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D Robelet

Publications and source records attributed to D Robelet.

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[Postoperative insulinotherapy. Methods and indications (author's transl)].

Postoperative insulinotherapy is widely used not only for diabetics, but also for patients suffering from glycoregulation anomalies induced by stress and parenteral nutrition rich in glucose. The authors point to recent progress in this field resulting from the development of new insulins and new procedures, such as continuous intravenous infusion with a constant flow. The correct management of insulinotherapy can be tabulated in accordance with different possible postoperative situations.

Diabetes Mellitus

[Use of a new solution of synthetic amino acids in postoperative surgical intensive care. Evaluation of the value of nitrogen intake started in the immediate preoperative period].

A new synthetic amino acid solution, Totamine, was studied in pre- and postoperative surgical intensive care in order to determine the possible value of beginning high protein intake during the preoperative period. A comparison was made between two groups of 11 and 15 patients respectively, divided on a strictly random basis, receiving 1200 calories and 12.4 g of nitrogen per day in the forme of Totamine carbohydrate concentrate, starting two days before operation in one of them and on the day of surgery in the other. No statistically significant difference was seen. Calorific and nitrogen intake in both cases appeared to be satisfactory during the early preoperative period and both local and general tolerance of the amino acid solution was excellent. During the late postoperative period, there was a tendency to negativisation of nitrogen balance which justified an increase in calorific and nitrogen intake.

Adult

[Post-operative hyperaldosteronism and related endocrine perturbations (author's transl)].

Electrolytes disturbances during operative period are believed to be related to an hyperaldosteronism produced by anaesthetic management and surgery. Effects of ethrane anaesthesia and surgery on hydroelectrolytic metabolism and endocrin function were investigated in 11 patients submitted to an abdominal surgery. Plasma and urinary levels of aldosterone were increased (x3) significantly (p less than or equal to 0.001) during operation, then decreased gradually in post-operative period, and return to normal values when Na/K ratio is reversed in urines. Relationship between hyperaldosteronism and other changes in endocrine function are established by determination of following hormones: A.C.T.H., cortisol, plasma renin activity (P.R.A.) catecholamines in plasma and urinary levels of 17-ceto, 17-hydroxysteroids and catecholamines. Ethrane anesthesia give a good neurovegetative stability since plasma catecholamines levels are not affected significatively. Plasma aldosterone level is correlated with urinary aldosterone and plasma renin activity. Plasma A.C.T.H. is much more increased at the operative time and decreases rapidly instead of plasma cortisol which decreases more slowly. Relationship of this hyperaldosteronism with anesthetic management, surgical stress intestinal transit disturbances, other endocrine function changes is discussed.

17-Hydroxycorticosteroids

Transfusion lung.

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Adolescent