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Biomedical subjects

J C Meurice

Publications and source records attributed to J C Meurice.

At least 19 recordsLinked to original sources
PubMed1992

Atrial arrhythmia as a complication of nasal CPAP.

We report a case of supraventricular rhythm disorder occurring as a complication of nasal continuous positive airway pressure (CPAP) in sleep apnea syndrome treatment. The investigations showed a preexisting atrial vulnerability revealed by positive pressure ventilation, hemodynamic changes with decreased cardiac output, and a rise in the right atrial pressure. Such complications may develop further studies to evaluate cardiovascular repercussions of nasal CPAP.

Aged↗
PubMed1992

[Bilateral chylothorax after mild trauma: apropos of a case].

The authors report a new case of bilateral chylothorax predominant on the left side, which occurred after movements of body trunk hyperextension in a 52-year old woman without any notable history. The clinical signs revealing the lesion were left thoracic pain and dyspnoea. The effusion had been preceded by a painless and transient left cervical tumefaction. The outcome was favourable after two left pleural draining punctures and rest.

Athletic Injuries↗
PubMed1992

[Mucoepidermoid bronchial carcinoma. Review of the literature apropos of a new case].

Muco-epidermoid bronchial tumours are rare and characterized by the coexistence of epidermoid, mucus-secreting and intermediate cells. The authors report the case of a 22-year old unmarried woman hospitalized for exploration of a febrile dyspnoea related to a right superior lobar atelectasis. Endoscopy showed a smooth, pediculate tumour arising from the right superior lobar bronchus where bronchial biopsy was negative. Right superior lobectomy was performed through thoracotomy and established the diagnosis of muco-epidermoid bronchial tumour. Surgery was followed by radiotherapy of the chest. Over a 5-year follow-up period there was no local or extrathoracic recurrence, and the patient is in good condition.

Adult↗
PubMed1991

Same location of the source of P1 of BAEPs and N1 of CAP in guinea pig.

The purpose of this study was to point out the location of N1 and N2 of the compound action potential (CAP) and the first waves of the brainstem auditory evoked potentials (BAEPs) by the mean of the section of the eighth nerve at the porus acousticus in guinea pigs. Our results agree with most of the studies in the literature. In the absence of lesion of the internal auditory artery, the section of the cochlear nerve induced the persistence, alone, of the P1 of BAEPs in which latency was similar to initial P1 before section, and the subsequent waves disappeared. Simultaneously, a monophasic negative potential (N1) of the auditory nerve remained without N2. When the section included the internal auditory artery all BAEPs and CAP components disappeared simultaneously and very suddenly just after the section. These results definitively excluded a proximal contribution of the cochlear nerve in the N1 of CAP and P1 of BAEPs. The N2 of CAP and P2 of BAEPs are not generated, even in part, in the intracochlear or intrapetrous portion of the cochlear nerve.

Action Potentials↗
PubMed1991

[Is chemotherapy with cisplatin useful in non small cell bronchial cancer at staging IV? Results of a randomized study].

The benefit of chemotherapy for patients with disseminated non small cell lung cancer (NSCLC) is controversial. The introduction of cisplatinum in the combination chemotherapy for NSCLC gave rise to higher response rates. To study the question of the usefulness of cisplatinum-based chemotherapy in disseminated NSCLC we conducted a prospective randomized trial comparing best supportive care to vindesine + cisplatin. Between December 1985 and March 1988, 49 patients with stage IV NSCLC were enrolled. Of the 46 eligible patients 24 were in the chemotherapy group and 22 in the best supportive care group. The treatment groups were not significantly different in terms of age, performance status, histology. Toxicity on the chemotherapy arm grade 3 or more was observed in 17.5% for neutropenia, in 8.75% for vomiting. There was one death related to treatment. The overall response rate in the chemotherapy group was 41.7%. Patients of the chemotherapy group had a median survival time of 199 days and the patients of the best supportive care group had a median survival time of 73 days. The difference in survival is highly significant (p less than 0.001).

Adult↗
PubMed1990

[Intestinal perforation occurring at the beginning of treatment: a severe complication of bacillary tuberculosis].

We report 2 cases of intestinal perforation caused by tuberculosis and affecting the small intestine in one case and the colon in the other case. The patients were men aged 49 and 51 years respectively. Both were cachectic and presented with advanced open pulmonary tuberculosis. Perforation in free peritoneal cavity occurred 2 and 8 days respectively after an antituberculous treatment was initiated. The outcome was rapidly fatal in both cases. Tuberculous enteritis has become rare, but it can still be observed in patients with severe open pulmonary tuberculosis, where the gastro-intestinal tract is contaminated by the large number of virulent mycobacteria swallowed. In such patients clinicians must be alert to abdominal premonitory signs. Intestinal perforations in free peritoneal cavity are uncommon. Most perforation are small, single or multiple, and located on the antimesenteric side of the terminal ileum. They may occur at any time, and particularly just after an antituberculous therapy has been instituted. Clinical presentation is one of acute peritonitis requiring emergency laparotomy. Mortality has been reduced by technical improvements, notably temporary enterostomy, but perforation remains a serious and often fatal complication of tuberculosis in patients with severe malnutrition.

Antitubercular Agents↗
PubMed1990

[Allergy to kiwi: an unrecognized allergy].

We reported 4 cases of an uncommon hypersensitivity: hypersensitivity to kiwi fruit. The clinical reactions, essentially buccal, occurred few minutes after ingestion of the fruit. The Radio Allergo Sorbent Test were positive in the 4 cases. The skin tests, with fresh extracts of kiwi, made in 3 cases were dramatically positive, while they are negative in controls patients. The kiwi fruit initially comes from China, but is now produced in France, and especially in Poitou-Charente. It contains a proteolytic enzyme call Actinidin with physical and chemical properties similar to those of Papain, who can perhaps explain this hypersensitivity.

