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Biomedical subjects

E Bertrand

Publications and source records attributed to E Bertrand.

At least 19 recordsLinked to original sources
PubMed1992

Comparative auto-controlled study between swim-up and Percoll preparation of fresh semen samples for in-vitro fertilization.

This study compared swim-up and Percoll preparation of fresh semen samples for in-vitro fertilization. Sixty trials of in-vitro fertilization (IVF), 38 with normal semen and 22 with abnormal semen, comprising 734 oocytes were included in the study. Each semen sample was prepared by both a swim-up technique and a simplified discontinuous (50%, 70%, 90%) Percoll gradient. The oocytes for each trial were distributed at random between the two sperm preparations and incubated with the same number of motile spermatozoa. Percoll gradient preparation produced a significantly higher final concentration of spermatozoa than swim-up preparation (mean +/- SEM: 6.6 +/- 1.5 x 10(6)/ml versus 1.9 +/- 0.2 x 10(6)/ml; P less than 0.01) but a significantly lower sperm motility (69 +/- 2% versus 94 +/- 1%; P less than 0.001) and a lower number of normal forms (55 +/- 2% versus 64 +/- 2%; P less than 0.01). The ability of the Percoll gradient method to extract motile spermatozoa was higher than that of the swim-up technique (20 +/- 15.6% versus 0.8 +/- 13.6%). Nevertheless, the rates of fertilization (61%), fertilization failure (18%) and polyspermia (9%), embryo quality evaluated by mean embryo scores (3.8 +/- 0.3) and the mean number of spare embryos frozen per trial (1.4 +/- 0.3) were strictly identical in both groups. The 24 pregnancies (including three from frozen--thawed embryos) obtained in these 60 trials (40% per oocyte retrieval) could not be separated according to the sperm preparation method, as embryos from both groups were replaced together.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Separation↗
PubMed1992

Rheumatic heart disease in Africa.

Rheumatic heart disease continues to be relatively common in many parts of Africa, predominantly affecting young people. Special attention should be given to its prevention by the inexpensive methods that have proved effective elsewhere, and to this end assistance should be provided by the international community.

Adolescent↗
PubMed1992

[Coronary disease in black Africans: epidemiology, risk factors, clinical symptomatology and coronarography, evolution].

The study of the epidemiological data (published since 1952) seems to show an increasing frequency of the coronary disease for 15 last years. But this incidence seems to reach a stable level about 6 to 7% of the cardiovascular diseases at the Abidjan Institute of Cardiology; and 3.17% in a study in 13 countries but without coronarography (except at the Abidjan Institute). The study of the risk factors show that they are the same ones than in Europa. The risk index in Black Africa was 2.1 to 2.7 risk factor patient. These numbers are lesser than the risk index noted in France (3.6 in coronary patients and 1.9 in non-coronary subjects). The signs of the disease show that myocardial infarctions were frequent (48.8%) and often were the first manifestations of the coronary disease (40%). Angina pectoris was observed in 32.2%, an ischemic cardiomyopathy in 6.6% and a ventricular aneurysm in 6.6%. A silent ischemia was observed in 5.5% among at risk diabetic patients. The in-hospital mortality after myocardial infarction was 15% and was the same in European and African patients. But the mortality in Africans was greater than in Europeans the next years. Coronarography showed that 18.8% of the patients with coronary disease had normal coronary arteries. The arteries were also normal in 19.9% of the patients examined after an infarction. These high percentages can be related to coronary arterial spasms or to recanalized thrombosis. A spontaneous spasm was observed in 6.6% of the patients (a provoked coronary arterial spasm was not studied. The coronary arterial lesion was an one artery disease in 38.8% of the coronary patients and 50% of the patients with infarction. The stenosis were frequently proximal (82.6%) and the anterior descending artery was interested in 45.6%. Ventricular aneurysms were observed in 56.6% and the ejection fraction was lower than 0.50 in 63.3%. These data permit to compare the myocardial infarction of Blacks with the myocardial infarction of the young occidental men. We can think that thrombolysis or angioplasty would be very useful but they are often impossible in the Black African conditions.

Africa↗
PubMed1992

[Acute thrombosis of the brachial artery and beta-thalassemia-sickle cell anemia].

The authors report about one case of left branchial arterial thrombosis in a 6-year-old child with thalassemia-sickle cell disease. In their opinion, although this hemoglobinopathy usually causes microthrombosis, its existence at the same time as that of the brachial thrombosis does not seem to be a coincidence. The actual origin of this disease remains to be found, as well as the role that thrombocytosis may play. The authors emphasize the relative rarity of thrombolytic arterial diseases in African Negroes and advise practitioners to recognize them, because their diagnosis, often established late in our climates, has severe consequences.

