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Biomedical subjects

C Vergnes

Publications and source records attributed to C Vergnes.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Fibrinolytic treatment with urokinase and streptokinase for recurrent thrombosis in two valve prostheses for the aortic and mitral valves during pregnancy].

The authors report a case of a patient who had two episodes of valvular thrombosis successfully treated with fibrinolysis using urokinase and streptokinase. They emphasise how efficient these treatments are in spite of the gravity of the initial picture and also point out the dangers and difficulties that can occur because of the risk of haemorrhage in pregnancy, and particularly during delivery and post-partum. They show once more that the treatment is harmless for the fetus. They conclude that using fibrinolytic treatment should be considered first when there is great danger to the patient, and the advantages and disadvantages of thrombolysis should be weighed up.

Adult↗
PubMed1991

[Mitral valve prolapse and angina with normal coronary arteries: research of a thrombogenic factor].

The potential thrombotic risk of mitral valve prolapse may, in certain circumstances, require preventive treatment. This study was aimed at determining whether the presence of angina in patients with mitral valve prolapse and healthy coronary vessels was accompanied by a high-risk thrombogenic profile. Forty two patients (19 women and 23 men) with anginal chest pain and angiographically normal coronary vessels were divided into two populations according to the presence (18 patients) or absence (24 patients) of mitral valve prolapse (MVP) shown by angiography. Before angiography, all patients underwent laboratory studies to detect any possible abnormality of plasma coagulation and of prothrombotic physiological fibrinolysis. Study of subgroups, according to sex and/or the presence of MVP, revealed no significant difference in the profile of laboratory parameters. Thus the presence of angiographic MVP in symptomatic patients free of atherosclerosis is not associated with the existence of any particular thrombotic profile and, theoretically, does not require preventive anti-thrombotic treatment.

Angina Pectoris↗
PubMed1989

[Low molecular weight heparin: an real alternative in thrombolysis in hemodialyzed patients. A trial of coronary thrombolysis].

Fibrinolytic treatments pose serious problems in subjects at high risk for hemorrhage, such as those requiring chronic dialysis. A 36-year-old patient requiring dialysis for the last 14 years due to chronic kidney failure was hospitalized for unstable angina combined with calcified mitral stricture. Prompt coronary arteriography revealed recent intracoronary thrombi. The failure of drug treatment and the surgical indication in light of unstable angina led the authors to use low-molecular-weight heparin b.i.d. for 12 days with monitoring of laboratory parameters (anti-Xa activity, APTT). No thrombotic or hemorrhagic episode was recorded. Control angiography indicating partial lysis of the left and right intracoronary thrombi led to exact evaluation of the residual underlying stenoses. A double aortocoronary bypass was subsequently performed combined with replacement of the mitral valve. This case gives a glimpse of the potential value of low-molecular-weight heparin as a valid alternative to conventional fibrinolysis in subjects requiring dialysis.

Adult↗
PubMed1989

Risk factors for myocardial infarction during coronary artery bypass graft surgery.

Patients with a particular thrombotic profile may be at greater risk of myocardial infarction during coronary artery bypass graft surgery. The thrombotic profile of 50 patients admitted to hospital with stable angina pectoris was determined prior to haemodynamic investigation. ECG results and determination of cardiac enzymes showed that 12 patients had suffered a perioperative myocardial infarction. These patients had a higher mean atherosclerotic score (42.1 +/- 10.5 vs 32.9 +/- 13, P less than 0.02), a longer aortic cross clamp time (59 +/- 15.2 vs 45.7 +/- 16.3 min, P less than 0.05), lower serum levels of protein C (101.2 +/- 26 vs 124.7 +/- 31.4%, P less than 0.05) and tissue plasminogen activator (322 +/- 580 vs 2307 +/- 2830 IU ml-1, P less than 0.01). There were no differences between the two groups in Jenkin's coronary score, the number and type of grafts, ejection fraction, left ventricular end-diastolic pressure, lipid profile or levels of markers of platelet release. In addition to a more severe distal coronary atheroma and a longer aortic cross-clamp time, patients with impaired endothelial fibrinolytic activity appeared to be at greater risk of myocardial infarction during coronary artery bypass graft surgery.

Aged↗
PubMed1989

[von Willebrand's disease and coronary atherosclerosis. Apropos of 3 cases].

