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Biomedical subjects

M Bertrand

Publications and source records attributed to M Bertrand.

At least 163 records · Page 9Linked to original sources
PubMed1985

A comparison of the antiemetic efficacy of prochlorperazine and metoclopramide for the treatment of cisplatin-induced emesis: a prospective, randomized, double-blind study.

This study compared high-dose metoclopramide and prochlorperazine for their antiemetic activities in the treatment of patients with solid tumors receiving cisplatin-based cancer chemotherapy, in a prospective, double-blind fashion. Sixty patients were entered in the study, and 28 patients on each regimen were evaluable. For regimen 1, metoclopramide was given intravenously (IV) over 15 minutes at a dose of 2 mg/kg 30 minutes before, 30 minutes after, and three hours after treatment with cisplatin. In regimen 2, prochlorperazine was given IV 30 minutes before and three hours after the cisplatin; a placebo was administered at 30 minutes after cisplatin. There was no statistically significant difference between the two regimens in their antiemetic efficacies during the first three hours. For emesis that occurred from three to 24 hours after administration of cisplatin, prochlorperazine was marginally superior. The median number of emeses in the metoclopramide regimen was 2.5 (range, 0 to 10+) compared to 1.0 (range, 0 to 10+) in the prochlorperazine regimen. This is not a significant difference. The overall incidence of adverse reactions was greater in the metoclopramide regimen, with drowsiness being the most common toxicity for both antiemetic programs. Thus, IV high-dose metoclopramide and prochlorperazine are similar and effective in the management of cisplatin-induced emesis. IV prochlorperazine at 20-mg dosage is surprisingly effective.

Adolescent↗
PubMed1985

[Long-term effects of transluminal coronary angioplasty. French multicenter study].

Although transluminal coronary angioplasty is now acknowledged as an effective treatment for coronary artery disease, the long-term outcome of patients treated by this method is still under evaluation. A french multicenter trial was set up and the long-term efficacy of transluminal coronary angioplasty was assessed in 546 patients undergoing the procedure before the 31/3/83. 380 initial successes (69 p. 100) were followed up for a period ranging from 6 to 48 months (average 19.9 +/- 10.4 months). A control coronary angiography was carried out in 88 p. 100 of cases. Restenosis (loss of over 50 p. 100 of initial angiographic improvement) was observed in 27 p. 100 of cases. Including the repeat procedures, the patency rate of the dilated vessels was 82 p. 100. Progression of atherosclerosis on another coronary artery was observed in 1.3 p. 100 of cases. After transluminal coronary angioplasty, 72 p. 100 of patients remained improved, 11 p. 100 underwent repeat angioplasty, 8 p. 100 underwent coronary bypass surgery, 1.3 p. 100 suffered myocardial infarction and 1.3 p. 100 died. Restenosis was associated with recurrence of angina pectoris in 90 p. 100 of cases (within 3.3 +/- 1.6 months) and a positive exercise stress test in 87 p. 100 of cases. Recurrence of angina due to progression of disease on the dilated vessel was observed in 24.2 p. 100 of cases; repeat transluminal coronary angioplasty was carried out for this indication in 38 p. 100 of cases, coronary bypass in 34.8 p. 100 and medical treatment was continued in 27.2 p. 100 of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1985

[Complications of transluminal coronary angioplasty. A multicenter French study (1983)].

The authors report the complications observed during 1 247 transluminal coronary angioplasties (TCA) performed in 1 187 patients in 17 french centers between 1979 and October 1983. There were 855 primary successes (68.9 p. 100). There were 41 cases of symptomatic dissection (3.3 p. 100) of which 32 underwent aortocoronary bypass surgery with a residual myocardial infarction (MI) in 13 cases (40.6 p. 100). Medical treatment of symptomatic dissection gave very poor results (7 out of 9 MI) and is formally contra-indicated. 67 per- or postoperative occlusions were observed (5.3 p. 100). This is the most serious complication which necessitates an emergency revascularisation procedure (TCA or coronary bypass surgery--CBS--) because MI rapidly follows in patients without a well-developed collateral circulation. In this series MI occurred in 28 out of 45 patients--62 p. 100--despite CBS. This underlines the value of an immediate repeat TCA which, when successful, results in a much faster revascularisation. Seventy-three MI (5.8 p. 100) were observed in the first 24 hours: 50 p. 100 were secondary to an angiographically documented coronary occlusion. The other two causes were coronary dissection and spasm. Emergency CBS was carried out in 107 cases (8.9 p. 100) mainly for coronary occlusion or symptomatic dissection. The mortality was 11 out of 1 187 patients (0.93 p. 100). Death occurred in the catheter laboratory in 3 cases, during the first 24 hours in the operating theatre in 1 case, and after the first 24 hours but before hospital discharge in 7 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1984

