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Biomedical subjects

A Rochette

Publications and source records attributed to A Rochette.

36 records · Page 2Linked to original sources
PubMed1985

Bromocriptine inhibition of hyperprolactinemia during surgery.

The material included two groups of 10 women undergoing diagnostic laparoscopy. General anesthesia was administered by injection of 0.1 mg fentanyl followed by infusion of propanidide-succinylcholine. The control group received no medication prior to surgery, whereas patients in the experimental group were given 5 mg bromocriptine per os. Blood samples for prolactin determinations were drawn as the patients were placed on the operating table and immediately following surgery. The association of anesthesia and surgery caused prolactin levels to rise from 10.9 +/- 3.5 to 168 +/- 18.7 ng . ml-1 in the control group (p much less than 0.001) and from 3.5 +/- 0.5 to 7.5 +/- 1.1 ng . ml-1 in the test group (p less than 0.001). A significant difference was noted between the two groups for their pre- and postoperative levels and prolactin response (p less than 0.05, p much less than 0.001 and p much less than 0.001, respectively). The proposed protocol successfully suppresses prolactin increase during surgery and constitutes a useful tool for investigating hyperprolactinemia and its consequences during this same time. Possible applications include in vitro fertilization and studies on prolactin receptor-bearing tumors.

Anesthesia, Intravenous↗
PubMed1984

[Comparison of midazolam and flunitrazepam as premedication administered rectally in infants].

The present study aimed to assess the pharmaco-clinical profile of infants premedicated with rectal midazolam. The results were compared with those of a reference drug, flunitrazepam. Infants undergoing minor surgery were divided into three groups: group A (n = 30), with a mean age of 15.8 +/- 13.2 months and a mean weight of 8.6 +/- 3.3 kg, receiving 0.33 mg X kg-1 flunitrazepam; group B (n = 15), with a mean age of 11.2 +/- 10.7 months and a mean weight of 9.3 +/- 3.1 kg, receiving 0.3 mg X kg-1 midazolam; and group C (n = 30), with a mean age of 15.5 +/- 9.1 months and a mean weight of 10.7 +/- 2.5 kg, receiving 0.4 mg X kg-1 midazolam. An aqueous solution of each drug was administered with atropine sulfate (0.02 mg X kg-1) 20 min prior to induction of anaesthesia. The drug was well tolerated in 84% of cases. Statistically significant haemodynamic changes consisted of: a 9 c X min-1 decrease in heart rate (p less than 0.05) and a 12 mmHg decrease in systolic and diastolic blood pressures (p less than 0.05) in group C; a 6 mmHg decrease in systolic blood pressure (p less than 0.05) in group B. The tranquilizer action was either excellent or good in 93% of groups B and C compared with only 40% in group A (p less than 0.001 in both cases). Somnolence was attained in 60% of group A, 26.6% of group B and 30% of group C. A mask was much better accepted in group C (86.6%) than in group B (66.6%; p less than 0.05) or in group A (36.6%; p less than 0.01). Therefore, midazolam given rectally at 0.4 mg X kg-1 was better than flunitrazepam, because of a greater therapeutic effect for an equivalent rate of side effects.

Age Factors↗
PubMed1984

[Intramuscular premedication with midazolam in infants and children].

The useful intramuscular premedication dose of midazolam was determined in 100 children divided up in three age groups: one month to three years, 3 to 10 years, 10 to 15 years. All biometric parameters were normal for the age, and comparable between similar age groups. Haemodynamic and respiratory parameters were not altered by the premedication. The reduction in anxiety, as assessed by the child's behaviour, was good or excellent in more than 85% of cases from all age groups; it was proportional to the dose used. The doses that had, for equivalent reductions in anxiety as assessed by the chi-square test, the least hypnotic effect, were: 0.5 mg X kg-1 before three years of age, 0.4 mg X kg-1 for the 3 to 10 yr olds, and 0.25 mg X kg-1 for the 10 to 15 yr olds. This fall in dose with age, quite usual in paediatrics, was not unexpected. The level of consciousness, one hour after surgery, was always normal. No undesirable side-effect was observed. These results, together with its physical, chemical and pharmacodynamic characteristics, make midazolam a choice drug for intramuscular premedication in children, with a foreseeable use in day-care anaesthesia. The unexpected finding of an age-dependent dissociation between the reduction in anxiety and the hypnotic effect is discussed in the light of a study carried out in the adult and recent data from the literature.