Adult↗
PubMed1989

[Neuropeptides and respiratory diseases: prospects in the treatment of asthma].

The autonomic nervous system includes, side by side with the sympathetic and parasymathetic systems, a third, non-adrenergic and non-cholinergic system called NANC. The mediators in this system are peptides acting as neurotransmitters, i.e. neuropeptides. The NANC system has two components: bronchodilator and bronchoconstrictor. The bronchial relaxant system, called non-adrenergic inhibitory system, has several neurotransmitters, viz.: vasoactive intestinal peptide (VIP), isoleucine histidine peptide (IHP) and methionine histidine peptide (MPH), all derived from a common precursor: pre-pro VIP. MHP has been described in man and IHP in some animal species. VIP relaxes the bronchial smooth muscle, is vasodilator and exerts cellular effects in phagocytes, lymphocytes and mast cells. VIP receptors are present on cells. The other component, called non-cholinergic excitatory system, has tachykinins as neuromediators, including substance P, neurokinins A and B, neuropeptide K and calcitonin gene related peptide (CGRP). Substance P contracts the bronchi, increases mucus secretion, dilates vessels and also exerts cellular effects in lymphocytes and phagocytes. Tachykinins act through receptors 3 types of which are now known: NK 1, NK 2 and NK 3. Other neuropeptides have been isolated, including galanin, neuropeptide Y, bombesin, gastrin releasing peptide, enkephalins and katacalcin. The coexistence, in pre- and post-synaptic positions, of the conventional mediators (noradrenaline, acetylcholine) and neuropeptides leads to the concept of co-transmission and makes the notion of nerve impulse transmission more complex. The development of neuropeptide agonists and antagonists opens new therapeutic prospects in the management of asthma.

Asthma↗
PubMed1989

[Fluoroquinolones: pharmacology, antibacterial spectrum and indications in pneumology].

Fluoroquinolones are antibiotics that act principally on DNA gyrase. At the moment, resistance to these antibiotics is purely chromosome-mediated. As regards pharmacokinetics, these compounds have a high bioavailability and penetrate extremely well into tissues and cells. Therapeutic concentrations are obtained in bronchial mucosa and lung tissue. In severe lower respiratory tract infections fluoroquinolones must be given in combination with other antibiotics to prevent the emergence of resistant mutants. The indications of fluoroquinolones in lower respiratory tract infections depend on their antibacterial spectrum. They are particularly useful in the treatment of infections caused by methicillin-sensitive or resistant staphylococci, Pseudomonas spp. (notably in cystic fibrosis) and intracellular organisms. They are not indicated for streptococcal infections, notably those due to Streptococcus pneumoniae, and for anaerobic infections. Fluoroquinolones are currently used mainly in hospital-acquired lower respiratory tract infections, in infected cystic fibrosis and in some acute episodes of chronic bronchitis since they are active against Haemophilus influenzae and Branhamella catarrhalis.

4-Quinolones↗
PubMed1989

[Value of nifedipine in respiratory failure related to obstructive chronic bronchitis during treatment over 6 months].

We studied the simultaneous effects of nifedipine on the pulmonary circulation and blood gases in 12 patients with pulmonary hypertension secondary to obstructive chronic bronchitis. Measurements were carried out at rest and during stress, initially then one hour after administration of 20 mg of nifedipine sublingually. They were repeated in a similar fashion after a 6-month treatment with 60 mg/day (group II) (30 mg/day in case of intolerance) (group I). The results of the immediate effect of nifedipine are in favor of a passive pulmonary vasodilatation secondary to the systemic vasodilatation. After six months of treatment, the pulmonary vasodilatation persists, but is associated with a decreased motor pressure indicating a more specific and more active pulmonary vasodilating effect of long-term nifedipine, especially during stress; this results in the improvement of the performance of the right ventricle without harmful effect on the blood gases. However, these results should be interpreted with caution on account of the small number of patients, the large interindividual variations and the absence of a reference population.

Administration, Sublingual↗
PubMed1988

[The role of inhalation chambers in the treatment of asthma].

Inhalation chambers (spacers), interposed between the aerosol doser and the patient's mouth take 3 forms: lengthened tubes, large volume plastic sacs and conical chamber in the shape of a pear. Their chief advantages are: A greater proportion of the drug reaches the airways, as the deposition in the oropharynx is reduced. Co-ordination of lung and hand, a major obstacle to the correct use of aerosol-dosers, is no longer necessary.

Administration, Inhalation↗
PubMed1986

[Interstitial pneumopathies during amiodarone treatment. Determination of serum amiodarone, typing of lymphocytes from bronchiolo-alveolar lavage].

We report 6 cases of diffuse interstitial pneumonia complicating therapy. The patients' study included the determination of amiodarone plasma level by high performance liquid chromatography (HPLC) and a study of lymphocyte subpopulations in alveolar lavage (wash cut). The mean cumulative dosage of amiodarone was 229 g; clinical symptoms were mainly weight loss, asthenia, dyspnea and dry cough. Bronchiolo-alveolar lavage fluids contained numerous lymphocytes, of which were T cells with a predominance of T8 lymphocytes. This is compatible with an immunoallergic mechanism as suggested in allergic alveolitis and in other drug induced pulmonary diseases. The determination of plasma amiodarone level performed after amiodarone withdrawal consistently showed a level inferior to the toxic one. These data confirm the lack of correlation between the pneumonitis outbreak and the amiodarone plasma level. Study of the red cell concentration of amiodarone and its major metabolites seems to be of greater interest.

Aged↗