Search PubMed⌕ Search

Biomedical subjects

P Bernadet

Publications and source records attributed to P Bernadet.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Sustained-released verapamil and ambulatory recording of blood pressure in mild to moderate essential hypertension].

An open study in 25 patients evaluated the efficacy and safety of Isoptine S.R., in some cases associated with Aldactazine in mild to moderate essential hypertension. After a placebo period of 2 weeks, the patients received sustained release verapamil (240 mg/24 hours) in a single morning dose for 6 months. An increase in the dosage (360 mg/24 hours in two subdoses) could be made during the first month of treatment if the diastolic blood pressure remained greater than or equal to 95 mmHg. If the diastolic blood pressure persisted at these levels at the second monthly assessment, a tablet of Aldactazine was associated. The blood pressure was evaluated by means of conventional clinical determinations and 24-hour ambulatory recordings carried out at the time of inclusion and then after 3 and 6 months of treatment. From the first month of treatment, the casual blood pressure determinations in the supine and standing position fell highly significantly (p less than 0.0001), resulting in a mean reduction of 22.3 mmHg in the systolic blood pressure (-12.6%) and of 17.4 mmHg in the diastolic blood pressure (-17%). The ambulatory recordings of blood pressure also showed a significant reduction in the mean systolic blood pressure over 24 hours (p less than 0.05 at the 3rd month of treatment), in the mean diastolic blood pressure over 24 hours (p less than 0.01) and the mean pressure (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Vascular complications in infectious endocarditis. Apropos of 86 cases].

During a 20 year period, 285 patients were hospitalised for infectious endocarditis (IE) in the Department of Cardiology of the Ernest-Conseil Hospital in Tunis and 86 of them, i.e. 30%, developed a vascular complication (VC). Among these 86 patients, there were a total of 108 lesions, including 52 neurological complications, 14 peripheral acute ischemic syndromes, 16 peripheral arterial aneurysms, 9 aortic aneurysms, 7 pulmonary embolisms, 6 splenic infarctions and 4 coronary lesions. The mortality in this patient group proved to be slightly greater than in the series as a whole, in particular concerning patients with multiple lesions and those with an artificial valve. No prognostic difference was seen between patients with a VC of aneurysmal type and of ischemic type, but the presentation and severity of lesions was very variable. The vascular complication was a presenting feature of IE in almost 40% of cases. The organism found most often was the streptococcus, above all in ischemic type IE as well as in the total patient group. Similarly, the preferential site was aortic, above all for aneurysmal type IE. Ultrasonography revealed a higher incidence of vegetations in this series of patients, above all in ischemic type VC, but anatomical studies have shown this to be an investigation of moderate sensitivity and poor specificity, poorly correlated from a prognostic standpoint with the risk of embolism. The conclusion of the study is above all the need to prevent such complications: embolic complications by early antibiotic treatment and valve replacement and aneurysmal complications by methodical routine angiographic evaluation and appropriate treatment.

Adolescent↗
PubMed1991

Immunotactoid glomerulopathy and cutaneous vasculitis.

A 22-year-old woman presented glomerulonephritis with Schönlein-Henoch-like syndrome and monoclonal abnormality. One month later, she developed a rapidly progressive glomerulonephritis with hypertension and persistent purpura. In the two renal biopsies performed during the first and the second attack, mesangial expansion and thickening of the glomerular capillary walls (associated with 50% of crescents in the second biopsy) were observed on light microscopy. By immunofluorescence faint deposits of immunoglobulins (light and heavy chains) and complement components were found present in the mesangium. Electron microscopy showed tubular microfibrils measuring 19-24 nm in the mesangium, subendothelial and subepithelial areas. A skin biopsy performed during the first attack demonstrated leukocytoclastic skin vasculitis. By immunofluorescence, no deposits were observed. Congo red staining for amyloid and cryoglobulinemia were negative. This case is similar to an entity recently described and named immunotactoid glomerulopathy.

Adult↗
PubMed1991

Fanconi's syndrome, kappa light-chain myeloma, non-amyloid fibrils and cytoplasmic crystals in renal tubular epithelium.

