Search PubMed⌕ Search

Biomedical subjects

P Even

Publications and source records attributed to P Even.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Surgically-treated small size non-small cell bronchopulmonary cancers without adenopathies (T1NO). 5-year survival and site of recurrences].

From October, 1976 to February, 1982, 48 patients with T1N0 non-small cell bronchopulmonary carcinoma were operated upon at the Laennec Hospital, Paris. Their characteristics were: mean age 57 years (range: 43-80 years); sex ratio 23; type of surgery: 35 lobectomies, 11 pneumonectomies, 2 bilobectomies; histology: 30 epidermoid carcinomas, 15 adenocarcinomas, 3 bronchoalveolar carcinomas. On 1st January, 1983, 10 patients had relapsed after a mean complete remission period of 20 months (range: 2-29 months); 5 only had a local relapse. The actuarial probability of relapse at 5 years is 45%. Twelve patients died after a median survival of 21 months (range: 0-44 months). Of these, 3 died post-operatively, 8 after relapse and 1 of infarction during a first complete remission. Most relapses involved the mediastinum (50%) and the brain (30%). As the preventive role of mediastinal and cerebral irradiation has now been demonstrated in more extensive forms of non-small cell carcinomas, such irradiations would be justified in the T1N0 forms.

Actuarial Analysis↗
PubMed1984

An analysis of the diagnostic methods for acute pulmonary embolism.

In spite of numerous sophisticated investigative procedures, acute pulmonary embolism (PE) is very frequently misdiagnosed. In order to improve the diagnostic approach to PE, the sensitivity and specificity of the commonly used methods were reviewed in a group of 421 patients with angiographically proved PE without associated cardio-pulmonary disease. The specificity of diagnostic procedures was, by decreasing order: positive pulmonary angiography (to affirm) = negative perfusion lung scan (to eliminate) greater than chest X-ray much greater than clinical symptoms, positive perfusion lung scan, ECG, blood gas, serum enzymes.

Acute Disease↗
PubMed1984

Penetration of cefsulodin into bronchial secretions.

The objective of this study was to evaluate the penetration of cefsulodin, a new cephalosporin active against Pseudomonas aeruginosa, into the bronchial secretions. The study was carried out in 28 patients with respiratory infections; 11 patients received a single dose of 1 g i.v. (bolus); 17 patients received multiple doses of 1 g every 8 h for 48 h. Simultaneous samples of blood and bronchial secretions were collected 30 min and 1, 2, 4 and 6 h after injection. Bronchial secretions were obtained from 23 patients by means of fiberoptic bronchoscopy and in 5 tracheostomized patients (with severe respiratory insufficiency) through a tracheostomy cannula. The assays of cefsulodin were performed by means of the microbiological agar diffusion technique. The results of the study showed a noticeable penetration of the drug into the bronchial secretions, with a mean peak reaching 3.1-5.3 micrograms/ml at the 3rd or 4th hour, a slow elimination and residual levels at 6 h ranging between 2.0 and 6.0 micrograms/ml. The rate of penetration was not influenced by the administration of multiple doses of the drug. The ratios between bronchial concentrations and simultaneous serum concentrations ranged between 10 and 30%, corresponding to the usual values found for other cephalosporins. In conclusion, this study provides satisfactory results and confirms the presence of bronchial levels capable of inhibiting P. aeruginosa.

Bronchi↗
PubMed1984

[Basal metabolism: definition and apparatus for its measurement].

The " Metabolisme de Fond" (MF) is defined as the energy expenditure of the whole body cells, except for the energy devoted to the locomotor activity. The continuous measurement of the MF is performed in the free moving rat using a computer-controlled open circuitry calorimeter. This system provides simultaneous measurement of the metabolic parameters (oxygen, carbon-dioxide, respiratory quotient) as well as the quantification of the behavioral parameters (food intake, locomotor activity, sleep). The measurement of the MF is based on the calculation of the slope of the curve linking the relative changes in the intensity of respectively locomotor activity and total metabolism. Such a computation of the MF requires the precise analysis and the subsequent mathematical correction of the physical phenomena occurring in an open circuitry calorimeter. Indeed the instantaneous electrical signal of locomotor activity is recorded before the delayed and distorted corresponding increase in the energetic metabolism which must be corrected. In conclusion, the method described here allows the direct determination of quick MF modifications in the freely behaving rat.

Animals↗
PubMed1984

[Measurement of basal metabolism in relation to food intake : ischymetric hypothesis].

