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Biomedical subjects

J Feret

Publications and source records attributed to J Feret.

11 recordsLinked to original sources
PubMed1991

Prevention of deep vein thrombosis after total hip replacement. The effect of low-molecular-weight heparin with spinal and general anaesthesia.

Enoxaparin, a low-molecular-weight heparin, has been used together with spinal or general anaesthesia in a prospective, randomised study of 188 consecutive elective hip replacements. Bilateral venography was performed on all patients on day 13 after operation. Group I (65 patients) received spinal anaesthesia and no immediate injection of enoxaparin. Group II (61 patients) received spinal anaesthesia and 20 mg of enoxaparin one hour after the onset of anaesthesia. Group III (62 patients) was operated on under general anaesthesia and received 40 mg of enoxaparin 12 hours prior to surgery. This group acted as the control group. In all three groups, 40 mg of enoxaparin was given 12 hours after the end of surgery and continued on a once-daily basis. Proximal DVT occurred in 6% of group I, 6.7% of group II and 6.5% of group III, not a significant difference. Distal DVT was present in 11% of group I, 5% of group II and 0% of group III; this was a highly significant difference (p = 0.007). Tolerance was good and the incidence of bleeding low in the three groups. Our results confirm the low rate of DVT in patients operated on under general anaesthesia with the standard procedure of 40 mg of enoxaparin on a once-daily basis started pre-operatively. The 40 mg-dose is also safe and effective in association with spinal anaesthesia if half the dose (20 mg) is injected an hour after the lumbar puncture.

Aged↗
PubMed1990

Once-daily dosing of enoxaparin (a low molecular weight heparin) in prevention of deep vein thrombosis after total hip replacement.

The main results of three successive prospective clinical trials which represent the successive steps in the definition of once-daily dosing of enoxaparin in elective hip surgery are demonstrated. In the first trial, a dose of 40 mg/day (4000 anti-Factor Xa IU), in one or two subcutaneous injections, was preferred to a dose of 60 mg because it gave the same efficacy with a better tolerance. In a second, randomized double-blind trial, the two modes of administration of a dose of 40 mg, in one or two injections daily, were found to be equivalent with regard to tolerance and efficacy. In a third prospective, controlled, randomized, double-blind multicentre trial, once-daily dosing of enoxaparin at the dose of 40 mg was found superior to 5000 IU of unfractionated heparin tds with regard to tolerance and efficacy. It is concluded that the dose of 40 mg/day, begun 12 h pre-operatively, gives the best benefit:risk ratio in elective hip surgery.

Aged↗
PubMed1979

[Factors responsible for post-operative infection].

Post-operative infection is often due to a combination of several factors. A decrease in immune defence processes represents the first factor. This is seen in situations such as malnutrition (undernourishment or obesity), alcoholism, diabetes, neoplasms, infections and old age. It may also be induced by therapy such as immunodepressants, antimitotic chemotherapy, corticosteroids and radiotherapy. Finally, certain antibiotics have been accused of reducing immune defences. The second factor responsible for infection is bacterial flora. Errors such as broad spectrum antibiotic therapy prescribed in the presence of unexplored fever, or changed repeatedly, are responsible for imbalance in the bacterial flora and the acquisition of resistance to antibiotics. These errors firstly increased the prevalence of infections and, secondly their severity and the difficulty of their treatment. The last factor responsible for infection is rupture of the natural barriers formed by the skin and mucosae. This is related on the one hand to surgery itself and, secondly, to the intensive care techniques surrounding the surgical act: venous catheterization above all, but also bladder catheterization, tracheal intubation, etc.

Anesthetics↗
PubMed1977

[Study of P50 and 2,3-diphosphoglycerate in 23 bronchoemphysema patients as a function of hypoxia and hemoglobin concentration].

2,3-DPG and P50 were measured in 23 patients with chronic obstructive lung disease. All patients had a chronic hypercapnia (PaCO2 greater than or equal to 45 Torr). They are shared in 3 groups, according to hemoglobin content [Hb] and hypoxia : group I(PaO2 = 48.0 +/- 2.4 Torr ; [Hb] = 15.9 +/- 0.3 g. 100 ml-1; n = 9), (M +/- 1 SE); group II (PaO2 = 46.4 +/- 5.0 Torr; [Hb] = 11.6 +/- 0.7 g. 100 m[-1; n = 7); group III(PaO2 = 61.4 +/- 2.4 Torr; [Hb] = 13.3 +/- 0.4 g. 100 ml-1; n = 7). 2,3-DPG (group I : 1.05 +/- 0.06 mole.moleHb-1; group II : 1.02 +/- 0.08; group III : 1.11 +/- 0.08) was not significantly different of 2,3-DPG value of 12 control subjects (0.96 +/- 0.04). P50 of group I (26.9 +/- 0.9 Torr) and group III patients (28.1 +/- 1.6 Torr) was not significantly different of control value of P50 (27.4 +/- 0.5 Torr). P50 of group II patients (29.6 +/- 0.8 Torr) was significantly higher than P50 control and group I values (p less than 0.05). All the patients of group II died. These results suggest that in patients with chronic obstructive lung disease : 1) P50 value is different with various clinical conditions; 2) P50 increase is a compensatory mechanism in severe hypoxemia with anemia, but is not sufficient; 3) [Hb] is the best data for clinical prognosis.

Acid-Base Equilibrium↗
PubMed1975

Biochemical criteria for the evaluation of drug efficiency on adjuvant arthritis and nephrotoxic serum nephritis in the rat: studies with phenylbutazone, L-Asparaginase, colchicine, lysine acetylsalicylate, and pyridinol carbamate.

The levels of serum orosomucoid, haptoglobin, and seromucoid were evaluated as possible quantitative criteria for the estimation of drug efficiency in adjuvant arthritis and nephrotoxic serum nephritis. In adjuvant arthritis, haptoglobin, seromucoid, and chiefly orosomucoid serum levels were generally very sensitive to anti-inflammatory agents such as phenylbutazone and pyridinol carbamate, and to immunosuppressive agents such as L-asparaginase. There was a significant correlation between the serum levels of these glycoproteins and the arthritis scores. In nephrotoxic serum nephritis, seromucoid levels were correlated with the proteinuria of the autologous phase and were found to be a good complementary criterion for the analysis of the efficiency of pyridinol carbamate, colchicine, iysine acetylsalicylate, and L-asparaginase.

Animals↗