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Biomedical subjects

M Mercier

Publications and source records attributed to M Mercier.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Dobutamine during anesthesia of patients at risk for heart failure. A controlled prospective multicenter study of 93 surgical patients over 64 years of age].

Most anaesthetic agents cause cardiac depression possibly hazardous in the elderly, especially in presence of a poor cardiac reserve. Ninety-three patients undergoing non cardiac surgery lasting more than 90 min. were entered in a double-blind multicentre randomized trial. They were 65 year old or more and unaffected by evolutive angina pectoris. After insertion of a Swan Ganz catheter and an arterial cannula, anaesthesia was induced by thiopentone, fentanyl and 02/nitrous oxide (50%). Forty-five patients were infused dobutamine 7 micrograms.kg-1.min-1 (group D) from 10 min. after induction till the completion of surgery. Forty-eight patients received a placebo (group P). Haemodynamic parameters were recorded throughout anaesthesia and at its emergence. After induction, heart rate, pulmonary capillary wedge pressure and mean pulmonary artery pressure did not change significantly; mean arterial pressure, cardiac index, stroke index and left ventricular stroke work index decreased by 21, 33, 28 and 42% respectively (p less than 0.001); systemic and pulmonary arterial resistances increased by 12 and 37% respectively (p less than 0.001). In group P, these changes persisted throughout the procedure but, 30 min after extubation, cardiac index returned to control levels due to a 25% increase in heart rate; in this group 4 patients presented with both perioperative low cardiac output and persistent postoperative confusion. With dobutamine, haemodynamic parameters returned to preoperative values and heart rate increased by 12 b.min-1. More arrhythmias and hypertensive episodes but less hypotensions occurred in group D. Substantial haemodynamic changes occur during anaesthesia and surgery in elderly patients. Dobutamine corrects the peroperative decrease in cardiac output and blood pressure, and might prevent postoperative neurological disorders.

Aged↗
PubMed1988

[Evaluation of health expenditures in the first 6 months after the diagnosis of cancer using a population register].

It is currently estimated in France, that the cost of cancer is rising to 25 billion francs, which represents approximately 6% of all health expenditure with an annual growth of 5-10%. The data from the Register of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the social security system, and its distribution in relationship with the different posts (assessment, type of treatment, supervision, transport) according to the cancer site. The average cost per patient within the first 6 months of the illness has been evaluated at 26,000 F (1984). The results show major differences for the cancer sites, care facilities and posts which are budgeted for.

Cancer Care Facilities↗
PubMed1987

Quality of life.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMed1987

[Assessment of the quality of life].

Increases in survival rates obtained in the years with cancer patients are offset by the aggressivity of the treatments and especially by those based on antitumor drugs. So far, oncologists have addressed themselves to the notions of survival (with or without evolution of the disease), and of indicators of tumor regression and toxicity. The global notion of quality of life may be an additional parameter for weighing the impact of anticancer therapies. The assessment of the quality of life of a patient is complicated by the issue of objective versus subjective judgements. The patient's self-appreciation of his status is of primary importance, but quality of life is only a relative assessment of the patient linked to the different stages of therapy. The quest for a suitable analytical tool endowed with sufficient sensitivity and reproducibility has not yet ended. Some authors regard to psychological contact as the only satisfactory means in terms of fruitfulness, although it raises questions of quantitative estimations. Others, especially anglo-saxon authors, have compiled questionnaires to be filled out by the patients and rated them using general or itemized scores. Similar to this type of questionnaires is the technique of the linear analogs which consists in asking the patient to express an appraisal of his state by indicated a position between two extreme situations on a linear scale graded in centimeters. Some authors have prepared general questionnaires suitable to all types of cancer. Others, instead, have perfected tools specific to certain types of tumors. Finally, methods of global assessment have also been proposed, notably by Bernheim. Thus, questions arise such as the evaluation (doctor's versus patient's judgement), and that of finding a tool for assessing the physical autonomy and the well-being (in the wide sense) of the patient. In addition, such a tool should be applicable to a large number of cancer patients in order to achieve an objective evaluation of the proposed treatments. Here we report preliminary results of a study aimed at answering these different questions. Our study intended to compare: the assessment of the general condition versus the toxicity of the therapy as evaluated by the patient and the doctor; the appreciation of quality of life as determined by questionnaires and linear analogues filled out by the patients and psychological interviews. Finally, a compliance study could be made on the assessment of the quality of life in a randomized chemotherapeutic trial concerning patients with metastatic breast cancers.

