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Biomedical subjects

J Petit

Publications and source records attributed to J Petit.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Transcatheter closure of patent foramen ovale in patients with platypnea-orthodeoxia: results of a multicentric French registry.

BACKGROUND: Dyspnea and the decrease in arterial saturation in the upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS). POS is secondary to the occurrence of an atrial right-to-left shunt through a patent foramen ovale (PFO). METHODS: This French multicentric study reports on 78 patients (mean age 67 +/- 11.3 years) with POS who had transcatheter closure of the PFO; frequently associated diseases were pneumonectomy (n = 36) and an ascending aortic aneurysm (n = 11). In all patients, the diagnosis was confirmed by transthoracic or/and transesophageal echocardiography. Five different closure devices were used: Amplatz (n = 45), Cardioseal (n = 13), Sideris (n = 11), Das Angel Wings (n = 8) and Starflex (n = 1). Closure was successful in 76 patients (97%). RESULTS: Oxygen saturation increased immediately after occlusion from 84.6 +/- 10.7% to 95.1 +/- 6.4% (p < 0.001) and dyspnea improved from grade 2.7 +/- 0.7 to grade 1 +/- 1 (p < 0.001). A small residual shunt was immediately observed in 5 patients (3 with the Cardioseal device, 1 with the Sideris and 1 with the Amplatz) leading to the implantation of a second device in one case (Cardioseal). Two early deaths occurred unrelated to the procedure (one due to sepsis probably related to pneumonectomy, another due to respiratory insufficiency). Other complications were: a small shunt between the aorta and the left atrium, two atrial fibrillations and a left-sided thrombus which disappeared with anticoagulant therapy. At a mean follow-up of 15 +/- 12 months, there were 7 late deaths related to the underlying disease. CONCLUSION: Percutaneous occlusion of the foramen ovale is safe and gives excellent results thanks to continuing improvement in available devices. This technique enables some patients in an unstable condition to avoid a surgical closure.

Aged↗
PubMedDate not supplied

New anti-inflammatory N-pyridinyl(alkyl)phthalimides acting as tumour necrosis factor-alpha production inhibitors.

This paper describes the synthesis of N-pyridinyl(alkyl)phthalimides related to N-phenyl-4,5,6,7-tetrafluorophthalimides known to be inhibitors of tumour necrosis factor-alpha (TNFalpha) production. Pharmacomodulation at the phthalimidic nitrogen led to the selection of two pharmacophoric fragments (2,4-lutidinyl and beta-picolyl), allowing significant inhibition of TNFalpha production (compounds 12 and 17). Variation of the substituents linked to the homocycle of their phthalimide scaffold indicated that high (TNFalpha production) inhibitory potency could be achieved, notably by 5-fluoro, 4- or 5-nitro, 5-amino and especially tetrafluoro substitution. The most active compound, N-(pyridin-3-ylmethyl)-4,5,6,7-tetrafluorophthalimide (32) (84% inhibition at 10 microM), also produced an anti-oedematous effect in the PMA-induced mouse-ear swelling test. Although less active than dexamethasone, it exerted a marked reduction in ear thickness after oral administration (63% vs. 85% for dexamethasone at 0.2 mMkg(-1)) and remained efficient after topical application (46% vs. 96% for the dexamethasone). It also induced potent inhibition in the rat carrageenan foot oedema test with an ID(50) (0.14 microMkg(-1)) comparable with that of N-(2,6-diisopropylphenyl)phthalimide (4) (0.15 microMkg(-1)).

Animals↗
PubMedDate not supplied

[Syringomyelia].

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

High prevalence of hepatitis C virus infection in Belgian intravenous drug users and potential role of the "cotton-filter" in transmission: the GEMT Study.

