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Biomedical subjects

B Lenoir

Publications and source records attributed to B Lenoir.

At least 19 recordsLinked to original sources
PubMed2006

[Acute cardiovascular complications of cocaine. About two case reports].

Concerning any socioprofessional category, some addictive drugs like cocaine are responsible for many complications. The authors relate two case reports of young patients who suffered from cardiovascular accidents due to this drug. The first one was diagnosed with an ischemic stroke caused by carotid artery dissection and a leg distal vascular obliteration, the second one with a myocardial infarction with transient left ventricular dysfunction. Through these two case reports, the authors take stock of the pathophysiological and therapeutic knowledge of cardiovascular accidents after cocaine intake.

Adult↗
PubMed2004

[Anaesthesia and amiodarone-associated hyperthyroidism].

Amiodarone can induce severe hyperthyroidism that justifies its withdrawal and initiation of antithyroid drugs. Impossibility to stop amiodarone, failure to control hyperthyroidism and unfavourable evolution can lead to thyroidectomy. Cardiac manifestations, persistence of hyperthyroidism and interactions between amiodarone and anaesthetic or haemodynamic drugs may contraindicate anaesthesia. We report nine consecutive cases of amiodarone-associated hyperthyroidism that prompted us to perform thyroidectomy under general anaesthesia. The features and anaesthetic data of patients were noted. The antithyroid medical treatment failed in all patients. After thyroidectomy, evolution was favourable in all nine cases, without any intra or postoperative complication, in spite of the extent of hyperthyroidism and the severity of the associated cardiac problems. Despite potential high risks, thyroidectomy for amiodarone-induced hyperthyroidism does not seem to increase morbidity or mortality and allows a quick return to euthyroidism and reintroduction of amiodarone.

Adult↗
PubMed2003

[Pulmonary embolism to the rescue in cardiac tamponade].

The association of cardiac tamponade and pulmonary embolism has not previously been described. We report the case of a patient, who presented with such an association, due to an underlying pulmonary carcinoma. When a major pericardial effusion is associated with pulmonary hypertension, some echocardiographic signs of tamponade may appear, such as a moderate right ventricular collapse, or the absence of a paradoxical septum. The presence of pulmonary hypertension in this context of tamponade may have paradoxically saved the life of this patient.

Adenosarcoma↗
PubMed2003

[Acute poisoning by chemical warfare agent: sulfur mustard].

OBJECTIVE: To review story, mechanism of action, clinical and therapeutic bases of a sulfur mustard poisoning, by accidental, terrorism or war exposure. DATA SOURCES: References were obtained from computerised bibliographic research (Medline), from personnel data (academic memoir, documents under approbation of the National Defense Office) and from the Library of Military Medical Service. DATA SYNTHESIS: Sulfur mustard is a chemical warfare agent with peace time results: leak, accidental handling, acts of terrorism. Sulfur mustard is a vesicant agent, an organochlorine agent, who alkylate DNA. Under liquid or gas form its main target are skin and lungs. Clinical effects are like burns with loss of immunity, with respiratory failure, ophthalmic, gastrointestinal and haematological signs. The last studies have improved knowledge about the mechanism of action, detection, protection and treatment. Methods for determination of sulfur mustard are based on gas chromatographic method and mass spectrometry. During sulfur mustard contamination the first priorities of treatment are to remove victims from the contaminated place and to initiate decontamination. Emergency workers and materials must take protection to avoid secondary contamination of emergency unit. With treatment of vital functions and respiratory failure, the new ways of treatment are about N-acetyl cysteine for lung injury, poly (ADP-ribose) polymerase inhibitors, calmodulin antagonists and Ca(++) chelators. Interactions between sulfur mustard and anaesthetic agents are not well known and are based on clinical observations. CONCLUSION: Emergency care unit can be confronted with sulfur mustard during accidental contamination or acts of terrorism. First and most efficacy priorities of treatment are to remove and to decontaminate victims. New means of detection and treatment are studied since several years but are not still appropriate to human victims or mass treatment.

Alkylating Agents↗
PubMed2001

Allogenic bone marrow transplantation with a donor presenting with an acute hepatitis A.

We report the unique occurrence of an allogenic bone marrow transplantation performed as the donor was suffering from an acute hepatitis A. The bone marrow was contaminated at the time of collection, as demonstrated by hepatitis A virus (HAV) RNA detected by RT-PCR. Hepatitis A virus infection in such a situation could have resulted in a severe liver disease in the recipient. However, although we could demonstrate that the recipient had been infected, he did not develop a symptomatic hepatitis A but only minor disturbances of liver function tests between days 35 and 55. Both the postponement of the transplantation and the use of intravenous polyvalent immunoglobulins have probably played a key role in decreasing the viral load and allowing a rapid clearance of the virus. A possible role of the grafted immune system might also be envisaged, as suggested by the de novo synthesis of IgM in the recipient.

