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Biomedical subjects

J Motin

Publications and source records attributed to J Motin.

At least 127 records · Page 7Linked to original sources
PubMed1982

[Acute tricyclic antidepressant intoxication. Evaluation of severity and treatment. A study of 16 patients with cardiovascular manifestations (author's transl)].

Among the 94 tricyclic antidepressant intoxications received in 3 years in the intensive care unit of Edouard Herriot Hospital, 16 with cardio-vascular manifestations are studied. The criteria of selection is the presence on the electrocardiogram (ECG) of a ventricular trouble in conduction excitability or automaticity. Eight times, the ingested dose exceeds 20 mg/kg. 10 times several toxics are taken explaining the severity of coma and the rarity of convulsions. 2 collapses, 1 shock, 1 cardiac arrest occur. The most frequent ECG abnormalities are: T modifications, (90 p. 100), prolongation of QT interval (60 p. 100), right bundle branch block (50 p. 100) or left one (25 p. 100). Only one death occurs; (1 p. 100 of this series). Ventricular dysrythmia or myocardial failure represent the main criteria in the evaluation of severity of the tricyclic antidepressant intoxication. For the treatment, a complete digestive evacuation is needed, Hemodialysis, plasmapheresis, or hemoperfusion cannot be actually recommended. The treatment of cardiac troubles involves essentially sodium. and eventually intra-cardiac pace maker.

Adolescent↗
PubMed1981

[Postoperative fentanyl analgesia by the epidural route].

The analgesic action of fentanyl administered by epidural injection in a dose of 0.2 mg diluted in 10 ml of physiological saline proved to be satisfactory in 21 patients who had undergone abdominal surgery. The mean duration of analgesia was 6 hours. The subjective improvement was associated with an increase in V.C. (congruent to 30%) and good tolerance of postoperative chest physiotherapy. Despite the absence of respiratory depression, the existence of drowsiness is suggestive of central impregnation the degree and role of which remain to be defined.

Analgesia↗
PubMed1981

[Glucose intolerance in injured patients (author's transl)].

Glucose intolerance occurring in injured patients is known to be a part of the general response to injury described by Cuthbbertson: early "ebb phase" with a decrease of energy production, then "flow phase" with hypermetabolism. Several processes can be responsible for the abnormalities observed: 1) Alterations in peripheral glucose uptake. 2) Absolute or relative insulin lack in connection with increased catecholamine release which is know to inhibit insulin secretion. 3) Decreased sensitivity and responsiveness to insulin in connection with increased levels of counter regulatory hormones (catecholamines, glucagon, growth hormone). 4) Non-suppressibility of hepatic gluconeogenesis by glucose. Glucose intolerance decreases glucose utilisation and leads to increased proteolysis always unfavorable for patients.

Glucose↗
PubMed1981

[Fulminant hepatitis B virus associated with acute pancreatitis. Report of two cases (author's transl)].

Viral hepatitis affections are sometimes associated with endocrine or exocrine pancreatic disorders. An acute necrotizing hemorrhagic pancreatitis seems to be the prerogative of the fulminating forms. The demonstration of HBS fluorescence in the pancreatic acini cells in one patient suggests the possible etiopathogenic role of HB virus in some cases, apart from the other factors involved.

Acute Disease↗
PubMed1980

[The diagnosis of traumatic rupture of the aorta. 36 cases (author's transl)].

Thirty six cases of traumatic rupture of the thoracic aorta (TRA) were diagnosed during the hours following the accident responsible. Rupture was situated at the aortic isthmus in 32 cases, the ascending aortic in 2 cases, the arch of the aorta in 1 case and the descending sub-isthmic aorta in 1 case. Ten patients had no rib fractures. In 16 patients not undergoing surgery before 20th hour after the trauma, 10 died of secondary rupture. The course of a TRA is thus unpredictable and it is of fundamental importance to make the diagnosis and undertake appropriate surgical treatment immediately. The essential clinical sign is a difference in blood pressure between the upper and lower limbs (6 6%). Radiological signs suggestive of TRA are, in a plain PA chest film : widening of the mediastinum (92 %), poor visibility of the knuckle of the aorta (89 %), left haemothorax (67 %), deviation of the trachea to the right (55 %) and lowering of the left main bronchus (47 %). The slightest suspicion of a TRA should lead to aortic angiography preferably via an arterial approach (humeral or femoral), or intravenously. Surgical treatment should not be delayed.

Aorta, Thoracic↗
PubMed1980

[Contribution of epidural infiltration in the treatment of acute ischemia in the lower inoperable limbs (author's transl)].