AIMS: To estimate viral seroprevalences for HCV, HBV and HIV among belgian intravenous (IVDU) and non intravenous (non-IVDU) drug users; to assess risk factors for HCV infection in IVDU; to assess feasibility of chronic hepatitis C follow-up in this population. DESIGN: Cross-sectional study. Demographic and behavioural characteristics were obtained by a standardized questionnaire. Serum samples were tested for HCV, HBV and HIV. SUBJECTS AND SETTING: 329 patients (244 IVDU and 85 non-IVDU) attending ten general practitioners in 1995. RESULTS: HCV seroprevalence was 78.3%; it was 35.7% for HBV and 0.9% for HIV in IVDU, vs 2.4%, 8.3% and 0%, respectively, in non-IVDU. In logistic regression analysis, independent risk factors for HCV infection were: 1/sharing of syringes and/or of "cottons" used as filters (adjusted prevalence odds ratio [POR] = 31.7; 95% confidence interval [CI] = 9.8-102.5), 2/duration of injecting upper than one month (adjusted POR = 8.6; CI = 3.0-24.7) and 3/age (adjusted POR = 1.2 by year of difference; CI = 1.0-1.3). A biochemical follow-up was obtained in 70% of HCV seropositive users; 79.5% of them had chronic hepatitis C (mean value of ALT = 3.5 times upper normal value, range 1.1-23.0). Among these, 24.7% went through liver biopsy during the three years follow-up period of the study. CONCLUSIONS: HCV seroprevalence is very high among belgian IVDU. Prevention strategies have to focus on neophytes injectors. They must be urgently revisited for what concern needles/syringes exchange programs: "cottons" must be included. Follow-up and treatment of chronic hepatitis C seem to be poorly effective among drug users.

Adolescent↗
PubMedDate not supplied

[The concept of renal dysplasia. Apropos of 67 cases].

The aim of this study, based upon 130 nephrectomies in children, was to emphasise the importance of congenital lesions in comparison with inflammatory lesions. In the context of congenital abnormalities, the abundance of our material made it possible for us to review our anatomical findings in the context of clinical and radiological data. This had led us to propose an anatomical classification of renal dysplasias. Although overlap cases exist, this classification into four separate entities according to the nature and extent of the histological and topographical lesions is satisfactory by virtue of its clarity. It is an agreement with the most recent publications of authors interested in the vast problem of renal malformations.

Child↗
PubMedDate not supplied

Adult heart transplantation: adverse role of chronic alcoholism in donors on early graft function.

Because of the increasing shortage of heart donors, selection criteria have been gradually extended. The purpose of this study was to determine the donor-related factors implied in early graft dysfunction and to define new selection criteria. The 70 consecutive adult patients who underwent heart transplantation in our institution between January 1988 and February 1992 were retrospectively studied. Mean donor age was 38 +/- 11 years (10 donors were more than 50 years of age; two donors were more than 60 years of age). Mean ischemic time was 130 +/- 39 minutes. An important proportion of donors (20%) had a history of chronic alcoholism. Thirteen patients experienced immediate graft dysfunction; five of them died within the first operative month. The different parameters studied, which were found to have no significant influence on the early graft function, were the age of the donor, the duration of inotropic support and the dose administered, a relative hemodynamic instability, resuscitation maneuvers, chest trauma, and weight mismatch between donor and recipient. Ischemic time was significantly longer in patients who died of cardiac dysfunction (p < 0.05). Chronic alcoholism in the donor was a very detrimental factor: 54% of patients who had early graft dysfunction versus only 12% of patients who had immediate normal graft function had received a graft from an alcoholic donor (p = 0.003). Excluding such alcoholic donors or reserving them for critically-ill recipients, with an increased risk of early graft dysfunction would be preferable.

Adult↗
PubMedDate not supplied

[Pharmacokinetic study of a new benzyl-1 isoquinoline derivative (458 L) after oral administration in men].

Pharmacokinetic study of 458 L. via oral route, was performed in twelve normal volunteers, in a randomized crossover design of three galenic forms. Plasma concentrations were determined, after extraction, by HPLC, with spectrofluorimetric detection. Plasmatic kinetics were fitted to a bi-exponential function with a distribution half-life of 1h and an elimination half-life of 11.5 to 14.7 h according to the form. Pharmacokinetic parameters evaluated as area under the curve (AUC), maximum plasma concentrations (Cmax), relative bioavailability (F'), have shown strong interindividual differences, specially in women group, and this with tobacco smoking.

Administration, Oral↗
PubMedDate not supplied

[Malignant Neuroleptic Syndrome during tiapride treatment].

