Listeriosis and AIDS: an unfounded assumption.
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Abortion, Habitual↗
Biomedical subjects
M Boucher
Publications and source records attributed to M Boucher.
Adult respiratory distress syndrome: a rare manifestation of Listeria monocytogenes infection in pregnancy.
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Adult↗
Successful repair of an anterior cervical lip detachment associated with a spontaneous term delivery: a case report.
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Adult↗
Chronotropic effects of pindolol. Relation between ventricular effects and control resting ventricular rate values in conscious dogs with chronic A-V block.
The chronotropic effects of pindolol were studied in the conscious dog with chronic A-V block. Pindolol significantly increased atrial rate, probably through both its strong intrinsic sympathomimetic activity and reflex withdrawal of atrial vagal tone in response to its hypotensive effect. Pindolol did not alter ventricular rate overall. However, in individual dogs, pindolol caused ventricular chronotropic effects that were inversely related to resting ventricular rate: it increased ventricular rate when the resting ventricular rate was low and reduced it when it was high. In view of the fact that pindolol is a beta-adrenoceptor antagonist endowed with a strong intrinsic sympathomimetic activity, this finding contributes to a better understanding of how pindolol affects heart rate.
Animals↗
Dopamine in the conscious dog with chronic heart-block. Mechanisms of chronotropic cardiac effects.
The chronotropic effects of dopamine were studied in the conscious dog with chronic A-V block. Dopamine at 12.5-200 micrograms/kg and 12.5-50 micrograms/kg/min lowered atrial rate independently of dose. After blockade of muscarine receptors or alpha-adrenoceptors, it raised atrial rate. After blockade of dopamine receptors, dopamine still lowered atrial rate, and did so dose-relatedly after blockade of beta-adrenoceptors. It raised ventricular rate, and at high doses also induced ventricular rhythm disorders. Blockade of muscarine receptors enhanced the ventricular cardioaccelerator effect of dopamine (P less than 0.025) at 100 micrograms/kg, while blockade of alpha-adrenoceptors reduced it (P less than 0.05). Blockade of dopamine receptors did not modify this effect, but blockade of beta-adrenoceptors reversed it. Dopamine at 25-200 micrograms/kg raised mean blood pressure. This effect was enhanced by blockade of muscarine receptors, reversed by blockade of alpha-adrenoceptors, and was unaffected by blockade of beta-adrenoceptors or dopamine receptors. These results show that the atrial cardiomoderator effect of dopamine is a vagal reflex response to its hypertensive action, and that it is limited by its direct beta-adrenergic stimulating action. They also show that the ventricular cardioaccelerator effect of dopamine is attenuated by a reflex vagal depressor effect consequent to the induced hypertension. No evidence was found for the existence of positive chronotropic dopamine receptors in either atria or ventricles.
Adrenergic alpha-Antagonists↗
Listeria meningitis during pregnancy.
Meningitis is the major pathologic manifestation of Listeria monocytogenes in the United States. Despite the fact that this organism has a well-known predilection for individuals who are pregnant or immunocompromised, to date, maternal listeric meningitis remains an unreported entity in the English literature. The authors report two cases of this disease and review the diagnosis and treatment of meningitis in general and, more specifically, of listeric meningitis in pregnancy. It is recommended that the initial treatment of bacterial meningitis during pregnancy should be a combination of ampicillin and gentamicin pending definitive identification of the causative organism and its antibiotic sensitivity pattern.
Adult↗
Pharmacological evidence for differences in the beta-adrenoreceptor populations mediating atrial and ventricular chronotropic responses in the unanaesthetized dog.
The beta-adrenoreceptor populations mediating atrial and ventricular chronotropic responses were studied comparatively in the unanaesthetized dog with chronic atrio-ventricular block. With this aim, we first compared the increases in atrial and ventricular rate induced by isoprenaline. We then compared the reductions of this isoprenaline-induced atrial and ventricular cardio-acceleration, observed after administration of cumulative doses of propranolol and alprenolol, both non-selective beta-adrenoreceptor blocking agents, and metoprolol, a blocking agent selective for beta 1-adrenoreceptors. Isoprenaline induced a much more intense stimulation of atrial chronotropic beta-adrenoreceptors than of ventricular chronotropic beta-adrenoreceptors, whether or not the cholinoreceptors were blocked. Similarly, all three beta-blocking agents induced a more intense blockade of atrial chronotropic beta-adrenoreceptors than of ventricular chronotropic beta-adrenoreceptors, whatever the dose of isoprenaline considered and whether or not the cholinoreceptors were blocked. These results cannot be readily explained by quantitative differences in the distribution of beta 1- and beta 2-adrenoreceptors in the heart, given the identical effects obtained with metoprolol, propranolol and alprenolol. Therefore, beta-adrenoreceptor populations are not identical throughout the nodal tissue, and in particular, differences occur between beta-adrenoreceptors in the sinus node mediating atrial chronotropic responses and those in the His bundle mediating ventricular chronotropic responses, which might be linked to differing sensitivities of these beta-adrenoreceptor populations.
