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Biomedical subjects

M Gallet

Publications and source records attributed to M Gallet.

At least 19 recordsLinked to original sources
PubMed1992

[A case report of Russel's diencephalic cachexia].

The case of an infant admitted for evaluation of severe emaciation with intermittent ocular anomalies including strabismus and nystagmus is reported. This case demonstrates the value of magnetic resonance imaging and transfontanellar ultrasonography for the diagnosis of diencephalic syndrome of infancy. The prognosis of this condition is usually grim, in particular because of the severe emaciation which is disproportionate with the tumour spread. Pathophysiologic hypotheses put forward to explain this cachexia are reviewed. Although cytokines such as TNF alpha are currently incriminated in the pathophysiology of cachexia induced by a number of conditions, they have not yet been studied in diencephalic syndrome of infancy. TNF alpha is a potent lipolytic agent. Excessive production of TNF alpha may be involved in the genesis of the emaciation characteristic of diencephalic syndrome. Inappropriate production of TNF alpha may respond to the administration of specific anti-TNF monoclonal antibodies. This approach may be considered as a means for treating emaciation in patients with diencephalic syndrome of infancy.

Astrocytoma↗
PubMed1991

Comparison of response rates to the angiotensin-converting enzyme inhibitor ramipril in mild-to-moderate hypertension in a double-blind, parallel-group study and an open single-blind study.

Appropriate clinical trial methodologies in general practice and suitable end points for dose-finding studies are discussed with reference to antihypertensive drugs in general and angiotensin-converting enzyme (ACE) inhibitors in particular. Two clinical studies were conducted with ramipril, a new nonsulfhydryl ACE inhibitor, to identify the minimum effective dose for the management of mild-to-moderate hypertension. Study 1 was a double-blind, parallel-group, randomized design with three treatment groups (placebo and 2.5 and 5 mg of ramipril), and study 2 was an open, single-blind design with individual dose titration from 2.5 to 5 mg of ramipril if the diastolic blood pressure (DBP) was greater than 90 mm Hg after 3 weeks. Response rates and DBP reductions with 2.5 mg of ramipril were similar in both studies, although overall response rates, DBP reductions, and side effect incidence appeared to be greater in the open, single-blind, dose-titration study. It is concluded that study methodology apparently influences efficacy and tolerability.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1991

[Value of a new fast CK-MB determination for the diagnosis of myocardial infarction during the 1st hours. Preliminary study].

This study evaluated the time for a new, rapid and reliable CK-MB analysis to become positive in myocardial infarction and compared it with classical total CK analyses. Serial analyses of total CK and CK-MB were performed in 49 consecutive patients referred to the Coronary Care Unit for suspected acute myocardial infarction. Twenty of these patients had myocardial infarction with rising enzyme levels, which enabled comparison of the precocity of one analysis compared to another. In these patients, the CK-MB analysis became positive on average 85 to 110 minutes before that of total CK. This result shows that CK-MB analysis can be a diagnostic sign of acute myocardial infarction at an earlier stage than the total CK analysis. The authors discuss the clinical value of this test in difficult indications of fibrinolytic therapy and underline that it enables a more objective assessment of the time of onset of necrosis than clinical data alone.

Creatine Kinase↗
PubMed1990

Private hospital and phase I.

Since December 1988. French law has authorized phase I studies and the creation of phase I units within public or private hospitals. The scientific standards regarding private hospitals are not different from those in public hospitals. Practitioners who conduct clinical trials in private hospitals are well aware of good clinical practices and methodological constraints. Phase I units can be structured in private as well as within public hospitals. Finally, the question to be addressed is whether clinical pharmacology and scientific investigations in healthy volunteers should be integrated in the policy of private hospitals.

Drug Evaluation↗
PubMed1988

Coronary-to-bronchial artery anastomosis complicated with myocardial infarction.

A patient with bronchiectasis had an inferolateral myocardial infarction. Coronary arteriography revealed a large anastomosis from the left circumflex artery to the left lower lobe bronchial arteries. The relationship between the patient's myocardial infarction and possible "coronary steal" is discussed.

Bronchial Arteries↗
PubMed1988

[Value of transcutaneous blood gas monitoring in fiberoptic bronchoscopy in intensive care patients].

