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Biomedical subjects

F Bridey

Publications and source records attributed to F Bridey.

31 records · Page 2Linked to original sources

[A sickle cell homozygote with transfusion deadlock. Favorable outcome with hydroxyurea treatment].

Alloimmunization following multiple transfusions, a frequently observed complication in sickle cell anemia patients, may make subsequent transfusion attempts extremely hazardous. The case of a young woman with sickle-cell anemia is reported; she was hospitalized for the treatment of extensive invalidating leg ulcers. The transfusion program that was initiated as a prerequisite to skin allografts had to be stopped, due to rapid occurrence of multiple alloimmunization. Broad spectrum alloantibodies precluded further selection of compatible blood units. In an attempt to get round this impossibility, a treatment with Hydroxyurea was initiated in order to boost synthesis of F-hemoglobin. After one year under this treatment, the patient's clinical status has clearly improved without requiring any new blood transfusion.

Adult↗

Randomized trial of subcutaneous low-molecular-weight heparin CY 216 (Fraxiparine) compared with intravenous unfractionated heparin in the curative treatment of submassive pulmonary embolism. A dose-ranging study.

BACKGROUND: We compared the efficacy and safety of different dosages of a low-molecular-weight heparin, CY 216 D (Fraxiparine), in the treatment of submassive pulmonary embolism with unfractionated heparin in a prospective, randomized, dose-finding study. METHODS AND RESULTS: The primary outcome was the evolution of pulmonary vascular obstruction. We enrolled 101 patients. Four patient groups were formed: standard heparin by continuous intravenous infusion (group 1) and Fraxiparine subcutaneously 400, 600, and 900 anti-Xa Institute Choay units/kg, respectively (groups 2, 3, and 4). Inclusions were stopped prematurely in groups 3 and 4 because of the incidence of major bleedings. At day 8, the improvement of the pulmonary vascular obstruction and the major bleedings were similar in groups 1 and 2. CONCLUSIONS: The Fraxiparine dosage of 400 anti-Xa Institute Choay units/kg is as effective and safe as unfractionated heparin in the treatment of submassive pulmonary embolism.

Analysis of Variance↗

Accuracy of measurements of HbF with OSM3 in neonates and infants.

The accuracy of the Radiometer OSM3 oxymeter for measurement of fetal haemoglobin (HbF) in infants was investigated, and compared to one of the standard reference methods using alkali electrophoresis of haemoglobin. Blood samples of 37 infants with different gestational (27-41 weeks) and postnatal (1-198 days) ages were analysed. The two methods gave very close results but a significant mean difference (range -4.5-16.5%). However, agreement between the two methods was judged clinically acceptable (95% limits of agreement -7.5-15.5%). A rapid determination of HbF percentage, using OSM3, is an important determinant for correct assessment of oxygen saturation in newborn infants in intensive care units.

Electrophoresis↗

Prenatal diagnosis in type IIA von Willebrand disease.

A prenatal diagnosis for fetal disease was performed at 20 weeks gestation in a severely affected patient with type IIA von Willebrand disease. In the fetal cord blood sample obtained under ultrasound guidance, the level of von Willebrand ristocetin cofactor activity was similar to that of von Willebrand factor antigen, and all the multimers were present. These results were compared to those obtained in 51 normal fetuses of similar gestational age (19-21 weeks). Normal fetuses showed slightly lower levels of von Willebrand factor than normal adults and in addition to all adult multimers, the presence of unusual large forms. This data compared with the case, allowed the exclusion of the diagnosis of type IIA von Willebrand disease in our patient's fetus. This was confirmed at birth in the cord blood.

Adult↗

Accuracy of two wavelength pulse oximetry in neonates and infants.

In 60 neonates (gestational age, 26.5-40 weeks; postnatal age, 1-14 days) and in 11 infants (gestational age, 26-33 weeks; postnatal age, 4.5-38 weeks), the accuracy of two wavelength pulse oximetry was examined. A total of 112 comparisons between transcutaneous pulse oximetry saturation (StcO2, NELLCOR N-100) and arterial oxygen saturation (SaO2, OSM2 RADIOMETER) were obtained. SaO2 ranged from 80 to 100%. Criteria for comparison between StcO2 and SaO2 were standardized: patients in behavioral state 1, StcO2 stable for 2 min, and arterial samples drawn from an indwelling arterial line. StcO2 was significantly related to SaO2 (P less than 0.01), but the difference, StcO2 - SaO2, significantly increased when SaO2 decreased [StcO2 - SaO2(%) = -0.39 SaO2(%) + 37.95; r = -0.64, P less than 0.01]. No significant relationship was found between StcO2 - SaO2 and either bilirubinemia (range, 5-222 mumol/L) or fetal hemoglobin (HbF) (range, 12-95%). We conclude that StcO2 overestimates SaO2 when SaO2 decreases, and this overestimation is not due to high levels of bilirubin or HbF.

Bilirubin↗

[Therapeutic approach to pulmonary embolism].

The purpose of this study is the retrospective evaluation of the treatment of 196 cases of pulmonary embolism. Therapeutic attitude was standardized. Intravenous heparin followed early on by oral anticoagulants remains the basic treatment of the majority of patients (74%). This treatment could be associated with: (1) Fibrinolysis with urokinase bolus at the time of massive pulmonary embolism with clinical and hemodynamic signs of shock (14%). No severe hemorrhagic complication was observed. 2) Inferior vena caval interruption in case of contraindications or failure of anticoagulation (29%). Only one death was observed in this study.

Anticoagulants↗

[Assay of products of fibrin and fibrinogen degradation in disseminated intravascular coagulations. Evaluation of a new technique].

OBJECTIVES: An increase in fibrin or fibrinogen degradation products (FDP) is highly indicative of the diagnosis of disseminated intravascular coagulation (DIC). We assessed the sensitivity and specificity of a recently developed method (FDP plasma) with respect to other classical methods. METHODS: FDP plasma was compared to another semi-quantitative method using monoclonal antibodies (D-di test), a semi-quantitative method on serum using polyclonal antibodies (Spli-prest) and a quantitative ELISA (D-dimer). The results from 34 patients with DIC were compared with those of several control groups (30 healthy volunteers, 34 women at the end of an uneventful pregnancy, and 24 of them after delivery), in order to assess sensitivity and specificity of each test. RESULTS: The 3 plasma tests using monoclonal antibodies demonstrated similar sensitivities (88-100%), which was clearly higher than the sensitivity of serum test, using polyclonal antibodies. Specificity was identical (97-98%) for the 3 semi-quantitative tests when normal ranges were defined according to the results of the control groups. It was higher than the sensitivity of the ELISA test. CONCLUSION: Due to their higher specificity, and to their rapidity, FDP semi-quantitative tests are the most suitable tests for the diagnosis of DIC. Spli-prest, which showed a low sensitivity, should be replaced by D-di test or FDP-plasma, which displayed similar good results.

Adolescent↗