Alprenolol↗
The ventricular system in chronic schizophrenic patients. A controlled computed tomography study.
Twenty-three chronic schizophrenic patients and 23 controls, all males between 20 and 40 years of age, were evaluated by CT scan. The lateral, third and fourth ventricles, the Sylvian fissures, and the largest sulcus from each of the frontal, parietal, and occipital lobes, were measured in order to determine whether the previously reported ventriculomegaly in schizophrenics was perhaps due to a disturbance of CSF flow or to atrophy, two common causes of ventricular enlargement. We found that in the schizophrenic group the third and fourth ventricles and both Sylvian fissures were significantly enlarged, but not the lateral ventricles or cerebral sulci. Our data suggest that these ventricular changes are not due to a disturbance of CSF flow or to cerebral atrophy. Other possible explanations are discussed.
Adult↗
Maternal morbidity as related to trial of labor after previous cesarean delivery. A quantitative analysis.
In patients with previous cesarean births, a trial of labor (TOL) appears to be a reasonable alternative to the standard practice of performing a routine repeat cesarean section (C/S). A major benefit of a TOL in these patients is a potential reduction in maternal morbidity. However, current data supporting this assertion have been somewhat incomplete or unconvincing. Thus, we retrospectively evaluated 873 patients with a history of previous C/S who delivered in 1980. A TOL in patients with a prior C/S was found to be safe and was associated with significantly less maternal morbidity than in patients who did not undergo a TOL. Thus, it appears that a TOL may be beneficial from the financial and social points of view.
Adult↗
Previous cesarean section and trial of labor. Factors related to uterine dehiscence.
Patients with previous cesarean section generally are subjected to repeat cesarean section for fear of uterine rupture and its subsequent catastrophic complications. Recently, however, since the practice of repeat cesarean section has been challenged, a select group of patients has been permitted a trial of labor (TOL) after they have fulfilled certain selection criteria. These criteria include not more than one previous low segment transverse incision, a nonrecurrent indication and absence of macrosomia with this pregnancy. We performed a retrospective study on 836 patients with previous cesarean sections. Of them, 308 were given a TOL. Factors considered to increase the risk of dehiscence were analyzed. On statistical analysis, none of the factors appeared to have any impact on the rate of uterine dehiscence.
Birth Weight↗
Oxytocin use during a trial of labor in patients with previous cesarean section.
In patients who have had a previous cesarean section (C/S), the use of oxytocin during a trial of labor (TOL) remains controversial. In order to better delineate the risks associated with oxytocin usage in patients with prior C/S undergoing a TOL, a retrospective investigation was undertaken. During the study period, January 1 to December 31, 1980, 308 previous-C/S patients underwent a TOL. Oxytocin was used on 58 (18.8%) for either labor induction (12) or augmentation (46). Vaginal delivery was accomplished in 31 (53.4%) of the patients who received oxytocin. Vaginal delivery was accomplished in 196 (83.8%) of the 292 patients who labored spontaneously. Patients who had no vaginal deliveries after previous C/S and required oxytocin were at a significantly increased risk of undergoing C/S. There was no statistically significant difference between the oxytocin vs. nonoxytocin groups with regard to instruments used in vaginal delivery, uterine scar dehiscence, transfusions, birth trauma or neonatal outcome. In patients with a previous C/S who undergo a TOL, the use of oxytocin in a judicious manner appears to be safe. However, additional studies are required to corroborate this conclusion.
Cesarean Section↗
[Use of cephalosporins as antibiotic prophylaxis in cesarean section].
Cefoxitin, a second-generation cephalosporin, was compared with cefazolin, a first-generation cephalosporin, and a placebo in a prospective, double-blind study of antibiotic prophylaxis in women undergoing nonelective cesarean section. In the groups that received cefazolin or the placebo there eas no statistically significant change in colonization of the cervix by aerobic bacteria by the fourth day after the operation, but there was a statistically significant increase in colonization by anaerobes. Cefoxitin had the opposite effect. Of the 14 postoperative infections in 11 patients, significantly more were in patients who had received the placebo; the numbers were too small to show a difference in effectiveness between the two antibiotics. Of the microorganisms implicated as the infectious agents, group B Streptococcus was the most frequent aerobe, and Peptostreptococcus and Bacteroides bivius were the most frequent anaerobes. Among the 15 patients for whom at least one perioperative specimen yielded positive culture results, a postoperative infection developed in 5 of the 6 who received the placebo, 2 of the 4 who received cefazolin and 1 of the 5 who received cefoxitin.
