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Biomedical subjects

F Patte

Publications and source records attributed to F Patte.

At least 37 records · Page 2Linked to original sources

[Pharmacology of nicotine].

Nicotine has a small molecular weight and is absorbed via the mucosa (Guccal or nasal), the pulmonary alveoli and the skin. The phenomenon of autotitration explains how a dependent smoker can unconsciously change his method of smoking to maintain a steady nicotine level. Nicotine leads to a liberation of catecholamines by acting on the nervous system through the intermediary of nicotine receptors. There is increased vigilance and powers of intellectual concentration, an awakening reaction and some anxiolytic and euphoriant effects. From the cardiac stand point there is an increased heart rate and blood pressure, as a result of the sympathomimetic effects. Elimination is via the kidneys as unchanged nicotine, cotinine and 1'-N-oxide of nicotine. Nicotine has an addictive action and is capable of inducing pharmacological dependency, tolerance and withdrawal syndrome in cases of abrupt cessation. A knowledge of the pharmacology of nicotine is important in the process of stopping smoking.

Cardiovascular System

[Sclerosing intravascular bronchiolo-alveolar tumor].

We report the case of a 56 year old female who was admitted to hospital in 1980 for assessment of disseminated nodular pulmonary opacities. The histological examination of a prescalene node biopsy showed features which were compatible with sarcoidosis. No treatment was given. In 1987 a discrete increase in the pulmonary nodules was noted. In 1989 effort dyspnoea occurred and there were pains in the right lower chest and an evening fever. The chest X-ray showed a right sided pleurisy and an increase in the size of the nodules with mediastinal lymphadenopathy. A histological examination of a pulmonary nodule, which was taken at an open lung biopsy enabled the diagnosis of a broncho-alveolar sclerosing intravascular tumour to be established. This is a rare tumour which has a slow evolution occurring most often in middle aged females. In 50% of cases the discovery is fortuitous. Besides patients present with non-specific symptoms. The radiological examination reveals multiple nodular opacities which are diffuse and 0.5 to 1.5 cm in diameter. Currently these tumours do not benefit from any particular therapy.

Diagnosis, Differential

[Mucoepidermoid bronchial carcinoma. Review of the literature apropos of a new case].

Muco-epidermoid bronchial tumours are rare and characterized by the coexistence of epidermoid, mucus-secreting and intermediate cells. The authors report the case of a 22-year old unmarried woman hospitalized for exploration of a febrile dyspnoea related to a right superior lobar atelectasis. Endoscopy showed a smooth, pediculate tumour arising from the right superior lobar bronchus where bronchial biopsy was negative. Right superior lobectomy was performed through thoracotomy and established the diagnosis of muco-epidermoid bronchial tumour. Surgery was followed by radiotherapy of the chest. Over a 5-year follow-up period there was no local or extrathoracic recurrence, and the patient is in good condition.

Adult

Evaluation of closed sterile prefilled humidification.

A closed sterile prefilled humidifier ('Aquapak 310') and a multiple-use humidifier ('Nebal 2') were evaluated in hospital departments to determine their susceptibility to bacterial contamination and cost. No bacterial contamination was found in the 389 samples of 'Aquapak 310' water. However, 54/164 (32.9%) samples of 'Nebal 2' water were found to be contaminated. Pseudomonas aeruginosa was the bacterium most often isolated. The cost analysis was highly influenced by the average use time. In the haemodialysis and respiratory medicine departments the average use times for the 'Aquapak 310' +/- SD were 61.6 +/- 36.2 days and 4.1 +/- 1.7 days, respectively. Using the 'Aquapak 310' system, there was a 51% financial saving in the haemodialysis department but a 2% loss in the respiratory medicine department. In these two departments we found a similar cost saving as far as staff time was concerned (88% vs. 89%). The major difference came from the cost of consumables: 26% saving in the haemodialysis department vs. 70% loss in the respiratory medicine department. Use of the prefilled sterile humidifiers represents a three-fold benefit, a lower infection risk for the patient, an important financial saving in the haemodialysis department and a decreased staff work load.

Cost-Benefit Analysis

[False asthmas of the adult].

Many conditions may simulate asthma, particularly tracheobronchial lesions that are dominated by tumoral stenoses, laryngeal anomalies and cardio-vascular diseases. At the time of the initial assessment of all sibilant dyspneas, certain other complementary examinations should systematically be made: pulmonary radiography, ORL examination and exploration of respiratory function.

