Biomedical subjects
Publications and source records attributed to P Benoit.
A case of left ventricular hydatid disease causing mitral insufficiency and revealed by accelerated idioventricular rhythm (AIVR) is reported. The traditional and more recent diagnostic procedures including echocardiography and immunology are reviewed. The persistence of AIVR and mitral insufficiency after excision of the cyst are discussed with respect to the surgical treatment.
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In a 69-year-old man admitted to hospital for shock with symptoms suggesting acute cor pulmonale, laboratory tests showed low proteinaemia associated with haemoconcentration. Vascular filling led to recovery, but the condition relapsed 6 months later, heralded by weight increase, swelling of the face and profuse swelling; the patient again recovered. On this last occasion, a monoclonal peak of IgG kappa thought to have antibody activity was discovered. These attacks of hypovolaemic shock seem to be due to sudden increases in capillary permeability.
The clinical profile of aorto-coronary bypass occlusion was drawn from a study of 49 patients with 56 occluded bypasses and 69 patients with 123 patent bypasses. All patients had undergone postoperative coronary arteriography or post-mortem examination. An anatomical cause of occlusion was retrospectively detected on the basis of pre-operative arteriographic findings or operation records in 82% of the cases, and on account of post-operative myocardial infraction (particularly significant when of late occurrence), residual angina and positive exercise tolerance test in 35%, 55% and 40% respectively of the cases. The last three criteria are of absolute diagnostic value when the arterial defects have been fully corrected by surgery.
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The first chapter looks at the advantages of continuous oral feeding (COF) over conventional oral feeding, from a physiological and physiopathological point of view. From this discussion the indications and contraindications for this type of feeding are drawn. Then a few major diseases of the digestive tract are examined: diseases of the bile salts, intra-luminal bacterial proliferation, acute bacterial diarrhoea, isufficiency of exocrine pancreatic secretion. In each case the use off continuous oral feeding is suggested.
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A comparative study of exercise electrocardiogrammes before and after aorto-coronary bypass surgery was carried out in 50 patients over a 2 year period. Coronary arteriography was used to assess the chirurgical results qualitatively ((electrocardiographic appearances) and quantitatively (work capacity and effort tolerance) with respect to the coronary lesions and permeability of the aorto-coronary vein grafts. Exercise electrocardiography has a place in the follow up of patients with aorto-coronary bypass grafts but it only gives information on the permeability of the grafts if all the significant stenosis are bypassed at surgery.
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A 58-year-old man with subcutaneous metastases from a naevocarcinoma was prescribed 1 138 mg/m2 of a new anthracylic derivative, dietoxy-acetoxy-daunorubicine, at doses of 180 mg every three weeks. Irreversible cardiac failure occurred nine months after starting treatment, and was considered to be due to the toxic effects of the compound. He improved for a short period after very high doses of vasodilatators but death occured very shortly afterwards. Histological examination revealed severe subendocardial fibrosis, disseminated interstitial fibrosis, and degenerative and necrotic lesions of the myocytes. The authors discuss the factors involved in the cardiotoxicity of the anthracyclines: total dose, intervals between doses, associated risk, factors (age, radiotherapy). Even at usual doses signs of myocardial dysfunction are found in one third of patients treated, with the presence of histological lesions in all these cases, but clinical cardiac failure is rarely observed.
A review of the hospital records of 164 children with leukemia diagnosed between January 1969 and December 1975 disclosed 51 episodes of septicemia in 43 patients; 57 infectious agents were isolated. Gram-positive bacteria were isolated as frequently as gram-negative bacteria, each type accounting for 45.6% of all the agents isolated. Only 2 of the 24 episodes of exclusively gram-positive septicemia were fatal, whereas 9 of the 23 episodes of exclusively gram-negative septicemia were fatal. The mean duration of neutropenia was 5.6 days in patients with gram-positive septicemia and 19.5 days in patients with gram-negative septicemia, a significant difference (P less than 0.01). Gram-positive septicemia was diagnosed after a mean of 5.9 days of hospitalization and gram-negative septicemia after a mean of 29.0 days, also a significant difference (P less than 0.001). In this exclusively pediatric population of leukemic patients gram-positive agents have to be considered as potential pathogens, and initial antibiotic therapy must be selected with this fact in mind.
A transient multiinnervation is observed in adult rats during reinnervation of the soleus muscle. Chronic blockage of the sciatic nerve with a cuff of the local anaesthetic lidocaine during reinnervation increases the number of multiply innervated muscle fibres. This result indicates that the selective elimination of redundant nerve terminals is regulated by the activity of the innervated muscle.
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