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P Kieffer

Publications and source records attributed to P Kieffer.

30 records · Page 2Linked to original sources
PubMed1999

Cardiac consequences of prolonged exposure to an isolated increase in aortic stiffness.

In elderly patients, aortic stiffness is a major determinant of increased end-systolic stress leading to left ventricular (LV) hypertrophy with impaired cardiac performance. However, in a rat model of aortic elastocalcinosis (induced by vitamin D(3)-nicotine [VDN] treatment), brief exposure (1 month) to increased aortic stiffness modified neither cardiac function nor cardiac structure. Here we report the impact of longer exposure (3 months) to aortic stiffness. Three months after induction of aortic stiffness, aortic characteristic impedance was measured in awake rats, 8 control and 10 VDN. Stroke volume was measured (electromagnetic probe) at baseline and after acute volume overload. LV weight/body weight ratio, collagen, and myosin heavy chain (MHC) contents were determined. Although aortic characteristic impedance increased (controls, 32+/-2; VDN rats, 50+/-8 10(3) dyne. s/cm(5); P=0.0248), stroke volume was maintained in VDN rats at baseline (controls, 223+/-18; VDN, 211+/-13 microL) and after volume overload (controls, 378+/-14; VDN, 338+/-15 microL). However, LV weight/body weight ratio (controls, 1.54+/-0.07; VDN, 1.73+/-0.05 g/kg; P=0.0397) and LV collagen content (controls, 31+/-4; VDN, 52+/-4 microgram/g dry wt; P=0.0192) increased. A shift from alpha-MHC (controls, 82+/-2%; VDN, 69+/-3%; P=0.0056) to beta-MHC (controls, 18+/-2%; VDN, 31+/-3%; P=0. 0056) was also observed. Three months' exposure to increased aortic stiffness in VDN rats induced LV hypertrophy with moderate interstitial fibrosis and a shift in the MHC-isoform pattern. Such structural adaptation maintains LV performance.

Acute Disease↗
PubMed1999

Elastic properties and composition of the aortic wall in old spontaneously hypertensive rats.

We hypothesized that age-linked changes in the composition and elastic properties of the arterial wall occur earlier in hypertensive than in normotensive rats. We evaluated the consequences of hypertension and aging on aortic mechanics, geometry, and composition in 3-, 9-, and 15-month-old awake Wistar-Kyoto rats (WKY) (normotensive) and spontaneously hypertensive rats (SHR) (hypertensive). The elastic modulus of the thoracic aorta, calculated from aortic pulse wave velocity and geometry, was higher in young and adult SHR than in age-matched WKY, as was wall stress; however, isobaric pulse wave velocity and pulse wave velocity-pressure curves were similar. Elastic modulus, isobaric pulse wave velocity, and the slope of the pulse wave velocity-pressure curve dramatically increased in old SHR compared with age-matched WKY; there was no further elevation of blood pressure or wall thickness. Fibrosis did not develop with age in SHR, and the ratio of elastin to collagen decreased in a similar fashion with aging in both strains. In conclusion, although elastic properties of the aortic wall are not intrinsically modified in young and adult SHR in comparison to age-matched WKY, aging is associated with a dramatic stiffening of the aortic wall in old SHR but not in WKY. Changes in blood pressure, aortic wall geometry, or scleroprotein composition do not appear to explain this age-linked aortic stiffening in SHR, suggesting that other mechanisms of disorganization of the media may be involved.

Aging↗
PubMed1998

Lymphedema combined with brachydactyly and tachycardia.

Hereditary lymphedema can appear at birth or later up to adulthood. It may be seen in connection with diverse symptoms forming various syndromes. The authors report a family with hereditary lymphedema, brachydactyly, syndactyly and tachycardia. Lymphedema and tachycardia could appear together by chance. However this combination could also be a syndrome.

Adult↗
PubMed1996

[Campylobacter fetus meningitis in adults].

Campylobacter fetus is an uncommon cause of meningitis in the adult. We report a case observed in an 84-year-old man with alcoholic cirrhosis. The patient presented fever, jaundice and a state of mental confusion. Blood and cerebrospinal fluid cultures identified Campylobacter fetus sensitive to several antibiotics. Ciprofloxacine-ceftriaxone combination replaced the antibiotics prescribed empirically prior to identification and led to regression of the fever and normal mental status within 4 days. Spinal tap on day 7 showed 20 white cells, 85% lymphocytes and normal protein level. Unfortunately, the patient later developed edema and ascitis with major jaundice. Oligo-anuria could not be controlled and the patient died two weeks after admission. Campylobacter fetus meningitis is predominantly seen in men, mean age of onset 50 years. Clinical signs are not specific and diagnosis can only be obtained on the basis of cerebrospinal fluid results. Adapted antibiotics are required.