Tiapride, a benzamide compound, is a neuroleptic drug used in the treatment of some behavior troubles, especially in the alcohol withdrawal syndrome. We report a new case of malignant neuroleptic syndrome during a tiapride treatment in a 39 year-old alcoholic patient who had been admitted after a minor trauma. Symptoms were typical, with malignant hyperthermia in the absence of sepsis, coma, extrapyramidal syndrome, rhabdomyolysis, and severe metabolic acidosis. Dantrolene succeeded to reverse hyperthermia and rigidity; probably due to its delayed administration however, irreversible acidosis led to the patient's demise.

Adult↗
PubMedDate not supplied

[Cystic dystrophy of the urinary tract excretory mucosa. A report of six new cases (author's transl)].

The authors report 6 cases of kystic dystrophy of the upper urinary tract. A review of the literature and the discussion of the described cases leads to some comments about the pathogeny, the diagnosis and the treatment of this poorly defined syndrome which is due to injuries to the mucosae under the influence of phenomenous more probably inflammatory than vascular.

Adult↗
PubMedDate not supplied

[Non-surgical treatment of pulmonary valve stenosis].

Percutaneous pulmonary valve valvuloplasty was attempted 17 times in 16 infants and children aged 15 days to 18 years. Valvuloplasty was performed during cardiac catheterization without general anesthesia. Balloon catheter was positioned across the pulmonary valve using a guide wire previously introduced in the right or left pulmonary artery. All patients experienced a decrease in the right ventricular peak systolic pressure from 111.5 +/- 35.9 to 69 +/- 28.9 mmHg (p less than 0.001), a decrease in the ratio of right ventricular pressure to systemic systolic pressure from 1.08 +/- 0.34 to 0.65 +/- 0.28 (p less than 0.001) and a decrease in right ventricular to pulmonary artery gradient from 88.52 +/- 37.2 to 54.82 +/- 29.4 mmHg (p less than 0.001). A child with a history of postoperative seizures had convulsions after the procedure and died 72 hours later. Four other patients are considered as a failure of the technique, 4 had clear hemodynamic improvement but right ventricular pressure remained above 50 mmHg, and 8 had satisfactory relief of their stenosis with a right ventricular pressure below or equal to 50 mmHg and a right ventricular to pulmonary artery gradient below 30 mmHg. These good results were confirmed in 2 patients, one year after the dilatation. Percutaneous balloon valvuloplasty is probably now the best treatment for pulmonary valvular stenosis. Short-term and results at distance from the procedure are good, and morbidity and cost are less than those for a surgical cure.

Adolescent↗
PubMedDate not supplied

[Treatment of rheumatic mitral stenosis in children and adolescents by a balloon catheter].

Between April 1986 and August 1987, eight children, 9 to 18 years old, with rheumatic mitral valve stenosis underwent a percutaneous balloon valvotomy. Immediate results were good. By echocardiographic measurements, mean transmitral gradients went from 23.7 +/- 7.1 mmHg to 5.8 +/- 4.7 mmHg (p less than 0.001), diastolic pressure half-times went from 299.0 +/- 15.6 msec to 123.3 +/- 42.3 msec (p less than 0.001) and mitral valve areas measured by planimetry went from 1.00 +/- 0.15 cm2/1.73 m2 to 2.68 +/- 0.71 cm2/1.73 m2 (p less than 0.001). Hemodynamic measurements showed a decrease in mean pulmonary artery pressure from 48.3 +/- 13.2 mmHg to 32.5 +/- 5.7 mmHg (p less than 0.01), a decrease in the mean left atrial pressure from 26.1 +/- 6.3 mmHg to 14.6 +/- 4.7 mmHg (p less than 0.02) and an increase in calculated mitral valve area (Gorlin formula) from 1.07 +/- 0.31 cm2/1.73 m2 to 2.73 +/- 1.17 cm2/1.73 m2 (p less than 0.02). The only complication observed was a grade III mitral insufficiency in a child with marked subvalvular fibrosis. Six patients had a very good result and one kept a moderate mitral stenosis. Percutaneous balloon valvotomy gives probably better results in children than in adults and obtains at least as good results as surgical closed mitral commissurotomy. Presently, this technique is the treatment of choice for rheumatic mitral stenosis in children. Contra-indications are intra-atrial thrombus and shortened, thickened subvalvular apparatus.

Adolescent↗