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Biomedical subjects

J Fabre

Publications and source records attributed to J Fabre.

At least 19 recordsLinked to original sources
PubMed1995

Results of heart-lung transplantation in children with cystic fibrosis.

Children with cystic fibrosis represent the largest group referred for, and undergoing, heart-lung transplantation at our institute. Between June 1988 and July 1993, 76 patients were accepted for transplantation, of whom 25 were transplanted, while a further 36 died waiting. Those transplanted ranged from 5-18 years of age and included 13 males and 12 females. Organs were used from donors matched by ABO blood group, size and cytomegalovirus (CMV) status. Post-transplant maintenance immunosuppression comprised cyclosporin A, azathioprine and prednisolone. Anti-thymocyte globulin and high dose methylprednisolone were given peri-operatively and for acute rejection episodes. Actuarial survival was 67% at 1 year, 61% at 2 years and 54% at 3 years. Obliterative bronchiolitis (OB) has occurred in 13 patients (52%) and was the major cause of mortality and morbidity. In three patients, OB was associated with the development of tracheal anastomotic stenosis. Other complications included diabetes mellitus (n = 9), pancreatitis (n = 1) and hypertension (n = 8). Despite these problems, those surviving the first year post-transplant showed a mean FEV1 of 71% (compared to 29% pre-transplant) and enjoyed an overall improved quality of life.

Actuarial Analysis↗
PubMed1995

Colonic transit in soccer players.

To evaluate the effects of exercise on colonic function, we measured total and segmental transit times in 11 male soccer players and nine male radiology student technicians. Diet was kept constant in all subjects, who maintained their normal activities. For the soccer players, normal activities included 15 h of training and one match each week. Transit times were measured with radioopaque markers, using the multiple-ingestion, single-radiograph technique. No overall difference in large bowel transit was observed between the two groups. Right colon transit was considerably slower in the soccer players, whereas left colon and rectal transit were slightly accelerated. We conclude that an intensive sport activity only modifies regional differences in large bowel function. This may be of importance in extreme conditions, such as those experienced by marathon runners. Data should be obtained before prescribing exercise to treat constipation.

Adult↗
PubMed1994

Evaluation of a cardiopulmonary preservation method for heart-lung transplantation.

This study was designed to examine whether concomitant administration of anti-free radicals with donorcore cooling on cardiopulmonary bypass (CPB) and hypothermic storage of the heart and lung, could provide successful extended cardiopulmonary preservation. Fourteen sheep heart-lung blocks harvested after core-cooling and cardioplegic arrest were preserved at 4 degrees C for 8.5 hr. Before and during CPB, the animals were perfused with Prostaglandin E1 (PGE1), superoxide dismutase (SOD), catalase (CAT) and deferoxamine (DEF). Cardioplegic arrest was induced with St. Thomas' Hospital solution (Plegisol) to which SOD, CAT and DEF had been added. The preservation solution consisted of Plegisol modified by the addition of K-lactobionate, raffinose, mannitol, SOD, CAT, DEF, a phosphate buffer and penicillin. Histological examination performed on 3 donor heart-lung blocks before and after CPB and cardioplegia, then immediately following cold storage, produced no clear evidence of structural damage in cardiac myocytes and lung parenchyma. Eleven donor organs were therefore transplanted in size-matched recipients with a total mean ischemic time of 12 hr. The combined administration of SOD, CAT, DEF, insulin and glucose during the initial period of reperfusion had no beneficial effect on cardiopulmonary performance. A progressive fall in Pa O2 and mean aortic pressure was observed post-operatively in the 7 animals that were weaned from CPB. Five of them died within 3 to 5 hr after CPB weaning, the remaining 2 animals died of cardiac arrest within the fourth hour. The results of this experiment seem to indicate that: 1. better organ function and improved survival could have been obtained if the duration of anti-radical treatment had been prolonged after reperfusion and, 2. physical manipulation of the donor grafts during harvesting and transplantation may have been partly responsible for the poor post-transplantation cardiopulmonary performance.

Animals↗
PubMed1992

[Therapy compliance. A matter of concern in clinical medicine].

Approximately one half of the patients takes prescribed medications irregularly or omits these altogether. On the basis of our own observations and published reports we analyze the factors influencing compliance. The motivation of the patients plays a decisive role, it is rooted in the meaning the patient gives to his existence, to where the strength of his family bonds and the confidence in the care-taking persons lays as well as the possibility to express himself which is most important. The better guidance and training of the doctors in the difficult task of strengthening such motivation may contribute to substantially improve this situation.

Adult↗
PubMed1992

The influence of patient and physician gender on prescription of psychotropic drugs.

There is a wealth of evidence that more psychotropic drugs are prescribed to female than to male patients. We studied the psychotropic drug prescription of 15 male and 9 female physicians to 2493 patients in the Ambulatory Care Clinic of a University hospital. The relative odds (RO) of benzodiazepine prescription to a female compared to a male patient was the same when the physician was a male or a female (adjusted RO: 1.8; 95% CL: 1.5-2.1). But female patients were significantly more likely to be prescribed psychotropic drugs of all types from a female than from a male physician (adjusted RO: 1.3; 95% CL: 1.0-1.7). Information on patient diagnosis or on severity of symptoms would be needed to determine whether the present results reflect gender differences in medical care needs, overprescription of psychotropic drugs to females or underprescription of psychotropic drugs to males.

Attitude of Health Personnel↗
PubMed1992

On the determinants of persistent gambling behaviour. I. High-frequency poker machine players.

