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Biomedical subjects

P Mathieu

Publications and source records attributed to P Mathieu.

At least 91 records · Page 5Linked to original sources
PubMed1996

[Should protocol of programmed ventricular stimulation be adapted to each patient? ].

The authors report the case of a 56 year old patient in whom the mechanisms of a wide QRS complex tachycardia recorded on an intensive care monitor could not be determined. The patient also had episodes of atrial flutter with left bundle branch block. Programmed ventricular stimulation with 3 extrastimuli triggered a non-specific ventricular flutter. One week later, the patient was resuscitated from a cardiac arrest which was undocumented. It was therefore important to elucidate the mechanism of the initial tachycardia. A second session of programmed ventricular stimulation was undertaken. As the use of 2 extrastimuli triggered runs of unsustained polymorphic ventricular tachycardia, the classical protocol was stopped. An infusion of low-dose isoproterenol was used to repeat programmed stimulation with a single extrastimulus. This protocol triggered sustained monomorphic ventricular tachycardia at 240/min. The diagnosis of ventricular tachycardia could therefore be continued.

Cardiac Pacing, Artificial↗
PubMed1996

[Comparison of the efficacy of 2 antiseptic solutions in the prevention of infection from peridural catheters].

Two antiseptic solutions (iodine polyvidone and chlorhexidine) were compared-in a prospective non-randomized study including 294 parturient women. This study aimed to assess their efficacy against infections through epidural catheters. All catheters were subsequently cultivated. Cultures were significantly positive in 3% of cases after iodine polyvidone and 1% after chlorhexidine decontamination (not significant). No clinical or biological infections were detected. Notwithstanding some apparently unavoidable but moderate contaminations, prevention of infections post epidural analgesia depends principally on a complete adherence to asepsia rules.

Adult↗
PubMed1995

Progression of digital osteoarthritis: a sequential scintigraphic and radiographic study.

Hand radiographs and scintigraphy were obtained initially and at the 4-year follow-up in 15 patients with symptomatic osteoarthritis (OA) of distal and/or proximal interphalangeal joints. For each joint, a 0-15 score was obtained for the OA radiographic lesions read blind by the same observer. An abnormal isotope retention over a bone reference area was assessed and quantified. The predictive value of scintigraphy for the OA radiographic progression was confirmed and shown to be improved by a second investigation. During the study period, the percentage of radiographic OA joints increased from 66.3 to 76.6%, but joints showing an abnormal scan decreased from 40 to 22.5%. Progression of the OA radiographic score was closely related to scintigraphic changes. The mean difference between the final and initial OA score was -0.08 in joints with two normal scans (N = 115), +0.73 in joints showing a first abnormal and a second normal scan (N = 94) and +1.8 in joints with two abnormal scans (N = 14) or a scan becoming abnormal (N = 47). An abnormal scan appears to represent a transient event, and this event is associated with a period of progression of digital OA. Potentially, anti-OA therapies that suppress joint isotope retention might slow down OA progression. The magnitude of joint isotope retention was positively correlated with the OA radiographic score established at the same time (R = 0.61 and P < 0.001), but showed no predictive value for progression of the latter.

Adult↗
PubMed1995

Evaluation of the Duke criteria versus the Beth Israel criteria for the diagnosis of infective endocarditis.

New diagnostic criteria for infective endocarditis (IE) have been proposed by the Duke University Endocarditis Service (Durham, NC) to update the widely used Beth Israel (Boston) criteria. We compared the Duke criteria with the Beth Israel criteria in a series of 115 consecutive patients with suspected IE who were hospitalized in a referral center. The diagnosis of IE was histologically and/or bacteriologically confirmed for 27 operated patients. If surgery had not been performed on these 27 patients, 22 vs. 12 would have been classified as having ¿clinically definite¿ and ¿probable¿ IE by the Duke vs. the Beth Israel criteria, respectively, whereas 0 vs. 5 would have been ¿rejected¿ by the Duke vs. the Beth Israel criteria, respectively. The improvement in sensitivity of the criteria from 44% (Beth Israel) to 82% (Duke) was statistically significant (P < .01). We confirm that the Duke criteria improve the sensitivity of diagnosis of IE. The specificity of these criteria should be further evaluated.

