Biomedical subjects

L Leroux

Publications and source records attributed to L Leroux.

10 recordsLinked to original sources

PubMed2006

[Direct thrombin inhibitors in coronary angioplasty. Value of bivalirudin ].

During coronary angioplasty, the association of platelet inhibitors and antithrombin agents is required to prevent myocardial infarction. Bivalirudine, a synthetic direct thrombin inhibitor, has been widely validated in this context and has shown its efficacy and safety in several comparative studies. It is officially recommended as a replacement of NFH and LMWH associated or not with anti-GPIIb/IIIa agents because at comparable efficacy it causes fewer bleeding complications. In acute coronary syndromes without ST elevation, anti GPIIb/IIIa agents reduce angioplasty-related complications and mortality, especially in high risk patients in salvage situations. In the REPLACE-2 trial the clinical efficacy of bivalirudine (associated only when necessary with anti-GPIIb/IIIa agents) was no less than that of NFH associated systematically with anti-GPIIb/IIIa agents at the time of intervention. The incidents of serious adverse events at 30 days (death, infarctus, emergency revascularisation, major bleeding) in the bivalirudine group was 9.2% versus 10.2% in the NFH group. In a retrospective analysis, these results did not seem to be influenced by the prior administration of clopidogrel. Finally, the one year follow-up results showed a lower mortality in patients treated with bivalirudine (1.9% versus 2.5%), essentially in the high risk sub-groups such as the elderly, the diabetic or the renal failure patients. Clinical trials are underway (ACUITY) to study the interaction of anti GPIIb/IIIa agents with bivalirudine in the first hours of acute coronary syndromes and should confirm a major role of direct anti-thrombin drugs in the safety of angioplasty.

Angioplasty, Balloon, Coronary↗

PubMed2005

[Platypnea-orthodeoxia syndrome a rare cause of post laparoscopic respiratory failure].

Platypnea-orthodeoxia syndrome is a rare cause of hypoxaemia per or postsurgery. This one is characterized by right-to-left intracardiac shunting responsible of postural hypoxemia in orthostatic position, which is improved by supine position. We described the first case of a platypnea-orthodeoxia syndrome occurred during laparoscopic surgery.

Aged, 80 and over↗

PubMed2001

Compensatory responses in mice carrying a null mutation for Ins1 or Ins2.

Intrauterine growth retardation and postnatal acute diabetes result from insulin deficiency in double homozygous null mutants for Ins1 and Ins2 (Duvillié B, et al., Proc. Natl. Acad. Sci. USA 94:5137-5140, 1997). The characterization of single homozygous null mutants for Ins1 or Ins2 is described here. Neither kind of mutant mice was diabetic. Immunocytochemical analysis of the islets showed normal distribution of the endocrine cells producing insulin, glucagon, somatostatin, or pancreatic polypeptide. Analysis of the expression of the functional insulin gene in Ins1-/- or Ins2-/- mice revealed a dramatic increase of Ins1 transcripts in Ins2-/- mutants. This compensatory response was quantitatively reflected by total pancreatic insulin content similar for both types of mutants and wild-type mice. Moreover, both mutants had normal plasma insulin levels and normal glucose tolerance tests. The determination of beta-cell mass by morphometry indicated beta-cell hyperplasia in the mutant mice. The beta-cell mass in Ins2-/- mice was increased almost threefold, which accounts for the increase of Ins1 transcripts in Ins2-/-mutants. This study thus contributes to evaluate the potential of increasing the beta-cell mass to compensate for low insulin production.

Animals↗

PubMed1999

Effects of various adjuvants (lactic acid, glycerol, and chitosan) on the injectability of a calcium phosphate cement.

Calcium phosphate cements are well-known orthopedic materials for filling bone. Various formulations are proposed. The current challenge is to place the material in the surgical site by methods as least invasive as possible. One approach consists of making the cement injectable by incorporation of various adjuvants. However, the requirement properties of the cement must be preserved: setting times suited to a convenient delay with surgical intervention, limited disintegration in aqueous medium, and sufficient mechanical resistance. Various additives were studied: in particular, lactic acid, glycerol, chitosan, and sodium glycerophosphate. Injectability, setting time, disintegration, and toughness after 10 days were followed in vitro. Glycerol greatly improved injectability and increased setting time, but decreased mechanical properties. Lactic acid reduced setting time, increased toughness of the material, but limited the dissolution rate. After injection, the cement did not present any disintegration. The effects lactic acid were correlated with the formation of calcium complex. Its association with sodium glycerophosphate is particularly interesting. Chitosan alone improved injectability, increased setting time, and limited the evolution of the cement by maintaining the OCP phase. Only slight disintegration was observed. These first results show that is possible to transform the cement into an injectable paste by addition of adjuvants without fundamentally modifying the chemical reactions occurring during setting and hardening.

Adjuvants, Pharmaceutic↗

PubMed1999