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Biomedical subjects

P Larroque

Publications and source records attributed to P Larroque.

At least 73 records · Page 4Linked to original sources

[Renal hydatid cyst. Contribution of radiology apropos of a case].

Hydatid disease, an infestation of gastrointestinal origin, is essentially localized in the two principal filters of the body, the liver and the lung (80% of localizations); 20% correspond to a random distribution (brain, bones, kidneys, etc.). The observation of a new case of rare renal infestation (1 to 5% of all hydatid cysts) constitutes an occasion to review the role of various radiological investigations in this disease. Computed tomography has a role in the diagnosis which is complementary to that of plan abdominal x-rays and ultrasonography. Intravenous pyelography may be performed subsequently. It has an essential role in the systematic investigation of other localizations.

Adult↗

[Plasma viscosity and erythrocyte filterability in borderline hypertension].

Hemorheological constants (plasma viscosimetry and erythrocyte filtrability index) were studied in 153 male subjects aged 19 to 23. Borderline hypertension defined by clinical criteria was found in 61 of these patients. Whilst there was no notable modification in plasma viscosity, by contrast there was a significant link between erythrometry and systolic and diastolic blood pressure. Erythrocyte deformability was all the more marked as blood pressure rose. These results would contrast with findings in the literature in cases of definite hypertension. The borderline nature of hypertension and the youth of the population was such that it could be considered that barometric factors had not yet influenced erythrocyte filtrability. The following hypothesis is therefore attractive: initially the red cell adapts itself to any possible increase in peripheral resistance. As the years go by its deformability is lessened by adverse changes affecting its membrane cytoskeleton.

Age Factors↗

[Nycthemeral blood pressure monitoring in the diagnosis of borderline arterial hypertension in young adults].

PURPOSE: Evaluating Blood Pressure Monitoring contribution at rest to the diagnosis and pathophysiology of borderline (BL) hypertension in the twenties. METHOD: a nycthemeral blood pressure recording each 15 minute has been performed during the 48 first hours of hospitalisation on two groups of white twenties males with a Dinamap: 143 CONTROLS. Mean age: 21.1 +/- 2 yrs, mean height: 177 +/- 7 cm, mean weight: 71 +/- 11 kg; 104 BL hypertensive patients. Mean age: 21 +/- 2 yrs, mean height: 178 +/- 7 cm, mean weight: 78 +/- 12 kg. Mean BP recording levels are smaller than casual measurements in two groups: CONTROLS (Casual BP: 125/71, BP recording on 24 hours: 117/60, day time: 121/63, nighttime: 110/54 mmHg). BL hypertensives (Casual BP: 144/83, BP recording on 24 h: 132/69, daytime: 137/73, nighttime: 121/60 mmHg). Nycthemeral BP variability measured by the standard deviation of mean pressure is not different in two groups for systolic variability, it significantly differs for diastolic variability (BL: 7.6/CONTROLS: 5.5, p less than 0.01). Correlations between casual BP and diurnal records are stronger in controls than in BL patients showing a lower predictive value of clinical assessment in BL patients. Though the same heart rate at sleep, BP is significantly higher in BL than in controls. It probably means that factors different from sympathetic activity are involved in pathophysiology of borderline hypertension. The whole measurement study on 24 hours of two groups show an important overlap (the 65th percentile in BL systolic BP correspond with the 95th of controls, the 74th percentile in BL diastolic BP correspond with the 95th in controls). That make difficult the recording evaluation for a given patient.

Adult↗

[Computerized processing, using a Macintosh, of ambulatory arterial pressure measurements collected on a Spacelabs monitor].

