Biomedical subjects
Publications and source records attributed to M Conte.
The obstetric pathology of North African women, which used to be fairly different from that of French women, is now tending to resemble that of the French population, as the customs of the immigrants tend to coincide with those of the local population, especially in the context of information and antenatal care.
On the basis of a series of 220 operated cases of genital prolapse, the authors describe the complications and classify the various elementary components of the prolapse (120 complete prolapses) and the associated lesions. The operative techniques are classified by category and the results are presented with a follow-up of two and three years. This homogeneous series demonstrates that the vaginal techniques are generally more effective.
Two series of trials of labour are compared: the first series without any particular analgesia and the second under epidural analgesia. The caesarian rate was significantly less in the second series because the trial of labour was able to be pursued for a longer period of time without any danger to the foetus. The authors consider that, provided cases of mechanical dystocia and maternal agitation are eliminated, trial of labour under epidural anaesthesia can result in a real cephalopelvic engagement.
Although urticaria is usually held to be a type 1 hypersensitivity reaction, it may also be the cutaneous manifestation of vasculitis mediated by immune complexes. In this study of 35 patients with chronic urticaria, the authors attempted to specify the prevalence of vasculitis and its possible correlations with particular clinical and/or immunological findings. In 10 cases, lymphocyte subpopulations were also studied, using monoclonal antibodies. Patients included 21 women and 14 men, aged 19 to 80. In each patient: a) systemic signs were looked for by history taking and physical examination; b) a skin biopsy was examined by optic microscopy and direct immunofluorescence; c) the following biological investigations were done: blood count, sedimentation rate, protein electrophoresis and immunoelectrophoresis, IgE, B virus markers, circulating immune complexes, anti-nuclei and anti-ADN antibodies, latex and Waaler-Rose tests, total complement, C3, C4, and C1 esterase inhibitor. Visceral involvement and various immunological disorders are most common in those patients with leukoclastic (n = 7) or mononuclear (n = 9) vasculitis. These patients, as well as those recently studied in the literature, have idiopathic chronic urticaria, the least severe of urticarial vasculitis.
The therapeutical effectiveness of L 105, a new drug preparation exhibiting antidiarrhoeal activity and containing Rifaxidin, was tested on 22 patients with acute gastroenteric syndrome of bacterial aetiology. In all patients there was a prompt restoration of intestinal function by the 2nd treatment day. Both local and systemic drug tolerance proved to be good in all cases.
Increased concentration of red blood cell 2,3-diphosphoglycerate (RBC 2,3-DPG) shifts the hemoglobin-oxygen dissociation curve to the right, thus theoretically allowing better oxygenation of tissues. To determine whether such a shift is physiologically significant, we investigated the effects of oral phosphate loading on several parameters including plasma phosphate concentration, RBC 2,3-DPG, hematocrit and hemoglobin concentration, maximal oxygen uptake (VO2max), and degree of lactic acidemia in 10 well-trained distance runners. After control determinations were made, either a phosphate load or a placebo was given for 3 d before the athlete was restudied. A placebo and two phosphate-loading studies were performed at weekly intervals, followed by 2 wk of rest and another post-intervention control study. Blood samples for control values were drawn before and after a standard warm-up period, after treadmill exercise at a 10% grade, and at the completion of the VO2 determination. After oral phosphate loading there was a significant increase in serum phosphate and RBC 2,3-DPG. Maximal oxygen uptake was significantly increased and correlated with the rise in RBC 2,3-DPG (r = 0.81). The increase in blood lactate after exercise on the 10% grade was attenuated during sessions which followed phosphate loading.
Irregular menstrual cycles are fairly common in drug-addicted patients. The purpose of this research is to stablish the connection between the administration of a narcotic and the onset of amenorrhoea. After a review of the literature and aetiopathogenetic hypotheses regarding ovulatory block, 39 heroin- or morphine-addicted patients personally observed during pregnancy are studied. Even relatively low doses of narcotics can impair normal ovarian function and ovulation so there is a risk that menstrual irregularities can arise even when doses are reduced.
Whatever surgical procedure is adopted in Dupuytren's contracture, it demands the utmost finesse and delicacy of technique. Even so, the functional and cosmetic results are often equivocal, but in our view Skoog's technique offers the most practical and effective method of treatment. It offers the following advantages: Duration of operation: In a case of moderate severity affecting only 2 digits the operation can be completed in 30-40 minutes. The surgical trauma is minimal and post-operative complications are therefore minimal. Recovery of function is rapid and there is complete absence of the disturbances associated with prolonged immobilisation. The relapse rate is minimal and certainly no greater than that associated with more radical techniques. The only disadvantage, if it can be so considered, is that the surgeon must be perfectly familiar with the detailed anatomy of the palm and fingers. Since the method does not involve the more extensive exposure and display of all the structures, as in other methods, it is easier in the absence of such knowledge to do accidental damage.
Second-degree intra-His bundle block is frequently of type I (Wenckebach periods) or 2:1. In this situation, the surface electrocardiogram does not permit distinction between intranodal (atrioventricular [A-V] and subnodal (intra-His) block. This study examined the value of bedside carotid sinus massage and atropine administration in diagnosing the site of block from the standard electrocardiogram in subjects with chronic A-V block and narrow QRS complexes. Fifteen patients had intra-His bundle block and 10 had intranodal block. The combination of two tests correctly located the site of block in 22 subjects, and was noncontributory in 3. Thirteen of the 15 intra-His bundle blocks and 9 of the 10 intranodal blocks were properly identified; in three cases the results were nondiagnostic, but no wrong diagnoses were made. The noninvasive bedside method of carotid sinus massage and the use of atropine permit both the localization and the determination of the type of block in the majority of cases of second degree A-V block and narrow QRS complexes. In a proper clinical context they can obviate the need for invasive electrophysiologic studies.
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In 5 patients, haemolysis was intrasplenic. Red cell deformity could be acquired by foreign red cells transfused into the patient. Association of the two abnormalities (acanthocytosis and glutathion peroxydase deficiency) was necessary for the onset of haemolysis. They progressed in parallel and varied in relation with the severity of the hepatic disease. The relationship between these two abnormalities is unknown but would appear to be dependent upon a factor of hepatic origin.
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