Aged↗
PubMed1994

[Yellow nail syndrome. Apropos of 2 cases. Review of the literature].

The yellow nail syndrome is a clinical syndrome without specific biological parameters. It is characterized by the following threesome of symptoms: nail abnormalities, primary lymphedema, and pleuropulmonary manifestations. In most cases lymphography shows abnormalities of the lymphatic vessels and spirometry shows a restrictive defect and rarely obstructive disorders. Pathogenesis of this syndrome is still unknown. It is, however, remarkable that the yellow nail syndrome may occur in association with other diseases, the most frequent of which are cancer affections and immune disorders. We report two cases of the yellow nail syndrome which were associated with cancer (neoplasm of the larynx and breast).

Aged↗
PubMed1993

[Lyme disease disclosed by disabling amyotrophy].

The Lyme disease, which was first found in Lyme, USA, in 1975 is an infectious multi-system disorder whose agent, the Borrelia Burgdorferi, was identified in 1983. Various disease manifestations have been reported since them. We report a case of Lyme disease manifestation in the muscle revealed by serious amyotrophy in the scapular muscles, in the neck and in the trunk with scapula alata accompanied by noctural lumbago which is resistant to non steroïd anti-inflammatory drugs. Electromyography showed patterns of the myogenic type in the serrate anterior and infraspinous muscles on both sides and patterns of the neurogenic peripheral type in the lower extremities. The histological, immunohistochemical and electron-microscopal studies of the muscle biopsy have been without any pathological result. Creatine kinase and aldolase proved normal. Serological antibodies were not significantly increased. A positive diagnosis was obtained by lumbar puncture which showed lymphocytic meningitis, by demonstrating specific antibodies in the cerebrospinal fluid and by Western Blot antibodies analysis. Efficacy of the antibiotic therapy has resulted in a rapid regression of the symptoms, which is a further confirmation of the previous diagnosis.

Aged↗
PubMed1987

[Krukenberg's tumor. Apropos of a case. Review of the literature].

A case is reported of krükenberg's tumor, this rare lesion characterized by the constant presence of typical signet ring cells being an ovarian metastasis from a general digestive cancer. The primary neoplasm is often overlooked while the ovarian tumor is already large and bilateral. In a pregnant patient with this lesion virilization of mother and child may occur, this endocrine activity being poorly documented and the subject of a literature review. The pathogenicity of this tumor is still unknown. Endocrine investigations should be enlarged in the fairly rare cases when diagnosis is suspected prior to ovarian excision. Treatment is currently surgical but survival is little improved. Other therapy is only poorly effective.

Female↗
PubMed1987

[Prognostic factors of decompensated chronic respiratory insufficiency. Apropos of a series of 272 cases].

Over a 6 years' period (1980-1986), 272 patients with chronic respiratory disease were admitted for respiratory failure to the same intensive care unit. The series was characterized by the high mean age of the patients (69.3 years) and by the high proportion of those who were ventilated (75%); 33.7% of the patients died within 1 month of discharge. The survival rate at 5 years estimated by the actuarial survival curve was 28%. Parameters measured during the acute decompensation phase were analyzed statistically. The main prognostic factors regarded as unfavourable were: old age and associated visceral failure particularly, important loss of weight and muscular atrophy, pre-existing neurological sequelae, left ventricular dysfunction, simplified Le Gall score above 15, presence of respiratory encephalopathy, stroke or viral infection as precipitating factors of decompensation, transfer from other hospital units after failure of medical treatment, and need for mechanical ventilation for more than 30 days.

Actuarial Analysis↗
PubMed1987

[Vital capacity restitution curve: prognostic value in chronic decompensated respiratory insufficiency].

From a series of 50 patients with acute decompensation of chronic obstructive lung disease (38 of whom were treated by mechanical ventilation), the authors demonstrate the prognostic value of an easily obtained parameter of respiratory function: the vital capacity restitution curve (VCRC). From daily measurements of vital capacity, beginning on the day of admission, a graph is constructed which shows an initial period of increase in the degree of restitution, followed by stabilization of the values. An analysis of the various parameters embodied in this graph provides information about the prognosis. Such graphs can be divided into 3 zones of prognostic value: a favourable zone, an intermediate zone (mediocre survival with or without mechanical ventilation) and an unfavourable zone (death during the acute phase). Although a favourable prognosis can be made after 4 days of observation and almost always by the 10th day, an unfavourable prognosis cannot be made before the 21st day.

Aged↗