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Biomedical subjects

A Davido

Publications and source records attributed to A Davido.

31 records · Page 2Linked to original sources
PubMed1989

[Tetralogy of Fallot. 20 years' experience in 144 cases].

Between 1968 and December 1987, 144 patients with tetralogy of Fallot were examined at La Pitié Hospital, Paris. 76 were female and 68 male, with a mean age of 8.1 years at the first visit. The patients were regularly followed up by the same physician relying on radiography of the chest, electrocardiography and, since 1982, two-dimensional echocardiography. These visits were coupled with an interview with the welfare officer attached to our department for information on the patient's way of life as well as his socio-professional and familial problems. 129 patients of mean age 14.8 years underwent corrective surgery preceded in 81 cases by palliative surgery. The overall immediate mortality rate was 12.4% (16 cases), falling from 19.5% between 1968 and 1977 to 3% during the last 10 years. The mean follow-up period was 10.7 years, with 51 patients being followed up for more than 10 years and 18 for more than 20 years. Late mortality now stands at 5.3% (7 patients, 6 of whom died of a cardiac cause). Residual lesions consisted in significant (27%) pulmonary insufficiency in 35 patients, residual interventricular septal defect in 16 patients (12.4%) and pulmonary obstruction in 11 patients (8%). 18 patients presented with dysrhythmias, including 7 cases of ventricular arrhythmia; 5 two-bundle blocks and 5 complete atrioventricular blocks were also observed. 11 patients required reoperation with a 27.2% mortality rate (3 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[54 cases of infectious endocarditis seen in 32 years in a population of 2038 congenital heart diseases].

A longitudinal study of a 32-year period (1954-1987) involving 2038 patients with congenital heart defects followed by the same physician yielded 54 cases of infective endocarditis (IE). Complex cyanogenic cardiopathies were particularly exposed to the risk of infection (8.2 IE for 1000 patient-years), then came ventricular septal defects (2.4), tetralogy of Fallot (2.3), aortic stenosis (2.0) and atrioventricular canal (1.7). The risk was smaller in patients with Eisenmerger complex (1.2), persistent arterial canal (1.4) and coarctation (0.7). Patients under 10 years of age (16.7%) were less affected than young adults in the 20-29 years age-group (33.4%). The organisms most frequently isolated were streptococci (42%); staphylococci ranked second (23%). Less common organisms were found in 14% of the cases, and blood cultures were negative in 21%. Systemic prophylaxis with penicillin V, introduced 16 years ago, seems to have almost halved the incidence of infective endocarditis due to penicillin-sensitive organisms.

Adolescent↗
PubMed1988

[Atrial septal defect and cyanosis. Apropos of 6 cases related to abnormal drainage of the inferior vena cava into the left atrium].

The authors report six cases of atrial septal defect (ASD) associated with abnormal drainage of the inferior vena cava into the left atrium responsible for right-to-left shunting, without pulmonary hypertension. The abnormal drainage could be due either to an anatomical malposition of the inferior vena cava opening into the left atrium, or to an abnormal blood flow from this vein, normally located through a low ASD, under the influence of anatomical, mechanical and haemodynamic factors. Clinically, all patients presented with light cyanosis and with the usual signs of ASD. None of them had elevated pulmonary pressure. The lesion, suggested by clinical findings, was diagnosed either at angiography, which in four cases demonstrated an abnormal pulmonary venous return, or at colour-coded doppler echocardiogram, or at surgery. In every case, surgical correction consisted of closure of the often low-sited ADS by a patch which diverted the inferior vena cava into the right atrium and the abnormal venous return towards the left atrium. The short--and long-term results of surgery were excellent. The authors review the literature concerning this unusual association of ASD with an abnormal drainage of the inferior vena cava into the left atrium.

Adult↗
PubMed1987

[Percutaneous transluminal angioplasty in complex congenital cardiopathies. Apropos of 2 cases].

Percutaneous transluminal angioplasty (PTA), already widely used in stenosis of peripheral, renal or coronary arteries, has now been extended to congenital heart diseases. Thus, in pulmonary or aortic orificial stenosis this simple and fairly safe method has proved to be a suitable alternative to surgery. In other cases it may be used for tiding the patient over a critical period pending surgery. Finally, PTA may be performed as a palliative treatment of lesions that are too complex for surgery or carry an excessively high operative risk. This applies to the two cases reported here, where PTA enabled us to dilate: the ductus arteriosus in a patient with single ventricle--an application which, to our knowledge, has not yet been reported--and a strongly stenotic pulmonary orifice associated with a complex heart disease. In both cases PTA was successful both haemodynamically and angiographically and was followed by marked clinical improvement. The published cases of complex congenital heart diseases where PTA has been used are reviewed.