Acute Disease↗
PubMed1991

[Development of echocardiographic and Doppler parameters after orthotopic cardiac transplantation, except during rejection periods].

The aim of this study was to evaluate spontaneous changes of Doppler and echocardiographic parameters of cardiac transplants in the absence of rejection. Based on 258 recordings representing the follow up of 30 patients after orthotopic cardiac transplantation in the absence of histological signs of rejection on biopsy within 24 hours, we tried to define: the evolution of these parameters from the first postoperative week to after the 30th month (average 12 months); the Doppler echocardiographic values of "normal" transplants: the values observed one year after surgery were compared with a control group age-matched to the donors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Transposition of the great vessels in western Africa. Apropos of 17 cases observed at the Institute of Cardiology in Abidjan].

During the last 10 years, 17 children with transposition of the great arteries (TGA) were admitted to the Cardiology Institute of Abidjan: 1 case between March 1978 and December 1985, 16 cases between January 1986 and December 1989. The average age was 58 days (range 5 to 270 days) at the first consultation, and 90 days (5 to 270 days) at the time of admission. The diagnosis was confirmed by echocardiography and hemodynamic investigation in 12 cases. There were 9 simple forms of TGA, 7 with ventricular septal defects (VSD) and 1 with VSD and pulmonary stenosis. Two children were taken back by their parents before any treatment was given. A Rashkind atrial septostomy was carried out in 11 children which increased aortic oxygen saturation from 35 +/- 18 percent to 57 +/- 19 percent; there were 3 unsuccessful procedures in children aged 2, 3 and 5 months with 2 deaths. Five patients later underwent surgical correction by a Senning procedure in 4 cases and anatomical correction in 1 case with VSD. All are well after an average 15 months follow-up (1 to 48 months). One of the 8 children awaiting surgery died. Therefore, TGA is not a rare abnormality in Black Africa; it represents 2 percent of the 887 cases of congenital heart disease observed during the same period. The inadequacy of means of diagnosis is certainly the cause of the relatively low incidence of this malformation, of the considerable delay in under specialist care and, as a consequence, of the greater difficulties in treatment, especially with regards to atrial septostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiocardiography↗
PubMed1989

[Generalized form of cerebral actinomycosis].

The here presented case was a woman 82 years old suffering for many years of arteriosclerotic Parkinson syndrome. During the last 8 months of her life she exhibited excessive talk flow and states of delirium. Twelve days before death she had a generalized attack of convulsions and the consciousness disorder increased. Moreover, meningeal symptoms were observed, a right side reflex syndrome with Babiński sign and temperature up to 38 degrees C were noted. Death occurred on the 9th day of hospitalization with symptoms of increasing circulatory-respiratory insufficiency. Pathomorphological examination revealed in the myocardium, lungs, liver, kidneys and thyroid multiple purulent foci containing actinomycotic granules. Neuropathological examination revealed both in the cortex and white matter the presence of numerous disseminate bodies staining intensively with HE, PAS- and Gram-Weigert positive and negative in the Ziehl-Nielsen method. Their structure, compact or fine-powdered corresponded to actinomyces colonies. They either showed no reaction or were surrounded by a wall of inflammatory cells such as: neutrophilic leucocytes, lymphocytes, plasmatic cells and histiocytes. The microabscesses were not encapsulated. The case was classified to a diffuse form of brain actinomycosis. The etiopathogenesis of the changes and the clinical-morphological correlations of this very rare infectious disease of the central nervous system are discussed.

Actinomycosis↗
PubMed1989

[Clinico-morphologic correlations in cerebral infarction after recurrent hemorrhage].

