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Biomedical subjects

F Baud

Publications and source records attributed to F Baud.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Follow-up angiography of 100 revascularizations of the anterior interventricular artery by the left internal mammary artery].

One hundred and fifty patients who underwent revascularisation of the left anterior descending artery (LAD) by the left internal mammary artery (LIMA) between 1981 and 1983 were recalled for control coronary angiography one year after surgery. One hundred patients gave consent. The patency rate in these 100 patients was 90 per cent. The presumed causes of the 10 thromboses observed were: for LAD (5 cases), technical problems (3 cases), competitive flow (2 cases). Ten per cent of the patent LIMA grafts were abnormal: moderate stenosis of the anastomosis (5 cases), small LIMA (3 cases), stenosis of the middle segment of the LIMA (1 case). In addition, we observed 7 cases of competitive flows: 3 cases with a LAD which was not sufficiently stenotic, 4 cases with a large saphenous diagonal bypass graft. If a diagonal artery bypass is necessary, it is better to revascularize by either a latero-lateral anastomosis with the LIMA or by using the right IMA. Ninety per cent of the patent grafts were quite satisfactory ar 1 year: regular, supple, and perfectly congruent with the bypassed artery which was injected massively. As a number of North American teams have shown, this good patency rate seems to be maintained at long term, which is not the case with saphenous vein bypass grafts.

Coronary Angiography↗
PubMed1986

[Heart transplantation 1985. Experience of the Pitié].

Heart transplant surgery has come of age over the last four years, after 17 years of clinical application: indications have been specified, techniques systematized and treatment and post-operative follow-ups have been clarified. The results are remarkable: survival at four years is more than 80 per cent, with normal socio-familial and often professional reintegration for almost all heart transplant patients. Increased application of heart transplant surgery in the months to come will transform prognosis in patients presenting irreversible cardiac lesions, but will raise the problem of the supply of donor organs.

Adult↗
PubMed1986

A radioimmunoassay for the antimalarial drug chloroquine.

We describe a 3H-based RIA for the antimalarial drug chloroquine (CLQ), the most commonly used antimalarial drug. In the assay a monoclonal antibody is used that is directed against 4-amino-7-chloroquinoline conjugated to keyhole limpet hemocyanin by the glutaraldehyde method. Besides CLQ, this antibody also recognizes with good affinity the 4-aminoquinoline homologs, hydroxychloroquine and amodiaquine. No extraction step or sample preparation is required, and the method can detect as little as 10 micrograms/L, the lower concentration in plasma of humans who are taking CLQ as a preventive measure. The between-assay CV is less than or equal to 10%, the within-assay CV less than or equal to 3%. Results correlate with those by liquid chromatography (r2 = 0.96). The speed and simplicity of the RIA method make it useful in evaluating the CLQ concentrations in acutely toxic patients.

Antibodies, Monoclonal↗
PubMed1984

[Cyanide poisoning. Priority to symptomatic treatment. 25 cases].

A retrospective study of 25 cases of cyanide poisoning has brought to light the following points: cardiorespiratory arrests are frequent (7/25) and often inaugural; in severe intoxications (7/25), deep metabolic acidosis is the rule, and cyanide poisoning should always be suspected in cases of coma with severe acidosis; mild intoxications are frequently symptomless. Anxiety and agitation should not be considered as evidence of cyanide poisoning; they are merely due to fear in most cases. The present treatment of acute cyanide poisoning relies basically on symptomatic measures: sodium bicarbonate, cardiac massage and, above all, assisted ventilation with 100% oxygen. Our experience does not support the concept of a lethal cyanide blood level when patients can rapidly be transferred by a medical team to an intensive care unit. Survival depends more on prompt medical care than on the accessibility to sophisticated antidotes.

Acidosis↗
PubMed1984

Surgery of prosthetic valve thrombosis.

From January 1978 to August 1983, 41 prosthetic valve thromboses in 34 patients were operated upon in our service. They comprised 15 aortic, 25 mitral and one tricuspid valve thromboses. Seven patients had massive thrombus with dysfunction of the prosthesis; others had small and disseminated thrombi on their prosthesis (34 patients). In the aortic position, valve thrombosis occurred on 10 ball valves and 5 pivoting disc valves. In the mitral position, they occurred on 17 ball valves, 7 pivoting disc valves and one bioprosthesis. In 2 cases, aortic valve thrombectomy was successfully done. Others had valve replacement. Hospital mortality was high: 13 deaths. Survivors are free of recurrent valve thrombosis. One had a minor peripheral embolus. Prosthetic valve thrombosis is a serious condition. There are special problems related to diagnosis and treatment of these patients which we discuss, according to our experience of more than 4000 valvular replacements.

Adult↗
PubMed1984

[Endocavitary removal of catheter fragments which had migrated into central cardiac cavities].

Five cases of endocavitary recovery of embolised fragments of catheter are reported. In three cases, the Dotter apparatus was used with a percutaneous approach. In the other two cases, a Dormia catheter was introduced after surgical venous cut-down. The embolised catheters were all recovered successfully in periods ranging from 10 minutes to 1 hour. Local anaesthetic was used in one case. The interval between initial rupture and recovery of the catheter ranged from several hours to 2 months. No complications occurred during or after these manoeuvres. This is a simple, rapid, and economical method which may save the patient from thoracic surgery, and should always be kept in mind.

