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Biomedical subjects

B Paramelle

Publications and source records attributed to B Paramelle.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Incidence of polyneuropathies in chronic obstructive bronchopneumopathies].

In a prospective study 43 patients with chronic obstructive lung disease and severe respiratory insufficiency were systematically investigated for polyneuropathy, although they had no risk factor of that disease. Electrophysiological recordings showed slight or significant signs of polyneuropathy in 17 and 15 patients respectively, thus indicating that the condition is frequent. Clinically, it was often silent or manifested only by sensory disorders predominant in the lower limbs. Electrophysiology suggested axonal degeneration associated with some degree of demyelinization, and these lesions were found at histology to be present in sensory nerves. Histological examination of the muscles showed peripheral mixed neurogenic atrophy probably due to hypoxia. Major thickening of basal material was observed in capillaries of the endomysium and endoneurium. Statistical analysis of clinical parameters and respiratory function values in relation to the presence and importance of polyneuropathy showed that the only significant difference was the longer duration of hypoxia in patients with nerve involvement. Age, alcoholism and the other respiratory function values did not seem to be correlated with lesions of the peripheral nervous system.

Aged↗
PubMed1986

[Neuropathies and chronic respiratory insufficiency: electrophysiologic study].

In order to determine the frequency and the characteristics of neuropathies in chronic respiratory insufficiency, a systematic study of 43 patients affected by a chronic obstructive pulmonary disease was performed. In addition to neurological and electrophysiological examinations (including 6 nerve conduction studies on median, ulnar and peroneal nerves and EMG of 4 to 8 muscles), nerve and muscle biopsies (of the superficial peroneal nerve and lateral peroneus brevis muscle) were performed in 13 cases. Polyneuropathies were found in 74% patients: but mild in 39%, severe in 35%. Most were subclinical or poorly symptomatic. We determined the importance and distribution of abnormalities on the different nerves. From this we established that neuropathies are mixed but predominantly of the axonal type. Axonal degeneration and demyelination were confirmed by nerve biopsy; muscles presented neurogenic atrophy. Statistical analysis showed that the duration of hypoxemia was related to neuropathy. The pathogeny of these neuropathies is discussed.

Adult↗
PubMed1986

[Value of a daily dose of theophylline in the treatment of nocturnal asthma].

The authors report the results obtained with one single daily dose of 10 mg/kg of a long-acting theophylline preparation administered in the evening to asthmatic patients previously treated with the same dose twice a day. Twenty-seven patients presenting with airway obstruction reversible by beta-stimulants entered the study; their mean FEV1 value was 57% of the expected value, and diffuse sibilances were present; paroxysmal attacks occasionally occurred, particularly at night. No significant difference was found between the two dosage regimens with regard to symptomatic improvement, adjuvant drug consumption, and plasma theophylline levels 12 hours after the evening dose. The classical side-effects of theophylline therapy were not increased by the once-a-day regimen. It is concluded that one dose of theophylline per day is effective in the treatment of nocturnal asthma.

Adult↗
PubMed1985

A comparison of flunisolide inhaler and beclomethasone dipropionate inhaler in bronchial asthma.

Ninety-nine patients, who had never previously taken inhaled steroids were enrolled in a randomized, single-blind, parallel study, the aim of which was to compare the efficacy and safety of flunisolide inhalation, 500 mcg twice daily, with beclomethasone dipropionate inhaler 100 mcg four times daily for the treatment of chronic asthma. The treatment period was for 6 weeks. The patients were examined clinically at entry, week 3 and week 6 and both treatment groups showed a marked improvement in almost all parameters during the course of the study. Flunisolide was statistically significantly superior to beclomethasone dipropionate for wheezing at week 6, coughing at week 6 and chest tightness at weeks 3 and 6. The number of asthma attacks per day decreased significantly more with flunisolide treatment than with beclomethasone dipropionate. The over-all evaluation of efficacy by both doctors and patients also showed flunisolide to be superior to beclomethasone dipropionate. In several other parameters there was a trend shown favouring flunisolide, and beclomethasone dipropionate did not show a superiority over flunisolide in any efficacy parameter. Both drugs were well-tolerated, with unpleasant taste being the most frequent complaint in the flunisolide group. No patient in either group withdrew from the study because of adverse events. In this study, flunisolide inhaler was more effective than beclomethasone dipropionate inhaler for the treatment of chronic asthma exhibited by patients who had never been treated with inhaled steroids.

