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Biomedical subjects

M Cupa

Publications and source records attributed to M Cupa.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Severe cardiac decompensation: value in the early hours of a combination of amrinone and dobutamine].

Ten patients with severe chronic heart failure (class III and IV of the NYHA classification) received treatment for severe heart failure with dobutamine (10, then 15 micrograms.kg-1.min-1), then with dobutamine combined with amrinone (7.5, then 10 micrograms.kg-1.min of each). Used alone, dobutamine improves cardiac performance (cardiac index from 1.8 +/- 0.24 l.min-1.m-2 to 2.65 +/- 0.44 l.min-1.m-2). These results are further improved when amrinone is associated with dobutamine. Blood pressure increases with dobutamine and no decrease is recorded when amrinone is introduced, despite a gradual decrease in systemic arterial resistances. Pulmonary artery wedge pressure shows a significant decrease only when the strongest dose of the combined drugs is used. However, this positive effect is counterbalanced by an increase in pulse frequency. Side effects, be it on the blood count (platelets count reduced from 255,600 +/- 3974 mm-3 to 207,400 +/- 3380 mm-3 with no clinic sign) or cardiovascular activity (one case of premature ventricular contraction; one case of transient junctional rhythm), do not require the suspension of treatment. Thus, the dobutamine-amrinone combination treatment seems a promising one.

Aged↗
PubMed1989

[Hyperoxia test during attempts to withdraw artificial ventilation].

A 30 minute test of hyperoxia (10 l.min-1) was conducted in patients (n = 21) with chronic obstructive lung disease during the weaning trials from mechanical ventilation. Two groups were formed according to whether the occlusion pressure at 100 ms (PO.1), index of central stimulation, decreased or not during the test. The first group lowered PO.1 and increased PaCO2 by decreasing VE (minute-ventilation), VA (alveolar ventilation) and increasing the VD/VT ratio; the others had a lower PO.1 and did not modify it after administration of 02 despite a lowered PaO2 initially identical to that in the first group. They held PaCO2 constant by increasing VE and by maintaining VA in relationship with an improvement in diaphragm contractility and/or a better response to hypercapnia stimulus. All the patients is this group were successfully weaned eight days after the study period.

Aged↗
PubMed1988

Assessment by dipyridamole-thallium-201 myocardial scintigraphy of coronary risk before peripheral vascular surgery.

From October 1983 to January 1985, 46 patients (38 men and 8 women; average age, 60 years; range, 37 to 83 years) underwent peripheral vascular surgery of either the internal carotid artery or the arteries of the lower limbs. Each patient had a thorough clinical examination, an ECG, and a dipyridamole-thallium-201 myocardial scan before operation. On the basis of results, they were divided into two groups: 20 patients with and 26 patients without chronic ischemic heart disease. Three major cardiac events were noted during or after a period of 1 month after surgery: There were two deaths due to cardiac ischemic events and one patient had postoperative unstable angina pectoris. These three patients were classified in the coronary group (NS). When the patients were classified on the basis of whether or not there was thallium redistribution on serial images after infusion of dipyridamole, 14 with redistribution and 32 without redistribution were noted. The three patients who had major cardiac events were in the former group (p less than 0.04). Our data suggest that patients in whom redistribution occurs have a high incidence of postoperative ischemic events. These patients should be considered for particular preoperative coronary care to avoid major postoperative cardiac events and to increase chances of survival.

Adult↗
PubMed1987

[Evaluation by myocardial thallium-201 scintigraphy using dipyridamole of the coronary risk in peripheral vascular surgery].

From October 1983 to January 1985, 46 patients (38 men and 8 women; mean age 60 years, range 37-83) underwent peripheral vascular surgery either of the internal carotid artery or of arteries of the lower limbs. All patients had thorough clinical examination, ECG and thallium dipyridamole myocardial scanning before operation, as a result of which they were divided into 20 with, and 26 without chronic ischemic heart disease. Three major cardiac events were noted during or following a period of one month after surgery: two deaths due to a cardiac ischemic event and one post-operative unstable angina pectoris. The three patients with these complications were classified in the coronary group (NS). When the patients were reclassified according to the presence or absence of thallium redistribution on serial images after dipyridamole, 14 had redistribution and 32 had no redistribution. The three major cardiac events were found to have occurred in the group with redistribution (P less than 0.04). Our study suggests that patients with redistribution have a high incidence of postoperative ischemic events. They should be considered for a particular pre-operative coronary management to avoid post-operative major cardiac events and to improve survival.

