given the parallelism in calcium and magnesium metabolisms, we have studied urinary magnesium in normal subjects and in patients with idiopathic hypercalciuria under conditions of basal and restricted diet, fasting, and after oral calcium overload. Serum magnesium values showed no differences between groups. Urinary magnesium levels are increased in absorptive hypercalciuria under free and restricted diet and calcium overload, returning to normal during fasting. Renal hypercalciuria patients maintain a high magnesium excretion under all conditions. This suggests that in idiopathic hypercalciuria there is an impairment of renal magnesium management, dependent on that of calcium because it normalizes when urinary calcium is normal.
Adult↗
Time, space and value.
The ability of animals to associate stimuli depends on whether the stimuli are processed by the cognitive system or the affective system. Historically, a distinction was made between "thinking" and "feeling" by the empirical philosophers of the Renaissance. Recent evidence indicates that cognition and affect can be fruitfully applied to animal research. When animals are required to search an external environment for hidden food baits, they display an objective mastery of time and space as if they have acquired a "cognitive map" of the test area. Tests of an animal's ability to span the time between two external events yield intervals which can best be measured in seconds or fractions thereof. When animals consume a food, the affective value of that food is adjusted according to its utility in the internal milieu. If the food is nutritious, visceral feedback raises the preference value of the food. If nausea ensues, the taste becomes disgusting. Tests of an animal's ability to span the time between eating and nausea yield intervals which can best be described in hours or fractions thereof. Cognitive and affective processes are qualitatively distinct and subserved by different neural systems, yet they are both essential for associative learning. We offer a theoretical scheme designed to weld the two components into a single unitary sequence.
Affect↗
West Berkshire perineal management trial.
One thousand women were allocated at random to one of two perineal management policies, both intended to minimise trauma during spontaneous vaginal delivery. In one the aim was to restrict episiotomy to fetal indications; in the other the operation was to be used more liberally to prevent perineal tears. The resultant episiotomy rates were 10% and 51% respectively. An intact perineum was more common among those allocated to the restrictive policy. This group experienced more perineal and labial tears, however, and included four of the five cases of severe trauma. There were no significant differences between the two groups either in neonatal state or in maternal pain and urinary symptoms 10 days and three months post partum. Women allocated to the restrictive policy were more likely to have resumed sexual intercourse within a month after delivery. These findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity.
Adult↗
Employment in pregnancy: prevalence, maternal characteristics, perinatal outcome.
Data from the Cardiff Births Survey was used to examine the relation between the nature of employment and perinatal outcome. The proportion of all expectant mothers who work during pregnancy increased from 38.7% in 1965/69 to 43.9% in 1975/79 (p less than 0.001). The percentage of working primiparas, however, remained unchanged at approximately 80%, whereas the percentage of working multiparas rose from 15.1% to 22.1%. The non-employed primiparas were more likely than the employed primiparas to be at the extremes of maternal age, to have a history of medical problems and previous abortions, and to attend less often for antenatal care. Perinatal outcome (measured in terms of perinatal mortality, birthweight, and length of gestation) was significantly better among the employed mothers. Non-employed mothers in social classes I and II seemed to be a particularly high risk group. Exclusion of mothers with an adverse obstetric or medical history considerably reduced the differences in perinatal outcome between the two groups. The findings suggest that healthy women without an adverse obstetric or medical history can safely continue in employment during pregnancy.
Birth Weight↗