Iatrogenic superior vena cava syndrome. A new entity.

Four patients with cancer developed superior vena cava syndrome following placement of a central venous catheter (Broviac or Hickman catheter) without evidence of mediastinal tumoral involvement. Diagnostic and therapeutic considerations are discussed.

Adult↗
PubMed1984

Prolonged pregnancy: surveillance of the fetus and the neonate and the course of labor and delivery.

The perinatal events in 184 term control pregnancies and 129 prolonged pregnancies were prospectively compared. Fetal surveillance consisted of weekly biophysical profile testing. Thirty-two infants were dysmature, and 10 of these had advanced dysmaturity. The incidence of advanced dysmaturity rose quickly after 44 weeks. This group was at greater risk for fetal distress, lower Apgar scores, and emergency cesarean section. The combination of oligohydramnios, a suboptimal nonstress test, and a low profile score was highly predictive of a neonate with advanced dysmaturity. In the control pregnancies, the rate of induction of labor was 13.81% compared with 39.84% in the prolonged pregnancies. The induced labor group had a 51.32% cesarean section rate. Our approach to prolonged pregnancy consists of elective induction of labor when the cervix is favorable and biweekly profile testing when it is not; however, the high incidence of advanced dysmaturity after 44 weeks warrants delivery.

Apgar Score↗
PubMed1984

Two-dimensional and M mode echocardiography in the human fetus.

One hundred unselected pregnant women underwent M mode and two-dimensional fetal echocardiographic studies between 14 and 43 weeks' gestation. The following cross-sectional views were obtained: high parasternal short axis, parasternal long axis, four chamber view, and an extended long axis to assess the aorta. These views successfully identified great vessel orientation and size (90%), atrial and ventricular size and function (90%), presence of atrioventricular valves (92%) and semilunar valves (75%), and presence and continuity of ventricular and atrial septa (91%) and the aortic arch (68%). Factors that limited visualization were persistent unfavorable lie, maternal obesity, and oligohydramnios. Disturbances in cardiac rhythm were the prevalent abnormal findings (16%). In addition, several anatomic defects were detected in utero and confirmed at autopsy. These included a biventricular cardiomyopathy, atrial septal defect, pericardial effusion, and hypoplastic heart. The potential applications of our ability to detail human fetal cardiac anatomy and dimensions are discussed.

Arrhythmias, Cardiac↗
PubMed1984

Texture analysis of ultrasound B-mode images by segmentation.

B-mode texture characterization by supervised methods of pattern recognition is subject to the following drawbacks: precise localization of the lesion to characterize is often difficult and, even when the lesion is well isolated, its texture can be corrupted by the presence of tumor non specific structures. These structures are not easily discernable and introduce a bias in the statistical measures. The results presented in this paper show that these problems can be circumvented by the use of an unsupervised method of image segmentation. The method enhanced the B-mode image and partitions the non specific structures and the lesion texture in different regions which can be characterized independently by statistical methods. The unsupervised approach also facilitates the clinical diagnosis done by visual inspection, by revealing subtle characteristics of the B-mode textures.

Adenocarcinoma↗
PubMed1984

Steroid-withdrawal radiation pneumonitis in cancer patients.

Two cancer patients developed steroid-withdrawal radiation pneumonitis. This complication is a recognized risk in the treatment of patients with Hodgkin's disease and other malignant lymphomas, but is under-recognized in patients receiving treatment for carcinoma.

Adenocarcinoma↗
PubMed1984

Effects of amphotericin B with combination chemotherapy on response rates and on survival in non-small cell carcinoma of the lung.

