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Biomedical subjects

R Limet

Publications and source records attributed to R Limet.

At least 289 records · Page 16Linked to original sources
PubMed1982

A coordinated attempt for prevention of child abuse at the antenatal care level.

The authors report the preliminary result of an integrated approach to the primary prevention of the child abuse syndrome. The problem has been approached through a new concept of prenatal and postnatal care, the obstetrical team working in close cooperation with the child psychiatrist of the department of pediatrics. The obstetrical team followed 91 patients during their pregnancy; they were all discussed at supervisory sessions. This permitted a gynaecologist and a social nurse to develop a therapeutic plan for 72 patients. For the 19 more problematic cases, the child psychiatrist intervened immediately in the surroundings of the antenatal clinic. Short, specific psychotherapeutic interventions based on the alleviation of a family crisis have remedied important stress situations. The favourable influence of this new methodology has led to: (1) reduction of a potentially high expected prematurity rate; (2) improved integration of out-patient and in-patient care; (3) improved adaptation of the health staff to this type of situation. A case example to illustrate the functioning of both teams is given.

Adolescent↗
PubMed1982

[Treatment of Prinzmetal's angina with normal coronary vessels by thoracic sympathectomy].

Two cases of Prinzmetal angina with normal coronary arteries are reported: coronary spasm was demonstrated in the left anterior descending artery in the first, and in the right coronary artery in the second case. Invalidating angina persisted despite maximal medical treatment with nitrite derivatives, nifedipine, verapamil and amiodarone. Homolateral thoracic sympathectomy led to long term remission of symptoms in one case and a short remission in the other, who then had to undergo complete denervation by plexectomy. Two hours after reoperation a refractory spasm of the right coronary artery led to the death of the patient. The possible causes of refractory coronary spasm and possible therapeutic approaches are discussed with reference to these cases.

Adult↗
PubMed1981

Prognostic significance of electrocardiographic findings in angina at rest. Therapeutic implications.

Ninety-five patients with angina at rest were observed in the coronary care unit. Eighty-one per cent presented concomitantly or had previously presented some other manifestations of coronary artery disease. These patients were divided into two subgroups. In subgroup 1 (40 patients), episodes of non-exertional angina were associated with a pattern of hyperacute subepicardial injury and, frequently, with ventricular arrhythmias. In subgroup 2 (55 patients), the episodes of angina at rest were attended by horizontal ST depression, isolated T wave inversion, or trivial ST-T changes. Coronary angiographic findings were similar in both subgroups. Symptoms regressed in only 9% of patients in subgroup 1 while they were receiving beta-receptor antagonists, whereas amiodarone alone or amiodarone with nifedipine was successful in 58%. Of these patients, 25% developed a myocardial infarction shortly after admission. In subgroup 2 patients, beta-blockers were successful in 61%. Amiodarone isolated or associated with nifedipine was successful in 55% of the patients in whom it was tried. Only 5% of patients in this subgroup developed a myocardial infarction during their hospital stay. It is concluded that: (1) observation of the electrocardiogram during spontaneous angina in patients with known atherosclerotic coronary heart disease may be of prognostic significance and may influence therapeutic decision. (2) Amiodarone by virtue of its anginal and antiarrhythmic properties may be particularly useful in the treatment of non-exertional angina.

Adrenergic beta-Antagonists↗
PubMed1981

[Involvement of the common trunk of the left coronary artery].

This work describes the observations made in a group of 32 patients suffering from left main coronary stenosis (narrowing of 70% or more). 28 patients underwent surgical treatment: they represent 14% of 200 consecutive surgical cases. The diagnosis of left main narrowing is not possible on clinical ground only. However, several common features can be noted. Patients without myocardial infarction commemoratives all experienced unstable angina pectoris. When a bicycle ergometric test could be realized, it was positive for a low work load. It showed a mean 3 mm ST depression for a mean charge of 75 watts. The repolarisation disturbance lasted long after interruption of effort (more than 7 minutes). Coronarography very often showed multiple vessel disease. the anterior descending artery was stenosed in 25 patients, the circumflex artery artery in 23 and the right coronary artery in 27 patients out of the 32. In the majority of the patients, an anastomotic circulation was evidenced. The direction of the vicarious flow was determined by the relative degree of stenosis on the arteries implied in this collaterality. The mortality of coronarography was 1/32. Among the 28 operated patients, 1 died shortly after operation, giving an operative mortality of 3.6%. During a mean follow-up of 15 months, 1 death during the first postoperative year, 2 failures, 2 partial successes and 22 clinical recoveries were noted. Out of 18 patients socially susceptible to work again, 12 are effectively working, 3 are retired and 3 are still totally unable to work at the present time.

Angina Pectoris↗
PubMed1980

Five years' experience with intraaortic balloon pumping. The changing of indications and the emergence of prognostic indices.

The authors report their experience with IABP during 5 years. 40 patients have been submitted to this procedure, 31 for spontaneous non-complicated myocardial infarction. Overall survival rate was poor in those non-surgical conditions (8/31); better outcome was obtained if IABP was applied earlier in the course of the infarction and if left ventricular filling was continuously assessed. Therefore, use of prognostic index (such as SWI/PWP) and monitoring of pulmonary wedge pressure is stressed. Incidence of sudden death is high among short term survivors 4 out 5 deaths in 8 short term survivors. Usefulness of IABP in preparation for surgery or/and as postsurgical support is evident in this series (5/7 successes) with the exception of patients who did not come off pump (2 cases) and for whom IABP was ineffective.

Assisted Circulation↗