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Biomedical subjects

M Dahan

Publications and source records attributed to M Dahan.

123 records · Page 7Linked to original sources
PubMed1984

[Effects of molsidomine during the cold test in stable coronary insufficiency under beta-blocker treatment].

The heart rate, cardiac output, coronary sinus blood flow, systolic and end diastolic left ventricular pressures, femoral arterial pressure and coronary oxygen arterio-venous difference were measured in 12 patients with stable coronary artery disease without cardiac failure on long-term betablocker therapy, before and 45 minutes after 2 or 3 mg sublingual molsidomine. The measurements were repeated in 8 patients during a cold pressor test. Under basal conditions, molsidomine decreased the systolic and end diastolic left ventricular pressures, mean femoral arterial pressure, cardiac output and double product. The coronary oxygen arterio-venous difference was unchanged. Coronary sinus flow and myocardial oxygen consumption decreased. In the 2 patients who were given 3 mg molsidomine, a progressive reduction in systolic left ventricular pressure to 70% or less than its initial value, necessitated immediate treatment with volume expanders. During the cold pressor test before molsidomine the systolic and end diastolic left ventricular pressures, mean femoral arterial pressure and the double product increased. Coronary sinus flow was unchanged overall: it decreased in 6 patients, increased in 2 patients and remained the same in 1 patient. Coronary resistance increased in 6 patients and decreased in only one patient. During the cold pressor test after molsidomine there was a significant reduction in the increase of systolic left ventricular pressure, mean femoral artery pressure and double product. Coronary sinus blood flow increased in 5 patients and decreased in only one case. Coronary resistance decreased in half the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1984

[Results and prognostic factors in surgically treated thymoma. Apropos of a series of 194 cases].

The authors analyse a series of 194 thymomas (epithelial tumours of the thymus gland) which were operated over a period of about 25 years. The long term prognosis (70% 5 year survival and 60% 10 year survival) is examined in terms of the anatomo-surgical stage of the thymoma, the histological type of the tumour and the presence of associated auto-immune diseases. The authors recommend a more rigorous classification which takes into account both the anatomo-surgical and the histopathological findings so that the indications for post-operative mediastinal irradiation can be extended in a attempt to reduce the rate of distant recurrence of these tumours.

Autoimmune Diseases↗
PubMed1983

[Hemodynamic and coronary effects of molsidomine in patients with stable coronary insufficiency in the basal state, during an atrial stimulation test and a cold test].

The heart rate (HR), the cardiac output (Qc) and the coronary sinus flow rate (Qcs), the left ventricular systolic and end-diastolic pressures (LVSP, LVEDP), the femoral artery pressure (FAP) and the difference between the coronary arterial and coronary venous oxygen tension (DAVcO2) were measured in patients with stable coronary insufficiency without cardiac failure, before and 40 to 60 minutes after 2 or 3 mg of molsidomine (M). In 20 patients, these measurements were made in the basal state, in spontaneous rhythm (SP). In 8 of these patient, (including 3 receiving beta-blockers) the measurements were made during an atrial stimulation test (ST) and in 8 other patients, all receiving long-term beta-blocker therapy, the measurements were made during a cold test (CT). At the basal state in SR, a gradual reduction in the LVSP to 70% or less of its initial value was observed in the patients receiving 3 mg of M (2 of whom received beta-blocker treatment). The LVSP was immediately restored by vascular filling. In 16 patients, M decreased the LVSP, the LVEDP, the FAP, the Qc and the double product (DP = LVSP X HR). The DAVcO2 was unchanged. Qcs and MVO2 (MVO2 = Qcs X DAVcO2) were decreased. In the course of ST, the haemodynamic and coronary changes are similar to those seen in the basal state. During the Ct, the increase in the LVSP, FAP and DP was significantly reduced by M. The variations in Qcs and coronary resistance (FAP/Qcs) were also significantly different after M., with better metabolic regulation of the coronary circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Bacterial endocarditis in congenital heart diseases].

The following observations were made on a series of 15 cases of bacterial endocarditis on congenital cardiac lesions admitted between 1971 and 1980, in 13 patients aged 6 to 48 years old (average 21 yrs old): --The low but constant incidence of endocarditis--The majority of causal lesions were ventricular septal defects of Fallot's tetralogy--The portal of entry diagnosed in 2/3 of cases was usually dental--The causal organism was a streptococcus in 80% of cases--The long period of pyrexia before, the diagnosis of endocarditis was made--M mode, and above all, 2D echo detected vegetations in half the cases where it was performed--The gravity of the immediate prognosis due to a 25% mortality and a high incidence of complications--Early complications present in 2/3 of cases were dominated by true "oslerian" lesions, cardiac failure, cerebral complications, pulmonary embolism and early relapse. --The relatively good secondary prognosis.

Adolescent↗
PubMed1978

[Surgical treatment of funnel chest].

The main problems of indication, operating techniques and results are recalled after 39 cases of pectus excavatum (P.E.) operated on 74 followed up children. Analysis revealed frequent family trend, respiratory past records of Marfan's morphological type and intrathoracic spur. Sternochondroplasty had varied stabilizing ways : first Garnier's technique, then Judet's costal clips, today the mediastinal rod of Morel. The relative deterioration of morphological results depended on the reliability of the manner of fixing. For good results, neither age, sex, nor the importance of the retraction interfered. The unfavourable elements are the gently sloping thorax and associated vertebral manifestation.