Adult↗
PubMed1985

[Primary hemostatic disorders caused by beta-lactams. Apropos of a postoperative hemorrhagic complication during treatment with cephalexin].

The authors report a case of haemorrhage due to cephalexin therapy. The bleeding started after an orthopedic operation in a patient without renal failure, receiving 3 g/day of cephalexin. Platelet function was very abnormal at the time of the haemorrhage with a bleeding time of over 20 minutes, which returned to normal when treatment was stopped. This case seems to be similar to other reports of haemorrhages during treatment with other beta-lactams.

Aged↗
PubMed1984

[Hemodynamic interferences between diltiazem and thiopental--experimental study in the pig].

The clinical applications of calcium channel blockers are rapidly growing; as barbiturates interfere with intracellular calcium movements, the possibility of drug interaction at this level must be considered. We have studied the haemodynamic interaction of Thiopentone and Diltiazem in pigs. A loading dose of Diltiazem (0.15 mg X kg-1) was injected followed by a continuous administration of 0.07 mg X kg-1 X hour. From the fifth to the tenth minute, the reduced afterload was associated with a moderate depression of the contractility of the left ventricle. These values returned to the initial level within 30 minutes. Heart rate and cardiac output were not modified. The stability of these two parameters is thought to result from the complex interaction of both drugs on the sympathetic nervous system and the ventricular function.

Animals↗
PubMed1984

[Anesthesia in surgery of Basedow's disease].

Adequate preparation for surgery can be achieved in patients with Grave's disease by a combination anti-thyroid medication, Lugol's solution and beta-blockers, mainly propranolol. Only in rare cases when this treatment had failed has plasmapheresis been used. No thyroid storm occurred in the 35 cases reported. Should this complication be encountered, plasmapheresis appears to be the treatment of choice.

Adrenergic beta-Antagonists↗
PubMed1984

A specific antihistaminic premedication anti H1 anti H2 for pediatric anesthesia.

The danger of the anaphylactoid reactions which occur during pediatric general anesthesia leads the authors to use a specific antihistaminic premedication. The association of cimetidine and hydroxizine has been proved to be adequate to avoid systemic histamine adverse effects and to diminish gastric secretion in pediatric anesthesia. The authors recommend oral administration.

Anaphylaxis↗
PubMed1983

[Immediate cardiac toxicity of rubidazone. A case reversible by isoproterenol].

It is reported the first observation of cardiogenic shock without delay, in a leukemic patient during a first injection of Rubidazone (22050 RP) which is recognized so far, as one of the least cardiotoxic anthracyclines. It has been concluded: --anthracyclines, beside the risk of a progressive cardiomyopathy which is related to the dose and very well known, can induce immediate cardiac injuries, which cannot be predicted yet; --the perfect myocardial protector is still to be discovered; --in this case, beta-adrenergic stimulators appeared to be able to control the cardiotoxic effect of Rubidazone; --the last fact could be considered in the decision to maintain the treatment when such an injury occurs during a chemotherapy or when it seems absolutely necessary to use such a drug.

Antibiotics, Antineoplastic↗
PubMed1982

[Peridural analgesia with high doses of fentanyl: failure of the method for early postoperative kinesitherapy in knee surgery].

Following orthopedic surgery of the lower limb, ten patients were given fentanyl 5 micrograms . kg-1 in a single epidural injection. Almost complete analgesia (P less than 0.001) was rapidly obtained. The total period of analgesia was rather short (182.3 +/- 32.1 min). The maximal analgesia period was 87 +/- 8.34 minutes. Despite this high dose of fentanyl (245 to 450 micrograms), in five patients the passive mobilization of the knee following surgery was extremely painful and, for that matter, impossible in three of them. Such high doses of fentanyl entail the risk of respiratory depression as respiratory rate is decreased (P less than 0.01) and the Pco2 is increased (P less than 0.01). Fentanyl should not be used at such high dosage and should probably not be preferred to morphine, considering that the duration of analgesia is short, that the analgesic score is identical to that obtained with lower doses or with longer lasting narcotics, that it does not prevent passive mobilization pains and that it entails a definite risk of respiratory depression.

Adult↗