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Biomedical subjects

B Tardy

Publications and source records attributed to B Tardy.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pentosan polysulfate-induced thrombocytopenia and thrombosis.

Pentosan polysulfate is a low-molecular-weight sulfated polysaccharide used as an antithrombotic drug. We present two patients who developed thrombocytopenia and venous thrombosis during treatment with pentosan polysulfate. The relationship between pentosan polysulfate and thrombocytopenia is supported by platelet aggregation and serotonin release tests. In the light of the literature and our two cases, it appears that pentosan polysulfate alone as standard heparin and low-molecular-weight heparin can induce thrombocytopenia and thrombosis. Platelet counts should therefore be periodically monitored during pentosan polysulfate treatment. In the case of pentosan polysulfate-induced thrombocytopenia, it seems that heparin or low-molecular-weight heparin should not be instituted during the acute phase even if platelet aggregation studies are negative, because of their low sensitivity. After remission of thrombocytopenia, whether or not glycosaminoglycans can be reinstituted, at least temporarily, after antibody had disappeared is still an open question.

Aged↗
PubMed1994

[Left main coronary artery disease].

There are many causes of left main coronary artery disease, the first of which is atherosclerosis. Other rarer causes may be observed, such as acute and chronic occlusions, spasm and primary and secondary dissection. The prevalence of stenosis of the left main coronary artery at coronary angiography is about 5%. The risk factors are the same as for coronary artery disease. The symptoms are angina, especially unstable angina. The diagnosis is suspected on the finding of an extremely positive exercise stress test, confirmed by coronary angiography. The results of the prospective large scale Veterans Administration trial showed surgery to be the treatment of choice with a 30 months survival of 80% in the surgical group compared with 64% in the medical group. The operative morbidity and mortality is less than 10% at present. Recent studies have reported a medium-term mortality of 4.3 to 10.25% with follow-up periods of 24 and 43 months respectively. The long-term survival and functional improvement are excellent, with values of nearly 80%. Chronic occlusion of the left main stem is rare, 0.01 to 0.7% in coronary angiographic studies. There is no difference in presentation, electrocardiographic or stress test features compared with other severe coronary artery disease. The diagnosis is angiographic and the treatment surgical because of the mediocre natural history with risks of sudden death and severe infarction. Acute occlusion of the left main coronary is rare for generally fatal. The mechanism is acute thrombosis and the clinical presentation is that of extensive infarction usually with cardiogenic shock.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Isolated burns after white-spirit ingestion in attempted suicide].

INTRODUCTION: We report an unusual complications of prolonged contact with white spirit leading to caustic burns. CASE REPORT: A 20-year-old patient was seen for caustic perianal burns several hours after ingesting one-half liter of white spirit in an attempted suicide. Motor diarrhoea also occurred quickly and a prolonged anal evacuation of white spirit. Complementary examinations did not reveal any lesions of the buccal, oesophageal, gastric or rectosigmoidal mucosa. DISCUSSION: Necrosis of the skin due to prolonged contact with petrol products is well known. Usually due to the delapidating action of dissolved petrol products on the superficial hydrolipid film and subjacent cell membranes. The absence of digestive tract lesions could be explained by the rapid onset of motor diarrhoea which may have limited the time of contact and thus protected the digestive tract mucosa which has a high content of mucopoly-saccharides and a low lipid content.

Adult↗
PubMed1994

[Anesthesia and general surgery in cardiac patients].

Close cooperation is necessary between the cardiologist and anesthesiologist preoperatively in order to identify the risks associated with a surgical procedure. This article reviews the various types of anesthesia and their effects on the cardiovascular system, in particular in relation to the category of cardiovascular disease. Accurate definition of the operative risk involves thorough evaluation of three essential parameters: cardiovascular status, the type of surgery and the type of anesthesia. These high-risk patients require management not only pre- and peroperatively, but also postoperatively, which is the period when the majority of complications occur. Mention is also made of drug interactions between anesthetic and cardiovascular agents.

Anesthesia, General↗
PubMed1993

[Phlebitis following travel].

