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Biomedical subjects

J Piquet

Publications and source records attributed to J Piquet.

50 records · Page 3Linked to original sources
PubMed1985

Pulmonary function after transverse or midline incision in patients with obstructive pulmonary disease.

Atelectasis and bronchopneumonia occur frequently in patients undergoing aorto-iliac reconstructive surgery. Transverse (T) incisions in upper abdominal surgery are thought to be followed by fewer pulmonary complications than midline incisions (M) but reports remain controversial. We studied the incidence of postoperative pulmonary complications and lung dysfunction after T and M incisions for aorto-iliac surgery in 13 patients with chronic obstructive pulmonary disease (COPD) and 13 control patients with normal lungs (C). For all subjects, we evaluated (1) postoperative clinical or radiological pulmonary events; (2) preoperatively and on postoperative days 2 (D2), 5 (D5), 9 (D9) and 12 (D12) - the forced expiratory volume in 1 s (FEV1), vital capacity (VC), alveolar-arterial oxygen difference (AaPO2), and (3) convenience for the surgeon. Operatively, aortic exposure was excellent with both incisions. Bronchopneumonia occurred only after M in five patients (1 C, 4 COPD). In contrast with the control patients in whom no difference was found between T and M incisions, the FEV1 of COPD patients was significantly less impaired with T than with M incisions (p less than 0.005 on D2 and p less than 0.05 on D5). VC decreased similarly with both incisions on D2 but on D5 the improvement was less with M (p less than 0.005). Changes in AaPO2 were more marked on D2 and D5 for the COPD patients with M incisions. We conclude that (1) in patients with chronic obstructive pulmonary disease, laparotomy with a transverse incision was associated with better postoperative lung function and fewer pulmonary complications; (2) in patients without pulmonary disease, midline and transverse incisions were equivalent.

Abdominal Muscles↗
PubMed1985

Effects of hypocalcemia on diaphragmatic strength generation.

We studied the effects of hypocalcemia on diaphragmatic force and diaphragm blood flow (Qdi) in 12 anesthetized dogs. The diaphragm was electrically stimulated with intramuscular electrodes surgically implanted in the ventral surface of each hemidiaphragm. The transdiaphragmatic pressure (Pdi) during supramaximal (50 V) 2-s stimulations applied over a frequency range of 10-100 Hz was measured with balloon catheters during tracheal occlusion at functional residual capacity. A catheter was placed via the femoral vein into the left inferior phrenic vein, and Qdi was measured by timed volume collections of left inferior venous effluent. A catheter was introduced in a femoral artery to monitor blood pressure (BP). In five additional dogs, the force generated by the sartorius muscle during electrical stimulation was also studied concomitantly to diaphragmatic force. The animals were mechanically ventilated throughout the experiment, and the arterial blood gases and pH were maintained constant. Hypocalcemia was induced by a continuous infusion of EGTA (70 mg X kg-1 X h-1), which led to a progressive decrease (P less than 0.0001) of ionized calcium plasmatic level from 2.21 +/- 0.4 meq/1 during control to 1.69 +/- 0.06, 1.25 +/- 0.5, and 1.07 +/- 0.5 meq/1 after 30, 60, and 120 min, respectively. Hypocalcemia decreased progressively Pdi, which amounted to 84 +/- 3 (P less than 0.001) and 98 +/- 2% of control values for the low frequencies (10 and 20 Hz) and the high frequencies (50 and 100 Hz), respectively, after 30 min of EGTA infusion and to 74 +/- 5 and 79 +/- 6% for the low and high frequencies, respectively, after 120 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Stable normocapnia during high-frequency body surface oscillation in rabbits.

In order to identify the useful range of frequencies and the effect of lung volume on gas exchange during high-frequency ventilation, particularly during high-frequency body surface oscillation (HFBSO), we studied 12 normal, anesthetized, and paralyzed adult rabbits in 2 groups at 1, 3, 5, 8, 12, and 16 Hz in random order. The rabbits were placed in a body box, and a "bias" flow system different from all previously reported systems was used. For a given animal at a given frequency, the oscillation magnitude was adjusted to ensure normocapnia, defined as PaCO2 equal to 40 +/- 2 mmHg, for at least 5 min. For the first group (n = 6) with a mean tracheal pressure of 0.5 cmH2O, the necessary tidal volumes (mean +/- SD) were 3.7 +/- 0.2, 1.9 +/- 0.2, and 1.5 +/- 0.1 ml/kg at 1, 3, and 5 Hz, respectively. Further increases in frequency resulted in only small decreases in the required tidal volumes: 1.4 +/- 0.1, 1.2 +/- 0.1, and 1.2 +/- 0.1 ml/kg at 8, 12, and 16 Hz, respectively. Arterial PO2 values were very similar at all 6 frequencies, with a mean of 78.6 +/- 3.3 mmHg in this group. For the second group (n = 6) with a mean tracheal pressure of 5 cmH2O, arterial PO2 values were again the same at all frequencies applied but were significantly higher (95.5 +/- 2.6 mmHg) than in the first group. No significant difference was observed in the tidal volumes required to maintain normocapnia between the 2 groups, i.e., at the 2 mean tracheal pressures studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Equally efficacious asthma management with budesonide 800 micrograms administered by Turbuhaler or with beclomethasone dipropionate > or = 1500 micrograms given through a pressurized metered-dose inhaler with spacer. The French Budesonide Trial Group.

