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Biomedical subjects

Y Gruel

Publications and source records attributed to Y Gruel.

102 records · Page 6Linked to original sources
PubMed1985

Treatment of heparin-associated thrombocytopenia and thrombosis with low molecular weight heparin (CY 216).

This report concerns 34 cases of heparin-associated thrombocytopenia in which standard heparin has been systematically replaced by LMW heparin CY 216 Choay. There were 21 women and 13 men, mean age, 69 years. Twenty-six of the 34 cases had thrombotic complications. All of the patients were treated by standard heparin of porcine mucosal origin, in most cases for prevention of deep vein thrombosis and pulmonary embolism. Twenty-six cases occurred along with orthopedic and traumatologic surgery (especially for total hip replacement, 15 cases). Four cases involved vascular surgery and three involved medical thrombotic disease. Standard heparin treatment was always replaced by LMW heparin CY 216. Initial doses were 0.30 ml three times daily, later increased to obtain global hypocoagulability. Surgical procedures (embolectomy and vena cava filter) were carried out when necessary. Five patients had thrombolytic treatment (urokinase) in conjunction with LMW heparin. The overall results were 31 recoveries, but with seven severe sequelae (three amputations and four hemiplegias) most often attributable to the first ischemic attack, and three deaths. For the last 16 patients, indirect platelet aggregation tests were performed (control platelet-rich plasma plus patient platelet-poor plasma plus LMW heparin): nine cases had negative tests, with nine recoveries and seven cases had positive tests, with five recoveries and two deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

A new method of ventilation with a mixture of helium and oxygen in the management of congenital diaphragmatic hernia. A preliminary study.

To prevent the severe prognosis of pulmonary hypoplasia in congenital diaphragmatic hernia, the authors developed a new method of ventilation, using a modulated mixture of helium and oxygen. Associated with a leptanalgesia (Chlorpromazine-Morphine), the authors observed with this method two good results. Efficiency of this technique has been confirmed by X-rays and successive pulmonary scintigraphies (Xenon 133).

Female↗
PubMed1983

[Therapeutic approach to bilateral hepatoblastoma].

The treatment of a case of bilateral hepatoblastoma by continuous infusion of adriamycin in the hepatic artery accompanied by ligature of the right hepatic artery enabled the authors to carry out six weeks later an extensive right lobe hepatectomy. Unfortunately the patient died seven weeks after the partial hepatectomy from complication of surgery. Thus it was possible to demonstrate the effectiveness of the intra arterial chemotherapy. No residual tumor could be found at autopsy. As in the case with the adult, arterial ligature combined with carefully targeted chemotherapy would seem to be potentially important therapeutic option in the treatment of malignant liver tumors in children.

Age Factors↗
PubMed1983

[Value of neuroleptoanalgesia in preventing recurrence of fetal shunts during treatment of diaphragmatic hernias].

A leptanalgesia (Chlorpromazine-morphine) was used in the treatment of postero lateral diaphragmatic hernia in six neonates. The treatment which was begun immediately after the arrival of the child and continued during and after surgery seemed to contribute to the favorable outcome observed in five of the babies. In spite of the empirical nature of their argument, the authors suggest the possible mechanism of action of the treatment. However they recognize that its effectiveness can only be assessed after careful hemodynamic studies.

Chlorpromazine↗
PubMed1979

[The place of lavage-irrigation of the peritonium in peritonitis from the appendix in children. A report of 10 cases (author's transl)].

Confronted with the difficult problems presented in acute appendicular peritonitis, whether generalized or multiple focused, the authors used the "lavage irrigation" method in ten cases. They analysed the local and general conditions that led them to employ this method, in light of the evolution of this technic which they had observed in their experiences whit it. They have attempted to elucidate, using information previously available in the literature, the indications, the steps, and the eventual complications of the "lavage irrigation" of the peritonemum in the child.

Appendicitis↗
PubMedDate not supplied

The white clot syndrome or heparin associated thrombocytopenia and thrombosis (WCS or HATT) (26 cases).

The Authors report a new iatrogenic complication of preventive or curative standard heparinotherapy. This so called "white clot syndrome" or "Heparin associated thrombocytopenia and thrombosis" is an anatomico-clinical entity characterized by severe, multiple, recurrent, arterial and/or venous thromboembolic accidents which are sometimes fatal. They appear, paradoxically, under heparin treatment and are concomitant with thrombocytopenia (generally less than 100 10(9)/l). Antiplatelet immunoallergic phenomena, via type IgG antibodies, induced by heparin, are the most commonly admitted in physiopathology; however they remain controversial. Treatment of "WCS" includes urgent suppression of standard heparin, administration of antivitamin K, or the new generation of low molecular weight heparin. This series presents 26 cases of HATT treated by LMWH (CY 216 CHOAY). Severe complications must be surgically cured. Prevention of WCS or HATT is mandatory by the systematic survey of platelet count during heparinotherapy.

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