Adolescent↗
PubMed1984

[Midazolam combined with neuroleptanesthesia as a hypnotic].

Two groups of 20 women randomly distributed underwent general anaesthesia based on dextromoramide and droperidol. Midazolam was given 0.2 mg X kg-1 in the first group, 0.4 mg X kg-1 in the second. Induction was considered satisfactory in more than 90 p. cent of patients in both groups (NS). Midazolam produced a decrease of systolic blood pressure of 9 mm Hg in group I (p less than 0,001) and 11 mm Hg in group II (p less than 0,001) as well as a decrease in diastolic blood pressure of 5 mm Hg (p less than 0,025) and 7 mm Hg (p less than 0,005) respectively. Heart rate decreased significantly only in group II (by 4 c X mn-1, p less than 0,01). These alterations were similar in both groups and did not reach physiologic importance. Maintenance of anesthesia as well as recovery were uneventful in all cases. Higher doses of midazolam reduced only slightly the dose of the neuroleptic. Its is concluded that midazolam is a good induction agent neuroleptic-analgesic anaesthesia. The use of more than 0.2 mg X kg-1 is of no particular interest but is well tolerated.

Adult↗
PubMed1983

[Postpartum cardiomyopathy attributed to the use of beta-mimetics].

A case of post-partum cardiomyopathy probably due to salbutamol is described. The patient was a young primipara without any cardiovascular disease. She presented a sudden left ventricular failure after Caesarean section for twins: salbutamol had not been given for a week. After 10 days' treatment with diuretics and vasodilators, the patient was cured, no sequellae remaining. It seemed the mechanism was multifactorial: direct myocardial injury, a reduction in the number of receptors, peripheral haemodynamic changes.

Adult↗
PubMed1983

[Quantitative study of pain in man. Validity of a simple instrument].

A generator producing painful stimuli every 20 ms by way of 2 ms square wave electrical impulses was used to study pain quantitatively, and the reliability of the measurements carried out on 24 healthy volunteers. The parameters measured were the levels of detection, pain and tolerance. The results showed that these levels were both stable and reproducible. However, there were very important individual differences.

Electric Stimulation↗
PubMed1983

[Disseminated intravascular coagulation. Retrospective study of 14 acute obstetrical cases].

To test the value of diagnostic and therapeutic data in obstetric DIC, 14 women were selected who presented a severe clotless haemorrhage with fibrin degradation products and/or soluble complexes, decreased fibrinogen (0.87 +/- 0.47 g X 1(-1)), platelet count (75.7 +/- 41 X 10(3) X ml-1) and prothrombin complex (33.7 +/- 12%). The hypovolaemia was treated at the same time as heparin was given in a bolus injection of 0.5 mg X kg-1 followed by a constant flow infusion of 1 mg X kg-1 X day-1 in all patients. Relevant obstetrical treatment was performed in 71.4% of patients. Fibrinogen, fresh frozen plasma, prothrombin complex concentrate and platelet concentrate were given if required. One patient, with severe toxaemia, died. Haemorrhage was stopped in 92.8% of patients after 4.5 +/- 0.8 h. Reversible visceral complications occurred in 28% of cases. The initial data used was easily obtained and seemed to give a reliable diagnosis in acute obstetrical DIC. Substitutive treatment was discussed in correlation with the evolution: PCC seemed pointless; the use of fibrinogen must become exceptional when fresh frozen plasma is available. Heparin remained necessary.

Acute Disease↗
PubMed1983

[Acute hepatic steatosis of pregnancy in an Addisonian patient].

A case is reported of acute fatty liver occurring in an Addisonian woman with a twin pregnancy. It is pointed out that Sheehan's syndrome or acute fatty liver of pregnancy is an exceptional cause of jaundice in pregnancy. Its severity is due to the syndrome, associating hepatic failure and renal, pancreatic and haemorrhagic complications. The history of the pregnancy and the past medical history are of less import for the outcome. The best treatment is delivery by caesarean section, together with symptomatic treatment of the complications. In case of jaundice of unknown aetiology in late pregnancy, the advantages of an early diagnosis by transjugular hepatic biopsy are discussed.