The von Willebrand factor (VWF) is a link in the platelet-vessel wall interaction which plays an essential role in the response of the vessel wall to an atherosclerosis-including aggression. However, can von Willebrand's disease really prevent the development of atherosclerosis? The authors report 3 cases of young men aged 36, 40 and 51 years with atherogenic risk factors and von Willebrand's disease (two mild and one severe form). The three patients developed both atherosclerotic lesions and thrombosis. This would suggest that VWF deficiency does not protect humans from atherosclerosis.

Adult↗
PubMed1988

[Recurrent thrombosis of an aortic valve prosthesis in a pregnant woman. Treatment with urokinase].

A 36 year old woman developed two thromboses on aortic valve prosthesis. The first thrombus at the 14th week of pregnancy was treated with urokinase (2,000 U/kg/h) plus heparin (700-1,000 U/h) over 24 hours and normal wing kinetics were obtained. The second thrombus developed at the 36 th week of pregnancy when the patient was receiving calciparin, and only transient improvement was obtained with similar doses of urokinase hourly over 72 hours. Progressive worsening resulted in higher doses (4,000 U/kg/h) being given without heparin and the thrombus then resolved. The use of urokinase for the first time in this indication allowed therefore, on two occasions and without hemorrhagic complications the cure of this recurrent thrombosis on aortic prosthesis, and the birth, by caesarean, of a healthy baby.

Adult↗
PubMed1987

Treatment of deep venous thrombosis with a very low molecular weight heparin fragment (CY 222).

Thirty patients presenting with phlebographically confirmed deep venous thrombosis were treated with a very low molecular weight heparin fragment (CY 222) in an open and prospective phase-2 trial. A uniform dosage of 750 IC anti-factor Xa units/kg/day was administered subcutaneously for 10 days or more to patients whose thromboses were categorized as postsurgical (17 cases) or medical (13 cases). The clinical symptoms of venous thrombosis diminished in 93% of the patients overall. The extent of vascular clearing was assessed by an original scoring system which compared the pre- and posttreatment phlebographies. The effect of treatment was globally rated 'very good' (more than 75% lysis) in 37% of the patients, 'good' (about 50% lysis) in 40% and 'poor' (0-25% lysis) in 17%; the phlebographic thrombosis worsened in 6.6%. Little change occurred in laboratory tests exploring thrombolysis, but a strong anti-factor Xa activity was detected.

Adolescent↗
PubMed1987

[CY 222, a very low molecular weight heparin, in the curative treatment of deep venous thrombosis. Apropos of 95 cases. Clinical and phlebographic results].

Efficacy of a very low molecular weight heparin, CY 222, in the treatment of deep venous thrombosis of lower limbs was evaluated in a prospective clinical trial instituted in November 1984. CY 222 was administered as subcutaneous injections of 0.03 ml.kg-1 daily (750 anti-Xa U.kg-1.d-1) as 3 divided doses over a minimum of 10 days. Efficacy was rated as a function of clinical and phlebographic criteria. The group of 95 patients treated was a heterogenious one: 38% medical, 62% surgical, and 48% of the total group had partial interruption of vena cava previous to study. The period between first clinical manifestations of the deep thrombosis and therapy varied between one day and 3 months (mean: 1 1/2 days). Clinical symptomatology significantly and globally regressed in 88% of the patients. Comparisons between phlebographic findings at start and end of treatment are expressed using Arnesen's score (cf. table).

Drug Evaluation↗
PubMed1987

[Familial protein C deficiency and venous thrombosis].

Constitutional deficiency in C-protein appears to be a very often underestimated or unrecognized cause of thromboembolic disease. C-protein deficiency in a family (father, son and daughter) was associated with clinical manifestations of thrombosis (post-embolic cor pulmonale, fatal pulmonary embolism, post-partum phlebitis), all appearing before 35 years of age. These three cases confirm the absolute need for routine exploration of physiologic inhibitors of coagulation in all young patients with venous thrombosis.

Adult↗
PubMed1985

[Thrombophlebitis and pulmonary embolism in congenital factor XII deficiency].

