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Biomedical subjects

R Barraine

Publications and source records attributed to R Barraine.

At least 73 records · Page 4Linked to original sources

[Treatment of atrial fibrillation with fenoxedil hydrochloride. Apropos of 112 cases].

One hundred and twelve patients with atrial fibrillation of different causes were treated with fenoxedil chlorhydrate. Sinus rhythm was restored in 81 cases (72.3 p. 100). The best results were obtained in the following conditions: hypertensive heart disease (77.6 p. 100), ischemic heart disease (75 p. 100), idiopathic atrial fibrillation (76.4 p. 100), senile lone fibrillation (78.2 p. 100). The results were average in valvular heart disease (57.1 p. 100) and in hyperthyroidism (40%). Age did not appear to be a deciding factor, the overall results being comparable in patients under 70 years of age (70.8 p. 100) and over 70 years of age (73.4 p. 100). Although recent atrial fibrillation was reduced more easily (83.3 p. 100), the results were satisfactory in chronic arrhythmias (over 3 years) (77.7 p. 100). The success rate was 76.3 p. 100 when the cardiothoracic index was over 0.60, and 66.6 p. 100 when less than 0.60. The antiarrhythmic effect of fenoxedil chlorhydrate is related to its electrophysiological properties as it depresses sinus node activity and atrioventricular conduction. No arrhythmic or conduction complications were observed during a short period (maximum 5 days) of close monitoring. However, lengthening of the QT and PR intervals was a common phenomenon. The advantages of fenoxedil chlorhydrate over electrical cardioversion (atraumatic, possibility of associating digitalis) and the results obtained whilst respecting the prescribing advice, justify its adoption as a method of converting atrial fibrillation.

Adult↗

[Determination of the optimal dose of captopril in the treatment of severe cardiac failure by hourly hemodynamic monitoring].

The optimal dose of Captopril was evaluated by hourly haemodynamic monitoring in 10 patients with chronic congestive cardiac failure (Stage IV of the NYHA Classification) after administration of 25 mg, 50 mg, and 100 mg of Captopril. A similar improvement was observed in all the parameters considered with all three dosages. At its peak effect (90 minutes) 25 mg of Captopril caused a fall in pulmonary capillary, and mean pulmonary artery pressures, and a fall in systemic resistance of 40%, 20% and 30% respectively; with 50 mg of Captopril, the effect was a fall of 36%, 24% and 35% respectively. The cardiac index rose by 17% with 25 mg of Captopril, 28% with 50 mg and 12% with 100 mg of Captopril. Although the fall in pulmonary capillary pressure remained significant up to the 6th hour, the improvement in cardiac index was not significant after the 3rd hour. After 8 days' treatment, plasma renin activity increased from 7.01 +/- 4.68 to 23.6 +/- 18.3 ng/ml/hour (p less than 0.02) and serum aldosterone fell from 1.175 +/- 386 p. moles/l to 497 +/- 277 p. moles/l (p less than 0.001). There was no correlation between basal plasma renin activity and pre- or post-therapeutic systemic resistances. The clinical and haemodynamic improvement was sustained after 2 months' treatment in 5 of these patients without side effects. Increasing the dosage of Captopril does not reinforce or prolong its action; moderate doses (25 mg) are as effective as high doses (100 mg). Captopril, which acts by inhibiting the renin- angiotensin-aldosterone system is the current treatment of choice in severe refractory cardiac failure.

Aged↗

[2 new cases of myocardial infarction after injection of vincristine].

The authors report two cases of myocardial infarction following the injection of vincristine. The vincristine is held responsible for several reasons: absence of past history or risk factors of coronary artery disease, no past history of mediastinal radiotherapy, the development of coronary manifestations several hours after the injection of vincristine. Both cases followed a fatal course. The pathophysiology of this iatrogenic complications is unclear. Any patient receiving such treatment should be carefully monitored clinically and electrocardiographically.

Aged↗

[Aneurysm of the azygos vein].

A case of azygos vein aneurysm is described. It is a very rare condition, this being the tenth reported case. The patient presented with superior vena cava obstruction and underwent successful surgical cure. This congenital malformation is practically always latent. The aneurysm is usually diagnosed after the discovery of a mediastinal mass on routine chest X ray. Although its variations in size with position and respiration are characteristic, angiography would seem to be essential to confirm its aneurysmal nature and the anatomical relationships. Surgery is usually simple and should be proposed even to asymptomatic patients because of the risk of thromboembolism.

Aneurysm↗

[Aneurysms of the azygos vein].

A case of aneurysm of the arch of the greater azygos vein is reported. This extremely rare congenital anomaly appears as a large rounded opacity in the anterosuperior mediastinum. Though diagnosis may be suspected by the variations in size according to the period of observation and the position of the patient, if can only be confirmed by angiography, to eliminate an aneurysm of the superior vena cava or one of azygos vein from obstruction of the inferior vena cava.

Aneurysm↗

[Electrophysiological study of a Portuguese case of amyloidosis with conduction disorders].

Cardiac involvement in the course of familial Portuguese amyloidosis, as apart from the other primary amyloidosis, is characterised by the early and wide-spread intracardiac conduction disorders, and the contrasting late presentation of the clinical signs. A case is presented of Portuguese amyloidosis which was typical from the viewpoint of the neurological disorders, the familial characteristics, and the positive biopsy; the main conduction defects found in primitive amyloidoses are also recalled. The patient described had for many years suffered from first degree heart block, and then presented with lipid changes with syncopal attacks which led to electrophysiological investigation of the conduction defect, no similar example of which has been found in the literature. The severity and widespread nature of the disorders which were found, together with the localisation of a sub-His block led us to implant the pacemaker. We have only found two other patients who had implants for disorders of conduction secondary to cardiac amyloidosis. Emphasis has been laid on the importance of this investigation which, when it leads to the positioning of a pacemaker, should avoid the onset of syncopal attacks and sudden death which together constitute one of the primary causes of mortality in primary amyloidosis. The length of follow-up in our case has been 14 months (April 1977).

Adult↗

[Penicillamine].

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Adolescent↗