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Biomedical subjects

C Richart

Publications and source records attributed to C Richart.

At least 19 recordsLinked to original sources
PubMed1992

[Syncope as presentation form of pulmonary thromboembolism. Study of 15 cases].

BACKGROUND: To evaluate the prevalence of syncope as a form of presentation of pulmonary thromboembolism (PTE) in the emergency department of a general hospital. METHODS: All the cases of PTE having gone to the emergency department between May 1983 and July 1989 were collected. A radiography of the thorax, arterial gasometry, an electrocardiogram and a pulmonary perfusion scintigraphy were performed in each patient. Ventilation scintigraphy and/or pulmonary DIVAS were also carried out when necessary. RESULTS: Of a total of 63 patients, 15 (24%) had a syncope as a primary manifestation. No significant differences were observed in regards to predisposing factors between the syncope group (S) and the non-syncope group (NS) with there being a predominance of women in the S group (p less than 0.05). Furthermore, the S group had a greater prevalence of tachycardia, hypotension, electrocardiographic changes, pleural effusion and perfusion defect greater than 50% in the pulmonary scintigraphy. CONCLUSIONS: PTE should be discarded in any patient with a clinical picture of syncope with hypotension and tachycardia, especially if female. When PTE is presented as a syncope it is generally a massive embolism.

Adult↗
PubMed1992

Mercurialis annua pollen: a new source of allergic sensitization and respiratory disease.

Sensitization to Mercurialis annua pollen in 13 patients admitted for allergy study of asthma, rhinitis, or rhinoconjunctivitis is described. Twelve of these patients were also sensitized to other common aeroallergens. In five patients, a relationship was found between exposure to M. annua pollen and elicitation of symptoms. All patients were prick test and RAST positive to an extract of M. annua pollen. Nasal provocation test proved positive in 10 of 12 patients, and bronchial provocation test was positive in the only patient in whom it was performed. Two late responses were recorded. Immunoblotting of the 13 sera revealed two different groups of relevant allergens; one of isoelectric point 10.2, reacting with 12 of the 13 sera, and the other allergen of isoelectric point 5.0 to 5.5, reacting with 11 of the 13 sera. M. annua pollen is able to induce both sensitization and clinical disease in atopic patients. Since sensitization to this pollen accounts for 8.5% of total positive skin tested patients in the same period, we believe M. annua pollen should be considered as a relevant allergen and thus included in skin test batteries. Some patients labeled as having "intrinsic" asthma or rhinitis might be sensitized to this and other previously unknown allergens.

Adolescent↗
PubMed1992

Long-term myocardial effects of correction of anemia with recombinant human erythropoietin in aged patients on hemodialysis.

Long-term myocardial effects of recombinant human erythropoietin (rhEPO) therapy were investigated in nine hemodialysis (HD) patients greater than 60 years of age. Echocardiographic studies were performed before the administration of rhEPO with a hematocrit of 20.8% +/- 1.9% and repeated after 6 (period I) and 24 months (period II) of treatment, when the hematocrit was increased to 34.1% +/- 2.3% and 32.3% +/- 2.8%, respectively. Left ventricular diameters were not significantly changed by rhEPO, although they tended to decrease at the end of the study (30.6 +/- 5.3 v 27.7 +/- 3.6 mm systole, and 50.3 +/- 3 v 46.5 +/- 3.7 mm diastole). Thickness of the interventricular septum and left ventricular posterior wall remained unaltered, although there was a downward trend (14.5 +/- 5.2 to 12.8 +/- 2.8 mm and 11.7 +/- 1.9 to 10.6 +/- 1.4 mm, respectively). Left ventricular mass index (LVM) progressively decreased from 181.5 +/- 61 to 153.8 +/- 38.3 (period I) and 135.7 +/- 45.6 g/m2 (period II, P less than 0.05). Stroke volume remained unaltered in period I, but it decreased from 93.7 +/- 10 to 65.2 +/- 12.8 mL (P less than 0.001) in period II, resulting in a decrease of cardiac index (CI) from 3.93 +/- 0.86 to 2.54 +/- 0.68 L/min/m2 (P less than 0.001) at the end of the study. Heart rate did not change during the study period. Blood pressure was kept constant, although antihypertensive therapy needed to be adjusted to prevent occurrence or aggravation of hypertension in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Pulmonary diffuse amyloidosis and ankylosing spondylitis. A rare association.

We report herein the association of primary pulmonary amyloidosis and ankylosing spondylitis. To our knowledge, this rare association has never been reported. This case reemphasizes that not all pulmonary complications that appear in the course of ankylosing spondylitis are related to the seronegative spondyloarthropathy. Primary pulmonary amyloidosis should be considered in patients with interstitial pulmonary disease.

