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Biomedical subjects

F Dalmay

Publications and source records attributed to F Dalmay.

12 recordsLinked to original sources

[Economic analysis of home based versus hospital outpatient chemotherapy in stage IV non small cell lung cancer].

BACKGROUND: French law and government decisions have induced new development for home base treatments. The objective was to compare cost of home base chemotherapy (HBC) versus outpatient infusions, for non small cell lung cancer (NSCLC). METHODS: 10 patients were selected in each category. D8 of their cycles was performed at home compared to outpatient infusion. Costs were based on national fees with cytostatic drugs as supplement. The real cost was also assessed through a specific questionnaire. RESULTS: 30 D8 infusions were carried out at hospital and 24 D8 infusions at home. Average cost by cycle was 2,829.51 euros [2 560.74-3 147.02] for hospital infusion, 2,372.50 euros [1 962.75-2 792.88] for HBC (-16.15%). Difference was -457.01 euros by cycle [-919.74; 26.82]. Real costs by injection for BHC was 484.42 euros [424.18; 540.32] versus a fee of 699.89 euros [643.64; 750.23]. There were no difference in terms of adverse events. CONCLUSION: HBC for NSCLC is feasible. Average costs by cycle is lower of 16% versus hospital infusion. The results of this non randomized study had to be confirm by further clinical trials.

Ambulatory Care↗

[Respiratory effects of risperidone? A prospective study].

Risperidone is an atypical neuroleptic which has been incriminated as a cause of respiratory symptoms. The purpose of this prospective study was to assess over a three-month period the respiratory status of patients free of allergic or respiratory disease treated with risperidone. Thirty-nine patients were enrolled. Twenty dropped out. One patient developed cough very likely related to risperidone but with no change in function. Bronchial hyperreactivity developed in two other patients who had no clinical symptom or sign of respiratory disorder. Despite the small number of patients in this study, risperidone would appear to have secondary respiratory effects. The high frequency of bronchial hyperreactivity observed in patients at inclusin and the nearly constant co-prescription of other psychiatric drugs suggests a potential combination effect (notably with selective seritonin reuptake inhibitors).

Adolescent↗

Non-AT(1)-receptor-mediated protective effect of angiotensin against acute ischaemic stroke in the gerbil.

Previous studies have shown that angiotensin II (Ang II), by mediating rapid recruitment of collateral circulation, has a protective effect in the setting of acute ischaemia. In an experimental model of acute cerebral ischaemia in the gerbil, Fernandez et al. have reported that the mechanism of the protective effect of Ang 11 is blood pressure (BP)-independent, and that the AT1-receptor antagonist, losartan, but not the ACE inhibitor (ACE-I),enalapril, decreases mortality following unilateral carotid artery ligation. The aim of this study was to examine there producibility of the respective effects of losartan and enalapril, and to verify that these differential effects are drug class-related. Acute cerebral ischaemia was induced in anaesthetised gerbils bv unilateral carotid ligation. The effect of pretreatment with two different ACE-I(enalapril and lisinopril), and two different AT1-receptor antagonists (losartan and candesartan), administered orally or intravenously, on mortality were compared. Kaplan-Meier survival curves at day three were analysed bv a log-rank test. Pretreatment with both enalapril and lisinopril significantly decreased survival at day three compared with controls, while the AT1-receptor antagonists losartan and candesartan, despite similarly lowering BP, did not increase mortality. Coadministration of losartan and enalapril increased mortality to the same extent as enalapril alone. This study confirms that Ang II contributes to protective mechanisms against acute cerebral ischaemia through non AT1-receptor-mediated, BP-independent effects.

Acute Disease↗

Study of blood flow parameters measured in femoral artery after exercise: correlation with maximum oxygen uptake.

To study the recovery periods of blood flow parameters in muscles after anaerobic exercise, instantaneous and mean blood flow velocity curves were recorded in the femoral artery in 22 sportsmen at rest and during the first 4 min of recovery after exercise (Ruffier-Dickson test). A flat ultrasonic probe connected to a Doppler system (Flow-Tester) was fixed on the skin at the level of the common femoral artery. From Doppler recordings, we calculated periods of recovery (return to baseline) of femoral blood flow velocity (FBFV RP), heart rate (HR RP) and femoral stroke distance (FSD RP). Also, Ruffier-Dickson index (RDI), VO(2)max in mL/kg(-1)/min(-1) and number of training hours were determined. We observed a high correlation between FBFV RP and VO(2)max (p = 0. 0002), and significant correlation between FSD RP and VO(2)max (p = 0.0238) and RDI (p = 0.0451). In conclusion, there is a excellent correlation between blood flow velocity recovery period in femoral artery after moderate exercise and VO(2)max in high-level sportsmen. The method of testing is simple and based on conventional Doppler technique. It can be used for the follow-up of training levels in sportsmen.

Adolescent↗

[Assessment of physical and sports aptitudes, overtraining prevention, and prevention of doping].

Present levels of training loads--which can exceed thirty hours a week for high level sportsmen--expose to overwork then to overtraining syndrome and finally to temptation of doping. At the same time testing techniques improve, particularly exercise tests with a linearly increasing load, and the follow-up of training effects on physical fitness provides more accurate data. The specialized literature has developed the notions of cardiac frequency reserve and of oxygen intake reserve within the last ten years. These notions, as those of produced power reserve, were applied here to assess the ventilatory threshold of 104 sportsmen (51 cyclists with high endurance and 53 team sportsmen with lower endurance) and of 223 sedentary witnesses. They allow, when completed with absolute level of aerobic endurance, to appreciate physical fitness of sportsmen all along sports season, to predict their capabilities to progress by an increase of training load or to reinforce the hypothesis of an over-working onset.

