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Biomedical subjects

P Hans

Publications and source records attributed to P Hans.

140 records · Page 8Linked to original sources
PubMed1982

[Practical assessment of brain dysfunction in severe head trauma (author's transl)].

Assessment of brain dysfunction in head injured patients is important as an index of severity of brain damage and forms the basis of monitoring. . The Glasgow Coma scale (G.C.S.) is a practical scale for nurses. The Liege Coma scale contains the three variables of the G.C.S. and provides informations concerning the brain stem reflexes. In a series of 60 head-injured patients, recovery rates were calculated on the basis of either Glasgow scores or Liege scores. The Liege Coma scale provides a more sensitive index of clinical course and a better prognosis.

Adolescent↗
PubMed1982

[Creatine kinase isoenzymes in severe head injury (author's transl)].

We measured the c.s.f. and serum creatine kinase activities in the first hours following the trauma, for 24 severe head injury patients. We found a good correlation between total CK and CKBB isoenzymes levels in the c.s.f. only. The c.s.f. values are a quantitative index of brain dysfunction assessed by the Liège coma scale, associating the Glasgow coma scale and the study of the brain stem reflexes. There is no relationship between CK activity and intracranial pressure.

Adolescent↗
PubMed1982

[Incidence of inappropriate secretion of antidiuretic hormone in patients with severe head injuries].

Eight patients with severe craniocerebral trauma were studied prospectively to assess the effects of the injury on sodium and water balance. Hyponatremic hypo-osmolar states occurred in 5 of the 8 patients. The cause was an inappropriate secretion of antidiuretic hormone (I.S.A.D.H.). We found an early I.S.A.D.H. (appearing within 2-3 days post trauma) whose presence was related to the craniocerebral injury (2 cases). We also found a late I.S.A.D.H. which may represent a response to positive-pressure ventilation, semi-recumbent position and centrally acting drugs. This tardive I.S.A.D.H. appeared 9-10 days after admission (3 cases). Radioimmunoassay for circulating and ventricular C.S.F. neurophysins shows an early and transitory increase of hNpI (the carrier of A.D.H.). hNpI was detectable during the hyponatremic hypo-osmolar states, thus demonstrating an inappropriate secretion of A.D.H.

Adolescent↗
PubMed1980

Compared effects of enflurane and of halothane on the intracranial pressure and the cerebral perfusion pressure in the dog.

In this study, we compare the values of the systemic arterial pressure (S.A.P.), of the intracranial pressure (I.C.P.) and of the cerebral perfusion pressure (C.P.P.) -- (C.P.P. = P.A.S. -- I.C.P.) -- in the anesthetized dog, artificially ventilated, before and after vaporization with two halogenated anesthetics, enflurane and halothane at different concentrations. The measures were made in a group of ten dogs in normoventilation and intracranial normotension conditions, in one hypercapnic dog with intracranial hypertension, and in four dogs after injection of sodium laurylsulfate in the internal carotide to induce cerebral edema. In normocapnic dogs, enflurane and halothane increase the I.C.P., decrease the S.A.P. and the C.P.P. Under enflurane 0.5%, the I.C.P., the S.A.P., and the C.P.P. show no significant variations. The increase in I.C.P. is due to the cerebral vasodilator effect of the anesthetics. At equal concentrations, halothane is more hypotensive than enflurane, and the changes in C.P.P. induced by both anesthetics depend more on the variations in S.A.P. than on the variations in I.C.P. In the hypercapnic dog, the vaporization of enflurane and of halothane further enhance the increase in I.C.P., since the vasodilator effect of the anesthetics is added to that of hypercapnia. The S.A.P. and the C.P.P. drop in relation to the concentrations of vaporization used. After sodium laurylsulfate, the administration of enflurane and halothane is accompanied by a drop in S.A.P. and in C.P.P. In this group, the decrease in I.C.P. recorded in two thirds of the cases can be explained by the hypotensive effect of the anesthetics which decreased the hydrostatic pressure in the cerebral vascular bed, a maintenance element of the edema.