A 59-year-old woman with kappa light-chain myeloma had Fanconi's syndrome characterized by renal glycosuria, generalized aminoaciduria, bicarbonaturia and decrease of phosphorus and uric acid reabsorption. A bone marrow biopsy showed the presence of 27% of dystrophic plasma cells; the cytoplasm of these cells was intensely stained with anti-kappa light-chain monoclonal antibodies. By light microscopy, the renal biopsy revealed a tubulointerstitial nephritis without glomerular lesions and with intratubular casts. By immunofluorescence, no deposits were observed along the glomerular and tubular basement membranes, but a positivity with anti-kappa light chain was noticed in some tubular epithelia and casts. By electron microscopy, fibrils (35-nm diameter) were observed in the cytoplasm of proximal tubular cells. These fibrils were situated in vesicles (100- to 600-nm diameter) in the luminal side of tubular cells. In the basal pole of the cell, fibrils seemed to group in crystals (120- to 200-nm diameter). Only kappa light-chain protein was demonstrated in these fibrils and crystals by an immunoelectron microscopic technique. These data suggested the pathogenic role of the fibrils and crystals present in tubular epithelium in the tubular proximal syndrome.

Bone Marrow↗
PubMed1991

Renin release regulation during acute renin inhibition in normal volunteers.

Blockade of the renin-angiotensin system by an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II (Ang II) antagonist is accompanied by a reactive rise in renin release. This rise is generally attributed to interruption of the short feedback loop between Ang II and renin release. Similarly, after the administration of a renin inhibitor, the plasma concentrations of active and total renin are increased and plasma renin activity is suppressed. The aim of the present study was to investigate if a fall in the plasma Ang II level is the unique determinant of the rise in the active renin (AR) level that follows renin inhibition. Six normal male volunteers participated in three successive 240-minute experiments at weekly intervals according to a single-blind randomized Latin square design. For experiment 1, Ang II was infused at 2 ng/kg/min from 0 to 60 minutes and at 4 ng/kg/min from 60 to 120 minutes. For experiment 2, 0.3 mg/kg of the new potent renin inhibitor Ro 42-5892 was injected at 30 minutes followed by infusion at 0.1 mg/kg/hr from 30 to 240 minutes. For experiment 3, Ang II and Ro 42-5892 were administered simultaneously at the same doses as described above. The mean +/- SEM Ang II concentration increased from 10.2 +/- 1.6 to 33.7 +/- 11.2 pg/ml after infusion of exogenous peptide. It decreased from 9.5 +/- 0.9 to 1.4 +/- 0.3 pg/ml after the injection of Ro 42-5892 and increased from 15.6 +/- 2.9 to 37.1 +/- 11.8 pg/ml after the simultaneous infusion of both compounds.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1991

[Malignant fibrous histiocytoma of the right ventricle and pulmonary artery. Apropos of a case. Review of the literature].

The authors report a case of malignant cardiac fibrohistiocytoma involving the right ventricular infundibulum and the pulmonary artery and responsible for a pseudo-thromboembolic right heart failure syndrome. Following discovery of the tumour mass on ultrasonography and catheterisation, wide excision of the pulmonary artery, pulmonary valve and the roof of the infundibulum as far as the middle part of the ventricle was performed under cardio-pulmonary by-pass. Reconstruction was performed with a valveless woven Dacron tube. The postoperative course was uncomplicated and the patient was still alive after 18 months. Histology revealed malignant fibrohistiocytoma. The authors also present a review of the literature of these rare tumours of the right-sided cavities (5 cases reported).

Aged↗
PubMed1991

[Regression of a coronary atheroma. Proof and doubts].

The regression of coronary atheroma appears to have been convincingly demonstrated by epidemiology or experimental models. Studies involving prevention based upon influencing the lipid factor have clearly shown a decrease in coronary events when drugs cause a lowering of blood lipids. Atheromatous lesions induced in the animal regress if exposure to the factors which have favourised these lesions is eliminated. Studies in man have confirmed the regression of atherosclerotic lesions in several vascular areas. Atheromatous coronary stenoses appear to regress or stabilise, essentially under the influence of hypolipidemic agents but also that of calcium inhibitors, platelet anti-agregants and, probably, anti-oxidising drugs. The clinical value of these therapeutic actions remains to be evaluated and the fate of fibrous lesions is not known. In contrast, relatively early lesions may already derive benefit from this new concept. Methods for assessment of regression in man nevertheless remain imperfect and require a very strict study protocol and methodology.

Coronary Artery Disease↗
PubMed1990

[Evaluation of mortality caused by ischemic heart disease in Haute-Garonne].