UNLABELLED: The use of the Spacelabs blood pressure recorder has given rise to processing programs running on Apple II and IBM PC computers. The authors have written in M.S. BASIC (2.1) a program who take advantage of graphic abilities and easy manipulation on Macintosh. The software was designed to perform three tasks: Communicating between Macintosh and Spacelabs station using serial interface (RS 232) without requesting specific interface card. Editing a report on two pages: The first is the listing of 96 measurements (one by 15 minutes). The second provides: patient identification, height, weight, diagnosis. Graphic representation of measurements Systolic and diastolic blood pressure (BP) repartition histogram for 24 hours, day and night. Standard deviation and mean of pressure and heart rate (HR) for those periods. A third optionally gives hourly chronogram and diagrams for cumulated BP and HR. Creating a file: 550 records can be stored on a 800 K floppy disk. The file handles: data for each patient (excepted identification). Random access and revision of each parameter is possible. SYNTHESIS: comparative reports for group patients and patient by patient analysing data with appropriate statistical test (ANOVA and correlation) are done.

Blood Pressure Determination↗

[Digital microembolism disclosing intracardiac thrombosis].

The authors report the observation of a 46 year old man with a case history of myocardial infarction at the age of 26 years, transient ischemic injury at 41 years of age, and in whom a focalised digital ischemic syndrome of microembolic nature led to the discovery of an intracardial thrombosis which was operated upon and progressed without complication. Bloody microembolisms of cardiac origin may be selectively revealed by acrosyndromes, the diagnostic elements of which are mentioned. They are poorly understood conditions. Their significance must not be neglected because of the risk of recurrence in macroembolic form. The pathogenesis of these obstructions and their specific responsibility for ischemic cardiopathies is reviewed. It is appropriate to emphasise the novelty of this observation since, in the context of ischemic cardiopathies, no attention has been devoted to microembolisms, in contrast to the numerous publications relating to macroembolisms. The symptomatic treatment is unremarkable, the etiological treatment of intracardial thrombosis is discussed.

Adult↗

[Acute myocardial infarction during athletic activity. 38 cases in the military milieu].

38 observations of myocardial infarction (M.I.) (group A), remarkable by their occurrence immediately (31 cases) or with a delay (less than 12 hours, 7 cases) after the onset of chest pain and/or lipothymia during (30 cases) or a the end (7 cases) of a non unusual physical effort, have been documented with a 60 items questionnaire for the analysis of exercise, mesologic and personal data. Group A comprised men averaging 37 +/- 8 years, with extreme at 24-54 (less than 40 years: n = 21, m = 30, 5 +/- 3.5 years), divided into high-level athletes (n = 15), very well (n = 12) or moderately (n = 7) trained, and sedentary (n = 4). This group was compared to a historical population of 105 men suffering from a M.I. non preceded by exertion (group B), average age 41 +/- 9, extreme at 19-54 years, with a comparable social status (sports adepts: 26 per cent). The analysis of the responses in group A discloses in order: time of onset of the M.I. (69 per cent before 9 hours), the need for physical performance (45%), heat discomfort (31%). It is endurance work 19 times (50%). Groups A and B are undifferentiated (0.8 less than chi 2 less than 2, p = N,5) concerning the number of risk factors (2.18 +/- 0.98 and 2.42 +/- 1.18), the preceding angor on exertion (24 or 63% and 59 or 56%), the topography of the M.I. (lower 58 and 59),the incidence of complications (extension, left ventricular failure, arrhythmias) in the acute phase (24 and 30%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Phlebitis of the arm. Apropos of 45 cases].

We report in this retrospective study the data of 45 patients presenting with deep venous thrombosis of the upper extremities. This includes: 22 phlebitis due to strains, 3 traumatic phlebitis, 3 phlebitis combined with an adjacent injury, 7 phlebitis following endovenous therapeutic procedures and 10 spontaneous phlebitis (4 during adjacent medical pathologies), 3 pulmonary embolisms, including a septic one are thus demonstrated. No patient died. The follow-up date of 12 patients out of 32 exhibiting a spontaneous phlebitis or phlebitis due to a thoracic outlet syndrome have been documented: 25 p. 100 of them still presented with severe injuries. All patients underwent heparin therapy, but no fibrinolytic. A surgical procedure of the thoracic outlet syndrome was performed, when liable to the disease. Data of this series was then compared with those of previous reports on the subject.

