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Biomedical subjects

P Mathieu

Publications and source records attributed to P Mathieu.

At least 109 records · Page 6Linked to original sources

[Endocarditis caused by heart valve prosthesis. Apropos of 35 cases].

35 cases of prosthetic valve endocarditis are reported. The diagnostic is based on clinical, echocardiographic, bacteriological and anatomical aspects. Heart failure, neurologic complications, positive culture of prosthesis, Staphylococcus aureus infection and perivalvular abscess are factors of a bad prognosis. The current therapeutic trends associate antibiotic treatment and infected prosthetic valve replacement rather for hemodynamic indications than bacteriological factors. General prognosis has a mortality of 40 p. cent. Prophylaxis of infection, although simple is necessary.

Adult↗

In vitro effect of nonsteroidal antiinflammatory drugs on proteoglycanase and collagenase activity in human osteoarthritic cartilage.

The effects of several nonsteroidal antiinflammatory drugs, used at concentrations achievable in synovial fluid, on human osteoarthritic (OA) cartilage metallo-protease activity in vitro was studied. Acetaminophen and ketoprofen had no effect; sodium salicylate, indomethacin, and diclofenac slightly decreased proteoglycanase activity. Piroxicam and tenoxicam suppressed proteoglycanase activity by 48.2% and 68.3%, respectively, and suppressed collagenase activity by 19.1% and 36.8%, respectively. Use of these NSAIDs may help to decrease cartilage catabolism in patients with OA.

Acetaminophen↗

Reoperation for secondary hyperparathyroidism in chronic renal failure.

From 1972 to 1987, 112 parathyroidectomy (PTX) operations were carried out in 105 haemodialysis or transplant patients by the same surgeon. Twelve had to be reoperated on (19 operations in all) for persistent (9 cases) or recurrent (3 cases) hyperparathyroidism. In six patients morphological tests (echography and technetium-thallium scintigraphy) contributed usefully by detecting parathyroid masses. Repeated surgery was finally effective in nine cases.

Adult↗

[Reduction in the incidence of postoperative diaphragmatic paralysis by using a phrenic nerve protector].

A prospective study of a consecutive series of 100 patients in whom a phrenic nerve protector was used during cardiac surgery under CPB demonstrated the existence of one case of postoperative left phrenic nerve palsy and three cases of postoperative right phrenic nerve palsy. Comparison with a previous series taken as the control revealed a very significant reduction in the incidence of left phrenic nerve palsy which decreased from 8% to 1%. The incidence of right phrenic nerve palsy was not significantly decreased which corroborates the role of pericardial cooling in the aetiology of these palsies and the absence of protection of the right phrenic nerve by the system used.

Female↗

[Serum hyaluronic acid and phospholipase A2 in an arthritic population].

Serum hyaluronic acid (HA) and A2 phospholipase (A2PL) activity were measured by radioimmunoassay (Pharmacia) and using a specific phospholipid substrate respectively, as potential markers of osteoarthritic synovitis. With neither age, treatment nor sample time taken into consideration, the concentration of HA (micrograms/ml) was 585 +/- 1,054 in rheumatoid arthritis, 379 +/- 409 in knee osteoarthrosis, 272 +/- 384 in hip osteoarthrosis, 131 +/- 144 in low back pain and 44 +/- 23 in osteoporosis, with no significant difference between the groups. HA was nevertheless found to be significantly higher in knee osteoarthrosis patients than in normal controls, when samples were drawn at the same time of day. Physical exercise (pedalling), as well as 20 hours lying flat and an intra-articular injection of corticosteroids did not cause any significant variation in serum HA levels in knee osteoarthrosis patients, in contrast to 20 hours of rest in the controls. A2PL activity was significantly higher in osteoarthrosis patients than in the controls, decreased with rest and corticosteroids and was not dependent upon sample time.

Aged↗

Study of an inhibitor of plasminogen activator (tranexamic acid) in the treatment of experimental osteoarthritis.

