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J Beaune

Publications and source records attributed to J Beaune.

66 records · Page 4Linked to original sources
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T lymphocyte disorder after Capnocytophaga ochracea endocarditis.

Capnocytophaga species are gram-negative rods which may cause disease in both non-immunocompromised and immunocompromised hosts. We describe a case of endocarditis due to Capnocytophaga ochracea in a non-immunocompromised patient with a decrease of blood CD4/CD8 ratio and lymphocyte proliferative response to ConA during infection. In vitro experiments showed that C. ochracea decreased lymphocyte proliferation to mitogens (ConA, PHA), cell surface CD4 antigen and IL2 receptor expression on peripheral blood mononuclear cells (PBMC) from normal volunteers.

Capnocytophaga↗
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Stroke volume from central aortic pressure? A critical assessment of the various formulae as to their clinical value.

Pulsecontour methods remain a potentially attractive approach for the calculation of stroke volume, since they might provide such information on a beat to beat basis, after a single calibration. In order to test the clinical value of this hypothesis stroke volume estimates from six different pulsecontour formulae were compared with stroke volume values obtained with an electromagnetic flowmeter in 10 pigs. Each of the formulae failed to confirm its usefulness under circumstances mimicking clinical conditions. The calibration constant obtained during control states varied widely (+/- 25%). In many instances polsecontour formulae predicted changes in stroke volume in a direction opposite from those measured. The need for recalibration was so frequent that the calibration merthod itself proved often sufficiently informative. It is concluded that in intensive care units pulsecontour formulae cannot contribute to the care of the patient. Its popularity is not justified and its increased use since the introduction of computers is not warranted.

Animals↗
PubMedDate not supplied

[Blood pressure control in hypertensive patients with stable coronary heart disease].

OBJECTIVE: To evaluate systolic blood pressure (SBP) control in hypertensive patients with a stable coronary heart disease (CHD) in general practice in France. METHODS: A survey was conducted in a sample of 206 general practitionners (GP) representative of the French medical population, in 2003 [LHYCORNE survey]. Each GP had to include 3 hypertensive patients, >18 years old, BP > or = 140/90 mmHg and/or treated for hypertension, and with evidence of CHD documented by myocardial infarction (MI) or angina pectoris (AP) [diagnosis previously established by a cardiologist]. Three office BP measurements were performed, the last two recorded. BP levels were considered as controlled by treatement if they were < 140/90 mmHg. RESULTS: 595 patients were included, 75% men mean age 66 years, 25% women mean age 73 years. All patients had a CHD: MI 46%, AP 54%; 533 (90%) had more than 2 cardiovascular risk factors: hyperlipidemia (411; 69%), smokers (375; 63%), diabetes (158; 27%). Mean BP was 140.7 +/- 14/80.8 +/- 9.7 mmHg; 553 (93%) of these hypertensive patients were treated, and 239 (40%) were considered as having a controlled SBP at the treshold of 140 mmHg: 47% in patients with previous MI and 38% with AP (p < 0.001). Diastolic BP (DBP) was <90 mmHg in 480 (81%) and pulse pressure was >65 mmHg in 202 (34%); 313 (53%) patients received a combination of three drugs or more; 354 (60%) had a beta-blocker, 260 (44%) a calcium channel blocker, 237 (40%) an ACE inhibitor, 287 (48%) other antihypertensive drugs (246 diuretics, 41%); 502 (84%) received antiplatelet therapy, 403 (68%) statins. CONCLUSION: This survey shows that systolic BP is not at goal in 6/10 hypertensive patients with stable CHD suggesting there is a place for a more effective combination therapy according to evidence-based medicine.

Adult↗
PubMedDate not supplied

[Aortic insufficiency caused by dystrophic aneurysm of the ascending aorta: study of development in 95 cases. Value of cutaneous biopsy in the etiologic diagnosis].

We present 95 cases of aortic valve incompetence (AI) due to a dystrophic aneurysm of the ascending aorta; the aneurysm was idiopathic in 83 cases and associated with Marfan's syndrome in 12 cases. The diagnosis was confirmed by histological examination of the aorta and aortography. Functional signs were not always present, since 42 p. 100 of patients were in NYHA classes I and II and 58 p. 100 in classes III and IV. The prevalence of angina was 26 p. 100. The cardiothoracic ratio was increased up to 0.62 +/- 0.07, and projection to the right was noted in 63 p. 100 of the cases. Sokolow's index was 5 mv or more in 24 p. 100 of the patients. The aortic root, measured in 42 patients, was dilated up to 54 +/- 13 mm. The end-diastolic left ventricular diameter was increased to 70 +/- 10 mm. Haemodynamic studies yielded the following results: cardiac index 2.33 +/- 0.6 1/min/m2, end-diastolic left ventricular pressure 24.7 +/- 12 mmHg, mean pulmonary wedge pressure 12 +/- 6 mmHg, left ventricular end-diastolic volume 199 +/- 67 ml/m2, and angiographic ejection fraction 53 +/- 12 p. 100. The angiographic volume of aortic regurgitation, graded according to Sellers' classification, was 3/4 or 4/4 in 89 patients; the maximum diameter of the dilated ascending aorta was 73 +/- 18 mm. Evolutive data confirmed that aortic incompetence due to dystrophy is more severe than that due to other causes: 36 months after surgery, the overall mortality rate was 30%. Only two factors in our series seemed to be predictive of a poor prognosis: the fact that the patient belonged to NYHA class III or IV, and a mean pulmonary wedge pressure above 10 mmHg. This, however, must be taken with caution in view of the small population samples studied. The value of skin biopsy was confirmed. This examination, performed in 27 patients, was compared with the pathological examination of the aorta. Skin biopsy is specific and provides a major argument in favour of dystrophic AI in patients under 40 years of age.

Adult↗