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Biomedical subjects

R Richard

Publications and source records attributed to R Richard.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Constrictive pericarditis: an underestimated complication of thoracic injuries].

Constrictive pericarditis is a well defined clinical entity, traditionally secondary to longstanding tuberculosis. Although posttraumatic constrictive pericarditis, due to haemopericardium, is well known during the postoperative period following cardiac surgery, it is underestimated in closed chest trauma. A new case of constrictive pericarditis is reported, due to neglected chest trauma. The discussion emphasizes the need for early diagnosis and surgical treatment, which determine the general prognosis of pericardial constriction. This implies systematic investigation of all cases of chest trauma, even minor, by transthoracic, or preferable, transoesophageal echocardiography, looking for haemopericardium.

Echocardiography, Transesophageal↗
PubMed1997

[Intracranial aneurysm and coronary ectasia].

BACKGROUND: Coronary aneurysms are uncommon and can exceptionally be associated with other aneurysmal localizations. CASE REPORT: A 34 year-old man with a history of aneurysm of the coronary arteries revealed by myocardial infarction without a wave six months earlier, presented cerebral hemorrhage secondary to an aneurysmal rupture of the anterior communicating artery. DISCUSSION: Other aneurysmal localizations such as the abdominal artery, pulmonary artery, hepatic artery, popliteal artery, coronary venous system or the left ventricle have been associated with coronary artery aneurysm. Only one case of coronary and cerebral aneurysm has been previously reported in the literature in an 8-year-old child with X-linked lymphoproliferative syndrome and EBV-induced infectious mononucleosis. Our case suggests that systemic aneurysmal disease may be a clinical entity and that cerebral angiogram should be discussed in patients with a coronary artery aneurysm.

Adult↗
PubMed1996

[Intrathoracic textiloma after cardiac surgery. Apropos of a case].

The authors report an exceptionally rare case of intrathoracic textiloma presenting with a recurrence of chest pain after myocardial revascularisation by double internal mammary artery bypass grafting. The diagnosis was suspected before reoperation from the results of echocardiography. CT scanning and magnetic resonance imaging. The authors discuss the clinical and paraclinical features and the treatment. The medico-legal aspects of this surgical complication are not negligeable.

Bandages↗
PubMed1995

Anticipated affective reactions and prevention of AIDS.

Controlling the AIDs epidemic may depend largely upon health education aimed at adolescents. A number of approaches have been applied to human immunodeficiency virus (HIV) preventive behaviour in adolescents, including the health belief model (Becker, 1974), protection motivation theory (Rogers, 1983), and the theory of planned behaviour (Ajzen, 1985, 1991). Since sexual behaviour is heavily influenced by emotions, a possible shortcoming of these models is that little attention is given to affective processes. In this study we investigated the role of anticipated, post-behavioural, affective reactions to (un)safe sexual behaviours in the context of the theory of planned behaviour (TPB). The results showed that anticipated affective reactions such as worry and regret predicted behavioural expectations over and above the components of the TPB. The implications for our understanding of adolescent sexual behaviour and for campaigns aimed at the reduction of risky sexual practices will be discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Spatiotemporal gait parameters measured using the Bessou gait analyzer in 79 healthy subjects. Influence of age, stature, and gender. Study Group on Disabilities due to Musculoskeletal Disorders (Groupe de Recherche sur le Handicap de l'Appareil Locomoteur, GRHAL).

The Bessou gait analyzer provides quantitative measurements of spatiotemporal gait parameters. The purpose of this study was to determine whether and how these parameters are influenced by age, stature, and gender. Seventy-nine normal individuals (38 males aged 20 to 80 years and 41 females aged 20 to 80 years) were divided into ten-year age groups. Males and females were studied separately. In each subject, the Bessou gait analyzer was used to measure spatiotemporal gait parameters (spatial parameters: stride and step lengths; temporal parameters: cycle, stance and swing durations). Mean walking speed was calculated in each subgroup. In both males and females, all study parameter values were identical for the left and right sides. Females younger than 60 years had shorter stride and step lengths (M: 1.5 +/- 0.2 m; F: 1.3 +/- 0.1; p < 0.001) but faster pace values (M: 104.8 +/- 9.0 cycles/min; F: 115.6 +/- 7.6 cycles/min; p < 0.001) than males, and consequently mean walking speed was similar in females and males (M: 4.8 km/h +/- 0.8 km/h; F: 4.4 km/h +/- 0.6 km/h). In contrast, females older than 60 years walked at the same pace as males and consequently had slower walking speeds. Stride length was correlated with age, stature, and gender. However, age was correlated with stature, and only age and gender had independent effects on gait parameters in the multiple regression analysis. In subjects of similar age and gender, effects of stature may need to be taken into account.