Adolescent↗
PubMed1985

[Pneumopathies induced by amiodarone. Clinical, paraclinical and physiopathological data. Apropos of 2 cases].

The authors report the cases of two men with coronary artery disease by amiodarone for 8 and 24 months respectively. They developed clinical and radiological changes of diffuse interstitial pneumonia, characterised by an inflammatory syndrome, restrictive changes on spirometry, reduced CO transfer and abnormal blood gases. Broncho-alveolar lavage showed a lymphocytosis with a large quantity of iodine in the macrophages and the presence of amiodarone and its metabolite in the supernatant fluid. The responsibility of this drug is imputed and the patients were cured within 3 months of its withdrawal with regression of clinical, radiological, spirometric and control alveolar lavage abnormalities. A favourable outcome without steroid therapy is practically unknown in the literature. These cases illustrate the possible risk of alveolitis or diffuse interstitial pneumonia during long term amiodarone therapy, the pathogenesis of which is discussed: iodine overload, direct drug toxicity or an immunological mechanism.

Aged↗
PubMed1985

[Healthy subjects with malignant cells in their sputum. Apropos of 60 cases].

Sixty cases of occult carcinoma of the lung are described. A distinction is made between "revealed cases" (23 cases) in which the carcinoma revealed itself within 5 months after the first cytological findings, and true occult carcinomas (37 cases) in which lesions developed within 5 months to 8 years after the first positive cytology. Mean survival in the "revealed cases" was 13 months. It was 51 months for true occult lung carcinomas and 68.5 months for occult carcinomas treated by chemotherapy starting at the time of discovery of malignant cells in the sputum. The method of choice is selective bronchial aspirates and brushings after repeated sputum cytology which allows for localization of the lesion and early surgery.

Adenocarcinoma↗
PubMed1984

[Long-term (6 months) treatment of chronic bronchitis with respiratory insufficiency using almitrine dimesylate. Double-blind study versus placebo].

The purpose of this controlled, double-blind therapeutic trial in chronic bronchitis patients with hypoxia and normocapnia was to evaluate the beneficial effects of a 6-month treatment with almitrine bismesylate on dyspnoea and blood gases, as well as the clinical, spirometric and pulmonary haemodynamic acceptability of the drug. Patients were allotted at random to either almitrine bismesylate 100 mg/day in two divided doses (n = 10) or a placebo similarly administered (n = 9). On entering the trial, both groups had comparable clinical symptoms, lung function, blood gas values and pulmonary haemodynamic values. A significant (p = 0.014) reduction of dyspnoea was observed in the treatment group but not in the placebo group. A significant (p less than 0.05) improvement in PaO2 was noted after 3 and 6 months of treatment while PaCO2, initially normal, was not significantly modified. There were no significant changes in respiratory rate and external ventilation in either group, and the mean pulmonary arterial pressure remained unchanged in all patients. No significant variations were observed in the patients' weight, systemic arterial pressure, heart rate or signs of right ventricular failure. In conclusion, this trial in chronic bronchitis patients with hypoxia and normocapnia demonstrated sustained improvement in hypoxaemia and clinical symptoms during a 6-month treatment with almitrine bismesylate, without changes in pulmonary haemodynamic values.

Almitrine↗
PubMed1984

[Desaturation and nocturnal pulmonary arterial hypertension in C.O.P.D.: effects of oxygen therapy].

The influence of low flow oxygen on saturation (SaO2) and mean nocturnal pulmonary artery pressure (PAP), was studied in a group of chronic bronchitics suffering from severe airflow obstruction with moderate respiratory failure. 20 patients had oxymetry on ambient air, six underwent a continuous recording of SaO2 and of PAP for 2 nights; the first on ambient air, the second on Oxygen. The six patients showed transitory desaturation, accompanied by instantaneous rise in PAP. The oxygen greatly improved the mean values and maximal variation of SaO2 and PAP, supporting the hypothesis that this treatment is capable of preventing T.A.P., and chronic cor pulmonale in patients whose diurnal blood gas values do not justify continuous oxygen therapy, according to classical criteria.

Aged↗
PubMed1983

[Influence of mixed venous blood PO2 on the pulmonary arterial pressure in chronic obstructive pulmonary disease (COPD): correlations in 128 patients].