Adult↗
PubMed1995

[Comparative outcome of aortic valve endocarditis with or without annular abscess].

Annular abscess is a not uncommon but serious complication of aortic valve endocarditis. The aim of this retrospective study was to evaluate the prognosis of aortic valve endocarditis with and without annular abscess. Between January 1981 and 1989, 122 consecutive cases of aortic endocarditis fulfilling the diagnostic criteria of Duke University were admitted to hospital. Group I included 40 cases with aortic ring abscess confirmed at surgery, in 35 patients; group II comprised 43 cases of operated aortic valve endocarditis without annular abscess in 41 patients and group III comprised 38 cases of aortic valve endocarditis treated medically without echocardiographic or angiographic signs of annular abscess in 36 patients. The patients in group III were significantly older than those in group I (57 +/- 14 years vs 44 +/- 17 years; p < 0.001). From the clinical point of view, endocarditis of prosthetic valves was slightly more common, but without reaching statistical significance, in group I, but the abscess was associated with more severe cardiac failure. Systemic embolism, atrioventricular block and pericardial effusion were equally common in the three groups. On the other hand, endocarditis with annular abscess was more often the result of infection with streptococci A, B, C or pneumoniae, than forms without abscess (22.5% vs 5% and 3% respectively in the 3 groups; p < 0.05). Of the patients treated surgically, destructive lesions of the valves were more common in cases of abscess (57.5% vs 35%; p < 0.05): the hospital mortality was higher in cases of abscess (17.5% vs 7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed1995

[Study of 6 cases of malaria acquired near Roissy-Charles-de-Gaulle in 1994. Necessary prevention measures in airports].

During the very hot 1994 summer, six new cases of airport malaria have been observed in and around Roissy-Charles-de-Gaulle airport. Four patients were regular or occasional airport employees. The two other cases were inhabitants of a city at 7 km. Entomological investigations suggest that cars of airport employees served to disseminate anophelines outside the airport areas. The six cases were very severe. One patient died. Apparently, W.H.O. recommendations on aircraft disinsecting procedures have not been fully followed. There is obviously a threat for areas near the airports.

Adult↗
PubMed1995

Quantitative assessment of radiographic normal and osteoarthritic hip joint space.

Radiographic joint space narrowing (JSN) is the hallmark of progression in osteoarthritis (OA). We developed a technique of measuring joint space of the hip by computer analysis of digitally stored pelvic radiographs. The interobserver coefficient of variation was 3.3%. Mean joint space width (MJSW) and joint space surface were more sensitive to change than interbone distance. In a retrospective analysis of 69 OA hips, MJSW decreased 0.43 +/- 0.43 mm per year and was lower in patients with the hypertrophic form of OA. Limitations were due to radiograph quality. This computerized measurement method is applicable to monitor progression of hip OA and appears to be of value in the evaluation of disease-modifying therapies for OA.

Adolescent↗
PubMed1995

[Extraligamentous lumbar intervertebral disk displacement].

The preoperative assessment of sciatica secondary to a herniated intervertebral disk has been radically changed over recent years due to the development of percutaneous treatment techniques which now offer an alternative to surgery. After recalling the terminology used for the position of a herniated lumbar disk in relation to the posterior common vertebral ligament (subligamentous or transligamentous hernia) and to describe whether or not the hernia is detached from the original disk (excluded or non-excluded hernia), the authors review the current state of the art of imaging for each type of herniated lumbar intervertebral disk.

Collateral Ligaments↗
PubMed1994

[Rate of joint space pinching in coxarthrosis].

Accurate measures of cartilage destruction are needed to evaluate the effects of chondroprotective agents in human osteoarthritis. Use of a digitalized image analyzer (HOLOGIC, ICMS software) to measure mean joint space width on roentgenograms of the hip is a simple, reliable method with a coefficient of variation of 3.3%. To determine the rate of joint space loss and to identify factors associated with this parameter, we retrospectively studied 56 hips with osteoarthritis in 39 patients (mean age at baseline 55.5 +/- 12 years; mean roentgenographic follow-up 5.2 +/- 3.6 years, mean number of roentgenograms per patient 3.7 +/- 1.1). Mean annual joint space loss was 13.5 +/- 16.6%, i.e., 0.42 +/- 0.38 mm, and was negatively correlated with the duration of roentgenographic follow-up (r = 0.95 and 0.97, p < 0.01). When only those subjects who were followed up for two to eight years were studied, mean joint space loss was only 6.7% with a considerably smaller standard deviation of 4.2%, i.e., 0.29 +/- 0.21 mm. No influence on the rate of joint space loss was found for age at onset of symptoms, age at the first roentgenographic study, side, gender, or location of the joint space narrowing. The roentgenographic stage or joint space width at baseline were positively correlated with the rate of joint space loss expressed as a percentage but not in mm. These data suggest that the absolute amount of cartilage lost is not influenced by the roentgenographic stage of the osteoarthritis at inclusion of the patient in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Serum parathormone profile during surgical treatment of hyperfunctioning parathyroid adenoma: a multicompartmental model.