Adult

[Articular manifestations in Wegener's disease. Report of 13 cases].

Seventeen cases of Wegener's granulomatosis have been reviewed in search of articular involvement. Articular symptoms were present in 13 cases (76 p. cent), and were inaugural in 9 cases (53 p. cent). Six of these patients experienced arthralgias, which were most often migratory, and were inaugural in 3 cases. Seven patients had arthritides, which were inaugural in 6 cases; they were fixed and additive in 6 of these 7 cases, making up a distal polyarthritis in 3 patients, and an oligoarthritis in the 3 other ones; they were transient and migratory in 1 case. The 3 cases of distal polyarthritis were inaugural and fulfilled the ARA criteria for rheumatoid arthritis; two of them were accompanied by nodules which were quite identical to rheumatoid ones. There was no axial involvement. Joint involvement was not destructive and had a favourable course under disease treatment. Myalgias were present in 3 cases, one of which simulated Horton's disease. Biological manifestations chiefly consisted of marked inflammatory changes. Antineutrophil cytoplasm antibodies were present in 11 out of 16 patients in whom they were searched; among 6 of these patients who had active disease, they were present in 5. The antibody level decreased as treatment reduced disease activity and suppressed joint involvement. Joint involvement in Wegener's granulomatosis seems to be the inconstant hallmark of disease activity. It requires no specific treatment.

Adult

[Intestinal perforation occurring at the beginning of treatment: a severe complication of bacillary tuberculosis].

We report 2 cases of intestinal perforation caused by tuberculosis and affecting the small intestine in one case and the colon in the other case. The patients were men aged 49 and 51 years respectively. Both were cachectic and presented with advanced open pulmonary tuberculosis. Perforation in free peritoneal cavity occurred 2 and 8 days respectively after an antituberculous treatment was initiated. The outcome was rapidly fatal in both cases. Tuberculous enteritis has become rare, but it can still be observed in patients with severe open pulmonary tuberculosis, where the gastro-intestinal tract is contaminated by the large number of virulent mycobacteria swallowed. In such patients clinicians must be alert to abdominal premonitory signs. Intestinal perforations in free peritoneal cavity are uncommon. Most perforation are small, single or multiple, and located on the antimesenteric side of the terminal ileum. They may occur at any time, and particularly just after an antituberculous therapy has been instituted. Clinical presentation is one of acute peritonitis requiring emergency laparotomy. Mortality has been reduced by technical improvements, notably temporary enterostomy, but perforation remains a serious and often fatal complication of tuberculosis in patients with severe malnutrition.

Antitubercular Agents

[Allergy to kiwi: an unrecognized allergy].

We reported 4 cases of an uncommon hypersensitivity: hypersensitivity to kiwi fruit. The clinical reactions, essentially buccal, occurred few minutes after ingestion of the fruit. The Radio Allergo Sorbent Test were positive in the 4 cases. The skin tests, with fresh extracts of kiwi, made in 3 cases were dramatically positive, while they are negative in controls patients. The kiwi fruit initially comes from China, but is now produced in France, and especially in Poitou-Charente. It contains a proteolytic enzyme call Actinidin with physical and chemical properties similar to those of Papain, who can perhaps explain this hypersensitivity.

Adult

[Neuropeptides and respiratory diseases: prospects in the treatment of asthma].

The autonomic nervous system includes, side by side with the sympathetic and parasymathetic systems, a third, non-adrenergic and non-cholinergic system called NANC. The mediators in this system are peptides acting as neurotransmitters, i.e. neuropeptides. The NANC system has two components: bronchodilator and bronchoconstrictor. The bronchial relaxant system, called non-adrenergic inhibitory system, has several neurotransmitters, viz.: vasoactive intestinal peptide (VIP), isoleucine histidine peptide (IHP) and methionine histidine peptide (MPH), all derived from a common precursor: pre-pro VIP. MHP has been described in man and IHP in some animal species. VIP relaxes the bronchial smooth muscle, is vasodilator and exerts cellular effects in phagocytes, lymphocytes and mast cells. VIP receptors are present on cells. The other component, called non-cholinergic excitatory system, has tachykinins as neuromediators, including substance P, neurokinins A and B, neuropeptide K and calcitonin gene related peptide (CGRP). Substance P contracts the bronchi, increases mucus secretion, dilates vessels and also exerts cellular effects in lymphocytes and phagocytes. Tachykinins act through receptors 3 types of which are now known: NK 1, NK 2 and NK 3. Other neuropeptides have been isolated, including galanin, neuropeptide Y, bombesin, gastrin releasing peptide, enkephalins and katacalcin. The coexistence, in pre- and post-synaptic positions, of the conventional mediators (noradrenaline, acetylcholine) and neuropeptides leads to the concept of co-transmission and makes the notion of nerve impulse transmission more complex. The development of neuropeptide agonists and antagonists opens new therapeutic prospects in the management of asthma.