Aerobiosis↗
A method for determining the atrial effective refractory period in the unanesthetized dog.
Extension to the unanesthetized dog with chronic A-V block of the method of determination of the atrial effective refractory period described in vitro by Dawes provides a useful model for the study in atria of potential antiarrhythmic agents. This model, which comes fairly close to physiological conditions, is capable of furnishing reproducible results which correlate well with those obtained by other techniques, as shown by a study of quinidine chosen as reference. It also makes possible long-term studies of the effects of prolonged administration of antiarrhythmic agents on atrial effective refractory period, under conditions close to those of therapeutic practice, and so is likely to have predictive value.
Animals↗
Cerebellar morphology in chronic schizophrenic patients: a controlled computed tomography study.
Simple, objective, linear, and density measures were used to evaluate by computed tomography (CT) the cerebellum-fourth ventricular region of 23 chronic schizophrenic patients and 23 normal controls. Our data suggest that a subgroup of chronic schizophrenic patients have cerebellar atrophy associated with a strong but nonsignificant trend toward increased cerebellar density. The implications of these findings are discussed in view of previous CT and neuropathological studies.
Adult↗
Effects of pindolol on the heart rate in the conscious dog with chronic atrioventricular block and the distribution of blood mass in the anesthetized dog.
The intrinsic sympathomimetic activity (ISA) of the adrenergic beta-blocker pindolol was studied by comparing its effects with those of propranolol in two experimental models: In the non-anesthetized dog with atrio-ventricular block created at least two months previously, propranolol at 0.078, 0.156 and 0.312 mg/kg depressed idioventricular automaticity without affecting atrial rate. Pindolol at 0.5 mg/kg raised atrial rate but left idioventricular rate unchanged. Beta-blockers depress the ventricular adrenergic tone which is strong in this model. With pindolol, this effect is offset by its ISA. Two successive injections of Thallium-201 enable variations in blood mass distribution caused by an agent administered between them to be studied. Isoprenaline increased blood flow in heart and skeletal muscles at the expense of lungs and kidneys. Pindolol (0.1 and 0.2 mg/kg) did not modify coronary blood flow, but increased muscular blood flow.
Anesthesia, General↗
Central brain morphology in chronic schizophrenic patients: a controlled CT study.
A comprehensive quantitative computed tomography (CT) study of the diencephalic region of 23 chronic schizophrenic patients and 23 normal controls was done. The third ventricle width, the Sylvian fissure widths, and the densities of the head of the caudate nucleus, thalamic nucleus, and medial temporal lobe were measured. In the schizophrenic patients, there was a significant increase in third ventricle and Sylvian fissure widths and a significantly greater density of both periventricular nuclei. The several explanations for this atypical association of atrophy with greater density are discussed.
Adult↗
Long-term observation of atrial and ventricular rates in the unanesthetized dog with complete atrioventricular block.
The evolution of atrial and ventricular rates was studied in unanesthetized dogs with complete A-V block over a three-year period. During the first 40 days after A-V block, atrial rate far exceeded the sinus rate recorded before surgery, but had fallen progressively back to this level by the 41st day, and remained there until the end of the three-year period. Ventricular rate had settled down to a plateau by the 31st day. These findings explain certain differences among previously reported results, and have led us to use such animals for drug studies only after the beginning of the third month after creation of the complete A-V block.
Animals↗
Acebutolol, metoprolol and propranolol in conscious dogs with chronic heart-block: chronotropic effects and relation between depression of ventricular activity and beta-adrenoceptor blocking potency.
1 Atrial and ventricular chronotropic effects of acebutolol, metoprolol and propranolol were studied in conscious dogs with chronic heart-block. Ventricular beta-adrenoceptor blocking activity was assessed for the three dogs against isoprenaline (1 microgram/kg) under the same experimental conditions. 2 Acebutolol and metoprolol significantly increased atrial rate. The effect was proportional to the dose for acebutolol, independent for metoprolol. Propranolol had no significant effect on atrial rate. All three drugs significantly lowered ventricular rate in proportion to the dose. 3 Ventricular beta-blocking potencies of metoprolol and acebutolol were respectively 2 and 3 times weaker than that of propranolol as indicated by ED50 values. 4 The ventricular depressor effect observed was proportional to the degree of ventricular beta-blockade present, although this may not be the only factor involved.
Acebutolol↗