To avoid the side effects associated with long-term administration of high doses of inhaled glucocorticosteroids, they should be used at the lowest effective dose. This study compared the clinical efficacy of budesonide given via a dry-powder, inspiratory flow-driven device (Turbuhaler), at a daily dose of 800 micrograms, with beclomethasone dipropionate (BDP) 1500 to 2000 micrograms given via pressurized metered-dose inhaler (pMDI) with spacer to adults requiring the latter dose of BDP to control their asthma. The study was performed as a 2-week run-in, 8-week open, randomized, multicenter, parallel-group design. Adult asthmatics with a forced expiratory volume in 1 second 55% or more of predicted normal and receiving BDP 1500 to 2000 micrograms daily entered the study. After a 2-week run-in, one group continued with BDP and the other was switched to budesonide through the Turbuhaler. After 8 weeks, morning peak expiratory flow (PEF) had increased by 5.9 L/min from a mean of 390 L/min in the budesonide group and by 1.9 L/min from a mean of 402 L/min in the BDP group. No clinically or statistically significant differences between groups were evident with regard to the change in this primary variable. Similarly, only small changes in evening PEF and secondary variables of lung function were seen, with no statistically significant difference between groups. The authors concluded that both treatments were equivalent in managing asthma in adult patients with stable asthma.

Administration, Inhalation↗
PubMedDate not supplied

[Plethysmographic measurement of lung volume in chronic obstructive pulmonary disease. Influence of the panting pattern].

In 9 healthy subjects and 22 patients with chronic obstructive disease, we computed total lung capacity (TLC) using an integrated flow pressure-corrected body plethysmograph. During panting manoeuvre, TLC derived from oesophageal pressure (TLCes) was compared to TLC derived from mouth pressure (TLCm). In healthy subjects, TLCm was identical to TLCes. Patients with obstructive disease exhibited different behaviours according to experimental conditions: a) in free frequency panting with mouth occlusion close to functional residual capacity (FRC) (9 patients), TLCm appeared to be significantly higher than TLCes (mean difference: 0.25 1; p less than 0.05); b) in panting with both low (less than 1 Hz) and high (2 Hz) frequencies and mouth occlusion close to FRC (7 patients), TLCm appeared to be significantly higher than TLCes only at a high frequency (p less than 0.05); c) in panting with both low and high frequencies and mouth occlusion close to TLC (6 patients), no significant difference was observed between TLCm and TLCes. These results suggest that in patients with chronic obstructive disease plethysmographic lung volume measurements are subject to error, due to the influence of extrathoracic airways. During occlusion at FRC, panting frequency was found to influence the results obtained, the error being minimized with low frequencies. In contrast, by occluding at TLC, we found that panting frequency was less likely to influence the results. However, potential sources of error still exist: for instance, the influence of abdominal gas or the panting pattern.

Adult↗
PubMedDate not supplied

[Radioimmunologic dosage of total IgE serum in various helminthiases and protozoan infections (author's transl)].

The both purposes of our investigation were to determine initially the level of total serum IgE in various parasitic infections and the variations of this level after the initiation of specific treatment. In the study, III sera from black race patients with a clinical and biological diagnosis of helmintic or protozoal infections and without allergic diseases were tested by the commercially available "Radioimmunosorbent test" (Pharmacia Laboratories). In helmintic infections: the IgE concentration was higher than normal level: --in 100% of patients infested with ankylostoma, trichocephalus (mean concentration m: 2,961 UI/ml) or schistosoma (m: 1,578 UI/ml); --in 70% of patients infested with ascaris (m: 1,110 UI/ml). In protozoal infections: the abnormal IGE level was found only in 44% and 14% of cases respectively of malaria (m = 704 UI/ml) and of leishmaniasis (441 UI/ml). The time course of total serum IgE determined after the treatment initiation showed that: a) in patients with intracellular helminthiasis and protozoal infections serum IgE concentrations were gradually increased in a statistically highly significant way; b) in cases with intestinal helminthiasis, high levels disappeared ane returned rapidly to normal values.

Adolescent↗