Child↗
PubMedDate not supplied

[Postpneumonectomy thoracic empyema and dosimetric CT scan. Report of two cases and review of the literature].

Following a pneumonectomy for cancer, the patients are classically observed by clinical examination and standard chest X-ray. However, torpid empyemas can be missed when they occur after the period of hospitalization and when they are not accompanied by a fever. At the time of postoperative radiotherapy, the dosimetric CT scan constitutes the first examination providing objective information of the endothoracic content. It is therefore necessary on this occasion to assure the normality of the postpneumonectomy pleural space while checking that the substituted liquid is homogeneous and above all that the internal mediastinal part of the cavity has a concave appearance. If that is not the case, an empyema should be suspected. The diagnosis, confirmed by a cytobacteriological examination of the pleural fluid, constitutes a counterindication of the radiotherapy. We present two cases of postpneumonectomy paucisymptomatic empyema which were diagnosed during the course of postoperative radiotherapy when the initial dosimetric CT scan was pathologic and could have allowed an earlier diagnosis.

Diagnosis, Differential↗
PubMedDate not supplied

Reliability of serum magnesium values during diabetic ketoacidosis in children.

OBJECTIVE: To determine the prevalence of hypomagnesemia in diabetic children during diabetic ketoacidosis and following restitution of acid-base balance. METHODS: Eight consecutive diabetic children, ranging in age from 8 to 16 years, hospitalized in the pediatric intensive care unit with diabetic ketoacidosis from October 1st. through December 31st, 1995. A control group of 33 metabolically stable diabetic children, and a control group of 30 healthy children. Both control groups were similar in composition regarding age and sex to the study group. None of the patients in the study group and none of the controls had Magnesium supplementation given to them during the study period. MEASUREMENTS: Total serum Magnesium concentrations were measured from peripheral venous blood in all 71 patients. For the study group serum Magnesium was determined in a serial fashion: 1. upon admission in diabetic ketoacidosis 2. 24 hours after admission 3. 72 hours after admission RESULTS: The prevalence of hypomagnesemia was 62.4% in patients with diabetic ketoacidosis, (Group 1), 25% in patients after partial correction of ketoacidosis, (Group 2), and none in patients after resolution of ketoacidosis, (Group 3). The prevalence of hypomagnesemia was 6% for the chronic, metabolically stable diabetic control group, (Group 4), but 0% for the non-diabetic control group, (Group 5). Average serum Magnesium levels were significantly lower (p less than 0.05), in patients admitted in diabetic ketoacidosis compared to those of both the diabetic and the non-diabetic control groups. Also average serum Magnesium levels were significantly lower (p less than 0.05), in patients with corrected diabetic ketoacidosis than those of the healthy control group. But there were no significant differences (p = 0.59263) in average serum Magnesium levels between the diabetic control group and the diabetic patients after resolution of ketoacidosis. CONCLUSIONS: In this study the prevalence of hypomagnesemia was documented to be higher than the average described elsewhere for pediatric, adult, and coronary intensive care units. As hypomagnesemia is an indication of Magnesium depletion, we speculate that the transient hypomagnesemia detected in our study group is an expression of a state of Magnesium depletion that is masked by correction of acidosis and the Magnesium shifts associated with it. Consequently serum Magnesium values ought to be considered most reliable during and not after correction of diabetic ketoacidosis. Since Magnesium was not supplemented to any of our patients, the normalization of their serum values must be the result of: a. decreased glycosuria-related urinary losses b. cessation of acidosis-related urinary losses c. Magnesium shifts from intra to extracellular space The high prevalence of hypomagnesemia and the significant lower average serum Magnesium levels in children with diabetic ketoacidosis reveals the magnitude of the problem and the potential for Magnesium depletion that occurs in diabetic children.

Adolescent↗
PubMedDate not supplied

[Efficacy and tolerability of fraxiparine in the prevention of thromboembolic complications in oncologic thoracic surgery].

A French multicentre, open, randomized trial was conducted in lung cancer surgery in order to test the optimal dosage regimen: Fraxiparine 3075 IU AXa (fixed dosage) and Fraxiparine 4100 or 6150 IU AXa (dosage adjusted for body weight only), over a period of 8 days. 75 patients were allocated to each group. Efficacy (Doppler ultrasonography at D0 and D8, controlled by bilateral ascending phlebography when positive) and safety, i.e. perioperative blood loss and postoperative bleeding complications were the main assessment criteria. The efficacy of the two treatment regimens was confirmed = no deep vein thrombosis and/or pulmonary embolism. No significant difference of safety was observed between the two groups: nevertheless fewer patients developed major bleeding complications in the Fraxiparine fixed dosage group (2 patients) than in the Fraxiparine adjusted dosage group (6 patients). Blood loss was comparable in the 2 groups; a statistical difference (p = 0.09) was showed between D0 and D2 in favour of Fraxiparine fixed dosage group. The results of this trial indicate that Fraxiparine administered at fixed dosage represents an effective and safe prophylaxis against fatal thromboembolism in patients undergoing oncologic thoracic surgery.

Anticoagulants↗