Asthma

[Fluoroquinolones: pharmacology, antibacterial spectrum and indications in pneumology].

Fluoroquinolones are antibiotics that act principally on DNA gyrase. At the moment, resistance to these antibiotics is purely chromosome-mediated. As regards pharmacokinetics, these compounds have a high bioavailability and penetrate extremely well into tissues and cells. Therapeutic concentrations are obtained in bronchial mucosa and lung tissue. In severe lower respiratory tract infections fluoroquinolones must be given in combination with other antibiotics to prevent the emergence of resistant mutants. The indications of fluoroquinolones in lower respiratory tract infections depend on their antibacterial spectrum. They are particularly useful in the treatment of infections caused by methicillin-sensitive or resistant staphylococci, Pseudomonas spp. (notably in cystic fibrosis) and intracellular organisms. They are not indicated for streptococcal infections, notably those due to Streptococcus pneumoniae, and for anaerobic infections. Fluoroquinolones are currently used mainly in hospital-acquired lower respiratory tract infections, in infected cystic fibrosis and in some acute episodes of chronic bronchitis since they are active against Haemophilus influenzae and Branhamella catarrhalis.

4-Quinolones

[Value of nifedipine in respiratory failure related to obstructive chronic bronchitis during treatment over 6 months].

We studied the simultaneous effects of nifedipine on the pulmonary circulation and blood gases in 12 patients with pulmonary hypertension secondary to obstructive chronic bronchitis. Measurements were carried out at rest and during stress, initially then one hour after administration of 20 mg of nifedipine sublingually. They were repeated in a similar fashion after a 6-month treatment with 60 mg/day (group II) (30 mg/day in case of intolerance) (group I). The results of the immediate effect of nifedipine are in favor of a passive pulmonary vasodilatation secondary to the systemic vasodilatation. After six months of treatment, the pulmonary vasodilatation persists, but is associated with a decreased motor pressure indicating a more specific and more active pulmonary vasodilating effect of long-term nifedipine, especially during stress; this results in the improvement of the performance of the right ventricle without harmful effect on the blood gases. However, these results should be interpreted with caution on account of the small number of patients, the large interindividual variations and the absence of a reference population.

Administration, Sublingual

[Occupational bronchopulmonary pathology caused by woodworking: diagnostic approach].

Woodworkers have a varied breathing pathology, with involvement of the upper airways mainly by ethmoidal cancers and rhinitis, tracheo-bronchitis with asthma, hypersensitivity pneumonitis due to wood moulds. The physiopathological mechanisms are numerous and often intricate: physical mechanism due to the irritant effect of wood dust, toxic mechanism caused by chemical substances which are present in wood dust or come from wood preservation products, immunological and allergic mechanism in which different allergens are concerned. Breathing pathology is the subject of 2 tables (No. 47 and 36) among those concerning occupational diseases. Lung function tests play an important role in the diagnosis of these diseases, with their 3 main objectives: search for airway obstruction, evaluation of bronchial hyperreactivity by means of non-specific challenge tests, and specific challenge tests performed in a laboratory or on the work site.

Humans

[The role of inhalation chambers in the treatment of asthma].

Inhalation chambers (spacers), interposed between the aerosol doser and the patient's mouth take 3 forms: lengthened tubes, large volume plastic sacs and conical chamber in the shape of a pear. Their chief advantages are: A greater proportion of the drug reaches the airways, as the deposition in the oropharynx is reduced. Co-ordination of lung and hand, a major obstacle to the correct use of aerosol-dosers, is no longer necessary.

Administration, Inhalation