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Biomedical subjects

M Galliot

Publications and source records attributed to M Galliot.

At least 19 recordsLinked to original sources

Measurement of carbon monoxide in simulated expired breath.

BACKGROUND: Environmental carbon dioxide (CO) detectors used as an early warning method have been adapted to measure CO concentration in expired breath. This technique has been validated in smokers with relatively low CO concentrations, but its applicability to poisoning has not been demonstrated. OBJECTIVE: To compare the reliability of toxicologically significant CO measurements performed using a portable CO detector with those obtained using infrared spectrometry, the standard method for blood CO concentration determination. DESIGN: Experimental study with a CO detector and infrared spectrometer. A balloon simulated respiratory movements and an expired breath. Balloon gas mixtures contained CO, in one of 21 different concentrations from 100 to 600 parts per million (ppm) in air. CO concentration was measured directly with the portable CO detector and two gas samples obtained at the beginning and end of the simulated expired breath were diluted, with validation, for spectrometric measures. MAIN OUTCOME MEASURES: Portable CO detector concentrations were compared with the mean value of the reference method. Simple linear regression was performed using ANOVA to evaluate the parallel between the model with the reference method. RESULTS: Portable CO detector concentration measurements were perfectly linear (R2=0.989, P<10(-3)) over a concentration range of 46-645 ppm. The difference from the reference plot was significant (P<0.01). CONCLUSION: Given the linearity of the measurements, the underestimation by the portable CO detector at higher concentrations can be corrected mathematically. A portable CO detector should measure CO in expired breath efficiently and reliably.

Breath Tests↗

Therapeutic trial of diazepam versus placebo in acute chloroquine intoxications of moderate gravity.

OBJECTIVE: Acute chloroquine intoxication is responsible for a membrane-stabilising effect which results in electrocardiographic (ECG) and hemodynamic disturbances. Diazepam is used in acute chloroquine intoxication on the basis of clinical and experimental observations, but its utility alone, in man, remains unproven. The goal of this study was to verify whether diazepam alone has an effect on the membrane-stabilising effect observed in moderately severe chloroquine intoxications. DESIGN: Prospective, multi-center, double-blind, placebo-controlled study. SETTING: Prehospital mobile intensive care units (Paris) and hospital intensive care units (paris and Dakar). PATIENTS AND PARTICIPANTS: Adults with moderately severe intoxication defined as: a suspected ingested dose of 2 or more but less than 4 g, systolic blood pressure (SBP) higher than 80 mmHg, QRS duration less than 0.12 s and the absence of dysrhythmia at inclusion. INTERVENTIONS: Patients received either a loading dose of 0.5 mg/kg diazepam followed by an infusion of 1 mg/kg over 24 h or an equivalent volume of placebo. MEASUREMENTS AND RESULTS: Outcome was measured by serial assessments of SBP, ECG (QRS and QT segments) and clinical deterioration. There were no significant differences observed in the initial or serial ECG or SBP measurements. There were no deaths and no patient had to be removed from the study due to clinical deterioration. CONCLUSIONS: Diazepam, at the dose studied, does not appear to reverse the chloroquine-induced membrane-stabilising effect in acute moderately severe chloroquine intoxication. Supportive intensive care of these intoxications appears to be all that is necessary.

Acute Disease↗

Spectrophotometric determination of plasma thiocyanate by formation of an ion-pair with methylene blue.

We describe a sensitive method for measuring thiocyanate in 500 microliters plasma samples. This technique, although slower than the standard method, improves sensitivity. It requires the extraction in chloroform of an ion-pair formed between thiocyanate ions and methylene blue in acidic medium. Within-day precision had a coefficient of variation of 2.5% and between-day precision a CV of 4.75%. The results were well-correlated (r = 0.997). For 30 non-smokers, the mean thiocyanate level was < 55 mumol/l, and for 30 smokers 90 mumol/l (SD = 20). The method was successfully applied to seven fire smoke victims treated with hydroxocobalamin.

Humans↗

[Intraperitoneal chemotherapy for ovarian adenocarcinoma: pharmacokinetics of cisplatin].

