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P Geslin

Publications and source records attributed to P Geslin.

At least 127 records · Page 7Linked to original sources
PubMed1986

[Laser-Doppler velocimetry: a new technic for evaluating of microcirculation. A reproducibility study].

The recent introduction of the laser-Doppler technique to measure capillary flow velocity offers new prospects in clinical pharmacology. We used this technique in 45 healthy volunteers (23 women and 22 men) to study the capillary network at the distal end of the third finger of the non-dominant hand. Each subject was tested twice at one-week interval. The results showed that the data concerning flow velocity and amplitude were perfectly reproducible, under standard conditions, after one week in each subject. No correlation was found between the microcirculation parameters and the subjects age, weight and, paradoxically, blood pressure and heart rate. We would suggest that this innocuous, sensitive and reproducible technique be used more systematically to evaluate the haemodynamic effects of drugs on capillary blood flow.

Adult↗
PubMed1986

[Corrected transposition of the great vessels in aged adults. Apropos of 2 patients aged 72 and 80].

The authors report two unusual new cases of corrected transposition of the great arteries diagnosed in patients 72 and 80 years of age respectively, presenting with symptoms of cardiac failure of recent onset. Both patients had mild or moderate regurgitation of the systemic atrio-ventricular valve, associated in one case with aortic regurgitation. This association would appear to be fortuitous although already reported in six occasions. The diagnosis was made by echocardiography and confirmed by catheterisation in one case, and by digitised intravenous angiography in the other. These cases are of interest for three reasons: They are very rare: there have been only 20 comparable cases reported in patients over 40 years of age, the eldest being 73. This is probably explained by the high frequency of associated malformations. They illustrate the decisive role of echocardiography in the diagnosis of congenital heart disease, even in the adult. They constitute a "natural experimental model" of a right ventricle submitted to systemic pressures and tend to show that, in the absence of other abnormalities giving rise to an additional pressure or volume overload, the right ventricle is capable of long term adaptation to this situation. These observations indicate a favourable long-term prognosis for children who have undergone "corrective" surgery at atrial level for simple transposition and in whom the right ventricle is required to assume the function of the systemic ventricle for the rest of their life.

Aged↗
PubMed1986

[Results of bacteriological technics and demonstration of pneumococcal antigens by counterimmunoelectrophoresis in 40 cases of Streptococcus pneumoniae pneumonia].

This study is conducted on 45 patients with Streptococcus pneumoniae pneumonias. Counter-immunoelectrophoresis (CIE) (detection of pneumococcal polysaccharides antigens in serum and/or urine and/or pleural fluid) and conventional bacteriological technics (blood culture and/or thoracentesis and/or transtracheal function) have been performed in all cases. Streptococcus pneumoniae has been identified with conventional bacteriological technics in 27 patients. Pneumococcal antigens have been identified in 28 patients. Both technics have been positive in 10 patients. The detection of antigens has been positive in 7 on 8 pleural fluids. The CIE is very useful in patients who has been treated by antibiotics before bacteriological examination of samples (6 CIE + and 1 bacteriological technic +). The association of the two technics is very useful. The percentage of cases with CIE / and bacteriology - is 40% (18 cases). The percentage of cases with bacteriology + and CIE - is 37.7% (17 cases).

Adult↗
PubMed1986

[Failure of anti-pneumococcal vaccination and prophylactic antibiotic therapy in 2 splenectomized subjects].

Asplenic patients are at high risk for the development of fulminant pneumococcal bacteremia. The mortality rate in those infected patients remains high. Therefore pneumococcal polysaccharide vaccine has been recommended, but despite penicillin prophylaxis pneumococcal sepsis can occur in vaccinated patients. We have observed two cases (one fatal) of overwhelming postsplenectomy pneumococcal sepsis in vaccinated patients who received long-term antibiotic prophylaxis. Both exhibited a poor antibody response to polyvalent vaccine.

Adult↗
PubMed1985

[Haemophilus influenzae infections in infants and macrolides. Importance of the choice of an effective antibiotic and compliance with its administration schedule].

