Consultant offers program for effective linen control. Part II.
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Biomedical subjects
Publications and source records attributed to A Mathieu.
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The distribution of peripheral blood lymphocytes with immunoglobulins (Ig) in 14 patients with monclonal gammapathies has been studied. The patients have been divided in two groups, one including patients never treated, the other those studied during or after treatment. The results, compared with 11 control subjects, show that lymphocytes with surface Ig from the same class of the serum paraprotein increased in every case of the first group and in some cases of the second.
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Taste assessment was tested in 20 obese and 20 normal-weight in-patients using watery solutions of saccharose and three synthetic sweeteners. Each patient was asked to assess ten different taste qualities of each solution on a point scale. There were highly significant differences between the two groups of subjects. The difference was especially marked for the categories "synthetic - natural", "unpleasant - very tasty", and "changeable - stable in times". These findings suggest changes in physical or central taste sensation in obese persons. This view is supported by their decreased ability to differentiate between saccharose and any sweetener. The results further support substituting sweetening agents for sugar in reducing diets.
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The authors sensitized guinea pigs to a halothane catabolite, trifluoroacetic acid, combined with guinea pig albumin. They then exposed the animals to halothane. There was no correlation between the presence of humoral and cell-mediated immune reactions obtained with the catabolite and the incidence of liver necrosis.
The authors present a critical analysis of immunological tests used by some authors to establish the diagnosis of halothane-induced hepatitis. These tests include the lymphocyte transformation test (LTT), the leukocyte migration inhibition test (LMIT) and detection of auto-antibodies. It has not been possible for all investigators to reproduce the results of these tests. The inhibition of these tests is not specific for halothane since it is also observed after infectious and serum viral hepatitis.
Variations in the C3 and C4 fractions of complement were studied in 15 patients who underwent surgery with either spinal anesthesia (5 cases) or general anesthesia using nitruos oxyde and a halogen compound (10 cases). Little peroperative variation was observed. An increase in C4 was observed in all cases postoperatively. Only a slight increase in C3 was observed after spinal anesthesia. The immune response of anesthetists exposed to halothane was investigated using PHA-induced lymphocyte stimulation (normal in males, elevated in females) and lymphocyte transformation to halothane and its metabolites (no evidence of allergy was observed).
A 3-year-old child developed extensive macular rash after ketamine. The mechanism of this reaction was investigated by the Prausnitz-Kutzner (P-K) test. It demonstrated that the histamine release was not the result of an anaphylactic reaction, but rather a direct pharmacological effect of the drug. The result suggests that this child can receive ketamine in the future without any severe manifestations. The mechanisms of histamine release are discussed and the treatment of its clinical manifestations is reviewed.
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Trifluoroacetate, a common metabolite of halothane, fluroxene, and enflurane, conjugated to guinea-pig albumin elicits specific serum antibody in guinea pigs. Two classes of antibodies were found: hemolytic, gamma-2, and anaphylactic, gamma-1. Repeated injections of the antigen, trifluoroacetyl-guinea pig albumin, often led to disappearance of circulating antibodies.
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Out of 196 patients with Behçet's disease, 12 (10 men and 2 women, mean age 34 +/- 7 years) had non-coronary arterial lesions. Behçet's disease was complete in 4 patients. The arterial lesions had appeared 8.6 +/- 8 years on average (20 years at most) after the first sign of the disease. Three patients showed evidence of stenosis or occlusion involving one or several arteries. Eight patients had both stenotic and aneurysmal lesions. One patient had an arteriovenous fistula. Another developed a false aneurysm at the site of introduction of a femoral catheter. Yet another patient developed an anastomotic aneurysm one year after implantation of an abdominal aortic graft. In 2 cases histology showed fragmentation of the media associated with vasculitis of the vasa vasorum. Two patients with pulmonary aneurysm died of massive haemoptysis. In 2 patients combined corticosteroid and cyclophosphamide therapy failed to prevent the development of aneurysmal lesions. Phlebitis was associated with arterial involvement in 7 patients. Comparison between patients with or without arterial lesions showed no significant difference in time of onset of Behçet's disease, sex, main clinical features and presence of HLA B5. Aneurysmal lesions respond poorly to medical treatment, and surgery is mandatory. Since recurrence at the site of anastomosis is possible, prolonged monitoring is required.
A correlation between the use of halogenated anesthetic agents and liver necrosis is not yet established in man. In an attempt to resolve this dilemma, guinea pigs were immunized with a complex of guinea-pig albumin and trifluoroacetate (TFA), a common metabolite of halothane and fluorexene, and then exposed to halothane on multiple occasions. Histology and liver-function tests showed no difference in the incidence of liver damage between groups of animals immune to TFA with cellular immunity and untreated control animals. However, a difference in the liver enzyme levels was seen between controls and animals showing humoral immunity.