Chemotherapy using cis dichlorodiamine platinum (CDDP) in doses of 30 and 60 mg/m2 was carried out in 6 patients who had adenocarcinoma of the ovary, that had not been treated before, 15 to 120 minutes before surgery was carried out. The results of doses of platin given on the blood levels are demonstrated. A slight and progressive increase in the plasma levels of CDDP with peaks between 0.6 and 1.95 of total platinum and 0.22 mcg/ml of free platin were found. The tissue levels in the region of the ovaries were found to be between 0.16 and 0.94 mcg/mg. There was a stepwise increase in the levels found in the pathological peritoneal cover of between 0.42 and 31.2 mcg/mg. This dropped as time went by; and then led to change in accordance with the intra-peritoneal concentrations. This study shows that it is possible when giving drugs intraperitoneally to avoid high plasma peaks and to obtain good levels of concentration of cisplatin in the peritoneum.

Adenocarcinoma↗

[Analytical exploration of drug addiction].

The natural and synthetic substances most frequently leading to drug addiction are described. They include cannabis, opium and cocaine with their respective derivatives. The authors insist on the problems encountered by analytical chemists when they examine urine samples containing these substances, owing to their metabolic degradation and to interferences between lawful and unlawful drugs. The limitations imposed by these problems to an unambiguous interpretation of the results obtained are defined, but they do not throw any doubt on the value of these investigations.

Chromatography, Gas↗

Aluminium loading in children receiving long-term parenteral nutrition.

Eight children on long-term, total parenteral nutrition (TPN) were found to have elevated aluminium (Al) levels in plasma (51 +/- 11 microg 1/1), urine (223 +/- 78 microg 24 h) and bone. The load of Al in TPN solution was 232 +/- 89 microg/day, and, among the different parenteral solution components high Al concentrations were found in amino-acids, calcium gluconate, potassium lactate, and trace elements, representing respectively 40%, 30%, 15%, and 10% of the total Al intakes. The authors conclude that children receiving long-term TPN have excessive Al intakes and are exposed to Al toxicity. The prevention of Al contamination requires careful control of the TPN components.

Journal Article↗

[Intracorporeal concealment of narcotics. Experience of medicolegal emergencies at the Hôtel-Dieu Hospital in Paris: 100 cases].

One hundred cases of intracorporeal concealment of narcotic drugs were observed over a 6-month period at the medico-judicial emergency centre of the Hotel-Dieu hospital, Paris. Twelve cases concerned dealers who had ingested packs at the time they were arrested. The other subjects had been carrying the drug in their digestive tract, rectum or vagina for transportation. The illicit drugs thus transported were cocaine in 20 cases (ingestion), heroin in 65 cases (ingestion 7, rectal or vaginal cavity 58) and cannabis in 3 cases. Packs for sale being fragile, the dealers were particularly exposed to overdosage. Their management prior to intoxication was the same as that of acute ordinary drug poisoning, i.e. washing out of the stomach. In carriers, the risk of severe poisoning was associated with ingestion. The lack of antidote makes cocaine poisoning particularly dangerous. Surgical extraction is now reserved to cases with intestinal mechanical complications and to those increasingly rarer cases of fragile transportation packs.

Adult↗

Protective cardiovascular effects of diazepam in experimental acute chloroquine poisoning.

To assess the effects of diazepam in chloroquine poisoning, we studied pentobarbital anesthetized and mechanically ventilated pigs. All the pigs received 50 mg.kg-1 chloroquine given intravenously for 25 min. Eight pigs acted as control (group C). Another 7 were treated with diazepam given intravenously 5 min after the end of chloroquine infusion: 2 mg.kg-1 of diazepam for 2 min, then 1 mg.kg.h-1 for 25 min (group D). Thereafter, all pigs were sacrificed. In both groups the chloroquine infusion induced a large fall in arterial pressure, a decrease in heart rate, and an increase in QRS duration. No difference was observed between the 2 groups for weight, systolic and diastolic arterial pressures, heart rate, QRS and QT durations before diazepam. After diazepam, systolic and diastolic arterial pressures, heart rate, urine volume, urinary excretion of chloroquine, plasma and blood cell chloroquine levels were higher, whereas QRS duration was lower, in group D compared to group C. No difference was observed between the 2 groups for urinary concentration of chloroquine, the ratio between plasma and blood cell chloroquine levels, hepatic, cardiac, and skeletal muscle chloroquine levels, and QT duration. After diazepam, the slope of the regression curve between QRS duration and plasma chloroquine levels was reversed in group D compared to group C. We conclude that diazepam counteracts some haemodynamic and electrocardiographic changes, and increases urinary excretion of chloroquine, in acute experimental chloroquine poisoning.