Acute Disease↗
PubMed1998

[A cause of intubation failure: a subglottic bridge].

We report the case of a patient with a history of facio-thoracic burns, the treatment of which included prolonged intubation, whose trachea could not be intubated because of a subglottic obstacle. The ventilation was easily controlled with a laryngeal mask. At the end of surgery for postburn cheloids, laryngoscopy through the laryngeal mask showed a transversal subglottic laryngeal band, a probable sequela of the previous prolonged intubation. The band was resected one week later. The conventional indicators for difficult intubation cannot detect the laryngotracheal obstacles to tracheal tube insertion.

Airway Obstruction↗
PubMed1996

Development of enzyme-linked immunoassays for human angiotensin I converting enzyme suitable for large-scale studies.

OBJECTIVE: To develop and validate a simple immunological assay for human angiotensin converting enzyme (ACE) based on monoclonal antibodies. METHODS: Microtitre plates were coated with mouse monoclonal antibody (MoAb) to human ACE (9B9) and incubated with diluted samples of human plasma. In the sandwich enzyme-linked immunosorbent assay (ELISA), the plasma ACE, bound to MoAb 9B9, was revealed using polyclonal anti-ACE antibodies and alkaline phosphatase conjugated to goat anti-rabbit immunoglobulin G. In the plate precipitation assay the ACE activity, quantitatively precipitated from human plasma by MoAb 9B9, was measured by enzymatic fluorimetric assay with p-benzyloxycarboxyl-glycyl-L-histidyl-L-leucine or p-benzyloxycarboxyl-L-phenylalanyl-L-histidyl-L-leucine as substrate, directly in the wells. RESULTS: These assays are specific for the amino-terminal domain of ACE and recognize differences in the conformations of native and recombinant ACE. The sensitivity of the sandwich ELISA was 200 pg/ml assay medium; it quantifies the ACE in 10 microliters human plasma or less. Intra- and inter-assay variability coefficients were 6.2 and 13.6%, respectively. Both variants of the assay determined the plasma ACE concentration in the presence of ACE inhibitors or EDTA. The ACE concentrations were determined by sandwich ELISA in a population of 138 middle-aged healthy Caucasian subjects. They were strongly correlated with the ACE gene insertion/deletion (I/D) polymorphism, which accounted for 20% of the variance of plasma ACE concentration in this population and 16-24% of the variance in plasma ACE activity as measured with three different enzymatic assays. CONCLUSION: The ACE concentration (but not inhibition) can be determined by this ELISA which is suitable for large-scale studies of plasma ACE levels.

Animals↗
PubMed1994

[Risks of hydrogen peroxide irrigation in military surgery].

Two cases of severe complications due to injection of hydrogen peroxide under pressure into areas of muscular attrition in war wounds are reported. In both cases the administration of hydrogen peroxide was associated with tachypnoea, with major arterial desaturation and a precordial "mill-wheel" murmur was heard. In one case, these symptoms were followed by hemiplegia caused by paradoxical arterial gas embolism, and in the other case by a pulmonary oedema confirmed by computerized tomography. Both patients recovered under hyperbaric oxygen therapy. The release of gaseous oxygen under the effect of tissue catalase and the membrane peroxydasic activity of hydrogen peroxide initiate such complications. The injection of hydrogen peroxide under pressure into a closed or partially closed cavity should therefore be strictly prohibited.

Adult↗
PubMed1993

[Cesarean section, mitral valve disease and pulmonary hypertension. Implications of hemodynamic monitoring on anesthetic management].

We present the case of a 25-year-old woman with mitral valve disease and severe pulmonary hypertension scheduled for Caesarean section under general anaesthesia. General anaesthesia for such cardiac patients requires usually high doses of fentanyl prior to intubation, which favours maternal inhalation and neonatal ventilatory depression. Invasive haemodynamic monitoring allowed a rapid sequence induction, with an optimal drug titration and an early recovery.

Adult↗
PubMed1992

[Towards a day care hospital. V. Does repetition of the Newman test induce learning?].

Newman's test consist in draw a line on two parts of a figure made of points. This test was achieved in four successive trials by thirteen boys and fourteen girls, all voluntary students. In two trials subjects wear Reiser screen which reduce to a slight extent distinctness of vision. Trial order was randomised. For each trial, time performance and four numeral criterions of graphic defects were compared to initial values. The test retest values are no significantly different. Reiser screen alter some criterions. So the Newman test is useful to assess awakening on condition that such criterion were used in reference to subject preanaesthetic values and with controlled conditions of environment.

Adolescent↗
PubMed1990

Self-poisoning with the beta-blocker bisoprolol.

A case of bisoprolol self-poisoning resulting in full recovery of the patient is described. The peak plasma level of bisoprolol was 541 ng ml-1. Sinus bradycardia was the only symptom observed, suggesting that cardioselectivity and absence of membrane stabilizing activity contribute to reduce the severity of beta-blocker intoxication.

Adult↗