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Biomedical subjects

M Cara

Publications and source records attributed to M Cara.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Transurethral resection of the prostate (turp syndrome), myth or reality? Analytic studies using a radioactive isotope method (author's transl)].

It is accepted that the laboratory and clinical so-called "transurethral resection syndrome" reflects passage into the body of a large fraction of the water used to perfuse the field of endoscopic resection. The major complete syndrome (dyspnoea, nausea, hypertension, raised central venous pressure, bradycardia then pulmonary oedema, cerebral oedema, cardiovascular shock and renal insufficiency) is rare: 1.5 per cent of cases of transurethral resection of the prostate in the literature, 0.6% in a series of the last 300 resections performed by the authors (2/300). Also was it not possible to hope for a complete physiological study of sufferers from this complication. Nevertheless, it may be considered that all transurethral resections of the prostate may be associated with similar movements of water to a minimal extent. In order to attempt to demonstrate this, the authors studied in a series of 19 patients pre- and postoperative blood volumes by a radio-immunological technique using pre- and postoperative serum albumin haematocrits. In this short series, patients who had undergone a short endoscopic resection (35 minutes on average) of a small adenoma (13 grams on average) with a mean irrigation of 10 litres of water rendered isotonic by the addition of glycocolle, without any transfusion or infusion being necessary during the course of the resection, the conclusion was simple: no variation in blood volume was demonstrated. Is the physiopathological hypothesis advanced to explain this phenomenon false? And is the problem in fact one of peroperative septicaemia?

Adenoma↗
PubMed1980

[Testing of medical devices (author's transl)].

The French regulation of medical devices is already old. it gradually begins since 1940 firstly for the need of safety in radiology. In 1952, an Interministerial Commission (Health, Welfare, Defense, Interior, etc.) was instituted for the medical devices approval: the anaesthesiological devices were examinated since 1956. But this regulation is weak because there is no effective penalty. Nevertheless it is efficient: it had allowed the collection of important documents especially in the fields of radiology, anaesthesiology and intensive care, and recently in hemodialysis. During the last ten years all medical devices in this fields were examinated by the French essay laboratories and their performances were registraded. If the compliance of a device is not effective the approval is not gived. For anaesthesiological and intensive care devices, the approval is give, after clinical testing, only for five years. This approval is not renewed if there are complaints about the device during this time. But medical devices are not easy to define and to test. The best definition seems the American one: "There is a new definition of "device". In broad terms, a device is a health-care product that does not achieve any of its principal intended purposes by chemical action within or on the body or by being metabolized. There is specific recognition that a device may diagnose "conditions" that are not necessarily "diseases" (Medical device Amendment, 1976)." The french regulation is of course not perfect: we suffer of a lack of a law on medical device thus this regulation is appliable only if the public health is envolved. Nevertheless a rather good protection of the patients is assured and the efficiency is gradually better as the international exchanges give technical and clinical informations.

Anesthesiology↗
PubMed1979

[Accidents and complications during aorto-coronary bypass surgery. 100 cases].

Using a series of 100 patients undergoing aorto-coronary bypass surgery in the department of Professor MATHEY at Laennec Hospital, the authors analyse the incidence of accidents and complications during the per- and postoperative phases. Acute hypertensive crises accounted for the most common complication, occurring in 49 per cent of cases. The authors attribute these hypertensive crises to inadequate neuroplegia in the anaesthetic protocol. Other complications are analysed in relation to the type of myocardial protection.

Adult↗
PubMed1979

[Prevention of complications following aorto-coronary bypass surgery. Proposed solutions].

In the light of per- and post-operative complications seen in the past, the most suitable anaesthetic protocol for aorto-coronary bypass surgery would appear to be neuroleptanalgesia. This anaesthetic technique appears to decrease the incidence of per- and postoperative hypertensive crises. In addition, the use of cardioplegia also made it possible to decrease the incidence of postoperative complications in a recent group of 39 patients.

Coronary Artery Bypass↗
PubMed1979

[Electrical risks and safety during the monitoring (author's transl)].

The different sorts of medical equipment, whose number is constantly increasing in the last few years in the patients environment, entail several kinds of risk for patients, users and surroundings. The authors give a few examples of these risks, which may occur in particular during the monitoring of physiological parameters and urge the people concerned to observe, in their own interest, the very strict safety rules imposed by the new I.S.O. (International Organization for Standardization) and I.E.C. (International Electrotechnical Commission) international standards. These standards, already made known through official publications, or as intended to replace national standards, which are often out of date in comparison to the evolution of medical technology. It is regretable that some people responsible for medical research have not attached sufficient importance to the safety problems of equipment used in medical practice.

Burns, Electric↗
PubMed1977

[Technics of anesthesia and hypothermia for the infant. Choice of replacement fluid for the circuit].

Sixty-five infants were submitted to complete repairment of a congenital cardiopathy under profound hypothermia and ECC. Description of the preparation of the young surgical patient, of the anesthesia, of the technique of ECC. The overall mortality was 35.5 p. 100. The hypothermia induced by ECC, does not introduce any supplementary risks as long as strict technical rules are respected.

Anesthesia↗
PubMed1976

[Anesthesia for resections-anastomoses of the trachea and the tracheal bifurcation].

Resection and anastomosis of the trachea or the tracheal bifurcation, raises numerous problems, which will be discussed in a series of 81 patients: -there is more or less marked ventilatory insufficiency related to the degree of the stenosis, and difficulties of expectoration responsible for retention of sputum; -per-operative ventilation. One must choose between an intubation catheter of small caliber in order to overcome the stenosis, or a large catheter to remain above it. The problem is all the more delicate to solve when the stenosis is tighter and higher; -during the period when the trachea is open, the surgeon must intubate the central part of the trachea with a sterile catheter. If the division is low, it is necessary to intubate the main bronchi or one only, and then create a marked shunt effect which would be ill-supported by the patient; -It is advisable to remove the catheter at the end of the operation. Awakening should be perfect in order to cough to be immediately efficacious in a patient who often has to remain with his head flexed forwards.

Adolescent↗
PubMed1975

Essay of any ventilators by means of a pulmonary model with adjustable resistance, compliance and vital capacity.

After a critical study of classic lung models, showing that linear resistances are not faithful nor justified and that pneumotachograph is not a good measuring apparatus because of its inaccuracy (it changes calibration according to the nature of gas mixture and needs integration to determine volumes), authors present their own lung "model". In this model, it is possible to adjust resistance, compliance, vital capacity and residual volume. Parabolic resistances are used, because they more approach physiologic ones. Building of resistances (diaphragms), compliances (rigid tanks with adjustable elements), vital capacity (elastic membrane between two grills) is simple to realise and easy to reproduce. Measures of pressure and volume are given directly by gauges and are insensitive to gas nature, which is important in respiratory physiology. Flow-rates are deducted from volume values. The lung model can be used in a twin-cell shape to show the effects of artificial ventilation in case of pulmonary asymmetry. Examples given underline the interest of having a model with resistances easy to build and an adjustable vital capacity.

Airway Resistance↗