The ischymetric hypothesis of the control of food intake ( ischys = power in greek) suggests that the physiological stimulus of hunger is characterized by the decrease of the "m etabolisme de fond". In the same way, satiety would occur as long as the MF remains at a high level. The complex problems dealing with the continuous measurement of the MF in the free behaving Rat have been solved recently. As a consequence, it has been possible to test directly the ischymetric hypothesis by measuring the MF oscillations around six meals taken by the same Rat during a 24 hrs. experiment. The results showed that the meals are indeed preceded by a progressive decrease of MF and that the termination of meals coincides with a high metabolic rate. The rapid increase of the MF occurring immediately after the onset of the meals could reflect the oropancreatic reflex inducing the well known anticipatory release and utilization of the endogenous reserves. If anything, the respiratory quotient exhibited only small but not systematic variations during the pre-prandial periods. This observation is in agreement with the ischymetric hypothesis which proposes that the decrease of MF inducing the onset of a meal is due not only to the decrease of the glucose utilization but also to the concomitant decrease of the utilization of the three kinds of metabolic substrates.

Animals↗
PubMed1984

[Bronchial diffusion of new anti-pseudomonal beta-lactams. Clinical significance].

In treating severe respiratory infections due to Pseudomonas aeruginosa and in patients with cystic fibrosis, new anti-pseudomonal beta-lactams constitute a good alternative to the traditional aminoglycoside antibiotic therapy. Among several criteria for the choice of an antibiotic, estimation of intrabronchial levels is to be taken into account. The authors report the results of the study of a new semi-synthetic penicillin, apalcillin, and two cephalosporins (cefsulodin, ceftazidime), active in vitro against Pseudomonas; their penetration into respiratory secretions was evaluated in 48 patients, intubated, tracheostomized, or undergoing fiberoptic bronchoscopy. Antibiotic concentrations were measured by the microbiological procedure. Bronchial penetration of apalcillin was early and noticeable, reaching a bronchial peak representing 20% of the simultaneous seric concentration. The local levels of cefsulodin and of ceftazidime did not differ from those achieved with cephalosporins studied previously; the bronchial peak reached 5,6 micrograms/ml for both drugs 2 hours after administration; this bronchial level corresponded to 15 to 20% of the serum concentration. The clinical response could not be evaluated due to the severe underlying pathology which compromised the outcome of the disease in the patients of this study. However, at least for apalcillin, a significant correlation was noted between bronchial levels, susceptibility of bacteria isolated in patients, and eradication of susceptible organisms.

Anti-Bacterial Agents↗
PubMed1983

[Penetration of netilmicin into respiratory secretions].

Aminoglycosides are often used in the treatment of severe Gram-negative infections, particularly those involving the respiratory tract. The purpose of this study was to evaluate the penetration of netilmicin into bronchial secretions. In 8 tracheostomized patients samples of bronchial secretions were taken at intervals through the tracheostomy cannula after intramuscular injection of netilmicin 2 mg/kg bodyweight. Concentrations of the drug were measured in bronchial secretions and in blood samples taken simultaneously, using the agar diffusion method (Grove and Randall procedure). The results showed significant penetration of netilmicin, with a mean bronchial peak reaching 3.4 micrograms/ml 1 h after the injection. Elimination was slow, with a mean residual level of 2 micrograms/ml at 6 hours. The bronchial to serum levels ratio was high (greater than 30% at 1 hour). Individual variations in both serum and bronchial levels were noted; they were unrelated to the underlying pathology. However, changes in bronchial concentrations correlated with changes in serum concentrations, which suggests passive diffusion across the blood-bronchoalveolar barrier. The fluctuations in bronchial levels and the usually low bronchial concentrations of aminoglycosides previously reported are discussed in relation to the methods used.

Adult↗
PubMed1982

[Pharmacokinetics of mezlocillin in bronchial secretions (author's transl)].

This study was designed to measure the penetration of mezlocillin into respiratory secretions taken from tracheostomized patients admitted to an intensive care unit. In these patients admitted to an intensive care unit. In these patients, samples can be taken at set intervals. Eighteen patients were divided into two groups, one group received a single i.v. dose of 5 g. mezlocillin and the other a one day treatment with eight-hourly infusions of 5 g mezlocillin, samples being taken after the fourth infusion. Antibiotic concentrations were measured in simultaneous samples of serum and bronchial secretions by an agar diffusion method. The results showed considerable penetration of mezlocillin into bronchial secretions. Two hours after the end of the infusion, the peak of bronchial mezlocillin concentrations varied from 10 to more than 20 micrograms/ml. The kinetics of bronchial levels exhibited slow elimination, with still measurable levels at the sixth hour (1.5 to 3 micrograms/ml). Important individual variations were seen in patients with different clinical conditions (respiratory insufficiency, acute intoxication in forced diuresis). There was no difference between the two groups of patients, which showed that no cumulation took place. It is concluded that the passage of mezlocillin in the human respiratory tract results in high bronchial concentrations which are bactericidal to most species of Enterobacteriaceae.