Amyloidosis↗
PubMed1992

[Macrocreatine kinase, a cause of MB isoenzyme levels falsely elevated].

The authors describe two cases of falsely elevated CPK-MB levels due to the presence of a Macro-CPK. The quantification of the mass of CPK-MB gave values lower than the cut-off level. Electrophoresis of CPK isoenzymes showed a type 1 Macro-CPK in one case and a type 2 Macro-CPK in the other. The authors recommend electrophoresis of CPK isoenzymes or quantification of mass if the clinical evolution or ECG changes do not correlate with the CPK-MB levels or if there is a low global CPK with high CPK-MB levels.

Aged↗
PubMed1992

[Macro CK type 2 as a cause of a false increase in CK-MB].

A case of CK-MB falsely elevated activity due to the presence of a macro CK is reported. The MB quantification showed inferior levels to the pre-established cut-off. The CK isoenzymes electrophoresis showed a type 2 macro CK. We suggest carrying out CK isoenzyme electrophoresis of CK-MB quantification in those cases in which the clinical course or ECG changes do not correlate with the CK-MB values, and in cases presenting low whole CK activity values along with high CK-MB values.

Aged↗
PubMed1991

[Evaluation of a program for the care of the diabetic. A 40-month continuity study].

BACKGROUND: To evaluate the long term efficacy of a program of attention to diabetes mellitus. METHODS: A continued 40-month follow-up study in a group of 47 diabetic patients treated with insulin (21 type I and 26 type II) with a mean age of 45.8 years and a mean duration of diabetes of 8.1 years. These patients were seen in the hospital outpatient clinic during the initial 12 months and in community clinics during the remaining 12 months. RESULTS: Mean basal glycemia (7.4 +/- 1.5 mmol/l) and HbA1 (8.3 +/- 1.1%) at 40 months were significantly lower than those in the initial 12 months (8.8 +/- 2.4 mmol/l and 9.2 +/- 1.2%; p less than 0.001) and in the beginning of the study (4.2 mmol/l and 11.2 +/- 1.9%; p less than 0.0001). In type II diabetics, cholesterol and triglyceride levels showed a significant reduction from the mean first year levels (6.2 +/- 0.9 and 1.6 +/- 0.9 mmol/l) to those in the 12-40 months period (5.8 +/- 0.8 and 1.3 +/- 0.5; p less than 0.01 in both instances). Initially, 22 diabetics (46%) used rapid acting insulin; at the end, 37 had included these preparations in their treatment (78%; p less than 0.001). Only 7 patients (14%) used multiple insulin doses at the beginning. After 40 months, 29 (61%) were treated with 3-4 insulin injections per day (p less than 0.0001). In 43 patients (91%) no severe hypoglycemic crisis had developed. In 45 (95%) macroproteinuria was not detected and 40 (85%) had not developed microangiopathic lesions in the retina or microangiopathic involvement elsewhere as evaluated with the available techniques. Psychical depression was evaluated at 40 months using a semiquantitative scale questionnaire. The overall responses in the intervention group (n = 20; 25.4 +/- 4.6) showed lower depression levels (higher scores) than a control group ( n = 22; 22.4 +/- 4.9; p less than 0.02) constituted by diabetics with similar characteristics but who had not been following the program. CONCLUSIONS: The programs for the attention to the diabetic are effective in the long term to achieved and sustain metabolic control, the acquired knowledge and, to a sizeable degree, the compliance with therapy, provided that they integrate the teaching with the treatment. It is very likely that these programs reduce the risk of late features of the disease and the tendency to depression, independently from the place where the patient is controlled.

Adolescent↗
PubMed1979

[The usefulness of the quantitative evaluation of the plasma levels of the carcinoembryonic antigen (CEA) in patients with respiratory neoplasms (author's transl)].

Plasma concentration of the carcinoembryonic antigen (CEA) was determined by radioimmunoassay in 80 patients affected with different neoplasms of the respiratory system, among which the most predominant was bronchial carcinoma. For this type of tumor the results showed a percentage of positivity of 69 percent, with a greater value in the disseminated neoplasias (81 percent) in comparison with those which were localized (48 percent). The concentrations of the antigen were greater in the metastatic tumors; in 55 percent of the cases levels above 40 ng/ml were observed. On the other hand this figure was reached only by 4 percent of the localized tumors. Values of the antigen higher than 40 ng/ml should lead to the suspicion of the existence of neoplastic widespread. Among the rest of the series the negativity noticed in all the cases of pleural mesothelioma stands out, and indicates that this type of tumors does not produce CEA.

Adenocarcinoma, Bronchiolo-Alveolar↗