Clinical-morphological analysis of cases in which, in the course of vasogenic necrotic brain lesion, hemorrhagic foci appeared within the infarcted area, was performed. The material comprised 355 cases with encephalomalacia (223 women and 123 men). The patients died at age between 39 and 96 years. In the clinical picture a sudden onset of the disease prevailed, with hemiparesis or hemiplegia associated in 216 cases with disturbances of consciousness. The course of the disease was in general progressive. Only in 30 patients improvement of clinical state was observed. The time of survival varied from several hours to several weeks. Most patients (140) died in the first week in deep cerebral coma or state of decerebration. In nine cases clinical symptomatology of herniation and secondary hemorrhages into the brain stem was found. A sudden onset and violent course of the disease resulted in a diagnosis of primary hemorrhage with penetration to the subarachnoid space or ventricular system in 32 patients. Only in six cases was a secondary hemorrhage into the primary infarction diagnosed clinically. Hemorrhagic malacia was most frequently (in 255 cases) located in region vascularized by the middle cerebral artery and very seldom, the basilar artery or cerebellar arteries. Malacia was accompanied by considerable brain edema. This was particularly intense in extensive infarctions and persisted even in cases with considerable long survival. In 45 cases secondary hemorrhagic foci were found within brain stem. The morphology of the infarction foci was variable in most cases. Independently to fresh unreactive diffuse necrosis, sometimes areas with various advancement of resorption and organization processes were observed in the same case. Both in areas of fresh reactionless malacia and of advanced macrophage-glial disintegration, or even in areas of advanced gliomesodermal organization, stand-like or spherical hemorrhages could be seen merging sometimes into extensive pools. The morphology of hemorrhagic foci was largely dependent on their size and localization. The hemorrhagic foci located close to the depth of the cortical sulci very often destroyed the cortex and white matter, and penetrated to the subarachnoid space (141 cases). In was usually almost impossible to detect the source of bleeding within the necrotically changed area. The resorption reaction at the edge of extensive hemorrhagic foci was in general minimal. A lesion of the vessel wall, caused by stasis of long duration, resulting from disorders of the vascular function in the course of defficient blood supply and ischemic brain edema are considered the main causes of bleeding into the pale infarction.

Adult↗
PubMed1988

[Chronic left parietal endocarditis. Clinical, paraclinical and peroperative study of 22 cases].

From 22 patients with left chronic parietal endocarditis (CPE), conducted an epidemiological, clinical, paraclinical and per-operative study. The CPE is frequently encountered in the Ivory Coast in Akan children living in forest areas in 81 p. cent of the cases. It causes a mitral insufficiency, of the which the essential mechanism is fibrosis of the sub-valvular apparatus. The clinical examination is that of a severe advanced mitral insufficiency. Cardiomegaly is the rule. In 31 p. cent of cases, the ECG shows a Qr in V1. The dip plateau on the apexocardiogram is never found and the protodiastolic endocardial resonance is inconstant on phonomechanical processor. The aspect in M of the interventricular septum, found in 72 p. cent of the cases on echo TM is of major importance when direct signs are missing on bidimensional sonograms. Angiocardiography remains the reference diagnostic examination. But only the surgical survey enables to demonstrate limited forms.

Adolescent↗
PubMed1987

[The Flack test: a test exploring the sinus function in athletes. Apropos of 351 tests].

A standardized Flack's test with continuous electrocardiographic recording was performed in 351 moderately trained athletes (317 men and 34 women; mean age 23.7 years). The test gave normal results in 310 subjects (88.3%). Tachycardia in excess of 100 beats/min was observed in 12 subjects (3.4%), and 56 abnormalities which were not present on previous ECG recordings at rest were noted in 29 subjects (8.3%); 27 of these abnormalities appeared immediately after a previous one. Out of these 56 abnormalities, 26 (44.6%) were associated with sinus dysfunction: sinus bradycardia in 8 cases, second degree sinoatrial block in 2 cases, third degree sinoatrial block in 3 cases and sinus arrest in 13 cases. In 16 cases of third degree sinoatrial block or sinus arrest escape rhythms were observed, including coronary sinus rhythm (3), junctional rhythm (12) and accelerated idioventricular rhythm (1). Five of the 56 abnormalities (8.9%) were disorders of conduction, i.e. first or second degree atrioventricular block, atrioventricular dissociation and blocked P waves. These disorders are known to be frequently associated with sinus dysfunction. In 9 out of 56 abnormalities (16.1%) disorders of excitability were present as atrial, junctional and ventricular extrasystoles. In 8 subjects the Flack's test resulted in the disappearance of disorders of conduction or excitability of the "athlete" type present at rest, as the Ruffier-Dickinson test, or the cycloergometric exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Comparison of platelet activity, fibrinolysis and environmental factors in 50 Africans and 50 Europeans. Role of fish consumption].

