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Biomedical subjects

M Rey

Publications and source records attributed to M Rey.

At least 109 records · Page 6Linked to original sources
PubMed1989

Late thrombolytic therapy preserves left ventricular function in patients with collateralized total coronary occlusion: primary end point findings of the Second Mount Sinai-New York University Reperfusion Trial.

The change in left ventricular ejection fraction from preintervention to predischarge was prospectively assessed in 393 patients with acute myocardial infarction. Within 12 h of symptom onset (mean 6.3 +/- 2.7 h), patients were randomly assigned to a double-blind intracoronary infusion of streptokinase, nitroglycerin, both streptokinase and nitroglycerin or conventional therapy without acute cardiac catheterization. Treatment effects were also assessed in prospectively defined angiographic subsets. There was a significant interaction between streptokinase and nitroglycerin (p less than 0.01), resulting in an increase in ejection fraction of 3.9 percentage units in the combined treatment arm (p less than 0.001). Patients with collateral flow to a totally obstructed infarct-related artery showed a significant improvement over those without collateral flow in the streptokinase (5.4 +/- 2.5%) and streptokinase-nitroglycerin (10.6 +/- 2.7%) arms, but not in the nitroglycerin arm. Time to treatment did not influence the change in ejection fraction. In patients with initial subtotal occlusion, thrombolytic therapy was of no short-term benefit because ejection fraction increased by 6% in all three intervention arms. These findings indicate that relatively late thrombolytic therapy results in significant myocardial salvage in those patients with collateralized total coronary occlusion. This benefit is potentiated by concomitant nitroglycerin therapy.

Aged↗
PubMed1989

[An unusual cause of EEG artefact: waterbeds].

The case reported presents difficulties of interpretation of electroencephalographic recordings made on a patient lying on a fluidized bed. The moving silica grains in fluidized beds simulate pathological electrogenesis, giving diffuse slow-wave abnormalities or paroxysmal epileptiform activity. It is therefore essential that fluidized beds be switched off when recording electroencephalograms.

Adult↗
PubMed1989

Treatment of endogenous depressions resistant to tricyclic antidepressants or related drugs by lithium addition. Results of a placebo-controlled double-blind study.

The therapeutic efficacy of lithium added to tricyclic antidepressants (TCA) or related thymoleptics was investigated in 27 endogenous depressive patients responding unsatisfactorily to these drugs alone. All patients received lithium during two weeks, however, with a delay of one week in 13 of them, the attribution to active treatment or placebo for the first seven days being double-blind. A statistically significant improvement compared to placebo occurred after lithium addition. The results of the double-blind part of the study as well as the observations during the total two-week period suggest that endogenous depression failing to respond to thymoleptic drug treatment can be improved within a short time by the co-administration of the two treatments in the indicated sequence. However, the proportion of patients improved and the rapidity of improvement noted in this study were less favorable than reported by the investigators who discovered the therapeutic principle.

Adult↗
PubMed1989

Comparison of three different regimens in the treatment of acute brucellosis: a multicenter multinational study.

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

Acute Disease↗
PubMed1989

Effects of RU 486 on hippocampal slice electrophysiology in normal and adrenalectomized BALB/c mice.

Modulation of the electrophysiological properties (amplitude, latency, paired-pulse facilitation) of the CA1 hippocampal field by different concentrations of RU 486 was studied in hippocampal slice preparations from normal (sham) and adrenalectomized BALB/c mice. In the sham group as well as in the adrenalectomized group, RU 486 had no effect with the lower concentrations used (0.05 and 0.5 nM), but produced a decrease in the population spike amplitude for the higher concentrations used (5 and 50 nM). This decrease was delayed and sustained. Combined application of RU 486 at 5 nM and corticosterone at 0.5 or 5 nM displayed an excitatory effect, but no inhibitory effect. Combined application of RU 486 and dexamethasone showed no significant effect. These results are related to the antagonist and agonist properties of RU 486 and to the different steroid receptor systems in the hippocampus.

Adrenalectomy↗
PubMed1989

[Early right posterior cerebral hemispheric lesion and right speech dominance in 2 right-handed female patients].

Two female patients presented a severe partial epilepsy of early onset and an extended right posterior hemispheric lesion of prenatal or perinatal origin. They were right-handed and all their first degree relatives were right-handed. Nevertheless, evidence of right hemispheric speech was documented in both patients, on the basis of a bilateral sodium amytal test in one case, and of a persistent aphasia after neurosurgical treatment in the other. The possible consequences of an early cerebral pathology on cerebral lateralization are discussed, including pathological right-handedness.

Adolescent↗
PubMed1989

[Massive myocardial infiltration by lymphoma of tonsilar origin simulating left ventricular hypertrophy: diagnosis using echocardiography].

We present the first described case in the literature of isolated left anterior hemiblock, in the setting of massive myocardial invasion by a primary tonsilar lymphoma. Such process evolved with a morphologic pattern mimicking left ventricular hypertrophy of unequal distribution. An hemodynamic behaviour of an infiltrative cardiomyopathy, with both systolic and diastolic important ventricular dysfunction, was observed. An early presumptive diagnosis of severe lymphomatous myocardial invasion was established by echocardiography. The pathologic examination confirmed it subsequently.