Adult↗
PubMed1981

[A study of the diffusion of cefamandole into bronchial secretions (author's transl)].

The penetration of cefamandole into bronchial secretions was investigated in 5 tracheostomized patients with respiratory tract infections and purulent or mucopurulent expectorations. Bronchial secretions were collected by aspiration through the cannula at successive predetermined times after an intravenous injection of 1.5 g of the drug. Cefamandole concentrations in simultaneous samples of serum and bronchial secretions were measured by the agar diffusion microbiological method. Useful concentrations of cefamandole were obtained in bronchial secretions, with an early peak (mean: 1.97 microgram/ml; range: 0.5 -- 4.6 microgram/ml) one hour after the injection. The ratio of bronchial concentration to simultaneous serum concentration reached 24% six hours after the injection. These results show that cefamandole achieves bronchial concentrations which are superior, or at least equal, to the MICs of organisms responsible for respiratory infections. This and the resistance of cefamandole to beta -lactamases suggest that this second generation cephalosporin can be valuable in acute bronchopulmonary infections.

Aged↗
PubMed1980

[Study of pulmonary lymphocyte populations obtained by alveolar lavage].

Purified alveolar lymphocytes obtained by bronchial lavage have been studied in 66 subjects: 8 normals, 24 sarcoidosis, 8 tuberculosis, 4 hypersensitivity pneumonitis, 6 collagen diseases and 16 miscellaneous. The following T and B lymphocyte markers have been used: E and EAC Rosettes, Surface membrane immunoglobulins, la antigen and human T lymphocyte antigens. The PHA or ConA responses of some blood and alveolar lymphocyte cultures have also been compared. The results emphasize: -- the tight correlation between the different marker techniques to T and B lymphocytes; -- the larger increases of T lymphocytes in active vs inactive sarcoidosis (p less than 0.001); -- the difference in T lymphocyte number in active vs inactive tuberculosis and in treated vs untreated miliary tuberculosis; -- the absence of alveolar lymphocyte increase in collagen diseases.

Adult↗
PubMed1980

[Sarcoidosis and portal and pulmonary arterial hypertension: a case report (author's transl)].

A 27-year-old patient, originally from Martinique, presented with a progressive hepatic granulomatosis with hepatomegaly, splenomegaly, and non-icteric cholestasis, associated with bronchial granulomatosis lesions. The sarcoidosis regressed rapidly after high doses (60 mg/day) of prednisone. Portal hypertension developed later and provoked a severe hematemesis from rupture of esophageal varices. Signs of pulmonary arterial hypertension were then observed, and the diagnosis confirmed by pressure tests after catheterization, and angiography. A portocaval shunt caused the esophageal varices to subside, but the pulmonary arterial hypertension, resistant to corticotherapy, was rapidly fatal. In the case reported, the pulmonary arterial hypertension, independent of any parenchymatous lesion, was attributed to fibrosis of the arterial walls. The association of portal and pulmonary arterial hypertension with sarcoidosis is a very rare occurrence, and the pathogenesis of this association remains a debatable subject.

Adult↗
PubMed1978

[Pharmacokinetic study of antibiotics in human respiratory tract (author's transl)].

We report the results of the study of the bronchial concentrations of several antibiotics. The experiment included 280 patients and the concentrations achieved in bronchial secretions were measured for 11 antibiotics. The samples of bronchial secretions were taken in situ by fibroscopy or through the tracheostomy cannula. The results of the study show that the rate of penetration is variable according to the different drugs; even in the same antibiotic family such as beta-lactam antibiotics the rate of penetration is variable. The bronchial levels of aminoglycosides, macrolides and tetracyclines are worthwhile, and are often superior to the MIC of the infecting organisms; the penetration is also dependant of the inflammatory conditions of the bronchi. Otherwise the sampling conditions were the best possible since samples taken by fibroscopy or by tracheostomy are not contaminated by saliva which is a factor of dilutional error. The methodology used in this study is an approach of pharmacokinetics of antibiotics in respiratory tract.

Adult↗