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Biomedical subjects

D Barnoud

Publications and source records attributed to D Barnoud.

29 records · Page 2Linked to original sources
PubMed1989

[Heterotopic hepatic transplantation in fulminating hepatitis].

Based on a rare case of heterotopic hepatic transplantation (HHT) carried out in a 24 year old woman for fulminant hepatitis of viral origin, the authors present the technique used and the principal post-operative events (rejection, resistant large volume ascites and the clinical course for the liver itself). They discuss the rarity of success in this type of graft, where the causes of failure in man have not been entirely elucidated: the venous pre-existing portal hypertension is probably a very unfavorable factor. The place of this particular type of HHT in cases of acute severe hepatic failure is then proposed: this may produce a smaller operative insult than orthotopic transplantation and, in this respect, deserves consideration when advanced hepatic encephalopathy is present, notably due to delay in finding a suitable graft.

Adult↗
PubMed1987

[Severe neurologic complications secondary to poisoning by slow-release theophylline].

Three cases of severe slow-release theophylline toxicity (plasma theophylline levels above 30 mg/l) in patients with severe chronic pulmonary disease are reported. Seizures were noted in all patients, and one had tachyarrhythmia. Two of the patients died. Several factors were present which may have impaired theophylline clearance, leading to toxic plasma levels. The mortality rate of theophylline intoxication being high, the initial doses should be sufficiently low to minimize the risk of adverse affects, and the best way to prevent theophylline toxicity is to monitor plasma concentrations. A management of patients with theophylline overdosage is suggested: oral administration of activated charcoal is the primary therapeutic measure; haemoperfusion or haemodialysis should be considered only in patients in whom conservative measures have failed.

Aged↗
PubMed1987

[Use of helium and oxygen mixtures in status asthmaticus].

Four patients in status asthmaticus and with alveolar hypoventilation were given a helium-oxygen (He-O2) mixture to breathe during 4 hours. Clinical improvement and return to normal of arterial blood gas levels were rapid and dramatic in all patients. The He-O2 mixture, which is a low density gas, causes a reduction in pulmonary resistance and an improvement in overall alveolar ventilation.

Adult↗
PubMed1985

[Pneumopathies induced by amiodarone. Clinical, paraclinical and physiopathological data. Apropos of 2 cases].

The authors report the cases of two men with coronary artery disease by amiodarone for 8 and 24 months respectively. They developed clinical and radiological changes of diffuse interstitial pneumonia, characterised by an inflammatory syndrome, restrictive changes on spirometry, reduced CO transfer and abnormal blood gases. Broncho-alveolar lavage showed a lymphocytosis with a large quantity of iodine in the macrophages and the presence of amiodarone and its metabolite in the supernatant fluid. The responsibility of this drug is imputed and the patients were cured within 3 months of its withdrawal with regression of clinical, radiological, spirometric and control alveolar lavage abnormalities. A favourable outcome without steroid therapy is practically unknown in the literature. These cases illustrate the possible risk of alveolitis or diffuse interstitial pneumonia during long term amiodarone therapy, the pathogenesis of which is discussed: iodine overload, direct drug toxicity or an immunological mechanism.

Aged↗
PubMed1981

[A new clinical entity: "the algodystrophic intermittent claudication of the lower limbs syndrome" (author's transl)].

A new clinical entity is proposed by the authors, "the algodystrophic intermittent claudication of the lower limbs syndrome", characterised by diffuse pains in the foot, having neither a constrictive nature, nor a radicular distribution. The pain appears after walking a certain distance, forcing the patient to stop, and reappears when he starts to walk again. Bone isotopic examinations and repeated radiographic investigations should be conducted when confronted with such a clinical syndrome in order to confirm the diagnosis of algodystrophy. In view of the polymorphic nature of this affection, it is not surprising that new clinical aspects can still be described at the present time.

Arteritis↗
PubMedDate not supplied

Effect of parenteral medium- and long-chain triglycerides on lymphocytes subpopulations and functions in patients with acquired immunodeficiency syndrome: a prospective study.

BACKGROUND: Total parenteral nutrition (TPN) may offer significant clinical benefit in malnourished patients with acquired immunodeficiency syndrome (AIDS). However, the immunologic effect of parenteral lipids remains unknown in these severely immunodepressed patients. METHODS: We undertook a prospective randomized double-blind multicenter study comparing the effects of two i.v. lipid emulsions used during TPN: long-chain triglycerides (LCT) or balanced emulsion of long-and medium-chain triglycerides (LCT/MCT). Thirty-three AIDS patients requiring TPN for wasting and reduced oral intake were allocated randomly to receive a ternary TPN mixture consisting of 1.5 g/kg/d proteins, 18 kcal/kg/d lipids, and 12 Kcal/kg/d carbohydrates for 6 days. The following tests were performed at days 0 and 7: immunoglobulins, complement fractions, lymphocyte subpopulations count, and lymphocyte proliferation with mitogens. RESULTS: Patients were all severely malnourished (weight loss: -14.0 +/- 1.3 kg). No clinical or biological differences were observed between the groups at baseline. At day 7, both groups reported a significant increase in weight. Patients in the LCT group exhibited a significant decrease in phytohemagglutinin A response (p = .04) compared with baseline. Patients in the LCT/MCT group exhibited a lower level of IgM (p = .03) and significant increase in C3 fraction (p = .03) compared with baseline. They also showed a tendency to have a higher CD4/CD8 lymphocyte ratio (p = .07), whereas other immunological parameters remained unchanged CONCLUSIONS: Parenteral ternary mixture containing LCT or LCT/MCT are clinically well tolerated in AIDS patients over 6 days. With 2 g/kg/d of lipids, LCT seems to induce significant abnormalities in lymphocyte function. Such abnormalities are not observed with LCT/MCT.

Acquired Immunodeficiency Syndrome↗