Transcutaneous carbon dioxide and oxygen tensions (PtcCO2 and PtcO2) were monitored in seven critically ill patients under mechanical ventilation during fiberoptic bronchoscopy. In these conditions, both PtcO2 and PaO2 and PtcCO2 and PaCO2 correlated, with correlation coefficients of 0.964 and 0.793 respectively. Fiberoptic bronchoscopy induced an average fall in PtcO2 of 42 +/- 2.57 mmHg and an average increase in PtcCO2 of 12.1 +/- 1.89 mmHg; these two parameters returned quickly to their initial values after the procedure. Holter monitoring showed an arrhythmia in five of the seven patients. Continuous measurement of PtcO2 and PtcCO2 was a safe and reliable method for monitoring mechanically ventilated patients undergoing fiberoptic bronchoscopy.

Aged↗
PubMed1988

Percutaneous transvenous caval interruption with the "LGM" filter: early results of a multicenter trial.

From September 1985 to December 1986, 100 patients undergoing percutaneous placement of a transvenous "LGM" caval filter were included in a multicenter prospective trial. Peripheral venograms completed by pulmonary arteriography or scintigraphy were obtained for all patients. Eighty-five patients had experienced pulmonary embolism, 59 had iliocaval thrombosis, while 40 had venous thrombosis confined to the lower limbs. In two instances, insertion or passage of the catheter was impossible. Ninety-eight "LGM" filters were placed percutaneously through the internal jugular vein, 82 of which were correctly positioned in the infrarenal inferior vena cava. Eight filters were positioned with a tilt of more than 15 degrees with respect to the vertical axis, five failed to open correctly, and three were incompletely open and tilted. No postoperative deaths were observed; there were two recurrent embolisms, and seven caval thromboses occurred during the year that followed insertion of the filter. The "user-friendliness" and efficacy of this percutaneous filter makes it a treatment of choice in the partial interruption of the inferior vena cava.

Aged↗
PubMed1986

[Clinical effectiveness of trimetazidine in stable effort angina. A double-blind versus placebo controlled study].

The antianginal activity of trimetazidine was evaluated in a double-blind, multicentric, drug-versus-placebo study. The 32 male patients who entered the study (mean age 59.5 years) were suffering from stable angina pectoris. The stability of angina was tested by two exercise tests performed at the beginning and at the end of a two-week preselection period with placebo. The patients received 3 tablets daily of either trimetazidine (20 mg per tablet) or placebo for one month. At the end of treatment, they underwent a third exercise test. A Mann and Whitney test, used to compare the result of pre- and post-treatment exercise tests, showed a statistically significant improvement with trimetazidine as compared with the placebo for the following parameters: total work went from 4.200 +/- 372 to 5.620 +/- 387 kpm with trimetazidine and from 4.191 +/- 399 to 4.564 +/- 431 kpm with the placebo (P = 0.012); duration of exercise from 10.2 +/- 0.5 to 12.1 +/- 0.5 min with trimetazidine and from 10.2 +/- 0.5 to 10.7 +/- 0.5 min with the placebo (P = 0.016); time to 1 mm ST segment depression from 8.3 +/- 0.6 to 9.8 +/- 0.5 min with trimetazidine and from 8.4 +/- 0.5 to 9 +/- 0.7 min with the placebo (P = 0.034). These results showed that the ischaemic threshold receded with trimetazidine, while the peripheral haemodynamic parameters were not significantly changed, either at rest or during exercise. Thus, trimetazidine does not act through a chronotropic or vasodilator mechanism but through cellular regulation mechanism.

Adult↗
PubMed1986

[Current concepts in cellular ischemia: role of trimetazidine].

