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Biomedical subjects

J Motin

Publications and source records attributed to J Motin.

At least 109 records · Page 6Linked to original sources
PubMed1985

Remission of acquired pure red cell aplasia following plasma exchanges.

A 22-year-old woman had an idiopathic pure red cell aplasia that failed to respond to high doses of corticosteroids. After a series of 10 plasma exchange procedures, bone marrow erythropoiesis and reticulocyte blood count returned to normal; the haematological remission has been now persistent for 12 months. The place of plasma exchange in the management of pure red cell aplasia and its mode of action will be discussed.

Adult↗
PubMed1985

[Acute amiodarone poisoning. Clinical and pharmacokinetic study].

A 73 years old patient, treated with Amiodarone for ventricular tachycardia, ingested 6 000 mg of Amiodarone. This did not induce hemodynamic troubles or aggravation of ventricular arrhythmia. Treatment included a gastric lavage and purging at the third hour. Plasma assay revealed a concentration of 3.69 mg/l at the fourth hour. Their evolution can be described as the sum of two exponentials. The half-life of the first exponential is 4.9 hours ; the half-life of the second one is 544 hours. Amiodarone is an antiarrhythmic agent of high safety.

Aged↗
PubMed1984

[Monotherapy of Pseudomonas aeruginosa septicemia with azlocillin].

Azlocillin was administered alone to seven patients without malignant or blood disease presenting with septicaemia caused by Pseudomonas aeruginosa. In 6 cases the infection developed after surgery and in 3 of these it was responsible for a state of shock, twice associated with acute anuric renal failure. The minimum inhibitory concentrations of azlocillin varied from 2 to 32 micrograms/ml; 5 strains were resistant to carbenicillin. The minimum inhibitory to minimum bactericidal concentrations ratio, measured on five occasions, was equal to 2. Bacterial eradication was obtained in 6 patients. One patient with multivisceral failure died during treatment and in this case the responsible organism had become resistant to azlocillin.

Adult↗
PubMed1984

[Hemoglobin dissociation curve and 2,3-diphosphoglycerate in erythrocytes in septic shock].

The oxyhaemoglobin dissociation curve (OHDC) and intraerythrocytic 2,3-diphosphoglycerate (2,3-DPG) play an important role in oxygen delivery, especially during shock. 62 determinations in eight septic shocks were carried out. Hem.O. Scan drew the OHDC at standard temperature and PCO2; P50 was modified for pH 7.40 (P50 std) by algorithm. When the patients had recovered from the shock, their average P50 std was higher than during the shock (p less than 0.02), and much more so than in normal subjects (p less than 0.01). There was a positive correlation between P50 std and 2,3-DPG, arterial blood pH, haemoglobin and cardiac index, as well as between 2,3-DPG and arterial blood pH. On the other hand, there existed no correlation between P50 std or 2,3-DPG, and Pao2, Paco2 and phosphoremia. The Hill number was normal.

2,3-Diphosphoglycerate↗
PubMed1984

[Posttraumatic fat embolism].

Between 1977 and 1982, fifty cases of post-traumatic fat embolism were treated in a general intensive care unit. Average age of patients was 25.5 +/- 13 years; there was no male majority. Mean free interval was 39 +/- 27 h. 12 cases (24%) had single fractures and 38 (76%) multiple fractures. Forty-four patients had a fractured femur. Thirty-two patients presented the complete clinical syndrome with general, respiratory, neurological and cutaneous signs. Thrombocytopaenia and hypocholesterolaemia were the biological signs most often seen. In forty-four patients, orthopaedic treatment consisted of immediate immobilization, usually with traction. Twenty-six patients were reoperated on: intramedullary nail for twenty patients, plate for the other six. Fat embolism appeared in spite of surgery in six cases; it worsened after surgery in six others. Seven patients had per- or postanaesthetic problems. Fourteen per cent of patients died. The decrease in mortality was mainly due to an improvement in mechanical ventilation techniques. Early surgical fixation remained the rule if there was no serious respiratory distress or haemodynamic instability, although it did not seem to change the mortality rate in this group of patients.

Adolescent↗
PubMed1983

Effect of PEEP ventilation on renal function, plasma renin, aldosterone, neurophysins and urinary ADH, and prostaglandins.

