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Biomedical subjects

J M Coget

Publications and source records attributed to J M Coget.

At least 19 recordsLinked to original sources
PubMed1990

Hyperbaric oxygen therapy in chronic vascular wound management.

Many nonhealing tissues are hypoxic, with oxygen tensions frequently ranging from 5 to 15 mmHg. In such an environment, the normal wound healing sequence is disrupted or halted and phagocytic killing activity depressed. So the adjunctive use of hyperbaric oxygen (HBO), based on physiologic data and clinical observations, can provide the substrate necessary to initiate and sustain the healing process. During a twelve-month period, 20 patients with a nonhealing wound were referred to the hyperbaric center: chronic arterial insufficiency ulcers in 9 cases, diabetic wounds (foot lesions) in 11 cases. Adjunctive HBO therapy, initiated twice a day, consisted of pure oxygen, 2.5 ATA, 90 min. The average length of sessions was 46 (15-108). Complete healing was observed in 15 of 20 cases. The wound management can be helped with the transcutaneous oxygen measurements under hyperbaric oxygen. The distal TCPO2 at 2.5 ATA pure oxygen is a reliable test to predict final outcome (healing or no change), when these values were not different in normal air and in normobaric oxygen: (table; see text) In hyperbaric oxygen therapy, when the distal TCPO2 value was inferior to 100 mmHg, all patients showed either no improvement or aggravation, and when the value was higher than 100 mmHg, wound healing was achieved with all patients.

Blood Gas Monitoring, Transcutaneous↗
PubMed1990

[Hyperbaric oxygen therapy in the treatment of wounds, in plastic and reconstructive surgery].

After recalling the mechanism of action of hyperbaric oxygen (HBO) on healing processes, the authors review the principal indications for this technique in plastic and reconstructive surgery, such as crush injuries and acute post-traumatic ischemia of the limbs, skin flaps and skin grafts, when there is a risk of their not taking, and burns. They stress the importance of strict, stratified therapeutic protocols with control of the hyperoxygenation induced by HBO. In the authors' experience, transcutaneous measurements of the partial pressure of oxygen under the hyperbaric atmosphere is a very useful method with a predictive value to determine the indications for treatment with HBO and to monitor its effects.

Blood Gas Monitoring, Transcutaneous↗
PubMed1989

[The value of studying the ocular conjunctiva in case-finding in prediabetic states].

Capillaroscopy, the only method available for the study of the microcirculation, without modifying its hydraulics, often provides a wealth of information in certain systemic diseases in which the microcirculatory involvement precedes clinical manifestations and of course, macrovascular complications. The prospective study of a healthy population is particularly demonstrative and the authors proposed scores on which diabetic microangiopathy could be suspected. The latter was confirmed by detailed laboratory investigations on one hand, and by the course of the disease on the other. For this reason, any subject at risk of diabetes should undergo at least one annual capillaroscopic examination of the ocular conjunctiva or if not, of the peri-ungual region. Furthermore, the study of microvessels in subjects with controlled and treated disease showed a regression of the anomalies which depended on proper control of diabetes, and this particularly nontraumatic test procedure which can be repeated and provides a wealth of information, can give a good reflection of proper therapeutic control, especially if it is performed by a trained and experienced investigator.

Capillaries↗
PubMed1987

[Raynaud's phenomenon and finger necrosis after treatment of ovarian seminoma with bleomycin, vinblastine and 5-fluorouracil].

Bleomycin is sometimes at the origin of a Raynaud's phenomenon (RP). From the literature, there does not seem to exist a dose-dependent relationship. The phenomenon occurs early or late and often is resistant to various medications. The possible physiopathological mechanisms are: direct vascular toxicity, hypersensitivity vascularization, alteration of platelets activity, alteration of Willebrand's factor, and as predisposing factors: association to periwinkle alkaloids or hypomagnesemia.

Adult↗
PubMed1987

[Flushes, blushing or hot flushes].