Five cases of meningitis due to Haemophilus influenzae type b are reported. In four, the same pathogen was recovered from blood. In every case, meningitis developed despite administration of macrolides for ENT infections (4 cases) or pneumonia (1 case). These five observations are conclusive evidence that macrolides failed to prevent meningeal diffusion of Haemophilus influenzae presumptively responsible for the initial focal infection. In vitro activity of macrolides against Haemophilus influenzae is poor. For the treatment of ENT infections in pediatric patients aged 2 months to 5 years, the age group most susceptible to infection by Haemophilus influenzae, we recommend amoxicillin which is more active and bactericidal. An adequate dosage should be used (50 to 100 mg/kg/24 h) divided into four oral doses given at six hour intervals. This therapeutic attitude may need to be revised if the prevalence of beta-lactamase-producing H. influenzae strains (5 to 10% as of now) were to increase. In this case, use of an amoxicillin-clavulanic acid combination under the same conditions as outlined above may prove satisfactory. Correct administration of judiciously chosen antibiotics in ENT infections in infants and children is the most effective means of preventing meningitis due to H. influenzae.

Amoxicillin↗
PubMed1985

[Determination of left ventricular volume by cardiac angio-scintigraphy at equilibrium. Comparison with a radiologic method].

Cardiac angioscintigraphy at equilibrium was performed after in vitro red cell labelling in the left anterior oblique and anterior views. A syringe of 10 ml labelled blood was placed on the patient's chest over the left ventricle and in contact with the camera's collimator in the LAO incidence. This syringe plays a dual part: as a direct reference for left ventricular radio-activity and as a marker for measuring the distance between the centre of gravity of the LV and the collimator by Links' method. The correction factor for absorption varies with each individual. An algorithm integrating this data automatically calculates the EDV in millilitres (ml) and the end diastolic and systolic volumes from the ejection fraction (EF) determined by an independent method. The study group was 100 patients (91 men, 9 women; 81 coronary, 11 valvular heart and 8 other diseases) with radiological EDV ranging from 107 to 1 283 ml and radiological EF ranging from 14 to 75 p. 100. A very significant correlation was observed between the radiological and scintigraphic EDV with a regression line close to that of identity: EDVs = 1.05 . EDVR-5 ml (or -3 ml/m2); SD = 48 ml; r = 0.953; p less than or equal to 0.001. The mean deviation between the methods was 35.7 ml (median 24 ml) or 13.7 p. 100 (median 9.4 p. 100) of EDVR. A large discrepancy (over 90 ml or 30 p. 100) was observed in only 7 patients, 4 of whom had severe mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1985

[Cardiac angioscintigraphy at equilibrium coupled with isoproterenol perfusion. Method of diagnosing chronic coronary insufficiency].

The effects of isoproterenol (IPNA) on global and regional left ventricular wall motion were studied by cardiac angioscintigraphy at equilibrium performed under basal conditions, during IPNA administration (per IPNA) and 10 minutes after (post IPNA) in 50 patients classified by coronary angiography as coronary (C) (n = 37) and non-coronary (NC) patients (n = 13), 5 reference subjects (REF) and 8 non-coronary pathology. The effects were assessed from variations of global LV function and from indices of regional wall function (12 regional ejection fractions - REF). The IPNA perfusion was well tolerated, even in patients with severe coronary lesions. 1. Diagnosis of myocardial dysfunction due to coronary artery disease: it was possible to separate the patients into C and NC groups according to the variations in EF, end systolic (ESV) and REF, especially post IPNA: NC group: per IPNA: 12/13 NC patients showed an increase in EF (+10.7%), a decrease in ESV (-41%) and increased or stable REFs. Post IPNA: 10/13 had raised EF (+4.6%), 9/13 had a reduced ESV (-17.4%) and 10/13 had stable or increased REF. C group: per IPNA: 15/37 C patients showed decreased EF, 12/37 had increased ESV and 15/37 had a decrease in at least two ref greater than or equal to 5%. Post IPNA: 25/37 had decreased EF, 21/37 increased ESV, 34/37 had at least two reduced REFs. These results show that decreased ref post IPNA (sensitivity 91.9%, specificity 66.9%) was a better indicator of coronary artery disease than VEF (sensitivity 68%, specificity 54%), increased ESV (sensitivity 57%, specificity 77%) or ECG changes (sensitivity 54%, p 0.05; specificity 91%, p less than 0.1). 2. Diagnosis of the extent of coronary artery disease: the post IPNA abnormal ref were situated in zones compatible with the coronary lesions: 10/13 single vessel disease (2 false negatives, 1 false localisation); 8/11 double vessel disease (1 false negative, 2 single vessel disease); 5/10 triple vessel disease (2 single vessel and 3 double vessel disease); 2/3 left main stem disease (1 single vessel disease). The study of REF demonstrated at least 2 diseased zones in 15/24 patients with multiple diseased vessels. Independently, the diagnosis of multivessel disease may be suspected by the fall in EF per IPNA (4/13 single vessel cases compared to 11/24 multivessel disease) and, more generally, by the fact that the EF and ZSV per and post IPNA appear more pathological with respect to the reference group when the coronary lesions are most diffuse.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1984

