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Biomedical subjects

G François

Publications and source records attributed to G François.

At least 19 recordsLinked to original sources
PubMed1992

Pharmacodynamic properties of propofol during recovery from anaesthesia.

Propofol was used to induce and maintain anaesthesia in 20 healthy adult ASA physical status 1 patients undergoing dental surgery. Recovery was studied using psychometric tests and clinical assessment while propofol blood levels were obtained at the same study times. Recovery was rapid and there were no significant differences 60 min after anaesthesia (t60) for the tracing test and 90 min for the choice reaction time. All patients were orientated in time at t30 and in space at t45; Stewart's score was maximal in all patients at t60; recovery of normal walking was slower, i.e. t120. Return to baseline for psychometric function was linked to a decrease in propofol blood level, for both the tracing test (P less than 10(-6)) and the choice reaction time (P less than 10(-3)). We conclude that propofol is a suitable anaesthetic agent for induction and maintenance of short duration dental anaesthesia.

Adult↗
PubMed1979

[Preoperative arrhythmias in ophthalmological surgery].

Continuous ECG recording (Holter technique) was carried out in 25 patients undergoing similar ophtalmological surgery for retinal detachment. The patients were selected at random and divided into two groups. Premedication (alimemazine 25 mg. atropine 0.5 mg given one hour before the operation) and induction (penthiobarbital 4 mg.kg-1 and succinylcholine iodide 1 mg.kg-1) were given in the same way. General anaesthesia was maintained in Group I (n = 12) with halothane and in group II (n = 13) using neuroleptanalgesia. There was no significant difference in the percentage of arrhythmias between the two groups. There was a remarkablly high prevalence of sinus bradycardia and ventricular pauses (8/25). The respective role of atropine and of retrobulbar local anaesthesia in prevention is discussed in the light of data from the literature. If arrhythmias occurring at the time of intubation are included, the total percentage of rhythm disturbances was 80 p. 100 (20/25).

Arrhythmias, Cardiac↗
PubMed1979

[Cardiovascular effects of a single injection of fentanyl in dogs under acute experimental conditions].

Experimental studies carried out in unselected dogs often face the problem of instabilit of various parameters both in terms of haemodynamics as well as acid-base balance. It is possible, with the injection of a single dose of Fentanyl of 0.35 mg.kg-1 given over a period of ten minutes to obtain, from the 30th minute after the injection, satisfactory cardiovascular stability (confirmed during 120 minutes in 9 dogs and 360 minutes in 2 of them). This haemodynamic state at T + 30 is obtained with a fall in mean blood pressure of -40 per cent, and an increase in peripheral resistance of +38 per cent and stroke volume of +11 per cent. This stability, obtained at the price of a stable normacapnia, correction of any possible metabolic acidosis and maintenance of body temperature, makes it possible to study the cardiovascular effects of certain types of treatment or of induced pathology.

Acid-Base Equilibrium↗
PubMed1979

[Results of a year's mycologic and immunologic surveillance of Candida in an intensive care ward].

Patients hospitalized in an intensive care unit must be considered to be exposed to a "high risk" in terms of candida infection. They often combine several of the factors favouring the development of "candida disease": generally deficient state, multiple antibiotics, iatrogenic or pathological immune depression. While certain patients who are admitted are already suffering from "candida infestation" (endogenous localization), the possibilities of exagenous infection are numerous. This study involved 63 patients spending at least one week in the department, from September 1977 to September 1978. Mycological (pharyngeal swab, urine culture, blood culture) and immunological (hemagglutination, immunoelectrophoresis, immunofluorescence) studies were carried out routinely on admission and then every week. Amongst the 63 patients studied, 12 were admitted with negative serology, which became positive during the first 10 days. 5 already had positive serology at the time of admission. From a mycological standpoint, the pharyngeal swab was frequently positive on admission (17 times out of 63). In 63 patients, the infection was acquired during the course of the hospital stay and, in this case, positive urine cultures were more regularly associated with a positive pharyngeal culture.

Candida↗
PubMed1978

[Effect of dobutamine on intra-pulmonary shunt].