Female↗
PubMed1985

Bronchial carcinoma after cervical carcinoma.

In a series of more than 2500 patients with cervical carcinoma who were regularly surveyed after treatment, ten cases of bronchial carcinoma confirmed by biopsy were found. The mean delay between the diagnosis of the cervical carcinoma and bronchial carcinoma was 28 months. This long interval, particularly when there was no distant metastases, raises questions about whether bronchial metastasis of cervical carcinoma or a second primary occurred. Comparisons with data of population cancer registries argue in favor of metastasis.

Adult↗
PubMed1985

[Comparative anti-ischemic activity of atenolol and diltiazem. Crossed single-blind randomized study using a computerized exercise test].

The anti-ischaemic activities of atenolol (200 mg) and diltiazem (240 mg) were compared in 23 patients undergoing retraining 4 weeks after a limited postero-inferior or anterior primary myocardial infarction. The patients, who had signs of residual ischaemia during stress with or without angina, were subjected to 3 exercise tests on a bicycle ergometer; a computer was used to analyze the results (Case-Marquette). The first test was performed under placebo, the second after randomized treatment with one of the two drugs and the third test after taking the other drug. The parameters evaluated were: total duration of the test, time of occurrence of a 1 mm ST-segment depression, maximal work load and total work performed, heart rate, systolic arterial pressure, heart rate X systolic arterial pressure product at rest and at submaximal and maximal stress, and ST depression at submaximal and maximal stress. The results showed that exertion was improved to the same degree by the two drugs, but atenolol had greater anti-ischaemic activity than diltiazem.

Aged↗
PubMed1984

Liver, kidney and small-intestine microsomal-mediated mutagenicity of carcinogenic aromatic amines.

The mutagenicity of 2-aminofluorene, 4-aminobiphenyl and 3,2'-dimethylaminobiphenyl towards Salmonella typhimurium was studied in the presence of microsomes from liver, kidney and small intestine of untreated and pretreated rats. The aim was to study a possible correlation between the organotropism of these amines and their activation into mutagenic intermediates by these three tissues. Pretreatment of the rats with phenobarbital, Aroclor 1254 and 3-methylcholanthrene injected intraperitoneally increased the liver microsomal-mediated mutagenic activity of the three amines but remained without effect on the activating capacity of microsomes from the kidney and small intestine. However, pretreatment with 3-methylcholanthrene administered intragastrically increased the small-intestine microsomal-mediated mutagenicity of 2-aminofluorene almost 3-fold but remained without effect on the mutagenicity of 4-aminobiphenyl and 3,2'-dimethylaminobiphenyl. No mutagenic effect was observed with 4-aminobiphenyl in the presence of kidney microsomes or with 4-aminobiphenyl and 3,2'-dimethylaminobiphenyl in the presence of small-intestine microsomes, obtained from either untreated or pretreated animals. It is concluded that no relationship exists between the mutagenic activities of the three amines, as detected in the Ames test, and their carcinogenic organotropisms.

Aminobiphenyl Compounds↗
PubMed1984

Mutagenicity of several derivatives of dipyrido[1,2-a:2',3'-d]imidazoles.

Different derivatives of dipyrido[1,2-a:2',3'-d]imidazoles have been investigated, as mutagens for Salmonella typhimurium. The nature of different substitution groups and their positions on the base ring influenced markedly the mutagenicity of these compounds. From this structure/effect relationship study, it was demonstrated that the 2 and 3 positions were of special interest. The 3-N-hydroxylated compound was the most active mutagen tested. We also observed that the frequently found frameshift mutagens were responsible for base-pair substitution. Metabolic activation by liver S9 mix increased the reversion rates of the strains tested. The SCE assays correlated poorly with the Salmonella/microsome mutagenicity test.

Cells, Cultured↗
PubMed1984

Quantitative correlation between the metabolism and the mutagenic activity of N-nitrosopyrrolidine.