Epidural infiltration easily causes without surgical intervention, paralysis of the sympathetic nervous system and analgesia. In this way, spasm and vasoconstriction are inhibited and the use of collateral vessels which are still permeable is facilitated. The antalgesic position of the dropped foot, which is a cause of oedema and hemodynamic disconfort, is eliminated. Out of 17 patients showing an acute ischemia of the lower limbs treated by this method, seven were cured, 3 of whom already having trophic disorders, 7 underwent local amputations and 3 had leg and thigh level amputations. Six months later 10 of these patients were doing well. The best therapeutic conditions of this treatment are non-atheromatous arteritis: angiospasm, toxic or inflammatory acute ischemia and Buerger's disease. On the other hand, the results are mediocre with atheromatous arteritis.

Acute Disease↗
PubMed1978

[Amylase-creatinine clearance ratios in burned patients (author's transl)].

The amylase/creatinine clearance ratio (ACCR) has been examined every 3 days, in 34 burned patients during the 20 days following the accident. This ratio was often abnormal since it was found increased at least on one occasion, in 75% of these patients, to be compared with 23 and 13% for amylase in serum and urine respectively. In another group of 9 burned patients, the ACCR was monitored for time-period between 10 to 52 days. It was observed that a high frequency in increased ACCR was associated with a fatal outcome. Finally simultaneous measurements of ACCR and of the beta2 microglobulin/creatinine clearance ratio (MCCR) showed that increased ACCR were statistically associated with increased MCCR suggesting a decreased renal tubular reabsorption of low molecular weight proteins in these burned patients.

Amylases↗
PubMed1977

[Variation of plasma amino acids in severe hepatitis with encephalopathy 10 cases].

Plasma levels of different amino acids were observed in 10 patients with severe hepatitis, 9 viral in origin and 1 toxic, over the course of the disease. There would appear to be a close relationship between the onset of encephalopathy and the appearance of a particular pattern in plasma amino acid equilibrium, characterised by a significant fall in the molar ratio existing between ramified amino acids (valine, leucine, isoleucine) and aromatic amino acids (phenylalanine and tyrosine). The role of these disturbances in the physiopathology of the encephalopathy and their effects on the synthesis of normal neurotransmitters and the intracerebral accumulation of false neurotransmitters is discussed.

Acute Disease↗
PubMed1977

[Mendelson's syndrome].

Mendelson's syndrome is discussed with a review of the literature and presentation of 27 personal cases studies. Accidental aspiration of gastric fluid occurs primarily during anesthesia, in cranial trauma victims, and in toxic coma patients. Tissue damage is proportional to the acidity and the quantity of aspirated fluid. The initial clinical manifestations are often serious, sometimes leading to acute respiratory distress syndrom with pulmonary edema. Frequent infectious complications, often with anaerobic microbes, are deciding factors in the prognosis. Artificial ventilation with positive pressure (sometimes continuous) is often necessary. Administration of corticosteroids at high doses is likely favorable. Prophylactic administration of antibiotics is initially directed against anaerobic agents. The prevention of this serious syndrome should be a primary concern of anesthesiologists and physicians treating comatous patients.

Adrenal Cortex Hormones↗
PubMed1976

Hepatitis B antigen (HBSAg) and/or antibodies (anti-HBS and anti-HBC) in fulminant hepatitis: pathogenic and prognostic significance.

Hepatitis B surface antigen (HBSAg) and antibodies to both the surface and core antigens of the hepatitis B virus (anti-HBS and anti-HBC) have been studied in 64 consecutive cases of fulminant hepatitis. HBSAg was detected by counterelectrophoresis in 23 (35-9%) but by radioimmunoassay in 38 (59-3%). Anti-HBS was detected by passive haemagglutination in 26 (40-6%), coexisting HBSAg and anti-HBS were found in 16 cases (25%). Using an indirect immunofluorescence technique, anti-HBC was found in all of the cases in whom either HBSAg or anti-HBS was present. The highest survival rate was observed in patients with no evidence of HBV infection (31-3%) and was lowest in those who had both HBSAg and anti-HBS detected simultaneously (6-2%). The prognosis of those who exhibited anti-HBS only was no better than those with HBSAg alone. In a further case, transient interruption of the asymptomatic chronic HBSAg carrier state with seroconversion to anti-HBS was associated with the development of a fulminant hepatitis syndrome. The results suggest that an unusually strong and rapid immune clearance of HBSAg may be involved in the pathogenesis of fulminant hepatitis.

Adolescent↗
PubMed1976

[Stress ulcer and acute postoperative renal insufficiency. An attempt at preventive treatment with Solcoseryl and proglumide].

The study grouped 68 patients treated for severe post-operative or post-traumatic renal insufficiency, having survived over 7 days after being admitted into the Reanimation Department. A group of 32 patients were given systematic preventive treatment for nervous ulcers witch Solcoseryl and Proglumide. A control group of 36 patients received no specific treatment. Nervous ulcerations (showing up in gastrocopy) are found in three patients in the group receiving treatment, as compared with seven in the control group. This preventive treatment appears to be of interest, especially as other local or neuroleptic treatments are difficult to use in the group of patients concerned here.

Actihaemyl↗