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Biomedical subjects

M Massin

Publications and source records attributed to M Massin.

At least 37 records · Page 2Linked to original sources

[Diagnosis and treatment of vasovagal syncope in the child and adolescent].

Recurrent unexplained syncope is a common and often frustrating clinical problem in paediatrics. Over the last decade, head upright tilt table testing has emerged as an important diagnostic method for the identification of patients whose syncope is likely to be neurocardiogenic in origin. At the same time, tilt table testing, by providing syncopal episodes in a controlled setting, has allowed for a greater understanding of their physiopathology. Treatment strategies remain controversial but beta-blocker therapy appears to be very efficient.

Adolescent↗

[Development of double-chambered right ventricle after surgical closure of a ventricular septal defect].

UNLABELLED: The double-chambered right ventricle (DCRV) is a rare cardiac malformation, often associated with ventricular septal defect (VSD). CASE REPORT: The authors describe a case of DCRV in a child who underwent surgical repair of perimembranous VSD at the age of 7 months because of systemic pulmonary artery hypertension and growth retardation. At this time, no pressure gradient was measured within the right ventricle and no muscle proliferation was observed on echocardiography or right ventriculography. Postoperative follow-up revealed hypertrophy of the moderator band accompanied by progressive development of a right midventricular pressure gradient, which reached 60 mm Hg at the age of 3 1/2 years. The child was operated after invasive confirmation of the diagnosis of DCRV and the haemodynamic data. The child is now 6 years old and no restenosis has been observed. CONCLUSION: DCRV is usually associated with VSD, but the course of the two diseases can be dissociated. The diagnosis of DCRV must be considered in any child with a history of VSD, even after surgical or spontaneous closure, when clinical examination reveals a systolic ejection murmur.

Abnormalities, Multiple↗

Counter-current aortography for aortic coarctation.

We describe a 1-month-old infant who developed a cardiogenic shock. Echocardiography suspected an aortic coarctation. Left brachial artery counter-current aortography gave safe and adequate imaging of the aortic coarctation. We see many advantages to this approach: (1) most complications associated with classical cardiac catheterization are significantly reduced, (2) adequate imaging of coarctation, anatomy of the aortic arch and eventually collateral circulation is obtained, (3) the volume of contrast is reduced, (3) increased risk of femoral artery injury is avoided, (4) the procedure lasts only a few minutes, and (5) no sedation is needed. We conclude that left brachial artery counter-current aortography is a safe, quick and relatively non-invasive procedure which can be used in infants in whom clinical, cross-sectional, and Doppler echocardiographic findings are suggestive but not conclusive of anomalies of the aortic arch, especially when magnetic resonance imaging is not available or cannot be performed safely because the infant is critically ill.

Aortic Coarctation↗

Nosology of lysosomal glycogen storage diseases without in vitro acid maltase deficiency. Delineation of a neonatal form.

We describe a boy with an early lethal hypertrophic vacuolar cardiomyopathy of neonatal onset. Abnormal intra- and extralysosomal glycogen storage disease was demonstrated in heart and skeletal muscles. Glycogen content was twice the normal in muscles and over 3-fold the normal in the heart. In this organ, over 50% of the intracellular space was occupied by glycogen and possibly oligosaccharides, as demonstrated by the quantitative morphometric analysis of electron micrographs. The activity of acid alpha-glucosidase was increased in the heart, skeletal muscles, and liver, but was normal in leukocytes. A review of the 11 previously published pedigrees of lysosomal glycogen storage disease with normal in vitro alpha-glucosidase activity allows the delineation of three clinical entities: juvenile and neonatal pseudo-Pompe diseases and partial Pompe disease. Partial Pompe disease, due to the tissue-specific absence of acid alpha-glucosidase, was observed in a single patient. The most common form is the late-onset pseudo-Pompe disease, which is characterized by severe cardiomyopathy and mild myopathy appearing in the second or third decade, prominent arrhythmia with Wolf-Parkinson-White syndrome, and sometimes mental retardation. Patients reported as suffering from Antopol disease probably belong to this group. Dominant inheritance (autosomal or X linked) is likely in most families. The present report appears to be the first one to describe a rapidly fatal neonatal form of lysosomal glycogenosis without acid maltase deficiency. The mode of inheritance of this form is not known. Differential diagosis includes Pompe disease (similar histology) and cardiac phosphorylase b kinase deficiency (similar clinical course). The delineation of neonatal pseudo-Pompe disease makes enzymatic confirmation mandatory in each case suspected of Pompe disease.

Glucan 1,4-alpha-Glucosidase↗

Percutaneous retrieval of broken silastic catheter from the left atrium in a critically Ill premature infant.

