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Biomedical subjects

M Cassin

Publications and source records attributed to M Cassin.

30 records · Page 2Linked to original sources
PubMed1992

[The multiple coronary spasm as the cause of acute ischemic events. A case report of a simultaneous spasm of the anterior descending and the circumflex during coronary angiography].

A case of simultaneous coronary artery spasm during coronary arteriography is reported. The patient, a 48-year-old male smoker, with an important family history of sudden death, underwent coronary angiography 5 months after anterior myocardial infarction. There were no lesions in the coronary arteries at the angiographic study. At the end of the procedure there was a sudden contemporary spasm of the anterior descending and circumflex coronary arteries. This severe condition was resolved with intra-arterial nitroglycerin. The relevance of multicoronary spasm as a cause of acute ischemic events and the possible influence of family history are discussed.

Acute Disease↗
PubMed1991

Combined therapy for Sézary syndrome with extracorporeal photochemotherapy and low-dose interferon alfa therapy. Clinical, molecular, and immunologic observations.

Extracorporeal photochemotherapy is a well-tolerated treatment of palliative benefit for patients with the Sézary syndrome, but up to 25% of patients do not respond to this form of therapy. Interferon alfa is a glycoprotein with immunomodulatory properties that is also an active agent in the treatment of Sézary syndrome; however, dose-related toxic effects often limit its long-term use. A patient with rapidly advancing Sézary syndrome was treated with a combination of extracorporeal photochemotherapy and low doses of subcutaneous interferon alfa-2b. In addition to the almost complete clearing of his skin lesions and the marked diminution of his extensive lymphadenopathy after 16 weeks of combined therapy, disappearance of the malignant T-cell clone from the peripheral blood was documented by Southern blot analysis. Normalization of the peripheral blood lymphocyte phenotypic profile and an increase in natural killer cell activity were also observed. The excellent clinical response to combined therapy has been sustained, without adverse effects, during 18 months of treatment and 22 months of continued follow-up. The long-term disappearance of the malignant clone from the blood of a patient with Sézary syndrome in response to therapy has not been previously described and thus represents a novel observation. Extracorporeal photochemotherapy and low-dose interferon alfa are well-tolerated therapies that, when combined, may have additive efficacy in the treatment of Sézary syndrome. These results suggest that further exploration of this therapeutic combination is warranted.

Combined Modality Therapy↗
PubMed1989

[ST segment elevation after elective electric cardioversion].

From a group of 142 patient with atrial fibrillation or atrial flutter treated with DC shock, we selected 5 cases who showed a marked ST segment elevation immediately after electrical cardioversion. Only two patients, who received high voltage DC shock (950 and 1220 Joules) revealed prolonged and significant increase of CPK values. Our data suggest that ST segment transitory elevation after DC shock should probably not be considered a sign of myocardial injury even though this could be the case when high voltage DC shocks are used.

Adult↗
PubMed1989

[Postoperative pseudoaneurysm of the ascending aorta. Report of a case].

Pseudoaneurysm of the ascending aorta is a rare complication after cardiac surgical procedures. This report illustrates a case of postsurgical pseudoaneurysm of the ascending aorta with ischemic clinical episodes due to compression of the right coronary artery. The patient underwent aortic and mitral valve replacement 6 years previously. The usefulness of echocardiography, computerized axial tomography and angiography is emphasized.

Aortic Diseases↗
PubMed1987

[Equilibrium angioscintigraphic evaluation of sequential changes in right ventricle function in patients with lower myocardial infarct and ischemic co-involvement of the right ventricle: long-term study].

The purpose of this study was to define the sequential changes in global and regional right ventricular function, using equilibrium gated radionuclide angiography, following transmural inferior myocardial infarction (IMI) and associated ischemic right ventricular involvement. 24 patients with IMI underwent radionuclide angiography within 72 hours of onset of chest pain; subsequent studies were done at 13 +/- 5 days and at 6 +/- 2 months. Scintigraphic evidence of ischemic right ventricular involvement was defined by depression of right ventricular ejection fraction (less than 40%) and regional wall motion abnormalities (hypo-a-dyskinesia of right ventricular free wall). Significant improvement of global right ventricular ejection fraction was observed in 15 patients at the second study, and in 21 patients at the third study. Right ventricular regional wall motion showed similar improvement from the initial to the final studies. Significant changes in right ventricular function occurred without concurrent changes in global and regional left ventricular ejection fraction. We concluded that patients with IMI and ischemic right ventricular involvement show frequently improvement of global and regional right ventricular function over time. This changes tend to occur early and without significant modifications in left ventricular function. The good prognosis observed in our patients, despite the high incidence of in hospital complications, might be related to the improvement of right ventricular function.