[Beneficial effects of coronary transluminal angioplasty on resting left ventricular systolic function].

Resting left ventricular systolic function was studied by cardiac catheterisation before and 6 months after effective transluminal coronary angioplasty (TCA) to evaluate the myocardial effects of this procedure. The global left ventricular systolic function was assessed by measuring ventricular volumes, the ejection fraction, the mean velocity of circumferential fibre shortening (m VCF) and mean normalised systolic ejection rate (MNSER). The regional function was studied by dividing the left ventricle into 8 regions using the Stanford radial model and measuring the percentage shortening and velocity of circumferential fibre shortening (VCF). These parameters were obtained from selective left ventriculography filmed at 100 frames/second in the RAD plane. Left ventricular function was analysed from the whole of systolic ejection and then sequentially during each third of systole (early-mid-and end systole). The 10 patients studied had an average age of 45 years. Coronary angiography was performed for unstable angina (6 cases), stable angina (3 cases) and post-infarction angina (1 case). Except for 1 patient with associated LAD and right coronary disease they all had single vessel disease. TCA was performed on the LAD artery in 8 cases, on a dominant left circumflex artery in 1 case and on a right coronary artery in 1 case. The efficacy was demonstrated by angiographic reduction of the degree of stenosis (85 to 25 p. 100 immediately after TCA, and 30 p. 100 at control angiography at 6 months), and by a reduction of more than 40 p. 100 in the average transstenotic pressure gradient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Antibiotic sensitivity of Streptococcus group B].

The minimal inhibitory and bactericidal concentration of 18 antibiotics for 412 isolates of group B streptococci from newborns, mothers or pregnant women were determined. 3.2% of these strains were less susceptible to penicillin G, 1% failed to be inhibited by erythromycin and 1% by chloramphenicol. Antibiotic-killing kinetics was studied with beta-lactams, aminoglycosides, and in combination for 20 isolates. Killing was accelerated by the combination. For these reasons, at least at the beginning of the treatment, the association of ampicillin and an aminoglycoside can be recommended.

Anti-Bacterial Agents↗
PubMed1983

[Microbiological diagnosis of epiglottitis].

Forty patients, between July 1977 and April 1982, with clinical diagnosis of epiglottitis were studied for the presence of capsular antigen by counter-immunoelectrophoresis (CIE) and for positive blood culture. Blood culture was positive, for Haemophilus influenzae only, in 15 patients. Haemophilus influenzae type b antigen was present in blood and/or urine of 25 patients (blood 14 patients, urine 18 patients). CIE associated with blood culture give conclusive proofs of Haemophilus influenzae etiology in 30 patients.

Antigens, Bacterial↗
PubMed1983

[Microbiological diagnosis of epiglottitis].

Forty patients, between July 1977 and April 1982, with clinical diagnosis of epiglottitis were studied for the presence of capsular antigen by counter-immunoelectrophoresis (CIE) and for positive blood culture. Blood culture was positive for Haemophilus influenzae only, in 15 patients. Haemophilus influenzae type b antigen was present in blood and/or urine of 25 patients (blood 14 patients, urine 18 patients). CIE associated with blood culture give conclusive proofs of Haemophilus influenzae etiology in 30 patients.

