PubMed Health⌕ Search

Biomedical subjects

J E Touze

Publications and source records attributed to J E Touze.

At least 19 recordsLinked to original sources
PubMed1996

[Ventricular extrasystole and arrhythmogenic right ventricular dysplasia. Critical analysis of the diagnostic value of non-invasive tests].

Asymptomatic ventricular extrasystoles were discovered in 2 active sportsmen (32 and 33 years). The cardiology work-up rapidly led to the diagnosis of arrhythmogenic right ventricular dysplasia in one. In the other, the clinical presentation was similar and the initial diagnosis was ventricular extrasystole with a healthy heart. Four years later however, the subject was still asymptomatic but a second evaluation revealed arrhythmogenic right ventricular dysplasia. This delayed diagnosis emphasizes the importance of renewed noninvasive evaluation of patients with asymptomatic ventricular extrasystoles.

Adult↗
PubMed1996

Electrocardiographic changes and halofantrine plasma level during acute falciparum malaria.

The aim of this study was 1) to assess the incidence of electrocardiographic changes after treatment with halofantrine and 2) to study the relationship between these changes and plasma levels of halofantrine and its main metabolite, N-desbutyl-halofantrine. Thirty-four male patients with uncomplicated falciparum malaria were enrolled in this study. Halofantrine was administered on two separate days at a total oral dosage of 24 mg/kg/day in three doses over a 12-hr period. The interval between the two treatments was seven days. Twelve-lead electrocardiography (ECG) was performed to measure the QT interval (QTc), ambulatory ECG monitoring was done to detect ventricular arrhythmia, signal-averaged ECG was performed to detect late ventricular potentials, and blood tests were performed to determine plasma concentrations of halofantrine and N-desbutyl-halofantrine. Maximum QTc was observed at 12 hr after both the first (P < 0.0002) and second treatments (P < 0.03). Signal-averaged ECG revealed late potentials in four cases (72 hr after the first treatment in one case and 24 hr after the second treatment in three cases). Ventricular arrhythmia was not observed. Significantly higher plasma concentrations of halofantrine were observed 2 hr after the second treatment. At this time, both the time effect and time interaction were significant (P < 0.008 and P < 0.02, respectively). The QTc interval was significantly correlated with the plasma halofantrine level (r = 0.41, P < 0.01) but not with the plasma N-desbutyl-halofantrine level (r = 0.30, not significant). In three cases, late ventricular potentials were associated with a maximum concentration of halofantrine. Our findings indicate that electrocardiographic changes are dose-dependent and that a second treatment at the same dosage may be hazardous.

Acute Disease↗
PubMed1996

[Electrocardiographic changes due to halofantrine in the treatment of malaria: therapeutic implications].

Electrocardiographic changes and their relationship with profiles of halofantrine (H) and desbutylhalofantrine (DBH) were assessed in a prospective study of 34 male patients with an uncomplicated falciparum malaria. H. was delivered in a one day in three intakes, 24 mg/kg/day. Seven days later the same regimen was administered. This study included a twelve-lead-electrocardiogram (to measure QTc interval), an ambulatory ECG monitoring a signal-averaged-electrocardiogram (to detect late ventricular potentials), and a kinetic-time profile of H. and DBH with high performance liquid chromatography. Data were obtained as follows: day 1 just prior to drug intake, 6 hours (H6), 12 hours (H12) after to drug delivery on day 1 and 8. There after on days 2, 3, 4, 9, 10, 11. Ambulatory ECG monitoring was recorded on day 1 and 8. QTc lengthening was noted in 10 patients with a mean QTc interval of 451 msec (range: 440-469 msec). Maximum QTc interval was obtained at H12 on day 1 (p < 0.0002) and 8 (p < 0.03). Signal-averaged electrocardiogram performed in 8 cases disclosed late potential in 4 cases (day 4: one case, day 9: 3 cases). No ventricular arrhythmia was observed on day 1 and 8. Plasma concentration time profile of H. showed a significant increase at day 8 H12 with a time effect (p < 0.0008) and a significant time-intake interaction (p < 0.02). QTc interval was significantly correlated with H. plasma level (p < 0.01) but not with D.B.H.. Late potentials were associated in 3 cases with a maximum plasma concentration level of H. These data showed that H. is potentially deleterious with a cardiac toxicity which appears dose-related, particularly during the second cure. Following this study, new prescription rules has been proposed before H. therapy.

Adult↗
PubMed1995

[Vagal syncope in young adults: specificity of the tilt-table test].