Adult↗
PubMed1985

[Ebstein's disease associated with Fallot's tetralogy. Apropos of a familial case, review of the literature, embryologic and genetic implications].

Ebstein anomaly is a rare congenital cardiac malformation, representing 0.3 p. 100 of all congenital heart disease. The authors report a case of a child with Ebstein anomaly associated with tetralogy of Fallot, whose father had an apparently simple Ebstein anomaly. The association of Ebstein-Fallot is extremely rare with only 5 previously reported cases in the literature. The association Ebstein-VSD-pulmonary stenosis is more frequent (13 cases), whilst the association Ebstein-isolated VSD (33 cases) and Ebstein-pulmonary stenosis/atresia (38 cases) are relatively common. Other very varied associations have also been described. Atrial septal defect is practically an integral part of Ebstein anomaly with an ostium secundum or patent foramen ovale in 51 to 80 p. 100 of cases. The possibility of 2 subjects in the same family with Ebstein anomaly is far from negligible. A review of the literature revealed 7 other reported "pairs". A certain number of other cases also demonstrate the association of Ebstein anomaly with another congenital cardiac malformation in the same family, usually a VSD or tetralogy of Fallot. Our familial case raises the question of a possible embryological link between Ebstein anomaly and tetralogy of Fallot. Our experimental embryological studies also suggest the presence of a common denominator between these two conditions.

Adult↗
PubMed1984

[Measurement of arterial pressure in children. Influence of the resting time, inflatable surface and type of arm-band].

Measurements of arterial pressure in children should be standardized as much as possible. The influence on readings of three factors--pre-measurement resting time, area of the inflatable surface and type of cuff--was investigated in 151 children divided into several homogeneous groups. The study showed that reliable values can only be surface area, it would appear that no modern apparatus provides accurate readings for all age groups. The cuff itself is of little importance, but diastolic pressure values are slightly increased when cuffs with an unprotected bladder are used.

Blood Pressure Determination↗
PubMed1979

[Diagnostic of left-to-right shunt by isotopic angiocardiography (author's transl)].

Isotopic angiocardiography was performed in 60 patients with proven congenital left-to-right shunt. A 99mTc labeled bolus was injected in a peripheral vein, and the first passage in the heart cavities was studied. Time-activity curves of the cardiac chambers were analysed, using a scintillation camera and a data processing system. In our study, we were able to confirm the presence of the shunt in 77% of the cases in which the radioactive bolus arrived well grouped in the vena cava. Quantitative results however remain imprecise. Isotopic angiocardiography indications are compared to radiologic angiocardiography and to right heart catheterism indications. Use of this non invasive technique could render more aggressive examinations unnecessary.

Adult↗
PubMedDate not supplied

[Shock caused by glafenine. Apropos of 7 complications].

Glafenine-induced shock. Seven cases. Glafenine is a widely prescribed analgesic drug, and shock is one of its severe side-effects. We report six documented and one highly probable cases of such accidents. From these seven cases and a review of the literature, we have extracted the clinical characteristics of glafenine-induced shock. Shock usually occurs about 30 minutes on average after taking one single tablet. Previous use of the drug is found in more than 50 per cent of the patients, and it was often followed by a neglected side-effect. A series of cutaneous and respiratory manifestations precedes or accompanies the shock. Two physiopathological mechanisms of glafenine-induced shock have been postulated: either anaphylaxis or idiosyncratic reaction involving the prostaglandins. In vitro tests give highly variable results and therefore are of limited value. Glafenine-induced shock is rare; its incidence, probably underestimated, is about 0.7 in 10(5) treatments. Prevention is essential, cure relies on adrenaline.

Adult↗
PubMedDate not supplied

[Hepatic amebiasis: an unusual clinical presentation].

BACKGROUND: Painful liver enlargement with fever are common signs of hepatic ambiasis. Exceptionally, atypical signs may also occur including symptoms suggesting renal sepsis. CASE REPORT: An 18-year-old woman from the New Caledonia was hospitalized in metropolitan France for suspected right-sided acute pyelonephritis. Urinalysis was normal and the kidney ultrasound suggested the need for an abdominal CT-scan which evidenced a voluminous 10-cm abscess pus. Serology for amebia was positive, confirming the diagnosis of hepatic amebic abscess. Outcome was rapidly favorable with intravenous anti-parasite treatment amebic abscess. Outcome was rapidly favorable with intravenous anti-parasite treatment and percutaneous drainage. DISCUSSION: Atypical signs of hepatic ambiasis may mislead diagnosis. The absence of a fetid odor at puncture helps guide diagnosis, confirmed by serology. Percutaneous drainage can hbe proposed for voluminous abscesses or if the risk of extrahepatic complications is eminent.

Adolescent↗