The effects of tranexamic acid, an inhibitor of plasminogen activator, were evaluated in a rabbit model of osteoarthritis induced by section of the knee joint anterior cruciate ligament. Prophylactic treatment administered intramuscularly thrice weekly for 12 or 24 weeks significantly reduced cartilage destructive lesions, increased cartilage hypertrophy but did not prevent changes in cartilage water and proteoglycan content. A suppression of synovial membrane stromelysin and collagenase activity was found while phospholipase A2 activity was unaffected.

Animals↗

[Epidemiology of aminoglycoside resistance in Streptococcus except in group D Streptococcus and Enterococcus].

During a ten month period (march-december 1989), all streptococcal strains isolated from clinical specimens sent to our laboratory were routinely tested for high-level resistance to aminoglycosides. High-level resistance was detected in 16 out of 475 streptococci: streptomycin (two strains), kanamycin (four strains), streptomycin and kanamycin (ten strains).

Drug Resistance, Microbial↗

Early and long-term outcome after emergency coronary artery bypass surgery after failed coronary angioplasty.

From April 1980 to January 1990, among 2,576 percutaneous transluminal coronary angioplasty (PTCA) procedures, 100 patients (82 men and 18 women; mean age, 54 +/- 10 years [3.9%]) underwent emergency coronary artery bypass graft surgery. Before PTCA 56 had unstable angina, 34 had prior myocardial infarction, and 60 had single-vessel coronary artery disease. The mean time period from the onset of ischemia to surgical reperfusion was 147 +/- 16 minutes; 155 grafts were placed (1.5 grafts per patient). In-hospital mortality was 19%; operative mortality was significantly related to older age (59 +/- 9 versus 53 +/- 10 years, p less than 0.05), presence of unstable angina (74% versus 53%, p less than 0.05), and development of cardiogenic shock or necessity of cardiac massage before surgery (53% versus 16%, p less than 0.0001). In addition, 57 patients developed a Q wave myocardial infarction. For hospital survivors, overall survival at 7 years was 94% (Kaplan-Meier method), with three cardiac deaths during follow-up; two additional patients had late myocardial infarction, and four had late PTCA. At a mean follow-up of 55 +/- 38 months, 78% of the patients had no chest pain, and 80% reported no dyspnea. All patients received antiplatelet agents or oral anticoagulants; 34% had no antianginal medications. Among the 40 previously employed patients, 73% resumed work after surgery. All patients with cardiogenic shock or cardiac massage who survived the initial hospital period were alive at follow-up. After an initial critical period, the long-term clinical outcome of patients with emergency coronary bypass surgery after failed PTCA is satisfactory.

Angioplasty, Balloon, Coronary↗

[Contribution of color echocardiography to the diagnosis of post-traumatic left ventricular-right atrial septal defect].

The authors report the case of an acquired left ventricle--right atrial communication after closed chest trauma. This communication was associated with rupture of the aortic isthmus and complete atrioventricular block. The left-to-right shunt which was assumed for a long time to be a small, well-tolerated, ventricular septal defect, finally required surgical repair. The diagnosis was eventually made clear by Doppler color flow mapping which was of great value in orienting the surgical procedure.

Adult↗

[Effects of naproxen (naprosyne) on the metabolism of arthrotic cartilage in man in vivo].

Degradative enzyme (proteoglycanase and collagenase) as well as proteoglycan synthesis enzyme (glycosyl-transferase) activity was studied in osteoarthritic fibrillated cartilage. Proteoglycanase activity was significantly lower in 10 patients with hip osteoarthritis treated with Naproxen (1 g/daily for 4 weeks) than in 10 patients treated with acetaminophen. Synthesis enzyme activity was similar in both groups. The results which confirm in vitro studies suggest that naproxen has not toxic effect on human osteoarthritic cartilage and could rather be beneficial.

Acetaminophen↗

[Cytokines, prostaglandin E2, phospholipase A and metalloproteases in synovial fluid in osteoarthritis].

