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J Bouget

Publications and source records attributed to J Bouget.

34 records · Page 2Linked to original sources
PubMed1988

[Pharmacokinetics of ceftriaxone in intensive care].

Pharmacokinetic parameters of ceftriaxone were studied on day 1 and 5 in 21 patients admitted in an ICU for severe infections. All patients received a single daily infusion of 2 g of ceftriaxone during 15 minutes. We have determined the ratio to the daily dose of serum ceftriaxone concentrations (peak level and trough level) and of areas under the curve. According to renal function and the existence of cholestasis, the results of our study showed: 1) In patients with creatinine clearance greater than 10 ml/mn and without cholestasis, a single daily infusion of 2 g ceftriaxone achieves therapeutic blood levels without any accumulation phenomenon. 2) In patients requiring hemodialysis without cholestasis, the period between two 2 g doses should be prolonged to 48 h. 3) Marked cholestasis and creatinine clearance greater than 10 ml/mn prolong the elimination half-life of ceftriaxone leading to an interval extension of the single dose of 2 g. Further investigations are needed in the latter situation.

Adult↗
PubMed1987

Massive hemoptysis from iatrogenic balloon catheter rupture of pulmonary artery: successful early management by balloon tamponade.

Cessation of massive hemoptysis after iatrogenic balloon catheter rupture of the pulmonary artery was observed after a 2-ml inflation of the balloon. A wedge angiogram showed a small cavity near the rupture. Secondary lobectomy was performed; however, the patient died 1 month later. Therapeutic approaches of this life-threatening complication are presented.

Aged↗
PubMed1981

[Value of serum myoglobin in acute myocardial infarction. Kinetic study].

The rise in serum myoglobin (MGB), total CPK (CKT) and its MB isoenzyme (CK - MB) was studied and compared over the first three days of acute myocardial infarction (AMI) and correlations were sought between the peak values of these three parameters and haemodynamic and biological indices of left ventricular function. Blood was taken from MGB (radio immunological technique), CKT and CK - MB (spectrophotometry) estimation every 2 hours for 24 hours and then every 6 hours up to the 72nd hour in 36 patients with AMI less than 12 hours old. On admission, this protocol was completed by a haemodynamic study (right heart pressures, systemic blood pressure, cardiac output measurement by thermodilution), arterial gases and ECG recordings. The average delays before the pathological rise, the maximal peak value and the return to normal were significantly shorter (p less than 0.001) for MGB (2, 6 and 25 hours) than for CK - MB (5,16 and 34 hours) or CKT (5,21 and 57 hours). The sensitivity of the diagnosis of myocardial infarction was not significantly higher with MGB than CKT or CK - MB either in the whole group (sensitivity of 91.6 p. 100 for MGB and 86.1 p. 100 for CKT and CK - MB) or in a subgroup of ten patients without transmural infarction (70 p. 100 for MGB compared with 60 p. 100 for CKT and CK - MB). A significant correlation was found between the peak values of MGB (p less than 0.02) and CK- MB (p less than 0.02) and the indices of left ventricular function (PCP, PAO2 and LVSWI). This was not observed with CKT. In conclusion, apart form technical problems which remain unresolved time-consuming investigation), serum MGB gives a much earlier and as sensitive a biochemical diagnosis of AMI as CKT and CK - MB. MGB and CK - MB are much better prognostic indicators than CKT as judged by the indices of left ventricular function. Finally, MGB estimation should be of particular value in the diagnosis of secondary extension of infarction.

Acute Disease↗
PubMed1980

[Study on myoglobinemia and its development during myocardial infarction (author's transl)].

Thirty six patients suffering from myocardial infarction were investigated by assay of their serum myoglobin, total creatine kinase and creatine kinase isoenzyme MB activities. Determination of serum myoblobin presents, with regard to creatine kinase MG, two major advantages: a very early increase after the onset of the pain (about three hours later) and a very quick clearance, allowing the diagnosis of a second episode of necrosis after about one day.

Creatine Kinase↗
PubMed1979

[Traumatic myocardial infarct].

Two cases of traumatic, closed chest, myocardial infarction in two young patients, aged 18 and 19 years respectively, are reported. They illustrate the two possible physiopathological mechanisms of this affection: in the first case, myocardial contusion after thoraco-abdominal trauma by crushing, probably complicated by a subendocardial tear of the inferior wall of the left ventricle, with a spontaneous favourable outcome; in the second case, a transmural myocardial infarction was observed secondary to a coronary lesion (? tearing of the adventitia of the left anterior descending artery) complicated by the early development of a large antero-apical aneurysm. Haemodynamic and arrhythmic complications necessitated infarctectomy and aorto coronary bypass surgery on the 35th day. The pathological lesions and their outcome are examined with respect to these two cases. The diagnostic, therapeutic and medieolegal problems associated with this condition are also discussed.

Adolescent↗
PubMedDate not supplied

[Water intoxication in psychiatric patients. 13 cases of severe hyponatremia].

Water intoxication mostly occurs in psychiatric patients. We observed 13 episodes of severe hyponatremia (less than 120 mmol/l) following a period of increased water consumption in 10 psychiatric patients (5 men, 5 women, mean age 48.8 years) treated with neuroleptics and/or benzodiazepines. Other causes of hyponatremia were excluded. The initial clinical signs were associated with severe gastrointestinal and neurological disorders requiring intensive care. In every case a gradual return to normal of natremia was obtained by creating a negative water balance while compensating for the sodium loss. From a study of urine and plasma osmolality ratio (U/P osm) on admission, several physiopathological mechanisms could be envisaged. A U/P osm ratio lower than 1 (6 cases) suggested a water intake exceeding the maximum dilution capacity of the kidneys (20-25 1), or a lesser water intake with little or no osmolal intake, or again an intrarenal disorder of urine dilution. When the U/P osm ratio was higher than 1 (7 cases), reflecting inappropriate secretion of the antidiuretic hormone, the hyponatremia could be explained by the psychosis itself, the treatment taken by the patients, a disorder of thirst regulation and/or a non-osmotic stimulation of vasopressin. This population, therefore, was heterogeneous: the mechanisms which contribute to this pathology are not fully elucidated, and they probably involve several factors.

Adult↗
PubMedDate not supplied

A microcomputer teaching and decision-support system for emergency medicine: use of hypermedia and artificial intelligence in combination.

Hospital emergency units are submitted to a continuous intensive and polyvalent practice of medicine. In addition to the few experienced physicians, the medical staff is often made up of young and unskilled students and residents. The ability to reach at any time a wide and flexible knowledge is of the utmost importance to improve the quality of care given to patients and to perfect bedside teaching. The purpose of this work was to present a computerized system, a kind of shell, using, in combination, artificial intelligence and hypertext/hypermedia tools. A modular architecture is presented integrating two entities: an illustrated encyclopedic hypertext network and several expert modules based on production rules concerning well-limited fields of medicine (basic clinical problem-solving, metabolic and acid-base disorders). An interface using the World Wide Web (WWW) will soon be proposed.

Artificial Intelligence↗