Doping in Sports↗

Acoustic properties of the normal chest.

Laënnec invented the stethoscope in 1816 and published a treatise on auscultation in 1819. We then had to wait until the 1950s to observe development of modern devices and methods of recording and signal-processing, which allowed objective studies of lung sounds in time and frequency fields. Tracheobronchial sounds generated by ventilation originate in the upper airways, the frequency content of these sounds has led to extensive research. Consolidated lungs act as more efficient sound conductors to the chest wall (bronchial breathing murmur). Tracheobronchial sounds contain higher frequency components compared to vesicular lung sounds. The origin of vesicular lung sounds has been becoming progressively clear for about 10 yrs. It is at least partly produced locally, deep, and probably intralobular. Clearly, further studies need to be performed in order to elucidate the true mechanisms involved in generating vesicular lung sounds, the redistribution of intrapulmonary gas or vibrations caused by the stretching of lung tissue. The devices developed are already useful for monitoring the state of patients in intensive care. Sooner or later, real time analysis and automated diagnosis will become available.

Auscultation↗

A method for determining the maximal steady state of blood lactate concentration from two levels of submaximal exercise.

The aim of this study was to estimate the characteristic exercise intensity (WCL) which produces the maximal steady state of blood lactate concentration (MLSS) from submaximal intensities of 20 min carried out on the same day and separated by 40 min. Ten fit male adults [maximal oxygen uptake (VO2max) 62 (SD 7) ml.min-1.kg-1] exercised for two 30-min periods on a cycle ergometer at 67% (test 1.1) and 82% of VO2max (test 1.2) separated by 40 min. They exercised 4 days later for 30 min at 82% of VO2max without prior exercise (test 2). Blood lactate was collected for determination of lactic acid concentration every 5 min and heart rate and O2 uptake (VO2) were measured every 30 s. There were no significant differences at the 5th, 10th, 15th, 20th, 25th, or 30th min between VO2, lactacidaemia, and heart rate during tests 1.2 and 2. Moreover, we compared the exercise intensities (WCL) which produced the MLSS obtained during tests 1.1 and 1.2 or during tests 1.1 and 2 calculated from differential values of lactic acid blood concentration ([la-]b) between the 30th and the 5th min or between the 20th and the 5th min. There was no significant difference between the different values of WCL [68 (SD 9), 71 (SD 7, 73 (SD 6), 71 (SD 11)% of VO2max] (ANOVA test, P < 0.05). Four subjects ran for 60 min at their WCL determined from periods performed on the same day (test 1.1 and 1.2) and the difference between the [la-]b at 5 min and at 20 min (delta ([la-]b)) was computed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Angiotensin-converting enzyme inhibition does not suppress plasma angiotensin II increase during exercise in humans.

Physical effort stimulates the reninangiotensin system (RAS). We studied the effect of an angiotensin-converting enzyme inhibitor (ACE inhibitor) in a double-blind placebo-controlled study, on eight volunteers undergoing physical stress on an ergometric bicycle. The effects of captopril (C) (50 mg, three times daily for 3 days) on arterial pressure (AP), O2 consumption (VO2), variations in auricular natriuretic factor (ANF), renin, angiotensin II (AII) plasma levels, as well as glomerular filtration rate (GFR) and microalbuminuria (MA) were evaluated. The different parameters were compared by analysis of variance (ANOVA). The pressure profile and VO2 were not modified by ACE inhibitor. Exercise stimulates release of renin; this action was greater with captopril administration (treatment effect: p < 10(-4), indicating blockade of the RAS. This inhibition was incomplete because AII levels increased markedly when captopril was given (no treatment effect: p < 0.37). Finally, ACE inhibitor resulted in decreased GFR (p = 115 +/- 5.8 ml/mn-1, C = 91.1 +/- 4, p < 0.05) with exercise without modification of MA. ACE inhibitor administration does not modify the physical performance of nonathletic subjects; AII is significantly increased with exercise despite captopril treatment; ACE inhibitor decreases GFR significantly but does not influence MA with prolonged physical effort.

Adult↗

[Blood lactate in the steeplechase horse: triangular and rectangular series of steps during short duration races].

Five steeplechase race horses were observed during incremental and constant-load exercises with the aim of separating effects of work rate and time on blood lactate. Each independent exercise (an incremental and three constant load tests) was a sequence of three two-minute runs, separated by two one-minute rest intervals for jugular blood sampling. The following observations were made: 1. During constant load exercises, in the five horses, blood lactate stabilized below 4 mmol.l-1: lactatemia critical velocity (LVC) = 3.33 +/- 0.16 mmol.l-1. Nevertheless, VCL, critical lactate velocity inducing LVC, was not statistically different from VS4, velocity inducing a 4 mmol.l-1 blood lactate during incremental tests. Remaining reticent on the meaning of "lactate threshold" often attributed to VS4, an incremental exercise thus seemed pertinent for routine long-term surveys of endurance. 2. If delta L is the blood lactate increase within a single short run, delta L increases linearly with running velocity for an incremental test, allowing the calculation of a "null" velocity, the highest velocity for which there is no significant lactate increase. For independent runs, delta L increased exponentially with velocity, with noticeable differences between horses. This individual short-term functional adaptation variability could be considered in assessment and follow-up of race horse fitness.

Animals↗