Concentrations of prostaglandin E2, interleukin 1 beta, interleukin 6 and tumor necrosis factor alpha, phospholipase A2, collagenase and proteoglycanase activity were determined in synovial fluid from 26 patients with osteoarthrosis of the knee and 10 with rheumatoid arthritis. Osteoarthrosis synovial fluid was characterised by the absence of interleukin 1 beta while tumour necrosis factor alpha and interleukin 6 were present in relatively large amounts, by a very high phospholipase A2 activity contrasting with a very low concentration of prostaglandin E2, and by a collagenase/proteoglycanase activity only slightly less constant and high as in rheumatoid arthritis. In osteoarthrosis patients, the interleukin 6 concentration, but not that of tumor necrosis factor alpha, was correlated with the collagenase and proteoglycanase activity of synovial fluid.

Adult↗

[Intra-arterial fibrinolysis of superior mesenteric artery embolism].

Intra arterial fibrinolysis for acute mesenteric embolism. Acute mesenteric ischemia has a poor prognosis because the diagnosis is often too late (greater than 12 h), leading to a difficult surgery in old patients. The lesions of the bowel don't always allow a single operative embolectomy but often need a resection when there is a long time interval between onset of symptoms and therapy. We report a case of acute embolism in the superior mesenteric artery with the clot located in its terminal part. A rapid diagnosis was made by arteriography and intra-arterial fibrinolysis was attempted with success permitting the complete cure of the affection, without sequellae. This treatment is only likely to be successful if it is carried out within 10-12 hours of the onset of clinical signs and symptoms.

Acute Disease↗

[Effects of non-steroidal anti-inflammatory drugs on the enzymatic degradation of osteoarthritic cartilage].

The proteoglycannasic and collagenolytic activity the fissured, osteoarthritic human cartilage has been studied in vitro, using proteoglycannases and collagen type II respectively as marked substrates. The effect of various NSAIDs, used at a concentration corresponding to that of the synovial fluid, on these enzymatic activities has been measured in vitro. Naproxen decreases in a significant and dose-dependent way the enzymatic degradation of the cartilage, but only an inhibition of the proteoglycannase can be hoped for in vivo. Not all NSAIDs seem to have inhibitory effects on the enzymatic degradation of the osteoarthritic cartilage.

Aged↗

Study of the effect of a glycosaminoglycan-peptide complex on the degradative enzyme activities in human osteoarthritic cartilage.

The in vitro collagenolytic and proteoglycanasic activity from human fibrillated osteoarthritic cartilage was determined using labelled proteoglycans and type II collagen as substrates. In vitro, a glycosaminoglycan-peptide complex (GP-C Rumalon) induced a dose-dependent inhibition of both collagenolytic and proteoglycanasic activities while sodium salicylate and indomethacin had only a weak suppressive effect on proteoglycanase. Phospholipase A2 activity was unmodified by GP-C suggesting that the effect of the drug on degradative enzymes was unrelated to prostaglandin formation.

Aged↗

Cartilage degradative enzymes in human osteoarthritis: effect of a nonsteroidal antiinflammatory drug administered orally.

The activity of stromelysin and collagenase was determined in fibrillated human OA cartilage using labeled proteoglycans and type II collagen as substrates. In vitro paracetamol had no effect on metalloprotease whereas TA induced a significant inhibition of stromelysin. In cartilage and synovium from nine patients treated with TA and nine patients treated with paracetamol during 8 weeks before surgery for hip OA, stromelysin activity was significantly lower in the TA than in the paracetamol group. The results suggest that TA has a potential chondroprotective effect in OA.

Acetaminophen↗

A CD4-like molecule can be expressed in vivo in human parathyroid.

The expression of several epitopes of CD4, a molecule usually restricted to a subset of T-lymphocytes, was observed after immunofluorescent labeling of frozen-cut sections of human parathyroid. Seven samples obtained from three subjects presenting adenomas and from seven renal insufficiency patients with secondary or tertiary hyperplasia were found to express this molecule. Dot enzyme-linked immunosorbent assay, polyacrylamide gel electrophoresis, and Western blotting were used to characterize this peptide in cytosol and membrane fractions of these glands. These studies confirmed, in the parathyroids found positive in immunofluorescence, the presence of a protein with a mol wt similar to that of lymphocyte-derived CD4.

Adult↗