Antigens, Bacterial↗
PubMed1983

[Relation between serum levels and inotropic effect of digoxin in advanced cardiac failure during long-term treatment].

The aim of this study was to determine the relationship of digoxin serum levels to their inotropic effects in advanced cardiac failure during long-term therapy with different dosages. The study was based on the analysis of left ventricular systolic time intervals (STI) measured at 97 follow-up appointments of 20 patients in advanced, stable cardiac failure over an average period of 37 days. The dosage of digoxin was varied at successive consultations so that the serum digoxin levels reached 0.50 ng/ml on at least one occasion. The serum digoxin levels (SD) varied between 0 and 4 ng/ml. Four levels of SD were individualised: A) "control" SD less than 0.25 ng/ml (22 consultations); B) SD: 0.25 to 1 ng/ml (n = 25); C) SD: 1.0 to 2.0 ng/ml (n = 29); D) SD greater than 2 ng/ml (n = 21) including 6 cases with clinical and/or ECG signs of digoxin toxicity. A progressive significant shortening of the electromechanical systolic index (Q-S2 I) was observed up to levels of 2 ng/ml (B and C, -18 ms and -28 ms respectively). The same phenomenon was observed with the ejection time index (ETi) and pre-ejection time index (PETi) (-7 ms and -14 ms; -11 ms and -15 ms respectively) compared to the basal values. At SD greater than 2 ng/ml the reduction remained stable and then started to decrease (positive difference between C and D). These changes were observed in the absence of significant variations of the heart rate. There was a significant linear relationship between the variations of the STI and SD in 15 out of 18 patients (in whom the regression could be calculated, these patients having attended at least 3 appointments). These linear relationships were observed for the Q-S2 i (11-18), the ETi (9-18) and/or PETi (10-18). An unexpected increase in the pre-ejection period was observed in 2 patients. In conclusion, a linear relationship has been shown between SD and inotropic effect which is particularly noticeable at SD levels less than 2 ng/ml. When SD is greater than 2 ng/ml, further increases in SD are associated with smaller variations of the STI. On the other hand, a significant inotropic effect is observed with small doses and SD levels less than 1 ng/ml. This inotropic effect persists unchanged at long-term.

Aged↗
PubMed1983

[Serotype and antibiotic resistance of pneumococci isolated at the Aix-en-Provence Hospital Center].

Over a 2 year period from April 1980 to April 1982, 240 pneumococci isolated from amongst 208 patients during 216 infectious episodes were serotyped. Sensitivity to standard antibiotics was determined for 209 of these strains. Pneumococci are divided into 33 serotypes. The vaccination cover provided by the vaccine currently commercially available is 70%. AUSTRIAN and GESLIN feel that the surveillance of bacteraemias is the most effective method for the choice of vaccine formula in order to eliminate the bias due to healthy carriers. In the present study, pneumococci isolated from 41 bacteraemias came from 14 serotypes and vaccine cover was 90%. Amongst 209 strains of Streptococcus pneumoniae, 25.8% were resistant to tetracyclines, 10.5% to sulphonamides, 6.6% to chloramphenicol, 5.7% to erythromycin, 2.8% to co-trimoxazole and none to penicillin.

Anti-Bacterial Agents↗
PubMed1982

[Radioimmunoassay of serum digoxin levels. Clinical exploration (author's transl)].

This work undertakes, in a second part, the clinical exploration of 947 serum digoxin levels of 281 hospitalized patients on a cardiology ward. Our results which coincide with those of other researchers, have led us to draw certain practical conclusions: the posology is determined first of all according to kidney function, weight and age of the patient. When the treatment is insufficient or on the other hand, poorly tolerated, a serum digoxin level is performed permitting thus: 1) in the case of ineffective treatment: to be sure of the patient's cooperation, to increase the posology if the serum digoxin level is not in the toxic zone, to discover an eventual pharmacokinetic problem; 2) to establish the responsibility of digitalis (when there are signs of intolerance or of intoxication), in case of arrhythmia, in patients with pacemakers, when associated drugs are capable of causing similar adverse effects; 3) to better manage a digitalis treatment in a high risk patient (unstable renal function, advanced myocardial disease, chronic obstructive disease).

Adult↗