The mortality due to ischemic heart disease may be assessed in the department of the Haute Garonne from a Register of cardiovascular disease. In this study the medical causes of death codified using the normal criteria of international classification of disease were compared with the causes of death classified according to the criteria of the Register determined in the same subjects after a complementary enquiry. Between July 1st 1984 and December 31st 1986, 800 consecutive cases of patients dying of cardiovascular disease aged 25 to 64 years at death were examined. A complementary enquiry into the cases of these patients was undertaken involving the treating physician and hospital establishments in order to determine the mode of death and to obtain clinical, ECG, biological and when possible autopsy results for each case. The sensitivity and specificity of the causes of death coded 410-414 according to the criteria of international classification of disease was 74 and 71 p. 100 respectively. The positive predictive value was 75 p. 100 and the value of the kappa index was 0.44. Therefore, the concordance between the causes of death codified by the usual classification and those codified after a thorough complementary enquiry was not very close. On the other hand, taken as a whole, the number of deaths due to ischemic heart disease by the international coding system (428 cases) was 2.1 p. 100 less than that observed after the complementary enquiry (437 cases). These results should, however, be interpreted with caution because of the high proportion (34%) of cases in which the cause of death could not be determined with precision even after the complementary enquiry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Malignant fibrous histiocytoma of the right ventricle and pulmonary artery. Apropos of a case. Review of the literature].

The authors report a case of malignant cardiac fibrohistiocytoma involving the right ventricular infundibulum and the pulmonary artery and responsible for a pseudo-thromboembolic right heart failure syndrome. Following discovery of the tumour mass on ultrasonography and catheterisation, wide excision of the pulmonary artery, pulmonary valve and the roof of the infundibulum as far as the middle part of the ventricle was performed under cardio-pulmonary by-pass. Reconstruction was performed with a valveless woven Dacron tube. The postoperative course was uncomplicated and the patient was still alive after 18 months. Histology revealed malignant fibrohistiocytoma. The authors also present a review of the literature of these rare tumours of the right-sided cavities (5 cases reported).

Aged↗
PubMed1989

[Improvement of left ventricular function after fibrinolysis using intravenous streptokinase].

Over a period of 13 months, 33 male patients, under the age of 72 years, admitted in the cardiology department following a myocardial infarction within 5 hours after painful onset, and treated with intravenous fibrinolytic agents, were included in this study. A coronary angiography with right anterior oblique ventriculography at 30 degrees was performed. Within the first 72 hours. The informations provided by this examination resulted in a coronary angioplasty performed in patients, a by-pass in 4 patients and medical treatment in 13 patients. After a mean delay of 8 months, a new control was performed using iodine ventriculography study of radial and segmental shortening fractions, Leighton's rotation). The results expressed, concern the sub-group of non-surgical patients: regardless of the site of the infarction, the percentage of akinesis (% AK) goes from 15.0 +/- 12.0 p. cent to 8.3 +/- 10.3 p. cent (p less than 0.01). The stroke volume (SV) is not significantly improved. In the group of inferior necroses, the global SV goes from 58.4 +/- 10.1 p. cent to 62.9 +/- 10.8 p. cent; p less than 0.05 and the % AK goes from 13.9 +/- 11.5 p. cent to 5.0 +/- 5.6 p. cent; p less than 0.001). Segmental kinetics in the inferior and infero-basal territories is significantly improved at eight months. In the anterior necrosis group, the study of the same parameters does not demonstrate any significant difference (too limited population). The imputability of the improvement of the parameters of the left ventricular function by arterial revascularization is clearly suggested by these results.

Adult↗
PubMed1989

[Non-neoplastic hypercalcemia].

Hypercalcaemia is a frequent situation in clinical practice. An earlier detection is facilitated by routine analysis of serum calcium. The clinical manifestations depend on severity and the rate of onset of hypercalcaemia. Paucisymptomatic and asymptomatic presentations are the most frequent. Causes of hypercalcaemia are numerous and the mechanisms are various. PTH and vit. D play a preponderant part. In first of all iatrogenic cause are eliminated (all vit D preparations, thiazide diuretics, milk-alkali syndrome). Among non neoplastic hypercalcaemia primary hyperparathyroidism is the first diagnosis. Nephrolithiasis and asymptomatic forms are the most frequent presentations actually. The biochemical profile is not always typical. Generally the association of echography and tomodensitometry lead to the topographic diagnosis. Parathyroid surgical exploration is often necessary in difficult cases. Secondary, the other rare causes of hypercalcaemia are studied: sarcoidosis and granulomatosis disease, thyrotoxicosis and dome endocrinopathies, immobilisation hypercalcaemia, familial hypocalciuric, hypercalcaemia. All of this causes of hypercalcaemia are potentially reversible.

Humans↗
PubMed1989

Risk factors for myocardial infarction during coronary artery bypass graft surgery.

