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Biomedical subjects

B Bourgeois

Publications and source records attributed to B Bourgeois.

14 recordsLinked to original sources
PubMed1994

[Sodium valproate and cognitive function].

In patients with epilepsy, cognitive functions can be affected by several factors individually or in combination. These complex interactions between various factors have been responsible for considerable methodological problems in the assessment of the effect of individual antiepileptic drugs on cognitive functions. A discussion on the effect of sodium valproate on cognitive functions should consider three aspects: whether valproate affects cognitive functions, how possible cognitive effects of valproate compare with those of other antiepileptic drugs, and finally whether valproate has a positive psychotropic effect. A suspected specific psychotropic effect of valproate could not be confirmed. The majorities of the studies in which the cognitive effects of valproate were assessed are comparative studies with other antiepileptic drugs in treated patients; however, some studies were based on the introduction or the discontinuation of valproate monotherapy or on a comparison between a high dose and a low dose. Like other antiepileptic drugs, sodium valproate can affect cognitive functions and behavior. When valproate has been compared with other antiepileptic drugs, the results have been either equal or in favor of valproate; however, overall these cognitive and behavioral effects are rather mild also for the other antiepileptic drugs and have been slightly overrated in the past.

Adolescent↗
PubMed1993

Felbamate: a double-blind controlled trial in patients undergoing presurgical evaluation of partial seizures.

We studied the efficacy and safety of felbamate, an investigational antiepileptic drug, in a unique, double-blind, placebo-controlled trial. Sixty-four patients with refractory partial-onset seizures who completed a routine evaluation for epilepsy surgery met seizure frequency entry criteria. Each patient received felbamate or placebo in addition to the anticonvulsant regimen present at the conclusion of the presurgical evaluation. The treatment phase consisted of an 8-day inpatient period and a 21-day outpatient period. The efficacy variable was time to fourth seizure. The difference in time to fourth seizure was statistically significant (p = 0.028) in favor of felbamate. Eighty-eight percent of the patients in the placebo group had a fourth seizure during the treatment phase compared with 46% of the patients in the felbamate group (p = 0.001). Adverse experiences with felbamate were generally mild or moderate in severity. This trial demonstrated the ability of felbamate to quickly and safely reduce the occurrence of frequent partial-onset seizures and maintain effective seizure control following reductions in the dosages of standard antiepileptic drugs.

Adolescent↗
PubMed1989

Surgery of localization related epilepsies in children.

Surgery of epilepsy is as successful in children as in adults. With very few modifications, similar evaluation methods and surgical techniques can be used. However, in the selection of the surgical candidates special considerations are necessary in children to establish the stability of the epileptogenic focus (to exclude the possibility of a change with maturation) and to define the clinical syndrome which very frequently is still poorly defined in that age group. The expectation that surgery of epilepsy at an early age will facilitate rehabilitation efforts has still not been confirmed by systematic scientific studies. Surgery of epilepsy has not been attempted in a sufficient number of children under 5 yrs of age to establish its value in that age group.

Adolescent↗
PubMed1988

[A case of fetal cystic hygroma. Clinical and echographic study].

In reference to a case of fetal cystic hygroma discovered on ultrasonogram, after 16 weeks of amenorrhea, the authors remind of the need for a karyotype; this is absolutely necessary in the therapeutic decision. Most of the time, it is related to a Turner's syndrome. In case of abnormal karyotype, a therapeutic interruption of pregnancy may be proposed. If the karyotype is normal, the ultrasonogram should be rechecked since hygroma regression has been described. If these images persist or become worse, it is related, most often, to a Noonan's syndrome and interruption of pregnancy may also be indicated.

Adult↗
PubMed1987

Monotherapy with valproate in primary generalized epilepsies.

Sodium valproate enteric-coated tablets were administered as monotherapy to 118 patients (median age, 19 years) with primary generalized epilepsies. More than half (56%) of these patients were transferred from prior drug therapy, most of them because of inadequate seizure control, and some because of adverse effects. Seventy-one percent of the patients experienced tonic-clonic seizures, either alone or in combination with other types of seizures, principally absences. Mean duration of follow-up was 18 months (median, 17 months; range, 1-68 months). At a mean daily dosage of less than 20 mg/kg, 83% of the patients became seizure-free. Therapy was equally effective against tonic-clonic seizures, absences, and myoclonic seizures. Tonic-clonic seizures were suppressed in 85% of cases (89% when patient had only one seizure type), absences in 82% (95% when patient had only one seizure type), and myoclonic seizures in 82%. Paroxysmal activity was present in 88% of the electroencephalogram (EEG) records before valproate monotherapy, and in 32.4% at the study's end. These results were achieved with generally mild and mostly transient side effects; side effects were reported by 16% of patients during the first month, and 2% at the last follow-up. No hematologic or hepatic toxicity was observed. The lag time between attaining steady-state serum concentrations and achieving maximal clinical improvement suggests that sodium valproate monotherapy should be given an adequate trial to ensure that patients derive the greatest possible benefit before adding or switching to another drug.