The metabolism of N-nitrosopyrrolidine (NPyrr) via alpha-hydroxylation is modified by pretreatments of the animals with compounds which affect the microsomal level of cytochrome P-450 and by addition, in vitro, of 2-diethylaminoethyl-2,2-diphenyl valerate hydrochloride (SKF 525-A), an inhibitor of cytochrome P-450. This phenomenon is due exclusively to the induction or the inhibition of the enzymatic activity involved in the microsomal metabolism. After preincubation in liquid medium, the mutagenic activity of NPyrr towards the Salmonella typhimurium strain TA 1530 is similarly modified by these effectors. A similar effect is not observed when using the plate incorporation method. The mutagenic intermediate is formed by the microsomal fraction. The presence of the S. typhimurium strain TA 1530 decrease the transformation of NPyrr into its ultimate metabolite (1,4-butanediol); there is a relationship between the formation of 1,4-butanediol and the mutagenic activity of NPyrr. The S. typhimurium strain TA 1530 is able to partially transform 4-hydroxybutanal, the first identifiable microsomal metabolite of NPyrr, into its ultimate metabolite (1,4-butanediol).

Animals↗
PubMed1983

In vitro and in vivo studies on the potential mutagenicity of alclofenac, dihydroxyalclofenac and alclofenac epoxide.

Alclofenac (A) and two of its metabolites, dihydroxyalclofenac (DHA) and alclofenac epoxide (AE), were tested for their mutagenic potential. Alclofenac and DHA showed no mutagenic, transforming or clastogenic potential in any in vitro experiment. The addition of a supplementary metabolic activation system did not change the response of those two compounds in any test procedures in vitro. AE, an intermediary metabolite between A and DHA, was mutagenic by itself in the Ames test, but in the presence of a liver post-mitochondrial fraction its activity of Salmonella typhimurium was greatly decreased. Dominant lethal mutations were not induced in male rats given alclofenac, and AE had no effect in the micronucleus test. In human volunteers given alclofenac at therapeutic dose levels, no mutagenic activity was found in the urine and no significant increase in the incidence of structural chromosome aberrations was observed in peripheral blood lymphocytes.

Animals↗
PubMed1983

The lateralizing and localizing value of adversion in epileptic seizures.

We studied 24 patients who had adversion as the first clinical manifestation of seizures. Seizures were recorded with depth electrodes as part of the evaluation for possible surgery for epilepsy. Head rotation did not help to lateralize the epileptic focus clinically, because deviations occurred ipsilaterally to the EEG focus in some patients, and because some patients had head rotation in either direction despite a unifocal epileptogenic abnormality. Furthermore, no cortical localization was consistently linked to either direction or degree of adversion. Adversion has no consistent lateralizing or localizing value.

Brain Mapping↗
PubMed1982

[Is a rise in haematocrit associated with a risk of cerebrovascular accident? A retrospective study of 150 subjects with previous CVA and 150 paired controls (author's transl)].

A retrospective study of the various factors associated with the risk of cerebrovascular accident (CVA) was conducted in 150 patients (87 women and 63 men) who had had a CVA and 150 paired control subjects of the same sex and age. No difference was found between these groups in systolic and diastolic BP, nor in blood glucose and cholesterol levels. However, there was a highly significant increase in haematocrit in CVA patients as compared with controls. The mean figures were +5,69% in men (p less than 0.00005) and + 3.85% in women (p less than 0.00001). It must be noted that the haematocrit values in CVA patients, although increased, remained within the normal range. A rise in blood viscosity could be the mechanism through which the haematocrit contributes to the risk of CVA.

Aged↗
PubMed1982

Non-mutagenicity of 2-methyl-2,3-epoxybutane and factors influencing the mutagenicity of 2,3-epoxybutane.

The compound 2,3-epoxybutane (2,3-EB) is a direct mutagen for the base-pair-substitution-sensitive strains TA 1530, TA 1535 and TA 100, in the absence and in the presence of metabolic activation by liver S9-mix. Under the same experimental conditions, the 2-methyl derivative of 2,3-EB was not mutagenic, up to 10 mg per plate. The parent compound (2,3-EB) was more active on strain TA 1530 in the presence of liver S9-mix. This was observed at every epoxide concentration tested. The increase of mutagenicity depended on the S9 concentration, the mix composition and to a small extent on the method utilized.

Animals↗