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Biomedical subjects

C Granthil

Publications and source records attributed to C Granthil.

At least 37 records · Page 2Linked to original sources
PubMed1984

[So-called pocket-sized spirometry versus respiratory function tests: a comparative study of vital capacity, forced expiratory volume in 1 second and Tiffeneau's coefficient].

A simplified preoperative respiratory assessment was carried out in order to assess the reliability of a pocket-sized spirometer. 30 patients were each tested using two methods: 1) the traditional extensive laboratory lung function tests and 2) a bedside test using a pocket-sized spirometer, which measured the vital capacity (VC), the forced expiratory volume in 1 second (FEV1), the peak flow (PEF) and the ratio of FEV1 to VC. The correlation between the two series of VC and FEV1 measurements was highly significant (p less than 0.001). Therefore, these two parameters could be considered as reliable when testing was performed at the bedside. However, the sensitivity of the FEV1/VC ratio was decreased; in three of the patients, the significance of this third parameter was not the same with the two methods. Measurements of peak flow were only collected at the bedside, and a statistical comparison was not established. Analysis of this last parameter always allowed us to confirm or not an obstructive syndrome when the values of FEV1 or FEV1/VC were in disagreement. The pocket-sized spirometer would seem to be a simple and reliable means of diagnosing respiratory insufficiency, its type (obstructive or restrictive) and its seriousness.

Aged↗
PubMed1984

[Facial cellulitis of dental origin].

A case of facial cellulitis of dental origin associating a retropterygoidal necrosis, a retro-orbital abscess and a cervicofacial cellulitis is reported. No related risk factors were found in this 28 year old man. Bacteriological analyses showed a mixed bacterial flora and the presence of candida. Direct examination favoured an anaerobic germ infection. However the culture and identification of theses germs were impossible. The clinical circumstances together with the results of facial computed tomography tended to make the diagnosis of an anaerobic cellulitis highly probable. The diagnostic and therapeutic managements are reviewed.

Adult↗
PubMed1984

A simplified acute physiology score for ICU patients.

We used 14 easily measured biologic and clinical variables to develop a simple scoring system reflecting the risk of death in ICU patients. The simplified acute physiology score (SAPS) was evaluated in 679 consecutive patients admitted to eight multidisciplinary referral ICUs in France. Surgery accounted for 40% of admissions. Data were collected during the first 24 h after ICU admission. SAPS correctly classified patients in groups of increasing probability of death, irrespective of diagnosis, and compared favorably with the acute physiology score (APS), a more complex scoring system which has also been applied to ICU patients. SAPS was a simpler and less time-consuming method for comparative studies and management evaluation between different ICUs.

Health↗
PubMed1983

[Use of a severity index in 8 multidisciplinary resuscitation centers].

A universal severity index for acutely ill patients was applied to 794 acute patients treated in eight medical and surgical French intensive care units located in teaching or community hospitals either in Paris or in provincial towns. Measured on the first day in hospital from objective numerical data, the index proved reliable and correlated well with hospital mortality and the sustained therapeutic efforts of the first 24 hours. It could be used in multicentre studies to compare outcomes and evaluate new treatments.

Disease↗
PubMed1983

[Temporomandibular staphylococcal arthritis].

Two cases of temporo-mandibular joint infection with several blood cultures positive for Staphylococcus aureus are reported. Positive diagnosis depended on the importance of the pain and trismus, as well as the lack of abscess formation. The rapid development of ankylosis requires treatment to be started as soon as the first signs appear.

Adult↗
PubMed1982

[Postoperative weaning from mechanical ventilation in adults].

Pulmonary complications remain the most frequent of postoperative complications (32-60), especially after upper abdominal surgery (14-41). Chronic respiratory insufficiency (80) also continues to be a major risk factor, in spite of the progress made in both anesthesiology and postoperative care. In the immediate postoperative period, weaning from mechanical ventilation is one of the most dangerous phases of anesthesia (84). We discuss the importance of weaning procedures, in particular, in patients with a high risk of pulmonary complications.

Adult↗
PubMed1982

[Intrabronchial diffusion of amoxycillin when administered by two different injection modes (author's transl)].

Twelve ICU patients, all with broncho-pulmonary infection were treated with 50 mg/kg-1/24 h-1 of amoxycillin administered every eight hours, either by one hour perfusion, or by brief IV injection (2'). Both modes were given to all of the patients in order to determine, by comparison, the most efficient treatment. There is no significant difference in serum levels after perfusion or IV injection. However, IV injection is preferable because of a significant difference in bronchial levels after 3 hours (p less than 0.01). In most cases, the bronchial levels and the bronchio/serum concentration ratios, while not significantly different, are higher than after perfusion. None of the results justify the use of perfusion.

Amoxicillin↗
PubMed1981

[Occult intrapulmonary hemorrhage caused by anticoagulants].

