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Biomedical subjects

J P Bonsignour

Publications and source records attributed to J P Bonsignour.

At least 19 recordsLinked to original sources
PubMed1997

[Intracranial aneurysm and coronary ectasia].

BACKGROUND: Coronary aneurysms are uncommon and can exceptionally be associated with other aneurysmal localizations. CASE REPORT: A 34 year-old man with a history of aneurysm of the coronary arteries revealed by myocardial infarction without a wave six months earlier, presented cerebral hemorrhage secondary to an aneurysmal rupture of the anterior communicating artery. DISCUSSION: Other aneurysmal localizations such as the abdominal artery, pulmonary artery, hepatic artery, popliteal artery, coronary venous system or the left ventricle have been associated with coronary artery aneurysm. Only one case of coronary and cerebral aneurysm has been previously reported in the literature in an 8-year-old child with X-linked lymphoproliferative syndrome and EBV-induced infectious mononucleosis. Our case suggests that systemic aneurysmal disease may be a clinical entity and that cerebral angiogram should be discussed in patients with a coronary artery aneurysm.

Adult↗
PubMed1997

[Hypothermia in traumatology].

Basing on the experience of the Chamonix hospital team which managed in six years 89 cases of hypothermia in trauma patients, this article reviewed the literature concerning the association hypothermia-trauma. Shock is a major triggering factor. The deleterious effects of hypothermia on the outcome is due to inadequate cardiorespiratory adaptation to shock and to increased bleeding. Although a few articles reported a beneficial effect of hypothermia in head trauma, further studies are required to assess the value of deliberate hypothermia in such patients. Restoration of a satisfactory haemodynamic activity is a priority and most often requires surgery. The rewarming manoeuvres should be initiated early and always be preventive. They are active, internal and rapid in case of haemodynamic instability and when the central temperature is below 32 degrees C. It can be more progressive and less invasive in other cases. During recovery from anaesthesia the patient must be closely monitored. In spite of a possible protecting effect, hypothermia remains an aggravating factor in traumatology and must therefore be either prevented or amended.

Accidents↗
PubMed1994

[Magnetic resonance imaging during the acute phase of severe head injuries].

In 1994, tomodensitometry is indispensable for diagnosis and treatment of acute head trauma. Magnetic resonance imaging (MRI) is more performant but not yet evaluated in this indication. Two homogeneous series of patients allow the authors to discuss interest and feasibility of MRI and to propose a new strategy for reception of acute head trauma.

Adult↗
PubMed1993

[Continuous infusion of vancomycin in post-neurosurgical staphylococcal meningitis in adults].

Eight adult patients with post-surgery meningitis caused by methicillin-resistant staphylococci were treated with continuous intravenous infusion of vancomycin in mean doses of 50 mg/kg/day. This treatment, which lasted 3 to 6 weeks, was well tolerated by the kidneys and resulted in cure in all cases; its effect on the ear was not evaluated. Stable concentrations of 4 to 7 mg/l in cerebrospinal fluid were obtained after the 48th hour of treatment.

Adult↗
PubMed1992

[The value and limitations of autotransfusion in traumatology].

29 autotransfusions were realised in severe cases of trauma (20% of a sample of 143 traumatic emergencies). The recovery of haemothorax blood as well as the peroperative collection by a Cell Saver allowed the retransfusion of 1989 +/- 1,838 ml (225-7070 ml) of autologous blood, amounting to 56% of the average blood loss. A total of 69% of the patients received homologous blood. Eight patients (where the haemorrhage amounted to 143% of the blood volume) showed some coagulation troubles. Autotransfusion assures the immediate availability of blood while reducing the immunological and viral transfusion risks. Therefore haemothorax autotransfusion should be used systematically. Peroperative recollection by a cell-separator works well but is technically more tedious.

Adult↗
PubMed1992

[Methods of reducing peroperative bleeding].

The reduction of bleeding during surgery can be aimed at for two reasons: to facilitate the operation by providing a bloodless field and/or to avoid blood loss requiring compensation by transfusion. These aims can be reached by reducing blood pressure or by acting on blood-clotting. For inducing hypotension sodium nitroprussiate and isoflurane are mainly used. Complex and precise monitoring is required for patient safety. Two drugs have been used to diminish bleeding: desmopressin and aprotinin. With the latter an important reduction (40 to 50%) of the blood loss has been achieved.

Blood Loss, Surgical↗
PubMed1991

MRI and cranial traumas in the acute phase.

The authors have reviewed 12 cases of severe cranial trauma examined by MRI and determine the position of this method in exploration in the acute phase. Since the 1970's, computerized tomography (CT) has completely modified the emergency diagnosis. Intra- and extracerebral blood effusions are readily recognized, but the patient is often in a dangerous situation and little help is obtained from CT which does not detect shearing lesions located in the white matter, the corpus callosum or the brain stem. Early MRI examination performed with gradient-echo sequences provides a better anatomico-clinical correlation, a better prognostic approach and even a new therapeutic approach.

Acute-Phase Reaction↗
PubMed1991

[Spinal cord injury and secondary autonomic function disorders].

Autonomic dysfunction is frequently reported after high level spinal cord injury. These disorders usually occur in the first days and resolve spontaneously within 3 to 6 weeks. Usual clinical aspects are hemodynamic abnormalities and often bradycardia which can lead to death. These dysfunctions rarely reappear during neurological status recovery. In this case report, usual autonomic disorders were noted after a T5 level spinal injury with partial motor lesions. However during motor recovery periods, arrhythmias occurred, including ventricular extrasystoles and bursts of ventricular tachycardia. Physiopathological mechanisms are discussed and regulation changes of sympathetic and parasympathetic autonomic nervous system are evoked.

Adult↗