Biomedical subjects

P Germonpré

Publications and source records attributed to P Germonpré.

3 recordsLinked to original sources

PubMed1998

Patent foramen ovale and decompression sickness in sports divers.

Patency of the foramen ovale (PFO) may be a cause of unexplained decompression sickness (DCS) in sports divers. To assess the relationship between PFO and DCS, a case-control study was undertaken in a population of Belgian sports divers. Thirty-seven divers who suffered from neurological DCS were compared with matched control divers who never had DCS. All divers were investigated with transesophageal contrast echocardiography for the presence of PFO. PFO size was semiquantified on the basis of the amount of contrast passage. Divers with DCS with lesions localized in the high cervical spinal cord, cerebellum, inner ear organs, or cerebrum had a significantly higher prevalence of PFO than divers with DCS localizations in the lower spinal cord. For unexplained DCS (DCS without commission of any diving procedural errors), this difference was significant for large PFOs only. We conclude that PFO plays a significant role in the occurrence of unexplained cerebral DCS, but not of spinal DCS. We further stress the importance of standardization and semiquantification of future PFO studies that use transesophageal contrast echocardiography.

Adult↗

PubMed1998

Intrathoracic pressure changes after Valsalva strain and other maneuvers: implications for divers with patent foramen ovale.

Scuba divers with patent foramen ovale (PFO) may be at risk for paradoxical nitrogen gas emboli when performing maneuvers that cause a rebound blood loading to the right atrium. We measured the rise and fall in intrathoracic pressure (ITP) during various maneuvers in 15 divers. The tests were standard isometric exercises (control), forceful coughing, knee bend (with and without respiration blocked), and Valsalva maneuver (maximal, gradually increased to reach control ITP, and as performed by divers to equalize middle ear pressure). All the maneuvers, as well as the downward slope of ITP at the release phase, were related to the control value. ITP levels were significantly higher than the standard isometric effort during a breath-hold knee bend (172%, P < 0.001), cough (133%, P < 0.05), and maximal Valsalva (136%, P < 0.05) whereas "usual" Valsalva maneuvers produced ITPs significantly lower than the standard (28%, P < 0.001). The downward slope of the pressure release curve was not significantly different among the different maneuvers (P < 0.1447). We conclude that maneuvers other than the usual divers' Valsalva are more likely to cause post-release central blood shift, both by the levels of ITP reached and by the time during which these ITPs are sustained. Divers (especially with PFO) should be advised to refrain from strenuous leg, arm, or abdominal exercise after decompression dives.

Adult↗

PubMed1996

Hyperbaric oxygen therapy and piracetam decrease the early extension of deep partial-thickness burns.

During the first 24 h, a progression of the burn wound in histological depth or extension is often noted. This can only partially be prevented by the routinely used protocols of fluid resuscitation and burn wound dressing. In a rat model of 5% TBSA burn, hyperbaric oxygen therapy (HBOT) and piracetam were evaluated for their ability to further prevent this early deepening of the burn wound. After infliction of the burn wound, the animals were treated with an accepted basic burn wound treatment consisting of mafenide 10% solution humid dressings. They were then randomized into three groups: a control group (n = 10), receiving no other treatment, a HBOT group (n = 17), receiving 60 min of HBOT (203 kPa) twice daily, and a piracetam group (n = 19), receiving piracetam (200 mg/kg IM) twice daily. On the third day of treatment, the entire burn wound was exised and examined histologically. It was found that both HBOT and piracetam had statistically significant effects on the preservation of epidermal basal membrane (P < 0.001 and P < 0.01, respectively). HBOT, but not piracetam, further had significant effects on the destruction of skin appendages (P < or = 0.05 and P > 0.05, respectively) and on the degree of subepidermal inflammation, as measured by leucocyte infiltration (P < 0.001 and P > 0.05, respectively). Furthermore, the HBOT group showed significantly less leucocyte infiltration than the piracetam group (P < 0.01). It was concluded that, although the clinical importance of the small effects on skin appendage and basal membrane preservation may be questionable, the effect on subepidermal leucocyte infiltration is striking and warrants further investigation of the anti-inflammatory effects of HBOT and possibly piracetam.

Animals↗