Hypoxic vasoconstriction is one of the main determinants of pulmonary arterial hypertension in C.O.P.D. The authors study in two groups of respiratory insufficiency patients (82 C.O.P.D. and 46 non-C.O.P.D.) correlations between mean pulmonary arterial pressure (PAP) and gasometric values. They show that: --no correlation exists in the patients who suffer from a restrictive syndrome; --in the obstructive patients, correlations are poorer between PAP and PaO2 or PvO2 than between PAP and a factor made up of these two parameters, according to the percentage of their theoretical values.

Blood Pressure↗
PubMed1983

[Indications and decision criteria for supplemental oxygen therapy in chronic hypoxemia].

Oxygen therapy is justified both on theoretical grounds and by clinical studies. Chronic hypoxia bodes ill for the system and is a prognostic factor in pulmonary disease. Low flow oxygen therapy has not shown any risk of pulmonary toxicity from anatomical or physiological studies. Clinical studies have shown that the correction of hypoxaemia by long term oxygen therapy improves exercise tolerance, mental state, the general sense of well being, polycythaemia, pulmonary hypertension, the quality of sleep, and finally the prognosis. But long term oxygen therapy is costly and requires patient co-operation and close supervision. It should be reserved for hypoxic patients in a stable state: the exact degree of hypoxaemia at which oxygen therapy is permissible cannot be defined precisely and depends on other criteria (such as polycythaemia, pulmonary arterial hypertension, nocturnal desaturation). Account should be taken of the PaCO2 level and the cause of the disease in deciding the oxygen flow. Polycythaemia, pulmonary arterial hypertension, nocturnal desaturation despite a normal waking PaO2, may represent some indications for oxygen therapy but further studies are necessary.

Blood Gas Analysis↗
PubMed1982

[A clinical study of tiapride in ten patients with chronic respiratory failure and in ten patients before fiberoptic bronchoscopy (author's transl)].

Ten patients with chronic respiratory failure (PaO2 = 56,19 +/- 10,54; PaCO2 = 49,17 +/- 7,31 torr) were given intramuscular injections of tiapride, Changes in alveolar ventilation were assessed clinically and by monitoring blood gases. No adverse effects were recorded. PaO2 was similar before and one hour after tiapride. There was no hypoventilation but, on the contrary, a slight decrease in PaCO2 (49,17 +/- 7,3 and 47,10 +/- 7,3 torr) and a significant increase in pH (7,358 +/- 0,023 and 7,378 +/- 0,028; p less than 0,05). Tiapride was also given to ten patients before fiberoptic bronchoscopy. Endoscopy was well tolerated in eight patients, in six there was no anxiety, and in all normal vigilance was retained.

Adult↗
PubMed1981

[Diagnostic radiology in mediastinal disorders : technical progress and current strategy (author's transl)].

After a brief reminder of recent progress in radiological methods in the diagnosis of mediastinal disorders, the authors study the contribution of Computerised Axial Tomography (T.D.M.). The advantages of T.D.M. in mediastinal disease rest on two characteristics : the morphological study of the mediastinum is made easier by the display of transverse axial cuts with nothing superimposed; the density measurements can distinguish between opacities which would appear similar on conventional radiology. Three facts have been established by the authors : T.D.M. raises the diagnostic sensitivity of radiology; in distinguishing between fatty, watery, vascular and solid tumours, it increases aetiological specificity; it simplifies the diagnostic approach while increasing the efficiency of radiology and the importance of its role in therapeutic decisions. In a typical case where one has just discovered an abnormal mediastinal opacity (and in whom a gastro-intestinal primary has been excluded), T.D.M. should be the first examination after standard radiography, because its results determine the remaining investigation. T.D.M. is specially indicated in evaluating a myasthenic or when investigating an anomaly in the infero-posterior mediastinum. A few cases do not entirely fit in to this schema, because of a particular clinical or radiological situation such as : mediastinal adenopathy; the assessement of the extent of a bronchogenic carcinoma; anterior cardio-phrenic opacities. The examination of the hila again has its limits when the abnormal opacity is small as there are errors in the technique due to the effects of incomplete volume. Finally, there remains the improved cost-effectiveness of the radiological examination of the mediastinum with the rational use of T.D.M.

Aortic Aneurysm↗