Intrapulmonary occult bleeding is a serious complication of anticoagulants. Diagnostic difficulties are such that this complication is rarely described: 8 cases in the literature. The authors report two new cases. In both of these patients oral anticoagulant therapy resulted in a severe haemorrhagic syndrome on a clinical (melaena and/or epistaxis) and laboratory (haemoglobin less than 9 g/100 ml and prothrombin time less than 10 p. 100) basis. After a period of 24 to 48 hours, an acute respiratory distress syndrome developed. There was dyspnoea without major haemoptysis, a hypoxia/hypercapnia syndrome and, by X-ray, the rapid development of a diffuse micronodular miliary picture. The diagnosis of intrapulmonary occult bleeding was based upon fibroscopy with bronchoalveolar lavage (BAL) showing the pathological presence of large numbers of alveolar siderophages. However, the worsening of hypoxia brought about by bronchoalveolar lavage is such that careful consideration must be taken before the technique is used. Intrapulmonary occult bleeding must therefore be borne in mind in the presence of an imbalance in anticoagulant treatment complicated by respiratory distress and a reticulonodular radiological appearance.

Anticoagulants↗
PubMed1981

[Clinical pharmacokinetics of flunitrazepam (Nacrozep) in intensive care patient (preliminary results)].

A protocol of repeated I. V. injections of flunitrazepam was constructed by mathematical simulation on the basis of pharmacokinetic data obtained from single intravenous injections given to healthy subjects. This protocol would given serum blood levels equal to 15 ng . ml-1, rapidly and compatible with long term artificial ventilation, thanks to the pharmacological action of flunitrazepam. Four patients in the ICU benefited from this protocol. The levels desired were not reached but in two cases out of four it was possible to continue artificial ventilation without the addition of any other drug. Furthermore it was possible to show that the three compartment model developed from healthy subjects remains valid in pathological circumstances. A second protocol based on pharmacokinetic data from four patients should allow us to obtain the objective aimed at.

Adult↗
PubMed1981

[Serial measurement of serum levels of amikacin. Value in therapy].

Amikacin serum levels were measured 256 times in 65 patients admitted into the intensive care unit for various reasons over 18 months. These measurements confirmed the dosage of 5 micrograms per kg repeated every 8 hours in patients with normal renal function. Forty eight hours before the first measurement, a control assay is essential to check that there is no residual antibiotic and that the antibacterial activity of the serum is zero. After this a single weekly control is sufficient to check that the residual level is effective and non toxic, i.e. between 2 and 6 micrograms per ml. However, in patients with acute renal insufficiency, there are three dosage schemas which should be used depending on the creatinine level. These three schemas are nevertheless not sufficient to continue effective therapy without a risk of toxic side effects. It is therefore necessary to check both the pack levels and the residual levels regularly from the beginning of treatment. Two to three weekly controls are essential to avoid a risk of toxic side effects.

Adolescent↗
PubMed1981

[Value of the determination of urinary 3-methylhistidine (3 MEHIS) in the evaluation of postoperative muscular catabolism].

Daily estimations of urinary 3 methylhistidine, creatinine and total nitrogen were carried out during the first four post-operative days in sixteen patients who had undergone uncomplicated abdominal surgery and receiving parenteral alimentation. Figures obtained for 3 methylhistidine (19.36 +/- 4.48 mumol/kg as a cumulative for the 4 days) could be used to assess the catabolism of muscular protein during this period at approximately 320 g for a 70 kg subject, i.e. approximately twice that found in the healthy adult. There was a good correlation between 3 MEHIS and creatinine. Muscular catabolism is hence proportional to the degree of lean body mass. By contrast, there was no correlation between the excretion of 3 MEHIS and nitrogen excretion. Finally, study of the effect of qualitative and quantitative variations in nitrogen intake on muscular proteolysis did not make possible any conclusion at present. Further studies are hence necessary.

Abdomen↗
PubMed1981

[Is the use of lidocaine in spray form permissible during intubation?].

The use of local anaesthetic in spray form for anaesthesia of the trachea before intubation may be the cause of changes in the wall of the balloons of endotracheal tubes. The direct application of the mixture freaon + alcohol + lidocaine to the wall of the balloon of different tubes does in fact result in appearance of herniations or fissures, explaining certain problems which have up to now imputed to the material used. It is therefore emphasised that the technique of local anaesthesia of the trachea must be carried out using material and products designed for the purpose.

Aerosols↗
PubMed1980

[Branched amino acids. Role and value in parenteral nutrition].

The authors undertook a general review of the principal studies concerning branched amino acid (B.A.A.) and justifying their use in large doses during parenteral alimentation. Certain particular features emerge concerning valine, isoleucine and leucine which render these three amino acids particularly valuable:--their metabolism is essentially mascular and they escape hepatic control in great part, in contrast to other amion acids;--broken down by muscle, they represent a significant source of energy, sometimes the only available, but may also be used in numerous metabolic processes;--particularly sensitive to hormonal actions, their metabolism is in addition regulated by different non-hormonal factors;--their regulatory role of insulin secretion is considered to be important by many authors;--their original behaviour in certain pathological circumstances, and in particular in malnutrition states, the post-agressive phase and in hepatic failure, has resulted in progress in the physiopathology of these pathological states and above all led to valuable therapeutic deductions;--their toxicity is negligeable and they may be given in large amounts during parenteral alimentation without causin intolerance reactions or severe disturbances in plasma aminograms.

Amino Acids, Branched-Chain↗