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Biomedical subjects

B Legros

Publications and source records attributed to B Legros.

28 records · Page 2Linked to original sources
PubMed1998

[Emergency EEG and brain injuries].

The aim of this study is to review indications for emergency EEG in case of brain trauma. The authors emphasize the indication of emergency EEG for the diagnosis of either cerebral death or early post traumatic seizures, and for the monitoring of intensive neurological treatments. Emergency EEG and diagnosis of cerebral death has been reviewed in another issue of this journal. Diagnosis of early post-traumatic seizures may be difficult in case of cranial trauma in either the presence or the absence of coma. Emergency EEG help guide the diagnosis of electrical signs of seizures, thus indicating that treatment with antiepileptic drugs is advisable. Severe post-traumatic coma requires barbiturate impregnation and moderate hypothermia. In this last case, emergency EEG is essential for the monitoring of pharmacological treatments. The authors conclude that continuous EEG monitoring could in the future substitute for standard EEG recorded in emergency.

Brain Death↗
PubMed1991

[Evaluation of cerebral hemodynamics by transcranial Doppler in anesthesia and reanimation].

Doppler technics are widely used for the investigation of the peripheral flows. The main objective of the method is to detect and quantify the vascular disease (stenosis, arterio-venous malformation) at the level of the carotid bifurcation or on the intracranial vessels. The spectral analysis provides informations on the velocity profile, and allows to quantify systolic, diastolic, and mean frequencies from which the usual haemodynamic parameters are determined. In case of vasospasm, the maximal frequency increases significantly (> 3 kHz). The amplitude of the diastolic flow is related to the vascular resistance. Vascular disease or distal vessel compression make the resistance increase; on the contrary vasodilation decreases the vascular resistance. The Doppler index R = S-D/S, with S and D the systolic and diastolic amplitude is generally accepted to change in proportion with the vascular resistance. The blood flow volume can be evaluated from the mean Doppler frequency, the vessel diameter, and the angle theta between the vessel and the Doppler beam. In case of intracranial arteries the diameter cannot be accurately measured by echography. Nevertheless if the diameter does not change and the angle theta remains constant, the variations of the mean frequency represent the blood flow volume changes. If there is a vasospasm, this method cannot be used, and the only possibility to evaluate the cerebral blood flow changes is to measure the variations of the common carotid blood flow or carotid mean frequency. The haemodynamic parameters are used in anesthesiology or in intensive care.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1985

[Antibiotic therapy of pneumopathies in intensive care and protected distal bronchial samples].

Bacteriology was performed on 57 specimens collected by the Wimberley protected catheter bronchoscopy technique (PCB) from 42 ventilated patients with severe head trauma hospitalized in the neurosurgical intensive care unit to determine the etiology of their pneumopathy. All patients had a nasotracheal tube upon arrival at the intensive care unit. For each sample, smears were examined and cultures under aerobic and anaerobic conditions as well as with CO2 were performed. In 34 (59%) of the 57 cases, examination of smears allowed rapid diagnosis and appropriate chemotherapy. In 47 (82%) cases, culture was positive, with a single pathogen being recovered in half of cases. The most prevalent organisms among the 75 species isolated were S. aureus (38%), P. aeruginosa (15%), Klebsiella (12%), Haemophilus (8%), and Pneumococcus (9%). Consistency with positive cultures of blood or pleural effusion samples was recorded in 92% of cases. Narrow spectrum antibiotic therapy can be chosen according to the results of PCB bacteriology and rapid automated antibiotic sensitivity testing obtained within 24 hours. PCB is therefore recommended in pulmonary infections in intensive care units.

Adolescent↗
PubMed1984

[Ultrasound and atheromatous disease : current contribution of Doppler spectrum analysis in carotid stenoses].

The carotid bifurcation plaque is a common pathology. Specific pathologic atheromatous findings have been studied in three hundred patients-carotid bifurcations. This study was carried with the Doppler technics and especially the spectral analysis of the Doppler. From that study it appeared that the most frequent disturbances could be classified according five grades, corresponding to the importance of the stenosis. The first grade corresponds to a stenosis responsible of an obstruction less than 40% of the vessel. The second one is a stenosis from 40% to 60% of the lumen. The third grade is the witness of a extended plaque and a stenosis between 60% to 75%. The fourth grade corresponds to a stenosis between 60% and 90%. The fifth grade is a stenosis superior to 90% of the surface of the artery, also called pre-occlusive grade. This ultrasonic method has been compared to the data provided by the angiography, the echotomography and the anatomopathology. The correlation is excellent in the three cases, and is of 95%. The authors emphasize that this method is the most accurate among the non invasive investigations and let hope that it might replace the traumatic ones in the future.

Arteriosclerosis↗