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Biomedical subjects

S Marchand

Publications and source records attributed to S Marchand.

At least 73 records · Page 4Linked to original sources
PubMed1991

Electrical stimulation of peripheral and central pathways for the relief of musculoskeletal pain.

One method for the treatment of chronic musculoskeletal pain involves stimulation of the peripheral or central nervous system. Such stimulation includes transcutaneous electrical nerve stimulation, dorsal column stimulation, and deep brain stimulation. This review discusses the clinical use of electrical stimulation for the relief of musculoskeletal pain, and describes the results of studies conducted in our laboratory suggesting that such stimulation reduces pain transmission along sensory-discriminative pathways.

Animals↗
PubMed1991

Suction blisters technique in amikacin diffusion through interstitial fluid in cystic fibrosis.

Modifications in the pharmacokinetics of aminoglycosides have been reported among patients with cystic fibrosis. We obtained suction blister fluid (SBF) to study the tissue diffusion of amikacin in cystic fibrosis in 2 children (a 9-year-old boy and a 7-year-old girl) over the course of bronchopulmonary infection. Amikacin was administered intravenously using a single dose of 5 mg/kg. The peak plasma concentrations were 24.5 and 11.2 mg/l, and the peak SBF concentrations were 8.3 and 3.2 mg/l. The ratio of the area under the curve in SBF and plasma was 58 and 60%, respectively. These results suggest a good penetration of amikacin through SBF and a good tissue diffusion of amikacin. The preliminary data suggest that the suction blister method may be useful to assess the tissue diffusion of drugs.

Amikacin↗
PubMed1990

Area of lateral ventricles measured on cranial ultrasonography in preterm infants: association with outcome.

The association between measurements of lateral ventricle area (determined by serial ultrasound scans) and outcome was studied in 70 preterm neonates of 33 weeks' gestation or less. The study group was subdivided into four groups according to cranial ultrasonographic findings at 2 weeks postnatal age: group A (n = 15) had isolated periventricular/intraventricular haemorrhage; group B (n = 20) had periventricular/intraventricular haemorrhage and dilated ventricles; group C (n = 24) had periventricular/intraventricular haemorrhage and periventricular leukomalacia with or without dilated ventricles; and group D (n = 11) had isolated periventricular leukomalacia. Eighty seven preterm infants with no evidence of intracranial disease and good neurodevelopmental outcomes at 2 years formed the control group. A poor outcome was observed in infants in group B, C, and D, particularly in those who had persistent dilated ventricles at 6 weeks postnatal age and extensive periventricular leukomalacia. There was no difference in outcome between group A and controls. During the first six weeks of life ventricular area growth velocities were significantly higher in groups B, C, D, compared with normal controls and group A. We suggest that persistent ventricular dilatation at this early stage carries a bad prognosis, which is the result of atrophy of the brain.

Age Factors↗
PubMed1990

Randomized study of vancomycin pharyngeal instillation as a prophylaxis of bronchopulmonary infection in intubated neonates.

In a randomized prospective trial, we investigated whether vancomycin (chosen for local microbiological reasons) given by instillation into the oropharynx of intubated neonates could reduce the frequency of pharyngeal and tracheal colonization, and then broncho pulmonary infection. Two groups of 20 neonates intubated for an expected ventilation period of more than 7 days were included in the study. There was no statistical difference between the two groups for weight, gestational age and duration of treatment. One group (V+) received 4 drops of a 5% solution of vancomycin every 8 h. The control group (V-) had no local treatment. Oropharyngeal and tracheal aspirates were collected twice weekly for bacterial examination. During ventilation, colonization occurred in the oropharynx of 5 V+ (on day 18 +/- 10) and 18 V- (on day 5 +/- 2.5; p less than 0.001); the colonization occurred in trachea of 5 V+ (on day 19 +/- 11) and 17 V- (on day 6 +/- 3.6; p less than 0.001). The same bacteria were identified on both sides in all infants colonized. This treatment produced no adverse effects and seemed particularly valid for very low birth weight infants.

Apnea↗
PubMed1990

[Not Available].

Explore the source record for details and available documents.

Anatomy↗
PubMed1990

[Bacterial infection in the newborn by maternal-fetal contamination: oral antibiotic treatment of the colonized newborn. Prospective study at a maternity unit].

It is not yet known how important bacterial colonisation of the newborn is but in most maternity units this, when it occurs, is treated by parenteral antibiotic therapy. We have, in a prospective study, given antibiotics orally (amoxycillin or clavulanic acid-amoxycillin) in neonates who were colonised by bacteria, and have studied their clinical progress in the first month of life, using a questionnaire to be filled in by the parents. There were 119 neonates treated in 19 months and of these 87.4% of the parents replied to the questionnaires. The children did well in every case. A pharmacokinetic study showed that 76% of the amoxycillin given by mouth was absorbed. It seems, therefore, to us to be useful to give antibiotic treatment by mouth in these neonates.