Anesthesia, Inhalation↗
PubMedDate not supplied

Evaluation of clinical thermometers for accuracy and reliability.

The purpose of this study was to examine the accuracy and reliability of a wide range of clinical thermometry instruments and technologies. In a historical sense, the purpose of this study was to determine if the improvements in speed, ease of use, and safety realized in the last 100 years have been offset by a loss of accuracy and/or reliability. In view of current events, the purpose was to determine if the new generation of electronic, digital clinical thermometers could be used to replace the traditional glass/mercury thermometers. Nine clinical thermometers representing electronic, digital oral, and predictive oral; electronic, digital infrared tympanic; and liquid crystal urinary technologies were evaluated. Accuracy was determined by comparing the temperatures obtained from these test instruments with those of the reference, glass/mercury oral thermometer. Reliability was determined by test-retest evaluation. All of the thermometers evaluated were significantly less accurate when compared with the reference thermometer in this study. All of the test instruments significantly underestimated higher temperatures and overestimated lower temperatures. This study indicated that the improvements in safety, speed, and ease of use of the newer clinical thermometers have been offset by a loss in accuracy and reliability. It also indicated that the current generation of electronic, digital clinical thermometers, in general, may not be sufficiently accurate or reliable to replace the traditional glass/mercury thermometers.

Adult↗
PubMedDate not supplied

[Incidence and treatment of subdural hygroma in severe head injuries].

In a population of 109 subjects with severe head injury (Liège score less than or equal to 12) we observed secondary development of subdural hygroma in sixteen patients. These liquefying processes were mostly secondary to the entry of CSF in the subdural space from tears in the arachnoid. Half the accumulations were accompanied by increased subdural pressure. Drainage of the subdural fluid brought clinical improvement in patients with elevated subdural pressure (greater than 15 torr).

Adolescent↗
PubMedDate not supplied

Epidural clonidine combined with bupivacaine for analgesia in labor. Effects on mother and neonate.

BACKGROUND AND OBJECTIVES: A double-blind study was conducted to assess the efficacy and the safety of epidural clonidine combined with bupivacaine for analgesia during labor. METHODS: Two groups of pregnant healthy women were allocated randomly to receive either 10 mL 0.125% bupivacaine plain solution (group B, n = 10) or with 75 micrograms clonidine (group B + C, n = 12). Visual analog scale (VAS) scores were measured over 30 minutes after each epidural injection. Patients were monitored with an automated blood pressure device (Dinamap and a pulse oximeter), and fetal heart rate was measured with a cardiotocograph. Plasma clonidine concentrations were measured at birth in mothers and in the umbilical cord by radioimmunoassay. RESULTS: Visual analog scale scores were significantly lower in patients who received clonidine. Patients required a second epidural injection after 55 +/- 9 minutes in group B and 127 +/- 11 minutes in group B + C (P < .05). Visual analog scale scores were also significantly lower in group B + C than in group B, after the second injection. Decreases in arterial blood pressure were comparable in the two groups, and no patient experienced arterial oxygen desaturation or bradycardia. Fetal heart rate was decreased in group B + C at the time of the second injection. The duration of labor after epidural administration was prolonged in group B + C patients compared to group B (282 +/- 43 minutes and 169 +/- 26 minutes, respectively, P < .05). Apgar scores at 1 and 5 minutes were similar in both groups. Plasma clonidine concentrations were, respectively, 0.31 +/- 0.16 ng/mL 60 minutes after the first injection and 0.62 +/- 0.13 ng/mL at birth in mothers while plasma umbilical cord concentrations were 0.56 +/- 0.12 ng/mL. CONCLUSIONS: The study documents that clonidine improves epidural bupivacaine analgesia during labor and demonstrates transfer of the drug across the placenta. Therefore, a more extensive study is required to determine the incidence of possible side effects of clonidine in neonates.

Adult↗