The term of economy class syndrome has been used to describe the deep vein thrombosis which may follow air travel. The mechanisms suggested for this include tendency to clot formation in the legs secondary to the reduced venous return induced by the sitting position with direct compression of popliteal and femoral veins, and secondary to dehydration and haemo-concentration. However, these conditions are also observed with others means of transport. We describe 16 patients with deep vein thrombosis following travel by bus, car, truck and train. These 16 patients represent 3.4 percent of 465 patients with thromboembolism managed over a 52-month period in our department. All but one patients had one or more risk factors for deep vein thrombosis. The mean duration of the trip was 14.2 hours and the first symptom occurred less than a week after the journey in 75 percent of the patients. These first symptoms suggested deep vein thrombosis in 8, pulmonary embolism in 5, and deep vein thrombosis with pulmonary embolism in 3 patients. Regular non alcoholic drinks and regular walks seem to be sufficient to prevent deep vein thrombosis in the great majority of travellers. However, low dose heparin on a temporary basis or elastic stockings could be considered in high risk subjects.

Adult↗
PubMed1993

High levels of tumor necrosis factor-alpha and interleukin-6 in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis.

We prospectively measured the concentrations of immunoreactive tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) in the serum and ascitic fluid of 14 alcoholic cirrhotic patients with spontaneous bacterial peritonitis (SBP) and 16 alcoholic cirrhotic patients with sterile ascitic fluid. TNF-alpha levels in ascitic fluid were significantly higher for the patients with SBP: 399.57 +/- 129.23 pg/mL vs. 35.76 +/- 5.57 pg/mL (P < .001). IL-6 levels in ascitic fluid were also significantly higher for the patients with SBP: 170,713 +/- 57,109 ng/mL vs. 5,414 +/- 973 ng/mL (P < .001). By contrast, serum levels of TNF-alpha and IL-6 were just slightly more elevated than normal values. The concentration of IL-1 in the ascitic fluid of all patients was elevated, but there was no difference between patients with SBP or sterile ascites in this respect. In the patients with SBP, levels of TNF-alpha and IL-6 in ascitic fluid decreased during the first 48 hours of antibiotic treatment. Our results suggest that measurements of TNF-alpha and IL-6 in ascitic fluid may become useful markers both for the diagnosis of SBP and for monitoring the treatment of cirrhotic patients.

Ascitic Fluid↗
PubMed1993

Myocardial infarction and nicotine patch: a contributing or causative factor?

A case of angina pectoris revealed by nicotine patch treatment is described in a patient who continued to smoke and subsequently suffered a myocardial infarction. The various side effects of nicotine and its derivatives are recalled. The action of nicotine on coronary vasomotricity and its mediators is discussed.

Administration, Cutaneous↗
PubMed1993

[A rare cause of loss of consciousness: mastocytosis. Apropos of 3 cases].

The authors report three cases of syncope due to systemic mastocytosis. This is a rare cause of syncope but should be recalled in certain circumstances. In the light of these cases, the authors review the literature with respect to this unusual presentation. Syncope may occur at any age. Loss of consciousness may be more or less complete, brief or prolonged, isolated or recurrent and usually accompanied by prodromal symptoms. The least controversial physiopathogenic mechanism of these syncopes is intense vasoplegia induced by the release of vasoactive mediators, especially histamine. When there is a clinical suspicion of mastocytosis, even in the absence of skin changes, the diagnosis is confirmed by biopsy which shows abnormally high numbers of mastocytes irrespective of the organ biopsied. The treatment of acute forms with collapse is based on intravenous infusion of macromolecular fluids and injections of epinephrine. Prevention is by drugs which inhibit the synthesis of histamine, the degranulation of mastocytes and the production of prostaglandin D2.

Aged↗
PubMed1993

[Localized type 2 dissection unrecognized by transesophageal echography. Apropos of a case].

The authors report a case of type 2 dissection, strictly confined to the terminal portion of the ascending aorta, not seen by transesophageal echocardiography because of the existence of a blind spot and responsible for a false negative. The role of TEE in the diagnostic approach to dissections is reviewed, as are its limitations, of which it is important to be aware because of the poor prognosis of pathology of this type.

Aged↗