Thirty-seven patients with non-small cell carcinoma of the lung were randomized to receive doxorubicin, lomustine, hexamethylmelamine, and methotrexate (ACHM) or ACHM plus amphotericin B (AMB). The complete plus partial response rate was 39% for ACHM plus AMB, compared to 23% for ACHM alone. However, the median duration of complete or partial response was only 3.0 months with ACHM plus AMB, compared to 7.0 months with ACHM. Most importantly, median survival was only 4.0 months with ACHM plus AMB, compared to 8.0 months with ACHM (P = 0.08; two-tail test). Myelosuppression was enhanced by the addition of AMB. Although AMB has biological and antitumor activity in certain clinical circumstances, it does not appear to have a meaningful role in palliative therapy of patients with non-small cell bronchogenic carcinoma.

Altretamine↗
PubMed1983

[Superoxide dismutase treatment of 2 cases of radiation-induced sclerosis].

Two patients with severe radio-induced necrosis were treated with bovine copper superoxide dismutase encapsulated in lysosomes (SOD). Two milligrams were injected subcutaneously every other day. This therapy was apparently effective on radio-induced inflammation and fibrosis. These are preliminary results that need confirmation. They suggest that SOD is useful, not only before radiation exposure, as a preventive, but also after exposure, as curative treatment for radiation injury.

Aged↗
PubMed1983

[Clinical use of vecuronium during celioscopy].

In order to determine if vecuronium can be used for short operations, 40 women were studied during laparoscopy, randomly assigned to four groups: suxamethonium 1 mg X kg-1 in a single bolus followed by an infusion (group A), vecuronium 0.05 mg X kg-1 (group B), vecuronium 0.06 mg X kg-1 (group C) and vecuronium 0.07 mg X kg-1 (group D). Mean duration of operation was 22-25 min. Tracheal intubation can be performed in good conditions in all patients in group A and D, in 5/10 in group B and in 7/10 in group C. During laparoscopy, muscular relaxation was considered excellent in all patients in group A and D, 5/10 sufficient and 5/10 excellent in group C, 5/10 insufficient and 5/10 sufficient in group B. There were 7 reinjections in group B, 2 in group C and 1 in group A. The delay between the end of the procedure and extubation was the same in group A and C (7 min). This delay was significantly higher in group D (9 min). The delay between extubation and positive head lift test was significantly higher in group D. We conclude that the time course of action of vecuronium 0.06 mg X kg-1 is that required for a pelvic laparoscopy of 22-25 min; however, the conditions of intubation are not always perfect. Intubation is easier with a 0.07 mg X kg-1 dose; this dose induces a slight delay for extubation and positive head lift test. In all cases, the patient must be closely watched in a recovery ward.

Adult↗
PubMed1982

[Plasma lipoproteins and apolipoproteins. Value of their determination in the detection of coronary atherosclerosis. Comparison with data supplied by coronarography].

Plasma lipids, lipoproteins and apolipoproteins A1 and B were determined in a reference population and in 273 patients who underwent coronary arteriography for evaluation of chest pain. The patients were divided into 3 groups according to arteriographic findings. The 102 patients in group A had normal coronary arteries; the 30 patients in group B had small vascular abnormalities but no significant narrowing; the 141 patients in group C had significant vascular lesions with greater than or equal to 50% narrowing. Total cholesterol and triglycerides were quantified using enzymatic methods. HDL cholesterol and phospholipids were enzymatically analyzed after phosphotungstate precipitation. Plasma lipoproteins were evaluated by quantitative electrophoresis based on densitometric scanning of the lipoprotein bands after separation and visualization by polyanion precipitation. Apoproteins A1 and B were measured by electroimmuno-diffusion assay using ready-for-use plates. Statistical evaluation of the data showed that group C patients had higher betalipoprotein and apo B levels and lower alphalipoprotein and apo A1 levels than subjects with normal coronary arteries. The predictive value of these results was established in relation to clinical findings. Plasma lipid measurements proved inadequate to separate the 3 groups. In contrast, the betalipoprotein/alphalipoprotein ratio and, still better, the apo A1/apo B ratio provided good discrimination. The results suggest that measurement of plasma apo A1 and apo B levels is the best means of assessing the risk of coronary artery disease.

Adult↗