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Biomedical subjects

B Rondelet

Publications and source records attributed to B Rondelet.

10 recordsLinked to original sources
PubMed2005

[Pulmonary arterial hypertension in intensive care unit and operating room].

OBJECTIVE: To review the perioperative anaesthetic management of pulmonary arterial hypertension. DATA SOURCES: Extraction from Pubmed database of French and English articles on the perioperative anaesthetic management of pulmonary hypertension for 9 years. DATA SELECTION: The collected articles were reviewed and selected according their quality and originality. The more recent data were selected. DATA SYNTHESIS: Pulmonary arterial hypertension is classically divided in primary and secondary. Primary pulmonary hypertension (familial and sporadic) is relatively severe and rare. Muscularization of the terminal portion of the pulmonary vascular arterial tree, caused by smooth muscle cell hyperplasia is the first change. Pulmonary arterial hypertension linked with disorders of the respiratory system and hypoxemia or pulmonary venous hypertension including mitral valve disease and chronic left ventricular dysfunction are often associated with high morbidity and mortality. The main consequence of pulmonary hypertension development is the occurrence of right-sided circulatory failure. A better understanding of disease pathophysiology will contribute to the development of new therapies increasing then the prognosis of these patients. The management of primary pulmonary hypertension or secondary pulmonary arterial hypertension is a challenge for the anaesthesiologist because the risk of right ventricular failure is markedly increased.

Anesthesia↗
PubMed2003

Expression of the serotonin 1b receptor in experimental pulmonary hypertension.

The pathogenesis of pulmonary arterial hypertension (PAH) remains uncertain. Both the serotonin and endothelin (ET) systems are believed to be involved. Recent studies pointed to the importance of the serotonin 2B receptor as a limiting step. The current authors investigated the lung tissue expression of serotonin receptors and of the serotonin transporter (5-HTT) by real-time-quantitative polymerase chain reaction in chronic overcirculation-induced PAH in growing piglets, with and without treatment with the dual ET receptor blocker bosentan. Pulmonary haemodynamic changes were described by pulmonary arterial impedance spectra. Three months after the surgical anastomosis of the left subclavian artery to the pulmonary arterial trunk, there was a shift of the impedance spectra to higher ratios of pressure and flow moduli, with increases in both 0 Hz impedance and characteristic impedance, and these changes were completely prevented by bosentan therapy. There was an increase in the expression of the serotonin 1B receptor. There was no change in the expression of the 5-HTT, and of the serotonin 2B, 1D, and 4 receptors. The overexpression of the serotonin 1B receptor was partially prevented by bosentan therapy. The present authors conclude that this early pulmonary arterial hypertension model is characterised by an endothelin receptor-dependent increased expression of the serotonin 1B receptor.

Animals↗
PubMed2002

Conversion from ministernotomy to full sternotomy in aortic valve replacement.

Conversion (C) from ministernotomy (M.S.) to full sternotomy was necessary in 5% of the cases in a series of 100 patients consecutively operated for Aortic Valve Replacement (A.V.R.) Analysis of the demographics and surgical techniques indicate older age, aortic fragility, diffuse coronary disease, chronic renal failure and left vent insertion as contributing factors. Despite increased operative blood losses, extra-corporeal circulation (E.C.C.) times, intensive care unit (I.C.U.) stay and hospital stay, no mortality was observed in the conversion group, as compared to 4.2% mortality in the total ministernotomy (MS) population. Preoperative patients selection, avoidance of technical pitfalls, and knowledge of alternative surgical measures are suggested to further decrease the incidence of conversions.

Aged↗
PubMed1999

The use of disharmonic motion curves in problems of the cervical spine.

Cervical spine motion was investigated by three-dimensional electrogoniometry in 257 asymptomatic volunteers and in 32 patients with cervical disc hernia or whiplash syndrome. Maximal ranges of main and coupled motions were considered. Motion curves were analysed qualitatively and using fitting of sixth degree polynomials. Motion ranges obtained were in agreement with previous observations. Significant differences between patients and volunteers concerned several primary and coupled components but not all. Qualitatively, patients displayed less harmonic curves, with irregularities and plateau-like appearances. Root mean square differences between data and fit were significantly modified in patients. Although cervical spine motion ranges may remain within normal limits in patients, motion patterns were altered qualitatively and quantitatively. Motion pattern analysis might prove a useful discrimination parameter in patients in whom anatomical lesions are not clearly identifiable.

Adolescent↗
PubMed1999

Normal global motion of the cervical spine: an electrogoniometric study.

OBJECTIVE: Establishment of a normal database and clinical reference of active global cervical spine motion ranges and patterns using a commercial electrogoniometer. DESIGN: Three-dimensional cervical motion ranges and patterns were analyzed in 250 asymptomatic volunteers. BACKGROUND: In vivo out-of-plane motion patterns of the cervical spine have not yet been reported in large populations, but could be of clinical interest. METHODS: In 250 subjects (aged 14-70 yr), motion range and patterns between the first thoracic vertebra and the head were analyzed for flexion-extension, lateral bending, rotation in neutral sagittal plane position and in full flexion using the CA 6000 Spine Motion Analyzer. RESULTS AND CONCLUSIONS: Average motion range in the sagittal plane was 122 degrees (SD: 18 degrees ). Flexion was slightly more important than extension. Out-of-plane components were negligible. Global bending range averaged 88 degrees (SD: 16 degrees ), left and right bending being comparable. Homolateral rotation was associated to lateral bending. Its extent was approximately 40% of the bending range. Global rotation range in neutral sagittal plane position was 144 degrees (SD: 20 degrees ), without significant difference between right and left rotations. Associated motion components were small. During rotation in flexed head position, global range (134 degrees, SD: 24 degrees ) was comparable to the one in neutral flexion. But heterolateral bending, averaging 60% of the primary motion, was associated to flexed rotation. Significant reduction of all primary (but not conjunct) motions with age were obtained. Sex had no influence on cervical motion range. RELEVANCE: Our results agreed with previous observations, validating the methodology used. They thus constitute reference data of cervical out-of-plane motion for clinical applications.

Adolescent↗
PubMed1993

[Hyperthyroidism induced by molar pregnancy].

A case is reported of a Senegalese patient admitted for hydatiform mole. The serum human chorionic gonadotrophin concentration (hCG) was 900,000 UI.l-1. The patient was recognized to be clinically hyperthyroid with raised T4 and T3 values, but a very low TSH concentration. After two days of beta adrenergic blockade and carbimazole, a suction curettage was performed under general anaesthesia. Propranolol was again administered 6 hours after the surgery. Thyroid function returned to normal level two weeks after removal of the mole, suggesting that hCG was responsible for the thyrotoxicosis. Serum hCG concentrations closely paralleled those of free thyroxine, but the correlation was difficult to assess because of carbimazole. Clinical thyrotoxicosis is rare in molar pregnancy. The diagnosis being made in semi-urgent conditions, this raises the question of how to obtain rapid stabilization of the disease before surgery.

Adult↗
PubMed1986

[Femoral nerve block as a postoperative analgesia technic in surgery of the knee].

A femoral nerve block was performed as a postoperative analgesic technique in 50 patients after knee surgery; this surgery is a very painful one. The technique used was the inguinal route, as described in the textbooks. Bupivacaine was used: 1.5 mg X kg-1 without exceeding 150 mg. The result was good in 46 patients, with four failures. The average duration of analgesia was 600 min, the shortest being 300 min, the longest being 1,200 min. This technique can be recommended after surgery of the knee as safe and reliable.

Adolescent↗