Adult↗
PubMed1987

[Fibrinolysis and hemorrhage after streptokinase in acute myocardial infarct].

The purpose of this study is to analyze the relationship between occurrence of hemorrhagic complications, kinetic of fibrinogen degradation-regeneration and the changes of prothrombin time (PT), partial thromboplastin time (PTT), after intravenous administration of Streptokinase (SK), 1.500.000 U., in acute myocardial infarction. 45 selected patients with acute myocardial infarction had pretreatment analysis and serial post-SK measurement of fibrinogen levels, PT, PTT (for 48 hours). Basal fibrinogen levels were 3.2 g/l and displayed significant depression for 18 hours (0.30-0.46 g/l) and normalization after 30 hours from SK infusion. Similar behaviour showed PT and PTT. Minor bleeding was identified in 25 patients. In bleeders mean fibrinogen levels, PT, PTT before and maximum changes after SK were not significantly different compared with non bleeders. We conclude that SK infusion produces important and prolonged changes of fibrinogen levels, PT, PTT; hemorrhagic risk is not related, however, to the extent of lytic state, but probably to pre-existent vascular derangement, predisposing to bleeding complications during fibrinolytic therapy. Therefore we believe to be prudent to delay the infusion of heparin for 12-18 hours after SK administration, when fibrinogen levels are beginning to increase.

Female↗
PubMed1986

[High prevalence of 2d and 3d grade atrioventricular block in patients with acute myocardial infarct and right ventricular ischemic involvement].

43 consecutive patients with acute inferior myocardial infarction (IMI) were evaluated with 12-lead electrocardiogram plus four additional right precordial lead V3R, V4R, V5R, V6R and equilibrium gated radionuclide angiography (EGRA) to detect ischemic right ventricular involvement. All patients were continuously monitored on the average 6 days; 11 of 43 patients had an episode of second or third degree atrioventricular block. Ischemic right ventricular involvement was diagnosed by electrocardiographic criteria in 60%, and by scintigraphic criteria in 70% of 43 patients with IMI. Utilization of electrocardiogram and EGRA for diagnosis of right ventricular involvement permit us to identify a subgroup of patients with IMI at high risk of developing second or third atrioventricular block (38% with ecg criteria and 33% with radionuclide criteria respectively) as regards those without right ventricular involvement (6% and 8%).

Adult↗
PubMed1985

[Isolated right ventricular infarct. Description of a case].

We report a case of extensive isolated right ventricular infarction, which was the result of proximal occlusion of a small right coronary artery in a dominant left coronary arterial system. The diagnosis and treatment of right ventricular infarction are discussed and the literature is reviewed.

Echocardiography↗
PubMed1983

[Hemodynamic effects of the acute administration of captopril in refractory chronic congestive heart failure. Study of 13 patients and review of the literature].

We examined the acute hemodynamic response to Captopril, an oral converting enzyme inhibitor, in 13 patients with chronic congestive heart failure (CHF) refractory to conventional therapy, including other vasodilators. Captopril was administered in four increasing doses of 25, 50, 100 and 150 mg. The cardiac index (Cl) increased significantly (average +22%) in patients with high plasma renin activity (PRA). Pulmonary artery diastolic pressure (PADP) considerably decreased in all patients. A moderate decrease in systemic arterial pressure (SAP) was also observed. The heart rate (HR) did not change. Peak effect occurred 90 minutes after administration for the Cl, 30 to 120 minutes for PADP and SAP. The drug was well tolerated. This study confirms the acute beneficial hemodynamic effects of Captopril in patients with CHF refractory to conventional therapy. The possible mechanisms are discussed and the literature is reviewed.

Blood Pressure↗