Comparative clinical trials have already enabled to appreciate the clinical efficacy of trimetazidine (TMZ) during chronic coronary angina. Two recent controlled studies have been done in patients with chronic stable angina, and conducted in double blind versus placebo, with randomized assignment of the treatments. They showed that TMZ administered either in a single dose (60 mg), or for one month at a daily dose of 60 mg, enabled on the one hand an improvement of the stress ability: increase of the total work (respectively 31 and 38 per cent), and of the duration of the stress (17 per cent in an average), and on the other hand, the recession of the myocardial ischemic threshold: increase in the time of appearance of a 1 mm sub-shift of ST (respectively 7 and 17 per cent). The absence of alteration, in each of the placebo and trimetazidine groups, of the cardiac frequency and systolic arterial blood pressure at rest and the double product on exertion, suggested a different mechanism of action from the usual anti-angina medications. Many experimental works have been able to show that trimetazidine has an intra-cellular "anti-ischemic" activity and a cardioprotective effect which would be present during ischemic phases. The anti-ischemic activity would counteract the harmful effects of hypoxia by maintaining cellular energetic reserves, and by decreasing the deadly membrane effects of the free radicals, particularly passive permeability to potassium. In the same experimental conditions of ischemia, the cardioprotective effect is demonstrated by the decrease of the creatine kinase leakage and the upholding or the rapid recovery of the myocardial electric activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1986

Antihypertensive effects of tertatolol: 3-month comparative study against acebutolol.

Thirty-two hypertensive patients (mean age 52.9 +/- 1.7 years) with a supine diastolic blood pressure (DBP) between 95 and 130 mm Hg (mean 104.3 +/- 0.8) received, following a randomized allocation, either tertatolol 5 mg (n = 16) or acebutolol 400 mg (n = 16) in a single daily dose. The 2 drugs were administered during a 3-month treatment period (from day 0 to day 90) in a single-blind fashion. At rest (n = 32), the decrease of supine systolic blood pressure (SBP) reached 27.3 mm Hg after 1 month of tertatolol treatment (from day 0 to day 30; p less than 0.01); there was a further decrease of 5.1 mm Hg from day 30 (D30) to day 90 (D90) (NS). The corresponding decreases after acebutolol treatment reached respectively 22.3 mm Hg (p less than 0.01) and 5.7 mm Hg (p less than 0.05). Similar results were observed in the upright position. The decrease of supine DBP reached 14.0 mm Hg in patients treated with tertatolol from D0 to D30 (p less than 0.01); a further decrease of 2.9 mm Hg occurred from D30 to D90 (NS). The corresponding decreases in patients administered acebutolol reached respectively 7.6 mm Hg (p less than 0.01) and 5.2 mm Hg (p less than 0.01). Similar results were observed in the upright position. On submaximal exercise (ergometric bicycle; n = 18), the decrease of SBP reached respectively 31.3 mm Hg during tertatolol treatment from D0 to D30 (p less than 0.01) and 8.8 mm Hg from D30 to D90 (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Acebutolol↗
PubMed1986

[Diltiazem and digoxin interaction. Development of digoxin plasma levels and electrocardiographic parameters in healthy subjects].

In order to determine the interaction between diltiazem and digoxin, plasma digoxin concentrations and the principal ECG parameters (24 hour Holter monitoring) were measured in 10 healthy volunteers under basal conditions (P0), with 0.375 mg/day of digoxin (P1 = 17 days), during association with 240 mg/day of diltiazem (P2 = 17 days) and then again on digoxin alone (P3 = 10 days). The addition of diltiazem was associated with a 20.4% rise in plasma digoxin concentrations (0.59 ng/ml vs 0.49 ng.ml). There was no significant variation of plasma digoxin after withdrawal of diltiazem; in some cases it remained unchanged, in others it fell or continued to rise. During the administration of digoxin and diltiazem, the mean RR period and the duration of the maximal pauses increased (p less than 0.05); the RR interval also increased (p less than 0.01) but the mean QRS duration and the QTc interval did not change significantly with respect to their values on digoxin alone. After withdrawal of diltiazem, the PR interval was the only parameter to decrease significantly (p less than 0.05). These results suggest that patients receiving this drug association should be followed up carefully.

Adult↗
PubMed1979

[Prevention and treatment of urinary infection in patients with an indwelling catheter: continuous vesical irrigation with a mixed antibiotic solution of neomycin and polymyxin B].

A method of continuous lavage of the bladder using a solution containing a mixture of Neomycine and Polymyxine-B was tried out in 32 patients with indwelling urinary catheters. To do this, a three-channel catheter was used, lubricated with an antibacterial cream and connected to a plastic container which could be emptied without removing the catheter. This method of treatment, which was effective, well tolerated and simple to use, would appear to be a useful addition to the prevention and treatment of urinary infections in patients with in-dwelling catheters.

Adolescent↗