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Biomedical subjects

J C Manelli

Publications and source records attributed to J C Manelli.

13 recordsLinked to original sources
PubMed1979

Severity and prognosis after early excisions from one to twenty percent of the body surface area.

The authors review 101 small and medium early excisions with immediate grafting. They study several parameters concerning the severity of the burn, the time and the duration of the surgical procedure, the blood losses, the effect on the protidemia during the shock period, the duration of the hospital care, the septicemic risk, the mortality, and the functional and cosmetic results. They come to the conclusion that, under 15% of the body surface area, early excision can be done at one single operation with hardly any risk, and that it is better to perform it as soon as possible (before 12 hours if possible). With a good splinting and a daily rehabilitation, the cosmetic and functional results are very satisfactory.

Blood Volume↗
PubMed1977

[Early respiratory involvement in burns. Mechanism and prognostic significance].

A retrospective study, on 87 flame burn patients, of arterial Pa02, chest X-ray and lactic dehydrogenase isoenzyme III revealed the very early onset (before the 24th hour) of severe respiratory problems. This involvement, with a severe prognostic significance, appears to be much more closely related to the extent of the cutaneous burn than to the inhalation of fumes or vapours, and seems to fall into the more general category of "post-aggression lung".

Adult↗
PubMed1977

[Syndrome of inappropriate secretion of vasopressin. Apropos of 3 cases].

3 cases of inappropriate vasopressin secretion during one case of anaplastic carcinoma of the lung, one case of carcinoma of the prostate with bony metastases and one case of acute intermittent porphyria are presented. The plasma levels of vasopressin, measured by radioimmunoassay were high. Treatment with demeclocycline was attempted in one case. The clearance of free water was positive but the treatment was poorly tolerated by the digestive tract.

Acute Disease↗
PubMed1977

[Circulating lipids in prolonged postoperative parenteral feeding: their changes depending on the nature of energy intake].

Repeated estimations of circulating total lipids and various fractions were made during the postoperative period in patients receiving parenteral nutrition for more than ten days. The patients were paired in relation to the underlying pathology and divided into two group : the first receiving energy supplements in the form of carbohydrates alone, whilst the second received part of this supply in the form of lipid emulsions (Trive 1000). Total lipids and various plasma fractions, with the exception of free fatty acids, increased progressively during the postoperative period, regardless of the inital values and independently of the lipid content of the nutrition fluids given. There was no significant difference between those patients who received lipid emulsions and those who did not. Free fatty acids remained at levels slightly greater than normal in the group which did not receive lipids. They were significantly higher in the group given lipid emulsions, though it was not possible to precisely define their orgin.

Adult↗
PubMed1977

[Comas of realimentation].

Parenteral realimentation in the patient with severely impaired nutrition is sometimes associated with the development of a metabolic encephalopathy with coma. The onset of this complication is sudden. The coma is deep, accompanied by signs of neuromuscular hyperexcitability and very marked hyperventilation. It generally regresses rapidly, without sequellae. The onset of such a realimentation coma should be feared in the presence of a certain combination of conditions : severely impaired nutrition, parenteral alimentation with a high level of nitrogen and calories, transfer to the anabolic phase (perfect carbohydrate utilisation, fall in blood phosphate levels with hypophosphaturia, sometimes very marked positivisation of nitrogen balance) and, sometimes, mild premonitory clinical signs. The relationship between this type of complication and hypophosphoraemia is quite definite, but the fall in serum phosphates would not appear to be directly responsible for the coma. The exact mechanism is not known. In order to avoid such complications, great caution should be observed in both the quality as well as the quantity of the intake, as well as in the clinical and laboratory surveillance of the malnourished patient undergoing realimentation.

Coma↗
PubMed1975

[Postoperative peritonitis. Use of metabolic disorders as criteria for reoperations].

The authors compared three groups of subjects: - the first group (11 patients) : re-operated for post-operative peritonitis; - the second group (6 patients) : re-operated for evisceration without any underlying lesion; - the third group (8 patients) : non-reoperated, complicated abdominal surgery. Study of the different laboratory parameters helped to identify a number of changes which could plead in favor of reintervention, in the group of peritonitis. Among these modifications, the progressive fall in the urinary Na/K ratio and the negativity of the nitrogen balance appear to play a privileged role.

Abdomen↗
PubMedDate not supplied

Chlormezanone-induced fulminant hepatitis in a pregnant woman: successful delivery and liver transplantation.

The case of a 29 year old woman affected by fulminant hepatitis during the third trimester of pregnancy, after a 3 week administration of chlormezanone is reported. Following induced Caesarean delivery, the patient underwent an orthotopic liver transplantation. The mother and her baby were in good condition 26 months after liver transplantation. In this case, chlormezanone was probably responsible for the fulminant hepatitis.

Acute Disease↗
PubMedDate not supplied

[Anesthesia for primary excision and grafting in the severely burned patient (author's transl)].

Through a retrospective study of 81 anaesthesias for primary excision with immediate grafting (performed within the first 72 hours after burning), the authors, using in most of the cases an anaesthetic procedure including neuroleptanalgesia and nitrous oxyde, with controlled ventilation, tried to determine: --the incidence of such a type of anaesthesia on the patient condition, --the period during which anaesthetic risk is the least. Studies of hemodynamic, respiratory and thermic changes, related with anaesthesia, and a study of coagulation changes, related with surgical procedure, have been performed. It appears that neuroleptanalgesia is a method available for primary excision with immediate grafting and that the elective period for anaesthesia and surgical procedure is situated within 12 hours after burning.

Adolescent↗