A critically ill premature neonate (birthweight 1,395 g, gestational age 30 wk) had a broken silastic catheter lodged in the left atrium. We successfully retrieved the foreign body by percutaneous approach using a helical basket catheter under echocardiographic control. Such a therapeutical option for a broken, lightly radiopaque catheter has not been previously described in very low birthweight, critically ill infants.

Catheterization↗

[Efficacy and tolerability of 2 presentations of eyedrops combining carteolol 2% and pilocarpine 2% in primary open-angle glaucoma and simple ocular hypertension].

PURPOSE: The aim of the study was to compare 2 combinations of eye drops containing 2% carteolol and 2% pilocarpine: LCM 1010: ready to use eye drops CBS 341A: eye drops to be reconstituted (freeze-dried powder + solvent). METHODS: Ninety-seven patients with primary open angle glaucoma or simple ocular hypertension were included in a randomized, double-blind multicentric study comparing 2 parallel groups of treatment. Intra-ocular pressure was greater than 21 mmHg with beta-blocker alone. One instillation of 2% carteolol-2% pilocarpine combination was given twice a day for one month. Before and after this treatment, intra-ocular pressure was measured at 9 am (12 hours after evening instillation) and at 11 am (2 hours after morning instillation). RESULTS: Both treatments reduced intra-ocular pressure by a comparable amount and there was no significant difference between groups at either measure: at 9 am: 2.11 +/- 2.39 mmHg (mean +/- SD) for LCM 1010 1.79 +/- 1.73 mmHg for CBS 341 A p = 0.25 at 11 am: 3.75 +/- 3.83 mmHg for LCM 1010 3.40 +/- 1.69 mmHg for CBS 341 A p = 0.42. Both eye drops were generally well tolerated. CONCLUSION: Efficacy and safety of ready to use eye drops 2% carteolol-2% pilocarpine combination proved to be comparable to that of eye drops to be reconstituted in the treatment of ocular hypertension poorly controlled by beta-blocker eye drops alone.

Adrenergic beta-Antagonists↗

[Stilling Duane syndrome and MRI: 2 preliminary results].

Dynamic mode magnetic resonance imaging (DMMRI) allows good visualization of the oculomotor muscles and allows their dimensions to be measured both when they contract and when they relax. The accuracy of this method has been checked and the measurements of the cross section of medial and inferior recti and of superior obliques can be considered to be valid. Measurements of length are inaccurate and the other muscles are not perpendicular to the sectional planes generally used in MRI of the head. By means of a fixation scale situated in the tunnel of the machine, the maximum diameter of medial recti in their thickest part was evaluated in two girls affected by a Stilling Duane retraction syndrome of the left eye. Two direction of the gaze were explored: 25 degrees at the right, then 25 degrees at the left, these angles being obtained by the fixation of particular points of the tunnel scale. The measurements have been made on axial sections, then on coronal sections, both medio-orbital and apical. The first finding is that the diseased medial rectus is much bigger than the healthy one. When relaxed, its thickness is about the same as that of the contracted normal muscle. Coronal orbital cross sections clearly show recession of the belly of the diseased muscle towards the back of the orbit. When contracted it stays in the apical plane and when relaxed in the medio-orbital plane. Lastly the relaxation is much weaker for the pathological muscle than for the healthy one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[A multicenter randomized study of fusidic acid ophthalmic gel and rifamycine eyedrops in acute conjunctivitis].

A total of 163 patients with acute, presumably bacterial, conjunctivitis were included in a randomized trial, comparing: 1% fusidic acid viscous eye drops, a new ophthalmic formulation of fusidic acid instilled twice daily with rifamycin eye drops, four times daily. Both drugs were given 7 days long. Bacterial origin of the conjunctivitis, mainly staphylococcal, was proved in 75% of the cases. Overall, at the end of the treatment, a satisfactory response, on bacteriological and clinical grounds, was recorded for 87.3 and 89.5% of the patients in the Fucidin gel and rifamycin groups respectively. 9 and 12% of the patients in each group respectively, had a clinical recurrence 15 days after the treatment. No significant difference between the groups clinically and bacteriologically was noted. Side effects, mainly burning and smarting were noted by the investigators in 8 and 11 patients treated by fusilic acid and rifamycin respectively. Two patients were taken out of the study in the rifamycin group because of allergy. The difference between the groups is not significant. The use of fusidic acid viscous eye drops as compared to rifamycin eye drops was judged significantly easier by the patients (P less than 0.02), especially because of the reduced number of applications, the lack of color, and the lase of application.

Acute Disease↗