Biomedical subjects
Publications and source records attributed to J B Cognet.
In two patients full-thickness burns were grafted with cultured autologous epidermis obtained using the technique described by H. Green. The grafts only took partially but produced satisfactory covering. Better efficiency and more information about the long-term characteristics of the resulting skin are necessary before routine use can be recommended.
Postoperative pain was treated by epidural administration of 30 to 50 mg pethidine (5 mg X ml-1) in a group of 36 patients who had undergone retropubic prostatectomy. Surgery was carried out under epidural anaesthesia with lidocaine. Pain was assessed by means of the visual analogue scale. A general study of the effects of injections and reinjections showed that analgesia thus obtained was excellent at the first hour after injection and lasted 3 to 5 h. The effect of the first postoperative injection on spontaneous pain was studied in 14 patients. Statistical analysis (Wilcoxon test) demonstrated that the fall in pain score was significant at the first and third hours after injection, but not significant at the fifth hour. The analgesia to that pain produced by coughing was studied in 11 patients. There was a significant decrease in pain at the first hour after injection; differences in pain scores at the third hour were not significant. No noticeable side-effect was observed. It was concluded that low doses of epidural pethidine were efficient on postoperative pelvic abdominal pain, but that doses should be increased if painless coughing was required.
Fifty-two traumatic ruptures of the thoracic aorta were hospitalized between 1972 and 1982, with 46 angiographies. The most significant clinical sign of aortic rupture is the difference in blood pressure between the upper and lower limbs. The frequency of chest film findings is discussed. The aortography by arterial route must be performed at the sligh test suspicion, sometimes without radiographic signs, to establish diagnostics and detect associated lesions (dissection) and unusual types (low localization, multiple localization, localized rupture of the intima.
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Thirty six cases of traumatic rupture of the thoracic aorta (TRA) were diagnosed during the hours following the accident responsible. Rupture was situated at the aortic isthmus in 32 cases, the ascending aortic in 2 cases, the arch of the aorta in 1 case and the descending sub-isthmic aorta in 1 case. Ten patients had no rib fractures. In 16 patients not undergoing surgery before 20th hour after the trauma, 10 died of secondary rupture. The course of a TRA is thus unpredictable and it is of fundamental importance to make the diagnosis and undertake appropriate surgical treatment immediately. The essential clinical sign is a difference in blood pressure between the upper and lower limbs (6 6%). Radiological signs suggestive of TRA are, in a plain PA chest film : widening of the mediastinum (92 %), poor visibility of the knuckle of the aorta (89 %), left haemothorax (67 %), deviation of the trachea to the right (55 %) and lowering of the left main bronchus (47 %). The slightest suspicion of a TRA should lead to aortic angiography preferably via an arterial approach (humeral or femoral), or intravenously. Surgical treatment should not be delayed.
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A pharmacological classification of corticoids can be carried out, based on the ratio of their glucocorticoid and mineralocorticoid activities. Their large number is due to the fact that they are practically all synthetic, and that minimal modifications in their structure gives rise to new drugs with variable gluco and mineralocorticoid activity.
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Auricular asystoly (A.A.) was the electrocardiographic pattern of 6 patients admitted for electrolytic disorders secondary to either renal failure or inadequate treatment. A rapid increase of blood potassium was the unique commun abnormality found to explain the dysrhytmia. Bradycardia (between 25 and 55 beats/mn) was present in each case with or without clinical symptoms. Temporary prophylactic pace maker insertion was performed in 4/7 patients. Recovery appeared after dialysis treatment in 6 cases, medical treatment in one, sinus rhythm being present in 6 and chronic atrial fibrillation in one. Prognosis of A.A. due to hyperkaliemia is good when hydroelectrolytic disorders are rapidly corrected. Follow up of blood electrolytes and electrocardiogram must be regular to prevent reccurencies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.