Search PubMed⌕ Search

Biomedical subjects

R Perron

Publications and source records attributed to R Perron.

13 recordsLinked to original sources
PubMed2000

Impact of routine use of intraoperative transesophageal echocardiography during cardiac surgery.

PURPOSE: To determine the relative impact of each category-based TEE indication according to the ASA guidelines. METHODS: In 851 patients undergoing cardiac surgery, TEE clinical indications were classified as category I or II according to the ASA guidelines. Category I indications are patients in which TEE is considered useful and category II are those where TEE is potentially useful but indications are less clear. All TEE examinations were reviewed by two anesthesiologists with advanced training in TEE. For each patient, the clinical impact of TEE in the clinical management was assessed using five criteria: 1) change of medical therapy; 2) change in the surgical procedure; 3) confirmation of a suspected diagnosis; 4) positioning of an intravascular device, and 5) substitute to a pulmonary artery catheter (PAC). RESULTS: TEE had greater utility in category I than in category II indications (15/53 (28%) vs. 110/798 (14%) respectively) (P<0.01). The nature of the clinical impact was as follows: modification of medical therapy in 67/125 (53%), modification of planned surgical intervention in 38/125 (30%), confirmation of a diagnosis in 34/125 (27%). The impact on therapy was higher in complex surgical procedures (39%) than in valvular replacement (19%) (P<0.01) and coronary artery bypass surgery (10%) (P<0.001). CONCLUSIONS: Our findings validate the usefulness of the ASA practice guidelines demonstrating a greater impact of TEE on clinical management for category I indications than for category II. TEE also had a greater clinical impact in complex surgical procedures and in valvular replacement.

Cardiac Surgical Procedures↗
PubMed1982

Characterization of the beta receptor responsible for enhanced histamine release from bovine leukocytes.

The present study was undertaken to determine the beta-receptor subtype responsible for the enhanced anaphylactic histamine release from bovine leukocytes produced by isoprenaline. The selective beta 1 antagonist practolol competitively inhibited the enhancement of histamine release produced by isoprenaline. The selective beta 2 agonists salbutamol and terbutaline produce no significant effect on antigen-induced histamine release. This indicates that the receptor responsible for enhancement of histamine release from bovine granulocytes is of the beta 1 subtype. The question is raised as to whether this is a normal physiological response or an abnormal condition produced by the sensitization procedure.

Albuterol↗
PubMed1979

[The concept of mental deficiency. Evolution of theories, attitudes and practices].

In the last twenty years a deep renewal of the conceptions about and the treatments of the mentally deficients has taken place. In an attempt to clarify somehow the confusion in the communication between specialists, the author reminds the classical position on this subject, which relies upon the definition of the idiocy: a state of a severe mental defect, set up early in life, with an organic cause and being incurable for this reason. In spite of the later considerable differenciation at different levels and types, the classical position maintains this definition as the ground of the nosographic class of the mental retardations (debility is considered then as a light idiocy), divided in two sub-classes of either "polygenic heredity" or accidents causing early brain damages. From a clinical point of view, such a theoretical position is difficult to apply, especially in cases of middle and light mental defects. From a theoretical point of view, this classical position has been often attacked: by the evidence of the socio-cultural factors of the intellectual development, by the analysis of the so-called instrumental troubles, by the studies about the early lack of mother-care and the child-psychoses with a defect, by the more recent works on dysharmonic evolvements, etc. All this has lead to major theoretical changes which force to give up the illusion of a "single class" of mental retardations and study therefore each case in the trajectory of its development, not only of the cognitive patterns but also of the whole personality structure. This clinical approach forces to admit organic, environmental (sociological and psycho-sociological) and relational, dynamic factors as well; and, to accept that their combination, replaced in a genetic context of the functioning patterns, establishes a new, properly psychological level of causality. So, even the idea of a "defectology" is non-sense; the factors and the problems in question are the same as in any other psychogenesis. Nevertheless, the study of cases, in which this psychogenesis is caracterized by a mental deficit, is very important.

Adolescent↗