Acute Disease↗
PubMed1982

[Midazolam as an intramuscular premedication agent: definition of posology as a function of age].

In order to determine the optimal posology of midazolam as an intramuscular premodication according to age, three groups of 25 patients were constituted. The mean age of group 1 receiving 0.12 mg . kg-1, was 31.6 +/- 7.3 years, the mean age of group 2, receiving 0.16 mg . kg-1, was 31.8 +/- 7.6 years and the mean age of group 3, receiving 0.10 mg . kg-1, was 73.8 +/- 8.2 years. The results were the following: sedation of anxiety was good or very good in respectively 80 p. 100 and 95 p. 100 of patients in groups 2 and 3, versus 48 p. 100 in group 1; a reversible sleep was obtained in 18 p. 100 of cases in group 2 and 44 p. 100 in group 3; no patient was asleep in group 1; overall clinical results were found satisfactory in 80 p. 100 of patients in group 2, and 95 p. 100 in group 3 versus 48 p. 100 in group 1. Neither incident nor adverse reactions were to be reported. There was no modification in respiratory rate; the slight hemodynamic modifications which appeared can be attributed to atropine sulfate administered together with midazolam. In conclusion, the appropriate posology of midazolam administered intra-muscularly decreases with age, from 0.16 mg . kg-1 for the thirty years old patients to 0.10 mg . kg-1 for the seventy years old patients. Midazolam exhibits a remarkable cardiorespiratory neutrality event in the elderly.

Adult↗
PubMed1966

[Cancer of the vulva: a clinical study of 46 cases].

Vulvar carcinoma is found primarily in elderly and postmenopausal women. Most patients unfortunately seek medical advice too late and only after various inadequate treatments have been applied. Radical vulvectomy is the treatment of choice in cases of epidermoid carcinoma. For the patients in the series reported who received adequate surgical treatment, the five-year survival rate was 71.4%, while for those who were inadequately treated it was only 11%.

Female↗
PubMedDate not supplied

Attention deficits: is there a right hemisphere specialization for simple reaction time, sustained attention, and phasic alertness?

Impairments of attentional focus often are claimed to be associated with lesions of the right hemisphere. Although some studies comparing right- and left-brain-damaged patients have supported this idea, others have not found differences between these patients in various attention tasks. The present study was carried out in order to further investigate the putative role of the right hemisphere in a simple reaction time task, a sustained attention task, and a phasic alertness task. Subjects were 46 patients with right-hemisphere lesions and 37 patients with left-hemisphere lesions. Results showed no difference between right- and left-brain-damaged patients in simple reaction time, in speed of response over time (sustained attention), and in the capacity to prepare to an uncoming stimulus (phasic alertness). Future studies will have to use a more precise categorization of lesions than only right-versus left-brain damage.

Adult↗
PubMedDate not supplied

Tolerance of intraperitoneal chemohyperthermia with mitomycin C: in vivo study in dogs.

Tolerance of intraperitoneal chemohyperthermia (IPCH) with mitomycin C (2 mg/kg) by irrigation of the peritoneal cavity via a closed circuit system was evaluated in Beagle dogs for possible use in the management of human peritoneal carcinomatosis. Of dogs, 24 underwent three digestive anastomoses each. They were randomized into three groups: control (n = 6), intraperitoneal hyperthermia (n = 8) and IPCH (n = 10). Peritoneal temperatures were maintained between 41-43 degrees C for 60 min. Tolerance was evaluated through clinical follow-up, biological samples (serum electrolytes, blood counts and serum enzymes), histological examinations and post-mortem macro- and microscopic controls of anastomosis. Mortality and morbidity rates were not different in the three groups. No anastomotic leakage occurred. Evidence of biological toxicity was minimal. Histological examinations showed no definitive tissue damage. IPCH appears to be a safe and reliable device in dogs. Plans to combine IPCH with MMC in surgical resection of patients with peritoneal carcinomatosis are underway.

Animals↗