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Biomedical subjects

A Castaigne

Publications and source records attributed to A Castaigne.

At least 145 records · Page 8Linked to original sources
PubMed1988

The influence of molsidomine on infarct size: an acute post-infarction pilot study with 303 patients.

In a multicenter, randomized and double-blind study, the efficiency of molsidomine on infarct size has been examined in 303 patients suffering from a first myocardial infarction and compared with a placebo. According to previous enzyme studies, and in order to detect a 20% reduction infarct size with conventional levels of risk, alpha = 0.05 and beta = 0.20, the recommended sample size was 264 patients. Thirty-three patients initially selected were excluded for protocol violation and, among the 270 patients definitively included, 133 were allocated to molsidomine and 137 to placebo, without any difference concerning age, delay of treatment, infarct location, and initial blood pressure. Test drugs were both initiated within the 6 first hours and administered orally at decreasing doses for 10 days: 16 mg on the first day, 12 mg on the second day, and 6 mg daily from the third to the tenth days. There was not a significant difference between the molsidomine and placebo groups regarding the enzyme evaluation of infarct size, neither for CK dosage (101.72 +/- 74.76 gram equivalents vs. 92.71 +/- 65.91 gram equivalents, NS) nor for its MB fraction (67.34 +/- 50.07 gram equivalents vs. 63.50 +/- 43.01 gram equivalents, NS). Moreover, changes in the Q- or R-wave sum during the 10 days of follow-up were strictly identical. However, in-hospital mortality was lower in the molsidomine group than in the placebo group (4.5% vs. 8.0%), but this reduction was not statistically significant. During the study, there were few side effects, mainly headaches, without withdrawal of the treatment.

Acute Disease↗
PubMed1987

[Methods of evaluating proposed treatments in the secondary prevention of myocardial infarction].

Attempts at quantitative evaluation by imaging methods of left ventricular dys-synergism consecutive to ischaemia meet with a number of problems. These include such methodological and technical factors as corrections for heart movements in the thorax during contractions, or for the heterogeneity of segmental dynamics in both space and time. In addition, several biological factors must be considered, such as the possible expansion of a necrotic wall, the presence of systolic dysfunction in the area adjacent to the infarct, the lack of proportion between the degree of dys-synergism and the reduction in coronary arterial flow, and the frequent delay in improvement of contractile function after blood flow has been restored in the ischaemic area. A knowledge of all these factors is important to quantify myocardial ischaemia by imaging methods, and especially to evaluate the size of an acute infarct and the beneficial effects of early therapeutic measures on that size.

Electrocardiography↗
PubMed1987

[New thrombolytic agents. Effect on the organization of care in myocardial infarction].

In the last few years, intravenous thrombolysis has widely become the treatment of reference in the acute phase of myocardial infarction. Among the new thrombolytic agents which are currently being evaluated, two are particularly ahead of the group: 1) the plasminogen tissue activator, known at this time for a revascularizing effect exceeding that of streptokinase for a lesser fibrinogenolytic activity; its effectiveness in terms of mortality remains to be defined; 2) the acyl-streptokinase presents the advantage over the classic streptokinase of being injected in one single injection of 5 minutes. The revascularizing activity of this product seems to exceed that of streptokinase, and the fibrinolytic activity is the same as streptokinase's. The effectiveness in terms of mortality remains to be evaluated. The better effectiveness of the new thrombolytic agents should not let us forget that the main problem is to organize patient's care and that improvement of the effectiveness of thrombolytic therapy is mainly obtained through improvement of the screening and an early diagnosis of myocardial infarctions. Organization or patient's care in central hospitals and at the level of emergency transportation services will perhaps enable, in the years to come, to increase a great deal the number of patients who can benefit from thrombolysis and thus to decrease hospital and post-hospital mortality of myocardial infarction.

Fibrinolysis↗