Catheterization↗
PubMed1983

[Intraoperative insertion of a catheter to measure left atrial pressure].

In the procedure described an ordinary intravenous catheter with its normal trocar is passed through the abdomino-thoracic wall, and the trocar is removed. Another trocar with a longer (3 cm) bevel is then introduced into the heart, the long bevel ensuring that the trocar is in the lumen of the left atrium only. The tip of the catheter, slightly bevelled in situ, is pushed into the atrium along this second trocar, which is then removed. This simple and safe technique facilitates measurements of left atrial pressure during the post-operative period in open-heart surgery.

Atrial Function↗
PubMed1983

[Pure defibrination after timber rattlesnake bite].

The only disorder of coagulation observed after a timber rattlesnake (Crotalus horridus) bite was a total absence of fibrinogen which lasted 64 hours despite hourly administration of cryoprecipitates. The pure defibrination experimentally obtained with this particular species of crotalid snakes underlines the specificity of the coagulation disorder and the impossibility of identifying the coagulopathy induced by venom poisoning without laboratory examination.

Adult↗
PubMed1983

[Acute hepatitis caused by isaxonine phosphate (Nerfactor)].

We report the cases of four adult patients suffering from acute hepatitis due to isaxonine phosphate (Nerfactor), a drug recently proposed for the treatment of the lesions of peripheral nerves. Hepatitis developed 14 to 166 days after the beginning of the administration of the drug. In all the patients, predominantly centrilobular hepatocytic necrosis was present. In two of our patients, the course of hepatitis was fatal. Hepatitis induced by isaxonine phosphate is likely to be due to an immuno-allergic mechanism.

Acute Disease↗
PubMed1983

[Inhalation pneumonia in toxic comas. Apropos of 200 cases with 4 deaths].

In 1946, Mendelson described 66 cases of gastric juice inhalation during obstetrical work with no mortality. Other studies studying different populations (essentially in post-operative condition) denounced a mortality from 19 to 64%. In Forensic Medicine, a bronchial regurgitation of gastric juice is denounced in 1/3 lethal toxic comas. This regurgitation can be the direct cause of the death, it also can be an epiphenomena, as suggests the high level of inhalation in agonic process of any cause: 1/4 of autopsy findings. In our department, 200 cases of inhalation pneumonia, during comatose intoxications have been registered between 1972-1982, with a frequency of 1/28 patients. All the patients were under assisted ventilation. 4 deaths occurred in this serie. This 2% mortality suggests the curability of gastric juice inhalation during comatose intoxications in not specifically respiratory-orientated intensive Care Units. These relatively good results are probably party related to the patients' recruitment: young population without underlying organic disease, with a rapid turnover and little hazards of nosocomial superinfections.

Adolescent↗
PubMed1983

[Reversibility of severe digitoxin poisoning with antidigoxin antibodies].

We report a case of severe digitoxin poisoning treated at the stage of ventricular fibrillation by infusion of FAB antidigoxin fragments with low in vitro covering properties. There were no side effects. The possibility of rapidly reversing the prognosis will permit the use of specific FAB fragments before the onset of potentially lethal cardiac arrhythmias, when these antibodies become more generally available.

Aged↗
PubMed1982

[Digitoxin poisoning: reversing ventricular fibrillation with Fab fragments of anti-digoxin antibody].

Purified Fab fragments of ovine anti-digoxin antibodies (Wellcome Foundation) were used to treat a patient who attempted suicide by absorbing 10 mg of digitoxin (serum concentration 265 micrograms/l). The poor prognosis, as assessed clinically and from serum potassium levels (7.5 mEq/l), seemed to warrant such a treatment. The weak (6.85%) cross-reactivity elicited in vitro between the anti-digoxin antibodies and digitoxin was compensated by increasing the doses, but improvement was observed with 3.6 g, i.e. about half the effective dosage initially considered. The criteria of effectiveness were clinical, electrocardiographic (reversal of the ventricular fibrillation), biochemical (simultaneous and opposite changes in extra- and intracellular potassium levels, suggesting that ATPase inhibition by digitalis is a reversible process) and toxicological: there was an increase in digitoxin serum levels suggesting displacement of the drug from tissue sites to plasma and other extracellular compartments where the Fab fragments are distributed, and Fab-bound digitoxin appeared fairly rapidly in the urine, which suggested shunting of the normal hepatic metabolic pathway.

Aged↗
PubMed1982

[Prolonged high plasma imipramine levels after acute intoxication (author's transl)].

A case of severe intoxication by tricyclic antidepressants with persistence during 14 days of abnormally high plasma imipramine levels is reported. The various factors capable of maintaining plasma imipramine at a high level are discussed. They include mechanical factors (intestinal absorption), ventilation under positive end-expiratory pressure, alterations of hepatic metabolism by other drugs such as metronidazole or cimetidine, and changes in tissue distribution. Attention is drawn to the risks inherent in the various treatments used against acute intoxications and in combined chemotherapy during intensive care generally. When such drugs are necessary, the plasma levels of those with higher toxicity should be monitored.

Adult↗