Adult↗
PubMed1994

Hypothermia and bleeding during abdominal aortic aneurysm repair.

Patients undergoing abdominal aortic aneurysm repair routinely have a depressed core body temperature during surgery, and hypothermia is known to cause abnormalities in coagulation. This study was designed to determine whether platelet function is altered as a result of hypothermia or heparin during abdominal aortic aneurysm repair. Ten patients scheduled for abdominal aortic aneurysm surgery were prospectively studied. Bleeding times and temperature were measured every hour beginning preoperatively. Each patient was heparinized intraoperatively, and the effects reversed with protamine sulfate prior to closure. Despite efforts to keep the patients warm, all of them developed hypothermia (mean lowest core temperature 34.8 +/- 0.7 degrees C). A significant linear relationship between the change in core temperature and the change in bleeding time was demonstrated. In 7 of 10 cases the greatest change in bleeding time occurred when patients experienced the lowest mean core temperature and not when they were heparinized. These data suggest that hypothermia has a marked effect on platelet function during abdominal aortic aneurysm repair. Although heparin can cause abnormalities in platelet function, hypothermia may be a more important role in inhibiting normal platelet function. By preventing severe hypothermia (< 35 degree C), excessive bleeding associated with abdominal aortic aneurysm repair may be minimized without the concomitant risk of blood product transfusion.

Aortic Aneurysm, Abdominal↗
PubMed1994

Changing adolescents' sexual behaviour: perceived risk, self-efficacy and anticipated regret.

This article focuses on determinants of adolescent AIDS-related behaviour. First, we will focus on the perception of risk for AIDS and possible optimistic biases in perceived risk. The behavioural consequences of optimism or perceived invulnerability will be briefly discussed. Next, we will focus on other determinants of sexual risk behaviour, i.e. self-efficacy and anticipated regret. Gender differences in the predictive power of these factors will be discussed. Finally, we will summarize the results of a series of studies investigating the role of anticipated regret as a determinant of adolescent sexual risk behaviour. The possible contribution of stressing anticipated regret in prevention programs aiming adolescents to adopt safer sex practices will be discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Course of the left ventricular mass in a population of 893 hypertensive patients. Effects of treatment with perindopril].

Left ventricular hypertrophy is now recognized to be a major and independent risk factor of mortality and morbidity. Although all classes of antihypertensives are able to reduce left ventricular mass, two recent metaanalyses have shown that ACE inhibitors are the most effective. The antihypertensive efficacy of perindopril in man is accompanied with a significant improvement in the functional properties of large arteries and with a reduction of LVH. This study was designed to assess the course of left ventricular mass by echocardiography in a population of 893 hypertensive patients with moderate left ventricular hypertrophy, treated with perindopril for 3 months. A significant fall in blood pressure was observed by the 6th week. The morphological and functional echocardiographic parameters on a large population provided more valid statistical results than in a small series. The left ventricular cavity was found to undergo symmetrical remodelling, adapted to the new haemodynamic status. The reduction of the thickness of the wall was in line with the reduction of the size of the ventricular chamber, and left ventricular mass was reduced by 8% (p < 0.001). Systolic function was preserved and diastolic function was improved. In particular, the E/A ratio was increased by 8% (p < 0.001) and the duration of isometric relaxation was decreased by 11 ms (p < 0.02). This improvement of filling was confirmed by the reduction of the diameter of the left atrium by 0.2 mm (p < 0.001). This open study in 893 patients therefore confirmed that perindopril corrects LVH in hypertensive patients.

Adult↗
PubMed1994

Aspergillus spondylodiscitis: successful conservative treatment in 9 cases.

OBJECTIVE: To assess the effectiveness of medical treatment by clinical, radiological, and biological analysis of outcome in 9 patients with aspergillus spondylodiscitis. METHODS: Retrospective study including 9 patients with aspergillus discitis, in which 7 were immunosuppressed; 3 were heart transplant patients, 2 had acute lymphoblastic leukemia, 1 hairy cell leukemia and one was receiving prednisone for bronchial asthma. Four patients had isolated spinal aspergillosis infection. In 4 cases, disc space infection occurred after pulmonary aspergillosis. In the last case the spondylodiscitis occurred after aspergillus endocarditis and mycotic limb embolism. In all cases a percutaneous needle biopsy of the intervertebral disc was performed; the subsequent culture produced Aspergillus fumigatus in 8 cases and Aspergillus flavus in 1. Itraconazole was given to all patients (mean dose: 350 mg/day); it was given alone in 2 cases, in addition to 5 flucytosine and amphotericin B in 6 cases, and in addition to amphotericin B in the last case. RESULTS: Improvement was obtained in the 9 cases, with full recovery in the absence of any surgical debridement after a mean treatment duration of 5.5 months and a mean followup delay of 16 months. CONCLUSION: Early recognition of aspergillus spondylodiscitis in immunocompromised hosts is important. Itraconazole alone or in combination is an effective therapy. There may be an increased incidence of aspergillus discitis due to the increasing frequency of immunosuppression associated conditions including organ transplantation, chemotherapy, or acquired immune deficiency syndrome.