A study of the development of intra-pulmonary shunts was carried out in ten subjects following an intra-venous administration of a 7.5 microgram/kg/min dose of dobutamine by electric syringe. All the subjects were on a respirator (FiO2=0,6 most often) and frequently with P.E.E.P. The shunts were determined at the FiO2 by which the subject was being treated. The cardiac flow was measured by thermodilution. In 9 cases out of 10 the intra-pulmonary shunt is sharply increased already in the first half hour by dobutamine. The shunt values are in the order of: -- 17.94p. 100 +/- 7.19 before the drug -- 26.50 p. 100 +/- 12.85 half an hour after the infusion beginning. The shunt increase is thus 47p. 100 of the average original value after half an hour, which is significant (p less than 0.01). The shunt is then stable at the attained value (hourly average : 26.05 +/- 12.25). These observations are discussed in relation to the obtained effects on the cardiac outout, to the PaO2, and to the quantity of transported arterial oxygen. It appears in this series that, in spite of the shunt increase, there is no risk of cellular oxygen deficiency.

Acid-Base Equilibrium↗
PubMed1977

[Thiamine deficiency in chronic alcoholics. Value of pre- and postoperative treatment].

Thiamine deficiency in the chronic alcoholic would appear to have a triple origin: inadequate intake, absorption and utilisation. Its consequences are well known: peripheral neuropathy, WERNICKE and KORSAKOFF type encephalopathies and cardiac problems (with asystole at the extreme). The active principle of thiamine, TPP or cocarboxylase, is involved as a coenzyme of pyruvate decarboxylase and of alphaketoglutarate decarboxylase in the ocidative decarboxylation reactions of the Krebs cycle. TPP is involved as a coenzyme of transketolase in the transketolisation reactions of the pentose pathway. The stimation of transketolase demonstrates a deficiency in thiamine. Fourteen patients suffering from surgical ENT malignancies were involved in the present study. Seven patients received vitamin B therapy before and after the operation. The results showed a significant decrease in thiamine deficiency. Seven were used as controls and did not receive vitamin B therapy. Transketolase estimations showed and increase in the deficiency. Thiamine deficiency exists in the chronic alcoholic and may be corrected by the administration of B vitamins.

Alcoholism↗
PubMed1977

[Clinical signs and etiological aspects of metabolic encephalopathies excluding liver encephalopathy and realimentation syndrome].

The clinical picture of metabolic encephalopathies has no aetiological specificity. It combines disturbances in conscious level dominated by disorientation and time and space and disturbances in motor activity, in particular tremor and asterixis. For each of the aetiologies studied, the following are considered: the circumstances of onset, the clinical and laboratory picture, the physiopathology and the treatment. From a diagnostic standpoint, particular emphasis should be placed upon the circumstances of onset which alone give any indication. The majority of these encephalopathies are caused by a lack of respect for simple rules in parenteral alimentation or by deficiencies. It is thus essentially an iatrogenic pathology. Treatment should be above all preventive.

Consciousness Disorders↗
PubMed1976

[Should all prosthetic valve patients be treated by platelet inhibitors?].

The number, volume and adhesive and aggregation activities of platelets were studied in 31 patients with artificial valves. The differences observed in comparison with a control population are due to stimulation of thrombocytopoiesis secondary to the destruction or concumption of the platelets, it being impossible to be sure as to the dominant mechanism. Under these circumstances it would seem important in each patient to verify the therapeutic effectiveness of platelet inhibitors or of traditionnal anticoagulants by direct or indirect study of platelet life duration.

Anticoagulants↗
PubMed1975

[Antidepressives and anesthesia].

Anesthesia and anti-depressors have a bad name: is their reputation justified? In the opinion of the Anesthesiologist, it is justified in a large part concerning the IMAO, because there is no absolutely secure solution in large scale surgery. On the other hand, the value of accidents must be reset in its proper place. Only the hypertensive increase is very worrying, not so the drop in tension, and it is often the therapeutical gesture which induces the catastrophe. As far as the tricyles are concerned, they never lead to real problems, if we are aware of the treatment to be applied.

Anesthesia, General↗
PubMed1975

[General anesthesia for electroshock therapy].

Those are a few reflexions to be pondered by psychiatrists, to remind them what are the dangers connected with anesthesia for electroshock-therapy. Some of those risks are well-known: inhalation of gastric liquids, recess in ventilation. Others are somehow more obscure: hyperkalemia, extended curarization after injection of succinylcholine. The risk is therefore still present: to know it is to be ready to face it.

Anesthesia, General↗