Administration, Oral↗
PubMed1990

[Conditions of low birth weight newborn infants at home after prolonged neonatal hospitalization; prospective study of 50 cases].

The hospitalisation of low birth weight neonates has an effect on the parent-child relationship. A prospective study on the effects of returning home and on home conditions was conducted in the neonatal unit over a 6-month period. Fifty infants were included in the study. The results showed that difficulties in the parent-child relationship took place after the infant returned home in 11 cases (22%). Examination of the possible role of factors prior to or during the hospital stay indicated the significance of the following: premature delivery, disturbances during the childhood one of the parent's, and the infant's stay in neonatal intensive care unit.

Child, Hospitalized↗
PubMed1990

[Pharyngeal and tracheal flora in intubated neonates: interrelations and role of streptococci].

Fourteen neonates intubated within 48 hours of birth were studied for a mean period of two weeks. None were candidates for antimicrobial therapy. Microorganism loads were evaluated twice a week, quantitatively in the pharynx and semiquantitatively in the trachea. Most microorganisms recovered were Gram-positive cocci. All species acquired reached 10(7) CFU/g by the time of the second sampling. All species recovered from the pharynx were recovered from the trachea within 0.25 weeks. The presence of alpha-hemolytic streptococci did not modify the other populations. A colonization pattern similar to that seen in the digestive tract but with specific features due to countercurrent colonization is suggested.

Colony Count, Microbial↗
PubMed1989

[Conventional mechanical ventilation in the premature infant and the full-term newborn].

Convention mechanical ventilation (MV) is installed after nasotracheal intubation by means of a volume generator or pressure reducer. Careful monitoring of the child's respiratory status is indispensable; sedatives and/or muscle relaxants may facilitate MV. The method is indicated in case of oxygen-resistant hypoxaemia or of global alveolar hypoventilation, or to cope with a severe general or neurological stress. While MV is being applied, there main and dangerous complications may occur: respiratory obstruction, pneumothorax and lower respiratory tract superinfection. Weaning must be progressive. As regards the practical handing of MV, the best way to adjust the respirator constants is to evaluate the time constant according to the nature of the lung disease and to the stage it has reached in its course. In the most severe situations, and particularly in case of hyaline membrane disease, one must try to obtain the best possible adequation between severity of the disease and ventilatory stress, without preestablished arbitrary limits.

Humans↗
PubMed1989

A primate model for the study of tonic pain, pain tolerance and diffuse noxious inhibitory controls.

A primate model of cold pressor pain is described in which the animal itself initiates all trials, may terminate painful stimuli at any time, and controls the duration of the experimental session, thus avoiding the inadvertent administration of intolerable pain stimuli. Pain tolerance time varies directly with stimulus intensity and is sensitive to motivational factors. This model will facilitate the study of endogenous pain-modulatory pathways and the assessment of analgesic treatments in animals.

Adaptation, Physiological↗
PubMed1989

Influence of indomethacin on the intrarenal uptake of gentamicin in endotoxemic rats.

Gentamicin is a commonly used antibiotic for the treatment of gram-negative-bacterial infections. Bacterial endotoxin is liberated during antibiotic therapy, and we have shown that endotoxemic animals accumulate more aminoglycosides in their renal parenchyma than normal animals. Vasoactive mediators, such as prostaglandins and thromboxanes, are released after endotoxin and are involved in inflammation. Indomethacin, a nonsteroidal anti-inflammatory drug known to inhibit the synthesis of these hormones, was infused intravenously as a bolus (3.0 mg/kg) or as a bolus followed by a continuous infusion (0.75 mg/kg per h) to rats given gentamicin. Levels of gentamicin in serum and kidney were increased 2 h post-antibiotic treatment in the endotoxemic animals. Renal function was not significantly disturbed. Indomethacin given as a bolus failed to correct the disturbed intrarenal pharmacokinetics of gentamicin induced by endotoxin. However, a bolus followed by continuous infusion of indomethacin resulted in low cortical and high papillary levels of antibiotic. These changes were correlated with the inhibition of prostaglandin synthesis from the kidney. These observations suggest an important role for prostaglandins in the interaction among endotoxin, aminoglycosides, and the kidney. Specific inhibitors of arachidonic acid metabolites should be investigated to further understand the mechanisms of this interaction.