Adult↗
PubMed1993

[Aspergillus spondylodiscitis. Apropos of 3 cases].

Three cases of Aspergillus discitis are reported in immunodepressed patients. Vertebrae osteomyelitis was preceded in 2 cases by pulmonary infection. The diagnosis was established in every case by disc aspiration or closed-needle-biopsy and mycological examination of the material. Aspergillus fumigatus was identified in two cases; in one case itroconazole led to recovery within three months.

Adult↗
PubMed1992

Clinical trials of an intravenous oxygenator in patients with adult respiratory distress syndrome.

In patients with severe adult respiratory distress syndrome, mechanical ventilation may not be able to ensure gas exchange sufficient to sustain life. We report the use of an intravenous oxygenator (IVOX) in five patients who were suffering from severe adult respiratory distress syndrome as a result of aspiration, fat embolism, or pneumonia. IVOX was used in an attempt to provide supplemental transfer of CO2 and O2 and thereby reduce O2 toxicity and barotrauma. All patients were tracheally intubated, sedated, and chemically paralyzed and had a PaO2 < 60 mmHg when the lungs were ventilated with an FIO2 = 1.0 and a positive end expiratory pressure of > or = 5 cmH2O. The right common femoral vein was located surgically, and the patient was systemically anticoagulated with heparin. A hollow introducer tube was inserted into the right common femoral vein, and the furled IVOX was passed into the inferior vena cava and advanced until the tip was in the lower portion of the superior vena cava. IVOX use ranged from 2 h to 4 days. In this group of patients, IVOX gas exchange ranged from 21 to 87 ml x min-1 of CO2 and from 28 to 85 ml x min-1 of O2. One of the five patients survived and was discharged from the hospital. The IVOX transferred up to 28% of metabolic gas-exchange requirements. One patient with a small vena cava showed signs of caval obstruction. Three other patients demonstrated signs of a septic syndrome after the device was inserted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Canine GM1-gangliosidosis. A clinical, morphologic, histochemical, and biochemical comparison of two different models.

The clinical, morphologic, histochemical, and biochemical features of GM1-gangliosidosis in two canine models, English Springer Spaniel (ESS) and Portuguese Water Dog (PWD), have been compared. The disease onset, its clinical course, and survival period of the affected dogs were similar in both models. Skeletal dysplasia was noted radiographically at 2 months of age, whereas at 4 1/2 months of age there was progressive neurologic impairment. However, dwarfism and coarse facial features were seen only in ESS. Both models had similar deficiency in activity of lysosomal beta-galactosidase, but possessed a normal protein activator for GM1-beta-galactosidase. Both models stored GM1-ganglioside, asialo-GM1, and oligosaccharides in brain. Furthermore, only the PWD stored glycoproteins containing polylactosaminoglycans in visceral organs, and neither model stored them in the brain. Morphologically, both models demonstrated similar storage material in multiple tissues and cell types. The ultrastructure of the storage material was cell-type specific and identical in both models. However, some differences in the lectin staining pattern were noted. Our clinical, biochemical, and histochemical findings indicate that PWD and ESS may represent two different mutations of the beta-galactosidase gene. Moreover, the authors conclude that it is difficult, and inappropriate, to apply the human classification of GM1-gangliosidosis (i.e. infantile, juvenile, and adult forms) to these canine models.

Amniotic Fluid↗
PubMed1991

Clinical, neurophysiological, biochemical and morphological features of eyes in Persian cats with mannosidosis.

The clinical, neurophysiological, morphological and biochemical manifestation of eyes from Persian kittens affected with alpha-mannosidosis were studied. Clinically the disease is characterized by progressive corneal and lenticular opacification. In addition there is asymmetry in shape and latency of signal conductions which were demonstrated by visual evoked potential studies. Morphological and histochemical studies revealed vacuolization of various ocular cell types which stained positively with Concanavalia ensiformis agglutinin (Con A) and wheat germ agglutinin (WGA). Biochemical studies illustrated low activity of acid alpha-mannosidase in cultured keratocytes and abnormal storage of partially degraded oligosaccharides in these cells, in vitreous humor and lens. This comprehensive study of ocular alpha-mannosidosis demonstrates enzyme deficiency which leads to abnormal storage of oligosaccharides in affected cells and is manifested by morphological alterations and functional impairment.

Animals↗