To explore the main factors which could be involved in the fluid retention induced by continuous positive pressure ventilation (CPPV), hemodynamics, renal, and hormonal parameters were measured in seven intensive care patients during three consecutive 60-min periods; one of intermittent positive pressure ventilation (IPPV), one of CPPV (PEEP 10 cmH2O), and finally one of IPPV. During CPPV, a 15% decrease in cardiac output was observed, without alteration in arterial pressure or right atrial transmural pressure. In addition, decreases were observed in urinary output by 34%, glomerular filtration rate by 19%, renal blood flow by 32%, sodium excretion by 33%, and potassium excretion by 26%. There was no change in the fractional excretion of sodium and free water. Institution of PEEP also led to a significant increase in plasma renin activity, plasma aldosterone, and urinary antidiuretic hormone, without significant variation in plasma neurophysins and urinary prostaglandins E and F alpha. All of the changes that occurred during CPPV were reversed when PEEP was withdrawn. It is concluded that the short-term antidiuretic effect of PEEP is mainly due to a hemodynamic impairment of renal function. The water- and sodium-retaining hormonal systems also are stimulated and could participate in the fluid retention during more prolonged respiratory support with PEEP.

Adolescent↗
PubMed1983

[Acute ajmaline poisoning. Study of 7 cases].

Seven cases of acute ajmaline overdose admitted over a 3 year period to a polyvalent intensive care unit are reported. The severity of this condition is related to the membrane stabilising and depolarising effects of ajmaline on the myocardium. The dose ingested varied from 10 to 40 mg/kg. The delay between ingestion and hospital admission ranged from 3 to 6 1/2 hours. The first cardiac disturbances can appear one hour after ingestion. Three cardiac arrests and one hypovolemic shock occurred. Three atrioventricular blocks, six intraventricular blocks, three ventricular tachycardias, and six prolongations of the QT interval were observed. Serum ajmaline levels varied from 0,8 to 6 mg/l. Symptomatic therapy was mainly based on sodium, temporary cardiac pacing, external DC shock, sympathomimetics and external cardiac massage with assisted ventilation. Cardiac bypass should be a part of the therapeutic arsenal. Elimination of the drug is assisted by a complete digestive evacuation. Renal or extrarenal dialysis is not indicated. One of the seven patients died. Prophylaxis is based on the non-prescription of ajmaline for benign cardiac disturbances.

Adolescent↗
PubMed1982

[Treatment of septicemia with latamoxef. Multicentric study of 60 cases].

Sixty patients including forty two males and eighteen females, age range: 18-87 years, received antibacterial single drug treatment with latamoxef for septicemia. Forty nine patients had underlying conditions including multiple trauma, neoplasm, cardiovascular, metabolic and respiratory tract diseases. Causative pathogens were isolated in all cases. The predominant isolates were E. coli (thirty), Klebsiella pneumoniae (tent) and Enterobacter (seven). A single organism was isolated in fifty seven cases; in the other three cases two organisms were isolated from blood cultures. Mean daily dosage was 46.6 +/- 6.1 mg . kg-1 (range: 14-113 mg . kg-1). In the majority of cases (fifty two) dosage was 3 g . d-1 or less; in thirty cases it was no higher than 2 g . d-1. Duration of therapy ranged from six to thirty eight days. Serum titer was measured in many cases and latamoxef blood levels were assayed in nine patients. A satisfactory clinical response was achieved in fifty eight cases and fifty eight bacteriological cures were also obtained. There was no statistically significant difference in therapeutic response between the 2 g and 3 g daily dosage groups. Tolerance was very good; untoward effects were few and required drug discontinuation in one case only.

Adolescent↗
PubMed1982

Post-traumatic-shock lung: postmortem microangiographic and pathologic correlation.

In post-traumatic-shock lung, increased pulmonary vascular resistance and pulmonary hypertension are prominent features. The explanation for them was sought by postmortem microangiography of the lungs of 17 patients dying of respiratory failure after trauma. The 10 patients with thoracic injury died earlier (1-8 days). Extravasation of contrast material due to alveolar capillary rupture was present in all but one specimen and occupied 20% of the sampled area. Pulmonary artery thrombi lay proximal to these extravasations. Hypovascular areas due to infection and hemorrhagic alveolitis were found in all patients and involved 40% of the surface area. The small pulmonary arteries were poorly filled and contained many microthrombi. Some patients had hematomas, cavities, and areas of interstitial edema occupying about 5% of the lung area and associated with compressed or occluded vessels. Several mechanisms including pulmonary trauma may be responsible for the antemortem rupture and obstruction of small blood vessels. In the post-traumatic-shock lung, small artery occlusion and compression are associated with pulmonary hemorrhage, infarction, and infection and are important contributors to perfusion abnormalities and respiratory failure.

Adolescent↗