Patients with a particular thrombotic profile may be at greater risk of myocardial infarction during coronary artery bypass graft surgery. The thrombotic profile of 50 patients admitted to hospital with stable angina pectoris was determined prior to haemodynamic investigation. ECG results and determination of cardiac enzymes showed that 12 patients had suffered a perioperative myocardial infarction. These patients had a higher mean atherosclerotic score (42.1 +/- 10.5 vs 32.9 +/- 13, P less than 0.02), a longer aortic cross clamp time (59 +/- 15.2 vs 45.7 +/- 16.3 min, P less than 0.05), lower serum levels of protein C (101.2 +/- 26 vs 124.7 +/- 31.4%, P less than 0.05) and tissue plasminogen activator (322 +/- 580 vs 2307 +/- 2830 IU ml-1, P less than 0.01). There were no differences between the two groups in Jenkin's coronary score, the number and type of grafts, ejection fraction, left ventricular end-diastolic pressure, lipid profile or levels of markers of platelet release. In addition to a more severe distal coronary atheroma and a longer aortic cross-clamp time, patients with impaired endothelial fibrinolytic activity appeared to be at greater risk of myocardial infarction during coronary artery bypass graft surgery.

Aged↗
PubMed1989

Correlations between M-mode markers of left ventricular hypertrophy and radionuclide angiographic indices of left ventricular diastolic function in mild to moderate hypertension.

This study was undertaken to determine the correlations between left ventricular hypertrophy and left ventricular diastolic function in mild to moderate essential hypertension. M-mode echocardiography and rest equilibrium radionuclide angiography were performed in 53 hypertensive subjects. The following M-mode echocardiographic parameters were measured: interventricular septal thickness, posterior wall thickness, left ventricular mass index, left atrial diameter and relative wall thickness. The following radionuclide angiography parameters were measured: ejection fraction, peak filling rate, time to peak filling rate, first third filling fraction and atrial contribution to total filling. Weak correlations were shown between left ventricular diastolic function and the M-mode echocardiographic parameters. The peak filling rate was negatively correlated with the interventricular septal thickness (r = -0.345; P less than 0.05), with the sum of the interventricular septal thickness and the posterior wall thickness (r = -0.395; P less than 0.01), with the left atrial diameter (r = -0.345; P less than 0.05), and with the relative wall thickness (r = -0.297; P less than 0.05). The time to peak filling rate was positively correlated with the left ventricular mass index (r = + 0.310; P less than 0.05) and with the left atrial diameter (r = + 0.323; P less than 0.05). These findings suggest that diastolic abnormalities in hypertensive heart disease are only in part related to the degree of left ventricular hypertrophy.

Adult↗
PubMed1989

Primary malignant fibrous histiocytoma of the right ventricle and main pulmonary trunk with a review of the literature.

We report the case of a 76-year-old man with a malignant fibrous histiocytoma of the right ventricle and main pulmonary trunk, diagnosed through echocardiography and catheterization. Extensive resection of the right ventricular outflow tract, pulmonary valve apparatus, and main pulmonary trunk was performed, and the defect was repaired with a valveless ventriculo-pulmonary Dacron graft. The patient recovered uneventfully, and was doing well 18 months after surgery. To our knowledge, this is only the 15th case of primary malignant fibrous histiocytoma of the heart that has been documented in the literature since histologic criteria and cases were published in 1977-78, and the 2nd such case of a primary tumor that has arisen in a right cardiac chamber. The case is presented in detail, along with a review of the literature since 1978.

Journal Article↗
PubMed1989

[Study of left ventricular diastolic function using pulsed Doppler in myocardial infarct in hypertensive subjects].

To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.2 (n = 12 pts) acute myocardial infarction without arterial hypertension. G.3 (n = 10 pts) arterial hypertension without history of coronary artery disease. G.4 (n = 12 pts) healthy subjects. Coronary angiography and left ventricular cineangiogram was performed in 24 pts (G.1 + G.2). Peak mitral flow velocity (cm/s) in early diastole (E), atrial systole (A), A/E and int A/int E ratios were measured by pulsed doppler. Age and heart rate were statistically similar in all groups. No difference was found among G.1 and G.2 in ejection fraction, and left ventricular segmental kinetic. (tables; see text) Conclusion left ventricular filling is impaired in pts with arterial hypertension and in pts with acute myocardial infarction; acute myocardial infarction increase the impairment of left ventricular diastolic function in pts with hypertensive heart disease.

Aged↗
PubMed1989

[Clinical, angiographic aspects and 18-month follow-up of 134 cases of left coronary trunk stenosis].

A series of 134 patients with left main coronary stenosis was followed up for an average of 18 months. The majority of patients presented with unstable angina and per-critical ECG changes. Coronary angiography showed that left main coronary stenosis is rarely an isolated entity but generally associated with diffuse coronary atherosclerosis. Left ventricular function is usually normal. Treatment is surgical whenever the coronary lesions, left ventricular function and general condition of the patient allow it. The medium-term surgical results are excellent on clinical symptoms and quality of life at the price of low perioperative mortality and morbidity.

Adult↗