Apart from physiological flushes represented by emotional or prudish blushing, post-prandial flushes and menopausal hot flushes, various pathologic flushes exist of various etiologies: endocrine, dysmetabolic, histaminic and iatrogenic. Their pathogenicity is based mainly on local metabolites secretion provoking vasodilatation of the intermediary microcirculation rather than of the terminal microcirculation. Treatment is a function of etiology and therefore of the patient's history and results of clinical examination, functional exploration and standard biologic tests.

Blood Vessels↗
PubMed1980

[Diagnosis value of Doppler signal. From the finger pulp (author's transl)].

Receiving of Doppler signal from the pad is able to make complete the diagnosis of vascular acrosyndromes beside clinics, functional processes and above all capillaroscopy at the fingertip, conjunctiva and skin surface. There is not any signal in acrocyanosis, generalized sclerodermia, sharp's disease and chronical arteriopathy. There is a signal in P.A.N., dermatomyositis and L.E.D., likewise in primary form of Raynaud, in acroparestesias, in erythralgias... On the other and, in case of acrocyanosis mixed with Raynaud, the signal vanishes.

Adult↗
PubMed1980

[Anthocyanosides and microcirculation (author's transl)].

There are many bioflavonoid compounds, but only a few of them are of value to physicians at the present time as they have not all been demonstrated as having activity on the terminal vascular bed. By using the simple technique of transillumination described by Knisely and Bloch the authors were able to confirm the activity of certain bioflavonoids on the terminal vascular bed of the frog's mesentery. This method demonstrates the point of impact of the compound in the microcirculatory bed and is thus able to evaluate the efficacy or not of compounds before they are marketed.

Animals↗
PubMed1980

[Capillaroscopy of the ocular conjunctive. Diagnostic value (author's transl)].

Capillaroscopy of the ocular conjunctiva is a simple technique, essential to carry out in conjunction with capillaroscopy of the peri-ungeal bed, in order to carry out complete dynamic exploration of the terminal vascular bed. The normal appearance is described, and then the morphological abnormalities, as well as the changes seen in certain purely vascular pathological states, as well as in system diseases, in particular collagen diseases, and diabetic micro-angiopathy, where this examination is of particular value and rich in information.

Adult↗
PubMedDate not supplied

[Clinical characteristics of pain in chronic venous insufficiency].

Since the report of the 1st International Conference of Phlebology at Chambéry, devoted to venous pain, the subject has scarcely attracted attention apart from the meeting of the Benelux Society of Phlebology devoted to "pain in the legs". Pain due to superficial venous insufficiency has scarcely changed in nature for 30 years and remains one of the major presenting symptoms in phlebology. Acute or chronic, punctate or diffuse, modifications in this functional symptomatology have been accentuated, or have varied in their aspects under the influence of certain fashions or certain habits of modern life, i.e.: sedentary behaviour, underfloor heating, the use of oral contraceptives or of menopausal hormone replacement therapy. However, the distribution of the various aspects of venous pain remains in the same proportions as those described by the authors cited previously. While the etiological diagnosis must essentially eliminate all other causes: arterial, neurological, muscular, articular, it is essential not to neglect deep venous insufficiency of the gemellar veins, often responsible for a wide range of symptomatology and still all too often neglected. The pathogenesis of this pain not only involves the concept of pain receptors but also the appearance of algogenic metabolites at the site of the microcirculatory unit, to which endothelial cells are particularly sensitive during stasis. In fact, pain is the expression of disorders concerning local exchanges, whether thermal, pressure, metabolic or hemorheological. It is the alarm bell of venous insufficiency and merits the attention of the phebologist who must thus undertake active treatment before problems become irreversible.

Chronic Disease↗
PubMedDate not supplied

[Hyperbaric oxygenation therapy and cicatrization].

HOT is a very useful therapeutic addition in chronic wounds presenting a healing problem and for which usual treatment were unsuccessful. In order to be fully effective, HOT must be included in a strategy of care, taking into account, not only the wound itself but the underlying disease. Peripheral delivery of oxygen and induction of tissue hyperoxygenation with HOT may be verified by measurement of the TcPO2 under HOT. The predictive value of these measurements is helpful in the decision for treatment and its management.

Aged↗