Adult↗

[Critical study of microscopic hematuria disclosed by screening tests].

Asymptomatic microscopic haematuria detected by dipstick in 0.28 p. 100 of 95,200 men was confirmed in only 0.11 p. 100. These results lead to the study of 272 cases to determine the value of dipsticks as a screening test and the benefits of complementary investigations to exclude symptomless diseases. Microscopic haematuria was confirmed in 65 p. 100 but results of other tests reduce the false positive screening results to 25.3 p. 100. Addis counting of at least 5,000 RBC/min is preferable to RBC count/ml which is dilution dependent. 77 p. 100 of microscopic haematuria are intermittent and can only be diagnosed by repeated Addis counts. In the absence of confirmed haematuria, only investigations to exclude proteinuria and urinary infections are justified.

Adolescent↗

[Role of dapsone in the treatment of Horton's disease and polymyalgia rheumatica].

The authors report 8 cases of Horton's disease and/or polymyalgia rheumatica treated with prednisone with an initially favourable result. However, the disease progressed despite relatively high dose steroid therapy, complications of which contraindicated increasing the dosage and even necessitated rapid withdrawal of steroids. The association of dapsone 100 mg/day orally had a rapid favourable effect in all 8 cases. However this treatment was well tolerated in only 3 patients and could only be continued in 4 out of the 8 cases. Manifestations of intolerance (methemoglobinaemia) rapidly regressed after withdrawal of dapsone but this was followed by another exacerbation of the disease, resulting in a therapeutic impasse. Despite the incidence of these iatrogenic complications, dapsone would appear to provide a therapeutic option in patients with Horton's disease and/or polymyalgia rheumatica resistant to high dose steroid therapy or in whom complications of steroid therapy impose a reduction in dosage or complete withdrawal of the drug.

Aged↗

[The complementary reasonable explorations to consider about young hypertensive patient. (With regard to 389 selection bed-rests in view of national service) (author's transl)].

About a retrospective study turning on 600 bed-rests during 3 years, the writers study 433 confirmed high blood pressures including 389 without therapeutic among which 67 p. 100 labil or limit H.B.P. and 33 p. 100 permanent H.B.P. By light of current ideas and withdrawn informations from complementary explorations done, they try to define a reasonable attitude concerning twenty years old young hypertensive male patients in view of selection. This attitude can be extended to the general field of young H.B.P. people. They establish that a good number of systemically researched elements are without great interest; functional signs, which are more the neurotonia witness than the H.B.P. consequence, heart or renal repercussion, negligible in this age, the too shematic distinction between permanent, labil or limit H.B.P. On the other hand, some parameters deserve to be searched : family antecedents (greater than 60 p. 100), obesity (approximately 20 p. 100), ocular repercussion (approximately 15 p. 100), perturbation of lipidemia, above all hypertriglyceridemia, hyperuricemia and urinary sediment abnomalies. As for I.V.U., in spite of an exact study of vascular times, and second reading by the same observer, it never allowed to display any renovascular H.B.P. Other pathologic uronephrologic established images are all almost associated to urinary sediment anomalies or to proteinuria. More, a few frequent incidents among young people and the price of the exam bring to purpose. I.V.U. only when H.B.P. context is hard or going with urinary signs. Other more specific exams (V.M.A., catecholamines) will be asked according to the context.

Adult↗

[The cost of alcoholism in a hospital medical department (author's transl)].

The authors evaluated the costs involved when alcoholic patients were admitted to a hospital medical department. Costs which were identical for all patients, such as basic services and hospitalization fees, were discounted, and only those for individual investigations and treatment were calculated. These costs were then compared with the average daily costs for non-alcoholic patients in the same department over the same period. The results are discussed in relation to other similar studies.

Age Factors↗