OBJECTIVE: The head-up tilt test has been used for more than 10 years to reproduce vagal lipothymia. The criteria for a positive test and specificity are however still lacking. METHOD: Thirty male volunteers, age 18 to 35 years, with no past history of lipothymia nor any signs of hypervagotonicity at physical examination, on fasting blood samples or on exercise tests with sudden interruption and Holter recording were selected for the study. Two head-up tilt tests at 60 degrees for 45 minutes were conducted, one with no presensitivisation and the other with a bolus of isoproterenol (2, 4, 6 and 8 micrograms) starting 30 minutes after the beginning of the test. Blood pressure was measured throughout the test. RESULTS: The systolic blood pressure curves showed drops of more than 30 mmHg accompanied by spontaneously resolving clinical signs in 6 of the 30 subjects during the non-sensitized tests and in 14 out of 30 during the sensitized tests. A symptomatic drop in systolic blood pressure of more than 30 mmHg compared to the moment before the malaise accompanied by clinical signs which did not resolve within 1 minute and required returning to the supine position occurred in one volunteer during a non-sensibilized test. This same type of reaction was observed in 4 volunteers during sensitized tests, three times after an isoproterenol bolus. CONCLUSION: Taking this later manifestation as the criteria for a positive head-up tilt test, the specificity of the non-sensitized and isoproterenol-sensitized tests in the young adult are 96.7 and 86.7% respectively. These findings must be considered with caution since there is no proof that these young men with no past history of hypervagotonicity but a positive head-up tilt test may be one day confronted with a situation generating a vagal reaction.

Adolescent↗
PubMed1995

[Halofantrine: for new rules of prescription].

Halofantrine is an antimalarial drug widely prescribed for chloroquine-resistant strains of Plasmodium falciparum. It has been recognized to cause serious deleterious effects which have dampened early enthusiasm for this compound. Basically, the adverse effects involve lengthening of the QTc interval, torsade de pointes and induction of late ventricular potentials. These side effects are related to the quinidine-like effect of the drug which has a chemical structure similar to quinine and quinidinic drugs. More recently, severe haemolytic accidents have been reported suggesting an autoimmunization mechanism. These side effects imply new rules for prescription and more prudent use of halofantrine, especially for prophylaxic therapy against malarial attacks in travellers.

Antimalarials↗
PubMed1995

[Goodpasture syndrome: role of an epidemiological factor? Apropos of two cases].

Goodpasture's syndrome is a rare pneumorenal syndrome. Although the antigenic target of this auto-immune disorder is now known, its etiology remains debated. We report two cases of Goodpasture's syndrome occurring in similar epidemiologic conditions concerning the moment the disease began, the age and sex of the patients, their place of residence and work and manipulation of chemicals. Thus, a common environmental factor could have been the trigger event of the Goodpasture's syndrome. The epidemiologic features of this disease are reviewed.

Adult↗
PubMed1995

[Arrhythmogenic right ventricular dysplasia disclosed by ventricular extrasystole].

Arrhythmogenic right ventricular dysplasia is one of the principal causes of sudden cardiac death in young subjects. In the absence of ventricular tachycardia, the disease can be revealed by simple ventricular extrasystole. In the light of such a case, the authors discuss the value of various complementary investigations for the diagnosis of these clinical forms with little or no symptoms. Detailed examination of the electrocardiogram followed by a search for late ventricular potentials are decisive steps before proceeding to invasive investigations which often remain essential to confirm the diagnosis. The prognosis remains uncertain, and is always dominated by the risk of sudden death, even in these apparently minor forms of the disease. This point further emphasizes the need for detection, which should be facilitated by the recent establishment of a list of diagnostic criteria.

Adult↗
PubMed1995

[Pathogenic approach of thrombopenia in dengue and its hemorrhagic complications].

Dengue is a frequent viral infection in the intertropical countries. The frequency and the severe forms of this infection are a real problem of public health. The haemorrhagic forms of the disease are constantly associated with thrombocytopenia. Its pathophysiology is still unclear. Among the different hypothesis, immune mechanisms play the main role. The authors discussed here the responsibility of the binding of immune complexes and the role of cytokines.

Antigen-Antibody Complex↗
PubMed1995

[Bipolar transseptal radiofrequency ablation of posteroseptal bundle of Kent. Apropos of a case].

The posteroseptal localisation of accessory pathways is sometimes responsible for important difficulties for radiofrequency current endocavitary ablation. Some authors have reported the exceptionally rare use of the transseptal bipolar mode for ablation of this type of accessory pathway. The authors report the case of a patient in whom failure of unipolar radiofrequency ablation at the tricuspid and then mitral annulus was followed by immediate success when the bipolar mode was used. The value of recording with the transseptal dipole at the ablation site is emphasised.

Adult↗
PubMed1995

Human pharmacokinetics of chloroquine and proguanil delivered in a single capsule for malaria chemoprophylaxis.

Two antimalarial prophylactic regimens were compared in 17 healthy volunteers. Regimen A consisted of daily ingestion of a single capsule containing 100 mg base chloroquine (CQ) and 200 mg proguanil (PG). Regimen B consisted of daily ingestion of separate tablets of CQ (100 mg base) and PG (two 100 mg tablets). Both treatments lasted for 12 days. Effective chloroquine levels were reached after 72 hours with both regimens (49.9 ng/ml for treatment A and 36.7 ng/ml for treatment B). Proguanil and cycloguanil plasma levels were significantly lower on sampling obtained at H3 (three hours later) and H6 (six hours later) on day 1 in the regimen A (p < 0.002). Thereafter there were no significant difference between the two regimens. Both regimens were well tolerated, but regimen A using the capsule appeared better accepted and facilitates compliance.

Adult↗