The case of a young man hospitalised for bilateral lower limb deep vein thrombosis is reported. None of the usual causes were found after systematic wide-ranging investigation. The only abnormality on admission was a spontaneous increase in the cephalin-kaolin time to 65 seconds compared to a control time of 40 seconds. Measurements of the clotting factors showed a moderate and isolated deficiency in factor XII (30 p. 100), also present in a brother (50 p. 100) and a sister (42.5 p. 100). Fibrinolytic therapy was administered : an initial course of Streptokinase was followed by extension of a left femoral vein thrombosis and pulmonary embolism. Two courses of Urokinase were given with an eight day interval without significantly improving the venous circulation. This case is an example of thrombogenic disease due to a deficiency of a clotting factor resulting in non-activation of physiological fibrinolysis.

Adult↗
PubMed1984

[Efficacy and value of fibrinolytic agents in chronic proximal venous thrombosis of the lower limbs].

Forty patients (mean age = 56 +/- 17 years) hospitalized for proximal venous thrombosis of the lower limbs of over 7 days duration were treated with fibrinolytic drugs: streptokinase (SK) 28 cases, urokinase (UK) 12 cases. The efficacy of fibrinolytic therapy was assessed by phlebography before and 4.5 +/- 2 days after onset of treatment. A phlebographic score based on Marder's method was used to quantify the thrombosis. The repermeabilisation of venous branches was also noted. The results show an overall efficacy of fibrinolytic drugs: total lysis was observed in 6 patients and partial thrombolysis in 18 patients. The overall reduction of the phlebographic score was -2.8 +/- 3.9, and the rate of repermeabilisation of the femoral veins was over 50%. Streptokinase seemed to be the most effective drug. Better results were obtained when the thrombosis was treated early and was proximally situated, but good results were also observed in cases of total thrombosis with a floating thrombus. Effective fibrinolysis was observed in thromboses of up to 3 months duration. There was no correlation between biological efficacy and clinical symptoms. In conclusion, fibrinolytic drugs are partially effective in semi-recent or chronic venous thrombosis and their usefulness should not be overlooked, especially in cases of persistent thrombosis of the femoral veins.

Adult↗
PubMedDate not supplied

Assessment of triplet fetal growth by using cross-sectional analysis of the birth weight.

OBJECTIVE: To model the growth of triplets. METHOD: Statistical analysis using data of a consecutive series of 76 triplet gestations (223 livebirths). RESULTS: The best model to describe the growth was linear regression (r = 0.76; r2 = 0.577; p < 0.0001; y = -2,858.05 + 139.66x). 34.2% of the sets had an intratriplet discordance rate of at least 25%, and 11.8% of the triplets had a maximum discordance rate over 40%. CONCLUSIONS: (1) Triplet fetal growth is strongly related to the gestational age; (2) the growth of each triplet in a same set may considerably differ, and (3) the use of singleton curves for triplet growth assessment is inadequate.

Adolescent↗
PubMedDate not supplied

[Sun exposure behavior of children between 3-15 years of age living in Montpellier].

OBJECTIVE: Increasing prevalence of skin cancer over the past few decades and their relationship with childhood sun exposure, show that educational campaigns on sun protection are urgently needed. The aim of this study is to estimate the degree of children's sun exposure in the south of France (43 degrees latitude north) and to study sun protection behaviors according to phenotypic characteristics. POPULATION AND METHODS: The population was a randomly selected sample of 573 schoolchildren between 3 and 15 years of age living in Montpellier. The questionnaire provided information about sociodemographic characteristics, summer sun exposure and sun protection. Phenotypic characteristics, reactivity to sunlight and number of sunburns since birth were also reported. RESULTS: Exposure time was very high: half of children spend over 6 hours per day outside in summer. The youngest children were the most protected either by sunscreen, or by shirt. On the beach, sunscreens were used more than half of the time of exposure by 70 p. 100 of the children. At the swimming pool, sunscreens were used by 45 p. 100 of the children and only by 14 p. 100 of them during other outdoor activities. A tee-shirt was only wore by 50 p. 100 of the children when playing on the beach, and by 75 p. 100 of them at the swimming pool. In addition, the application of sunscreen varied by body site. The adolescents, although they were exposed less than the youngest children, were very poorly protected. Light skinned children who do not tan easily had highest risk of sunburns, although they were generally more protected. CONCLUSION: The parents are able to identify highly sensitive children according to phenotype, but in practice the use of sunscreens and tee-shirt is very low. Parents and adolescents must be the target population but also insufficiently protected children. Health education at school must be an important measure for prevention.

Adolescent↗