Adolescent↗
PubMed1977

Priapism in preterm infant.

This report of transient priapism in a preterm newborn with respiratory distress syndrome discusses clinical course, therapy, possible etiologic factors, and previously reported cases in newborns. Possible causes include use of arterial catheter, red cell transfusion, hemodynamic changes from a patent ductus arteriosus, and hypoxia.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Usefulness of serum lipid determination in diabetic practice.

In order to evaluate the importance of measuring serum lipids in the current care of diabetics, blood triglycerides were measured in 155 diabetics and 59 controls. Comparison with a chemical method confirmed the usefulness of the nephelometric method for the diagnosis and control of hyperlipemia in current practice. The importance of measuring serum lipids was confirmed by a close correlation between lipemia and cardiovascular complications such as coronary insufficiency, high blood pressure, and peripheral arterial insufficiency. It appeared also that glycemia and cholesterol are not sufficient to assess the biological pattern and prognosis of diabetes. Thus, lipemia is an essential parameter in the evaluation of any diabetic because of its value regarding prognosis and control therapy.

Aged↗
PubMedDate not supplied

Temporal lobe epilepsy in early childhood.

To explore the electroclinical features of temporal lobe epilepsy (TLE) in early childhood, we studied results of video-EEG and other tests of 14 children aged 16 months to 12 years selected by seizure-free outcome after temporal lobectomy. Four children had mesiotemporal sclerosis, 1 had cortical dysplasia, and 9 had low-grade temporal neoplasms. The children had complex partial seizures (CPS) with symptomatology similar to that of adults with TLE, including decreased responsiveness and automatisms. Automatisms tended to be simpler in the younger children, typically limited to lip smacking and fumbling hand gestures. Scalp/sphenoidal EEG showed anterior/inferior temporal interictal sharp waves and unilateral temporal seizure onset in the 4 children with mesiotemporal sclerosis and in the child with cortical dysplasia, but EEG findings in 9 children with low-grade temporal tumors were complex, including multifocal interictal sharp waves or poorly localized or falsely lateralized EEG seizure onset. In children without tumors, video-EEG was critical to localization of the epileptogenic zone for resection, but in patients with tumors video-EEG was less localizing and its main value was to confirm that the reported behaviors were epileptic seizures with semiology typical of temporal lobe onset.

Age Factors↗
PubMedDate not supplied

The effect of ultrafiltration on dialysance. Mathematical theory and experimental verification.

It is known that convective transport (ultrafiltration, QF) augments diffusive transport. This augmentation achieves great importance as solute molecular weight increases. Previous mathematical treatments of dialysance (D) have provided the relationship between D and blood flow rate (QB), dialysate flow rate (QD), and dialyzer membrane surface area permeability product (KoA), in the limit of QF = 0. The authors derived the relationship between D (defined as D') and QB, QD, and KoA for the general case of QF greater than or equal to 0: D' = X-Y/In X/Y . [(1-ó) QF + KoA] for X = X(D', QF, QD) = 1 - [D'/QD + QF] Y = Y(D', QF, QB) = D'-QB/QF-QB ó = the Staverman reflection coefficient. This equation demonstrates an approximate linear increase in D' as QF increases. Experimental verification is provided by in vivo studies of dialysis patients in which the dialysance of vancomycin doubles as QF is increased from 0 to 50. Because D' varies linearly with QF, this allows for the determination of KoA and ó. Using the Cobe 500HG Hemophan membrane, KoA for vancomycin was determined to be 6.54 and ó = 0.88.

Diffusion↗
PubMedDate not supplied

[Evolution of patients with rheumatoid arthritis treated with immunosuppressive agents between 1965 and 1973].

The authors report the results of a study of 139 of their patients with severe rheumatoid arthritis, treated with chlorambucil of cyclophosphamide between 1965 and December 1973, with an observation period of 4 to 12 years. 8 patients were lost to follow-up, 38 died and 93 were reexamined. In this series 7 deaths were attributed to hemolymphoreticulopathy of various cytological types; 6 deaths were due to visceral cancer and 2 others to cancer of the tonsils. They confirm that such treatments increase the risk of hemopathy but apparently not the risk of visceral cancer. The risk was not a function of the total dose of the drug administered since no neoplasia was observed in the 25 subjects who received the highest doses. The addition of chlorambucil to cyclophosphamide seems to increase the risk of hemopathy. It was noticed that the 7 cases of hemolymphoreticulopathy occured after 60 years.

Adult↗