Persistent gambling was studied as a function of the reinforcement of arousal and winning during normal poker machine playing sessions. Play rate, heart rate, winnings, subjective excitement and expectations of winning were recorded for five male and five female high-frequency players. Autoregressive regression analysis indicated that wins affect play rate for up to three minutes, while effects of the other variables were inconsistent. Markov chain analysis confirmed that wins smaller than 50 credits tend to elevate play rate, while larger wins cause a breakdown in the otherwise very regular rate of play. Results are discussed in relation to the development of impaired control of gambling behaviour.

Adolescent↗
PubMed1991

[Cardiac sarcoma disclosed by hypereosinophilia].

A 48 year old woman presented peripheral eosinophilia and neurologic symptoms which were related to a right parietal hypodense lesion. Further investigation led to the discovery of a left atrial cardiac tumor which had been incompletely resected and diagnosed as sarcoma. Eosinophilia than decreased. Two months after cardiac surgery, intracranial hypertension appeared and another expansive cerebral mass was discovered on CT scan. The patient was treated by radiotherapy. Two years later, the patient presented left abdominal pain. An increase of eosinophilic rate was noted. Abdominal CT scan revealed an heterogenous mass in the spleen. Splenectomy was performed and the tumor was diagnosed as a metastasis of the cardiac sarcoma. This case illustrates a rare tumor which is distinctive by its clinical signs: peripheral eosinophilia and neurologic signs. There were no cardiac symptoms. The clinical evolution was good after more than two years from initial diagnosis. This implies that a surgical attitude is recommended in such cases.

Eosinophilia↗
PubMed1990

[Between nihilism and fanaticism: the ethics of prevention].

Opinions diverge on the ethics of preventive medicine. A balance needs to be struck between nihilism (doing nothing) and fanaticism (doing too much). The authors consider the ethical aspects of preventive medicine from the practising physician's viewpoint. Various aspects can be identified: SCIENTIFIC AND METHODOLOGICAL: Like any medical act, preventive practice relies on good scientific data. The epidemiologic studies should be clinically relevant and their recommendations must be interpreted critically before being incorporated into clinical practice. It should not be forgotten that we are dealing with patients and their behaviour. Tactful dialogue and personalized intervention are essential. DEONTOLOGICAL: Modern medicine is oriented toward health maintenance and promotion, thus including prevention. Although the community has drawn obvious benefits from preventive practices such as the use of vaccines, prevention must not be allowed to become a medical tyranny. Respect for the individual should remain its central concern. ETHICAL: The "meaning of life" must not be forgotten. Factors such as quality of life should always be kept in mind in measuring the benefits of prevention. By providing objective information and tailored counselling, the aim of prevention is to encourage expression of the individual's own responsibility for her/his own health. FINANCIAL: Preventive medicine is not covered by health insurance schemes. Cost-benefit analysis should consider not only the economic aspects of prevention but also its positive impacts on the entire social field. SOCIAL AND CULTURAL: The findings of epidemiologic studies must be adapted to precise socio-cultural environments. In our culture, for example, caregivers should be the first to practise what they preach. It must also be remembered that at the present time the basic preventive measures are still not accessible to everyone.

Culture↗
PubMed1990

Intrathecal administration of 131I radiolabelled monoclonal antibody as a treatment for neoplastic meningitis.

Fifteen patients with neoplastic meningitis received a single intrathecal injection of between 11 and 60 mCi of a 131I radiolabelled monoclonal antibody (MoAb), chosen for its immunoreactivity to tumour. Major toxicity was manifest as nausea, vomiting and headache (7/15 patients), reversible bone marrow suppression (3/8 patients) and seizures (2/15 patients). Nine patients were evaluable for either a tumour or clinical response. Six of these demonstrated an event-free response that was maintained for periods of between 7 and 26 months.

Antibodies, Monoclonal↗
PubMed1990

[Place of muscular exercise test in screening in asymptomatic smokers].

The diagnosis of smoking-related chronic obstructive pulmonary disease (COPD) is often made too late. Could the study of breathing pattern during exercise testing help in earlier detection. In order to test this hypothesis, we studied 34 asymptomatic smokers (S) compared to 55 nonsmoking controls (NS). The subjects, divided into 3 age groups (30-60 yr), were comparable in terms of anthropometric and spirometric characteristics. The smokers from 30-50 yr had a lower VO2max than the controls (p less than 0.01) whereas the older smokers (50-60 yr) had a VO2max comparable to that of the controls. The study of breathing pattern indicated rapid, shallow breathing by all smokers. Thus exercise testing, and the abnormalities observed in breathing pattern, would seem to help in early detection of COPD in asymptomatic smokers.

Adult↗
PubMed1989

[Peripheral thyroid insufficiency. Criteria of equilibrium in treatment with L-thyroxine].

During treatment of primary hypothyroidism, the respective values of hormonal assays (total and free T4 and T3, ultrasensitive TSH assay, TRH test) and of the serum markers from peripheral tissue response to thyroid hormones used to detect overdosage are matter to debate. Thirty-four female patients with hypothyroidism, aged 38 +/- 7 years (mean +/- SD) were studied. the mean dose of L-thyroxine required to obtain clinical euthyroidism was 100 +/- 35 micrograms/day. Thyroid hormone and TSH concentrations were measured 20 to 24 hours after the last dose of L-thyroxine and after fasting overnight and were compared with the concentrations obtained in 45 euthyroid controls aged 32 +/- 10 years.

Adult↗
PubMed1989

[Before we forget...].

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Health Services Accessibility↗