Alprostadil↗
PubMed1989

[Methemoglobinemia after accidental Nestosyl ingestion].

Nestosyl is usually used for dental pain in children. We report a methemoglobinemia after accidental ingestion of 10 ml in a 2 year-old girl. Cyanosis was cleared and O2 saturation and PaO2 were normalized 15 mn after methylene blue (1 mg/kg) administered intravenously. Nestosyl contains butoform, benzocaine, resorcine and 8-hydroxyquinoleine: the 3 latest can induce methemoglobinemia. The benefit of the drug is not demonstrated and this potentially severe side effect justifies its delivery only after medical prescription and information about its dangers.

Anesthetics, Local↗
PubMed1987

Effects of acetylethylcholine mustard on [3H]quinuclidinyl benzilate binding and acetylcholine release in rat brain synaptosomes.

The effects of acetylethylcholine mustard and its aziridinium derivative (AMMA) on acetylcholine (ACh) release and [3H]quinuclidinyl benzilate (QNB) binding were studied in rat cortical synaptosomes. After incubation for 5 min at 37 degrees C, AMMA reduced [3H]QNB binding with an IC50 of 9 microM. Following incubation for 5 min with 50 microM AMMA and washing, there was a 62% reduction in the [3H]QNB binding capacity with no change in the KD value for the remaining receptors, a result indicating the irreversibility of the AMMA binding. AMMA and oxotremorine both reduced the basal and 30 mM K+-induced release of newly synthesized [3H]ACh in dose-dependent manners over a 2.5-min period. At identical 50 microM concentrations, AMMA produced a much longer inhibition of basal [3H]ACh release than oxotremorine did. The inhibition of basal and 30 mM K+-induced [3H]ACh release by AMMA (10-250 microM) was blocked by 2 microM atropine during a 2.5-min release incubation, but not during a 30-min release incubation. After synaptosomes were treated with 50 microM AMMA for 5 min and the unbound drug was washed out from the tissue, [3H]ACh release (basal and K+-induced) was reduced. AMMA (50 microM) reduced high-affinity choline uptake and ACh synthesis by greater than 90% in this tissue, but these effects did not account for the [3H]ACh release inhibition, because they were not atropine sensitive and hemicholinium-3 had no effect on [3H]ACh release under the conditions used in these studies, i.e., after extracellular [3H]choline was washed out. Taken together, these results suggest that AMMA may be an irreversible agonist at presynaptic muscarinic autoreceptors.

Acetylcholine↗
PubMed1987

[Erythromelalgia, arterial hypertension and increased excretion of urinary catecholamines].

A 7 year-old girl was hospitalized with acute, severe and drug resistant erythromelalgia. During her stay in the hospital, she presented with an epileptic seizure associated with hypertension (220-120 mmHg). Catecholamine urinary excretion was markedly increased. Diagnoses of pheochromocytoma and acrodynia were excluded. Erythromelalgia and hypertension both disappeared in a few days without any relapse after a 2 year-follow-up. Catecholamine urinary excretion returned to normal levels in a few weeks. A skin biopsy which was performed in an affected site, showed a slight and questionable reduction of the density of autonomic adrenergic nerve terminals in the periarterial and glandular plexuses. The relevance of transitory excess catecholamine excretion and its link with erythromelalgia and hypertension are discussed. The hypothesis that the disorder could be explained by an abnormality of distal autonomic axons is likely.

Catecholamines↗
PubMed1986

Pharmacokinetics of amikacin in cystic fibrosis: a study of bronchial diffusion.

36 pharmacokinetic studies of amikacin were performed to evaluate the bronchial diffusion of amikacin in 9 children with cystic fibrosis, 3 to 15 years old. Amikacin was administered i.v. according to a variable dosage regimen. Four children without cystic fibrosis were enrolled as controls. The mean half life was 1.1, the volume of distribution averaged 0.26 l/kg, and the mean plasma clearance was 131 ml/min/1.73 m2, which no differed from that of the controls. The mean peak plasma concentration was always above the MIC but its level depended on the unit dose: 18.5 mg/l, 25,95 mg/l and 31,46 mg/l for doses of 5, 7.5 and 12.5 mg/kg, respectively. Between consecutive amikacin infusions, the plasma level was above the MIC for 21% and 46% of the time after the 5 and 7.5 mg/kg doses. The maximum concentration in sputum between H1 and H2 was always below the MIC, except after 15 mg/kg. The ratio AUC sputum/AUC plasma was between 0.028 and 0.61, and it increased from the beginning to the end of the course of treatment. No side effects were observed on hearing, or vestibular and renal function. The results are used to suggest more appropriate dosing regimens.

Adolescent↗