The authors have studied 50 Ivorians and 50 Europeans people, all living in Abidjan for at least 10 years. Platelet aggregability with increasing ADP concentration (0.6, 1.2, 2.4 mumoles/l), collagen (0.4 mg/l), or ristocetin (1 g/l) was examined. Fibrinolysis and the euglobulin test were also studied before and after anoxia. Other blood parameters measured were: hematocrit, hemoglobin level, platelet count, bleeding time, Howell coagulation test, cephalin tests, prothrombin activity ratio, fibrinogen level. Metabolic tests included: glycemia, cholesterolemia, triglyceridemia, uricemia, A1 and B apoproteins, protidemia, gamma globulinemia. Environmental factors such as physical activity, alcohol and smoking habits, fish consumption, chloroquine prophylaxis were evaluated. The most evident result was lower platelet aggregability in Ivorian people as compared to Europeans. A more precocious and important fibrinolysis activity, either spontaneous or after anoxia was noted in the Ivorian group. Lower platelet number, fibrinogen level, and prothrombin activity were present in the Ivorian group as compared to the European people. The authors eliminated the influence of age, and considered environmental factors as predominant in the genesis of such difference, i.e., hypocholesterolemia, lower smoking and drinking levels. They emphasized the higher fish consumption in Ivorian people.

Adult↗
PubMed1987

[Cardiac hypertrophy, dilatation and performance in top athletes].

The authors have studied three groups of patients: 12 reference patients (REF) leading a sedentary life; 22 athletes of international fame, practising an endurance sport (END), including 10 long distance and middle-distance runners, 12 cyclists and 12 top (RES) athletes practising a resistance sport i.e. 12 sprinters. There is no age difference between the two groups. The RES have a larger body area than the REF and END. The cardiac frequency is lowered in the athletes without any difference between RES and END. There is no difference as far as the athletes' blood pressure is concerned. On the EKG, the Sokoloff index is significantly higher in END than in REF and RES. Sonographic data were especially analyzed. END present a hypertrophic myocardium and ventricular dilatation. The hypertrophy, more assymmetrical than that of RES, is more marked at the level of the septum. There is a non-significant tendency toward an excentric hypertrophy. RES present a marked hypertrophy with little or no dilatation. This hypertrophy is more symmetrical and concentric than in END patients. As far as the pump function is concerned (FR, FE, VES): it is not altered in RES (this fact is found in the literature). On the contrary, in END patients, the pump function (FR, FE) is diminished (this fact is debated in the literature), in spite of an increased systolic ejection volume. The total contraction function is not altered in RES nor in END patients. An increased septal contraction rate is noted, which is significant in RES patients and non-significant in END patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Silent coronary artery disease in black African diabetic patients. A prospective study of 50 patients.

Silent coronary heart disease (CHD) has been researched among a sample of 50 black African diabetic patients in a prospective study. The diabetic patients were chosen on the following criteria: male sex, age ranging from 40 to 60 years, absence of history of CHD, normal EKG. A stress test was performed in all cases. A coronary arteriography was done each time the exercise test was positive, doubtful or non-conclusive. This study has shown a prevalence of 10% CHD:31 exercise test negatives, 17 exercise test non-conclusives, 2 exercise test positives, 5 coronary arteriography with significant narrowing. There were 3 patients with one vessel disease (LDA: 2 cases, CFX: 1 case), one patient with double vessel disease (CFX, RCA) while another had a triple vessel disease (RCA, LDA, CFX). Proximal lesions were encountered in 5 cases and distal lesions in 3 cases. The authors conclude that CHD exist in a silent state among black African diabetics. Its prevalence is lower than in white diabetics. The coronary lesions are mostly limited. Proximal narrowing and one vessel disease were mostly encountered.

Adult↗
PubMed1986

[Infectious endocarditis surgically treated during the acute phase. 26 cases].

Twenty-six patients with infective endocarditis were operated upon during the active phase. The endocarditis was native in 24 cases and developed on cardiac valve prosthesis in 2 cases. Depending on the valve involved, the patients were divided into 3 groups: Ao (aortic valve, n = 13), M (mitral valve, n = 10) and T (tricuspid valve, n = 3). The overall mortality rate was 26% (group Ao 20%, group M 20%); death was due, in most cases, to haemodynamic failure. The duration of pre-operative antibiotic therapy, the functional stage of the disease and the cardiothoracic ratio had no influence on post-operative prognosis. In contrast, the presence of vegetations (notably on the aortic valve) at echocardiography and the pumping and aortic clamping times played a role in operative mortality. Twelve patients were followed up for a mean period of 23.9 months. They are all in stage I or II with significant decrease in cardiothoracic index. In Africa, where bacteriological facilities are often inadequate and cardiac valve diseases are diagnosed at a late stage, infective endocarditis is active in many cases. Under these conditions, early surgery is justified when heart failure is present and the infection is not clinically controlled.

Acute Disease↗