Patterns of intact parathyroid hormone (iPTH) elimination and subsequent recovery of parathyroid function were studied in seven patients undergoing surgical removal of solitary hyperfunctioning parathyroid adenoma. Using a sensitive two-site immunoradiometric assay, iPTH levels were measured pre, peri-, and postoperatively. Blood samples were taken at very early and at late stages, including 3, 6, 9, and 15 minutes and 48, 72, and 96 h after adenomectomy. A biexponential formula was calculated to fit the decreasing values of iPTH in all patients. The PTH half-life in the early phase was 1.4 +/- 1.1 minutes (95% confidence limits). The PTH half-life in the second phase was 64.45 +/- 32.19 minutes (95% confidence limits). A third phase is represented by a slow, linear increase in plasma iPTH values as a result of the recovery of healthy suppressed parathyroid glands. The extrapolation to baseline of the later phase shows that the recovery of normal parathyroid function begins as soon as 240 minutes after adenomectomy and is independent of the decrease in PTH of adenomatous origin. All individual results were consistent with this model. Five patients had iPTH values below 5 pg/ml, one had 15 pg/ml, and the last had 27 pg/ml 5 h after parathyroid adenomectomy. The recovery of the hormonal activity of the remaining glands occurred rapidly. By the postoperative hour 24 the mean serum iPTH concentration was 12.28 +/- 8.07 pg/ml. The intraoperative serum iPTH concentration offers a model to assess both recovery of hormonal secretion from functionally suppressed parathyroid glands and disappearance of parathyroid hormone.

Adenoma↗
PubMed1994

[Serum phospholipase A2 activity in osteoarthritis].

Serum phospholipase A2 activity in 67 osteoarthritis patients and 17 controls was determined using a radiolabeled specific substrate. Serum phospholipase A2 activity was significantly higher in osteoarthritis patients (115 +/- 73.6 dpm/h/ml) than in controls (45 +/- 25 dpm/h/ml) (p = 0.002). In 41 osteoarthritis patients, serum phospholipase A2 activity was unrelated to age, time since onset of osteoarthritis symptoms, duration of morning stiffness, Lequesne's index, roentgenographic stage of osteoarthritis, number of joints with osteoarthritis, erythrocyte sedimentation rate, or serum C-reactive protein levels. In 12 osteoarthritis patients who were evaluated twice at a mean interval of 46 days, changes in serum phospholipase A2 activity were unrelated to changes in Lequesne's index. Blind evaluation of long-term joint space loss was performed in 14 patients; serum phospholipase A2 activity increased only in those patients with progressive joint space loss, but the difference was not statistically significant as compared with the controls. These data suggest that serum phospholipase A2 activity is not useful in practice as a marker for osteoarthritis.

Adult↗
PubMed1994

[Recommended methods for the determination of catecholamines and their metabolites in urine. Significance of results in the diagnosis and follow-up of pheochromocytoma and neuroblastoma].

Laboratory investigation of catecholamines is useful for the clinician in the diagnosis and management of phaeochromocytoma and neuroblastoma. This work summarizes current knowledge on catecholamines and their metabolites and discusses the main indications for their determination. It also examines the most practical methods for studying the secretion of these hormones, ie extraction, separation and quantification using high performance liquid chromatography coupled with electrochemical detection. The workshops attended by the members of the catecholamines working party of the French Clinical Biology Society and phaeochromocytoma and neuroblastoma specialists enabled the role of such determinations in the diagnosis and management of these diseases to be clarified.

Adolescent↗