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Biomedical subjects

P Hans

Publications and source records attributed to P Hans.

At least 127 records · Page 7Linked to original sources
PubMed1985

Relative prognostic value of best motor response and brain stem reflexes in patients with severe head injury.

The object of this study was to determine whether the addition of information on brain stem reflexes improves the prognostic precision of the Glasgow coma scale for patients with severe head trauma. The study is based on 109 patients with a Glasgow coma score of 7 or less during the first 24 hours after injury. The average age was 23 years. The patients were classified into three groups according to their actual outcome after 6 months: dead, 44 patients; persistent vegetative state and severe disability, 13 patients; moderate disability and good recovery, 52 patients. We then compared, by means of multiple group logistic regression, the prognostic ability of motor responses alone using the Glasgow criteria and of brain stem reflexes via an original approach. We showed that the predictive capabilities of brain stem reflexes were greater than those of motor responses. Although closely related (r = 0.68), the use of these two parameters in a single scale, the Glasgow-Liege scale, improves the precision of prognosis, especially for those head trauma patients with initial and complete loss of consciousness. Age was also revealed to be an important factor for outcome prediction.

Adolescent↗
PubMed1985

One-stage excision of high-flow arteriovenous malformations.

The authors describe two cases of high-flow arteriovenous malformations which illustrate a new technique to reduce the risk of brain swelling and diffuse hemorrhage during or after operation. This technique, used in the latter of the two cases, includes occlusion of the shunt, followed by the progressive tightening of a Selverstone clamp placed on the cervical internal carotid artery, lowering of the systemic arterial pressure, and the use of barbiturate anesthesia. Clamping and anesthesia are maintained for a 24-hour period after surgery.

Cerebrovascular Circulation↗
PubMed1985

[Pediatric papular acrodermatitis and double primary infection by the hepatitis B virus and the Epstein-Barr virus].

A case of papular infantile acrodermatitis was evaluated in a twenty-two month-old child. Laboratory data showed the presence of a cytolytic hepatitis associated to an increase in circulating monocytes (1.500/mm3) with hyperbasophilic cells. Hepatitis B surface (HBs) antigen was detected in the serum, associated to anti-HBc antibodies of the IgM class, without detectable anti-HBs antibodies. Simultaneously, EBV serologic profiles were consistent with a primary infection. The authors review the clinical presentation of previously described cases according to their suspected cause, and discuss the etiologic role of both EBV and HBV in the hereby reported case.

Acrodermatitis↗
PubMed1984

Changes in cerebrospinal fluid enzyme activity after severe head injury. Diagnostic and prognostic values.

We studied CSF CK and LDH isoenzyme activities in 27 patients with severe head injury and in 10 patients with chronic hydrocephalus not related to trauma. CSF enzymes showed an increased activity immediately after trauma, contrasting with the low values measured in the patients with hydrocephalus. In severe head injury, we found a correlation between enzyme release and brain dysfunction assessed according to two methods: the Glasgow coma scale (GCS), and the Liège coma scale (LCS) which uses elements of the GCS and the study of 5 brain stem reflexes. The correlation between enzyme activity and the Liège coma scores is better than that observed with the Glasgow coma scores. High enzyme activity is associated with a bad outcome at six months. It has a prognostic value on so far as it reflects the severity of traumatic structural brain damage.

Adolescent↗
PubMed1984

[Correlation between the Liège scale and a biomechanical marker of the cerebral lesion].

Brain type creatine kinase isoenzyme (CK.-1) was measured in the ventricular cerebrospinal fluid in a series of 42 patients within 7 +/- 3,4 hours following severe head injury (GCS less than or equal to 7, LCS less than or equal to 12). The presence of the CK.-1 isoenzyme correlated with the degree of head injury as indexed by the Glasgow coma scale and the Liege coma scale. There was a significant logarithmic correlation between CK.-1 activity in the C.S.F. and the coma scores. However, the correlation with the Liege coma scale score (r = -0,84) is significantly better (Z = 1,97; p less than 0,05) than with the Glasgow coma scale score (r = -0,65). Thus, the Liege coma scale is a better index of neurological trauma.

Adolescent↗
PubMed1984

[Intracranial pressure in severe brain injuries. 2nd Part: Therapeutic interests and prognosis].

Sixty-seven patients with severe head injury underwent intracranial pressure (ICP) monitoring (10 extradural and 57 intraventricular). All patients had Liege coma scale (LCS) score of 12 or less. Ventriculitis (E. Coli) occurred in one patient (1,8%). The intraventricular method allows C.S.F. drainage with lowering of I.C.P. even with slit ventricles. After 8 days, if an intracranial hypertension persists, we perform a ventriculo-atrial drainage. Pressure recording is a useful way of following the patient's evolution and a guide for prognosis of survival. If I.C.P. is constantly below 5 torr, then the probability of a bad outcome is great. The study also confirms the high mortality rate (93%) if I.C.P. is greater than 40 torr.

Adolescent↗
PubMed1983

Stimulation of cyclo-oxygenase by lidocaine, a pro-lipoperoxidant.

Lidocaine, which was recently demonstrated to be a good pro-lipoperoxidant, was tested on in vitro PGs biosynthesis, and on arachidonate-induced arterial hypotension, in the rabbit. In the in vitro experiments, lidocaine alone was a poor stimulant of cyclo-oxygenase, but it enhanced significantly the cyclo-oxygenase activation of uric acid. In the rabbit, lidocaine lowered the i.v. arachidonate dose necessary to obtain a significant drop of blood pressure.

Animals↗
PubMed1983

Creatine kinase isoenzymes in severe head injury.

Brain-type creatine kinase (CK) isoenzyme (CK-BB) was found in the ventricular cerebrospinal fluid (CSF) and the serum in a series of 35 patients within 13 hours following severe head injury. There was a good correlation between total CK and CK-BB activities in CSF only. The values found in the CSF appear to be a quantitative index of brain dysfunction at admission, and did not correlate with intracranial pressure activity. High levels of CK-BB in the CSF correlated with a poor outcome, and thus offer a reliable criterion for the assessment of the severity of head injury.

Adolescent↗
PubMed1983

Continuous intravenous administration of drugs.

Continuous intravenous administration of drugs may be a problem in clinical practice; for several reasons patients do not always receive the dose of drug intended for them. Problems of parenteral fluid composition are related to the solvent, dilution and drug interactions. Physical factors influencing drug stability are light and adsorption onto perfusion sets. Examples are reported for each problem. A practical solution, based on personal experimentation, is proposed for diazepam and nitroglycerin administration.

Adsorption↗
PubMed1982

Intravenous nitroglycerin perfusion techniques--clinical implications.

Two types of intravenous nitroglycerin (NTG) perfusion sets were studied using laboratory techniques. A known concentration of NTG was placed in each of these sets, and an evaluation was made as to the dose of NTG actually received by the patient after passage of the NTG solution through the sets. Set number one consisted of a glass container and polyvinyl chloride (PVC) tubing. After passage through this set, there was a rapid and significant decrease in the NTG concentration, i.e. the dose actually received by the patient is less than the dose theoretically administered. Set number two consisted of a polypropylene syringe and polyethylene tubing. After passage through this set, there was no significant change in the NTG concentration, i.e. the patient receives the full theoretical dose.

Angina Pectoris↗