Adult↗
PubMed1988

Protective effect of the bispiperazinedione ICRF-187 against doxorubicin-induced cardiac toxicity in women with advanced breast cancer.

Studies in animals suggest that the bispiperazinedione ICRF-187 can prevent the development of dose-related doxorubicin-induced cardiac toxicity. In a randomized trial in 92 women with advanced breast cancer, we compared treatment with fluorouracil, doxorubicin, and cyclophosphamide (FDC), given every 21 days, with the same regimen preceded by administration of ICRF-187 (FDC + ICRF-187). Patients were withdrawn from the study when cardiac toxicity developed or the cancer progressed. The mean cumulative dose of doxorubicin tolerated by patients withdrawn from study was 397.2 mg per square meter of body-surface area in the FDC group and 466.3 mg in the FDC + ICRF-187 group (no significant difference). Eleven patients on the FDC + ICRF-187 arm received cumulative doxorubicin doses above 600 mg per square meter, whereas one receiving FDC was able to remain in the study beyond this dose. Antitumor response rates were similar (FDC vs. FDC + ICRF-187, 3 vs. 4 complete responses; 17 vs. 17 partial responses; and 9.3 vs. 10.3 months to disease progression). Although myelosuppression was slightly greater in the FDC + ICRF-187 group, the incidence of fever, infections, alopecia, nausea and vomiting, or death due to toxicity did not differ between the groups. Cardiac toxicity was evaluated by clinical examination, determination of the left ventricular ejection fraction by multigated nuclear scans, and endomyocardial biopsy. In comparisons of the FDC group with the FDC + ICRF-187 group, clinical congestive heart failure was observed in 11 as compared with 2 patients; the mean decrease in the left ventricular ejection fraction was 7 vs. 1 percent when the cumulative dose of doxorubicin was 250 to 399 mg per square meter (P = 0.02), 16 vs. 1 percent at 400 to 499 mg (P = 0.001), and 16 vs. 3 percent at 500 to 599 mg (P = 0.003); and the Billingham biopsy score was 2 or more in 5 of 13 patients undergoing biopsy vs. none of 13 (P = 0.03). We conclude that ICRF-187 offers significant protection against cardiac toxicity caused by doxorubicin, without affecting the antitumor effect of doxorubicin or the incidence of noncardiac toxic reactions.

Adult↗
PubMed1988

[Fatal consequences of fructose infusion in undiagnosed fructose intolerance].

A 13-year-old girl with previously undiagnosed fructose intolerance was operated on for acute appendicitis. Postoperatively she received several infusions containing fructose or sorbitol. Haematemesis occurred on the fourth postoperative day, as well as tarry stools and jaundice. Blood sugar was 2 mg/100 ml, Quick test 3%, liver enzymes were markedly elevated, serum bilirubin was over 9 mg/100 ml, and there was a metabolic acidosis. Despite intensive treatment, including haemodialysis and plasmapheresis, she died on the 11th postoperative day.

Adolescent↗
PubMed1988

In-vitro synthesis of alpha 2-macroglobulin by human gingival fibroblasts.

Cells from explants were cultured in the presence of [L-35S]-methionine for 24 h. Cultures containing cycloheximide or cultures frozen immediately after addition of labelled methionine served as controls. The medium was removed and, after washing, cells were disrupted by repeated freezing and thawing. Synthesis of alpha 2-macroglobulin (alpha 2-M) was evaluated by autoradiography of the SDS-PAGE patterns obtained with the culture medium, and by autoradiography of the crossed immunoelectrophoretic patterns obtained with both the cell extract and the culture medium. There was incorporation of labelled methionine in newly-synthesized alpha 2-M. No autoradiographic bands were found in the frozen preparations, and there was a progressive inhibition of globulin synthesis in the presence of increasing concentrations of cycloheximide. This synthesis of alpha 2-M by human gingival fibroblasts may explain the presence of free alpha 2-M in gingival fluid and might be of significance in the control of proteolysis during gingivitis and periodontitis.

Cells, Cultured↗
PubMed1988

Hemispheric lateralization of motor and speech functions after early brain lesion: study of 73 epileptic patients with intracarotid amytal test.

This study reports results of a bilateral intracarotid amytal test in 73 epileptic patients with medically intractable focal seizures. No right-handers but 50% of left-handers have a right dominance for speech in this particular population. Lateralization of cerebral speech functions, as well as manual preference, are dependent on the neurological disease and can shift conjointly or independently. We study the relationships of those shifts to different variables related to the cerebral pathology: age at onset and lateralization of epilepsy, extensive brain damage, neurological deficit.

Adolescent↗
PubMed1988

[Antibiotic pharmacokinetics in patients with mucoviscidosis].

In this review we summarize the available literature on the pharmacokinetics of antibacterials in cystic fibrosis. A special impact is given on the results of our group which will be put in perspective with the results of other authors. The homogeneity of our patient population allows a valid comparison between patient and volunteer data. We do not confirm the previously suggested strongly enhanced elimination of antibacterials in CF. Our findings have recently been confirmed by other investigators. However, since in the clinical situation a more heterogeneous group of patients is treated it seems rational to increase the dose of the antibacterials by about 20-30%.

Anti-Bacterial Agents↗