Animals↗

Arterial-venous plasma concentration differences of meprobamate in acute human poisonings.

Arterial-venous plasma concentration differences of meprobamate were studied on admission of acute overdose in man. The patients were divided in two groups. In the control group (n = 25) two successive blood samples were collected from the same vessel. In the study group (n = 35) femoral arterial and venous blood samples were collected simultaneously. In the control group the differences were not significant. In the study group the differences were statistically significant (P less than 0.01). The present study suggests that the origin of blood samples should be stated for toxicological studies and that the toxicokinetics may be more complex than those recognized previously.

Adolescent↗

Arterio-venous plasma concentration differences in amitriptyline overdose.

The aim of this study was to determine whether femoral arterio-venous plasma concentration differences (AVD) of amitriptyline exist during acute intoxication in man. All patients studied were comatose and were divided into a control group who had two successive blood samples drawn from the same vessel and a study group who had samples drawn from the femoral artery and vein simultaneously. Serial plasma concentrations of amitriptyline were measured by gas liquid chromatography. In each group the differences were assessed by means of the Wilcoxon matched pairs test. In the control group (n = 13) there were no differences (T = 31, n = 12). In the study group (n = 24) the AVD were significantly different (T = 52, n = 23). For amitriptyline, the arterial or venous origin of blood samples for toxicological studies must be stated.

Adolescent↗

Power of isoniazid acetylation and pigmentation; first experimental tests in the rabbit: comparison with clinical data.

A positive correlation has been observed clinically at the Centre Edouard Rist, Paris, between the degree of pigmentation and the power of isoniazid acetylation in so-called "caucasians". The investigation was based on a relatively small sample of 153 observations, but sufficient to allow a significant statistical analysis. Comparing the results with data published in the literature, it may be assumed that this relationship between the power of acetylation and pigmentation would be applicable to all human beings. The rabbit, having as in man a bi-modal distribution of the power of acetylation, was used for further research of this correlation in that animal. The results of this research in rabbits may be compared with those in man, but further studies are required in view of the interest of this comparison and of the possible consequences of the relationship of pigmentation and the degree of acetylation of isoniazid in human therapeutics.

Acetylation↗

Ventilatory effects produced by the i.v. administration of incremental doses of thiopentone in the dog.

Ventilation, ventilatory pattern and ventilatory drive were studied in five dogs during the administration of increasing blood concentrations of thiopentone. Ventilation (VE, RR, VT) and blood-gas tensions (pHa, PaCO2, PaO2,) were measured. Ventilatory pattern (VT, TI, TE, Ttot) and ventilatory drive (VT/TI) and occlusion pressure) were analysed. Occlusions of the airway were performed at end-inspiration and at end-expiration. Thiopentone produced a biphasic action on respiratory rate, ranging from tachypnoea during light anaesthesia to a progressive slowing of respiration with deepening anaesthesia. The Hering-Breuer reflex did not seem to be modified by the level of anaesthesia, whereas the central mechanisms which modulate the duration of inspiration and of expiration, were perturbed.

Anesthesia, Intravenous↗

Adult respiratory distress syndrome and silicone injection.

This report describes a case of adult respiratory distress syndrome (ARDS) after massive subcutaneous injections of silicone. The patient, a 23 year-old transsexual man, treated with mechanical ventilation, died on the 12th day of hospital, in septic shock and refractory hypoxemia. Autopsy findings revealed empty vacuoles surrounded by macrophages in various organs, especially in lung tissue. Toxicological analysis by emission by high frequency induced plasma showed silicone in the organs with histological lesions. The pathophysiology of this ARDS is considered.

Adult↗