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Biomedical subjects

M Galliot

Publications and source records attributed to M Galliot.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Fatal pneumopathy linked to subcutaneous injections of liquid silicone into soft tissue].

The case of a 23-year old transsexual male who developed a lethal lung disease 48 hr after a 1 l subcutaneous silicone fluid injection is reported. Histologic examination showed optically empty oil red O negative vacuoles in several specimens, and particularly in the lungs; refractile particles of silicium were also found. We identified the material as silicium, and evaluated its quantity in tissues by atomic absorption and spectrometric and toxicological analysis. Experimental studies and rare human accidents suggest that silicone fluid is transported by migrating phagocytes, thereby explaining lymph node, spleen, liver, adrenal and lung deposits. In our patient's report, we added gradual blood contamination to explain the progressive development of respiratory failure with the severity of the respiratory disorder linked to the massive dose injected. Massive silicone blood embolization could be excluded because of the interval between the injection and emergence of the first clinical signs.

Adult↗
PubMed1982

[Prolonged high plasma imipramine levels after acute intoxication (author's transl)].

A case of severe intoxication by tricyclic antidepressants with persistence during 14 days of abnormally high plasma imipramine levels is reported. The various factors capable of maintaining plasma imipramine at a high level are discussed. They include mechanical factors (intestinal absorption), ventilation under positive end-expiratory pressure, alterations of hepatic metabolism by other drugs such as metronidazole or cimetidine, and changes in tissue distribution. Attention is drawn to the risks inherent in the various treatments used against acute intoxications and in combined chemotherapy during intensive care generally. When such drugs are necessary, the plasma levels of those with higher toxicity should be monitored.

Adult↗
PubMed1982

[Respective roles of gastric lavage, haemodialysis, haemoperfusion, diuresis and hepatic metabolism in the elimination of a massive meprobamate overdose (author's transl)].

A case of massive meprobamate intoxication (100 g) is reported. On admission, 8 hours later, the plasma meprobamate level was 460 mg/l. The initial shock (hours 8-12) was successfully treated with blood volume expansion and dobutamine. The plasma meprobamate level, which was 340 mg/l when haemodialysis and haemoperfusion were started, fell to 110 mg/l at the end of the treatment. Recovery was uneventful. The amounts of drug eliminated by each method were as follows: (a) gastric lavages at 8 and 26 hours: 66 g; (b) haemodialysis (18-29 hours): 8.5 g; (d) haemoperfusion on Hemopur-charcoal (20-28 hours): 7.5 g (as measured by elution); (e) diuresis (26 hours): 2 g. It may be concluded from these data that sizeable amounts of drug can be extracted by haemodialysis and haemoperfusion, that gastric lavage remains the least invasive and most rewarding method of elimination, and that the role of hepatic metabolism in detoxication has to be taken into account.

Adult↗
PubMed1981

Biological evaluation of hemoperfusion in acute poisoning.

The efficiency of hemoperfusion in acute poisoning cannot be clinically estimated, because: (a) concomittant intestinal absorption, hepatic metabolism, and urinary excretion must be taken into account. (b) With supportive treatment alone, spontaneous recovery usually occurs in 98% of the intoxications in Intensive Care Units. The efficiency of hemoperfusion can only be estimated biologically. Measuring the blood level at the beginning and the end of hemoperfusion as well as measuring the clearances of the drug is misleading. A better method is to measure the amount of extracted drug, either indirectly by calculation (from hourly differences of arterio-venous measures of drug concentration multiplied by the blood flow) or directly by elution of the cartridge. In a practical way, if the blood level of drug is readily available after the patient is hospitalized, the optimum efficiency of hemoperfusion can be estimated beforehand, so that the decision to carry out the hemoperfusion can be maintained, postponed, or abandoned. For the most part, the experience of toxicologists has shown hemoperfusion to be ineffective for drugs with weak extracellular distribution (such as Digoxine, tricyclic drugs, heavy metals, Colchicine). Its effectiveness for certain drugs with poor in-vitro dialysance (such as Paracetamol) or with a small percentage of intestinal absorption (such as Paraquat) is still debatable. In the case of intoxications by hypnotic drugs, one hemoperfusion allows an average of 4-12% of the ingested medium and short barbiturates, and 7-17% of the ingested Meprobamate. Whether these results can be judged satisfactory, life-saving, or insignificant is largely a matter of personal standards.

Acute Disease↗
PubMed1979

[Haemoperfusion on coated activited charcoal. Experience in French anti-poison centres based upon 60 cases (author's transl)].

Sixty three sessions of haemoperfusion on coated activated charcoal were carried out in 60 cases of poisoning. The indications concerned 2 clinical situations: - massive poisoning with coma (by hypnotics or chlorine-containing solvents) with high extracellular concentrations of the toxic agent, with the aim of reducing the duration of the coma; - intoxications with a high mortality rate, such as those due to paraquat, colchicine, digitoxine, tricyclic antidepressants, and heavy metals, even when plasma levels were low in relation to the dose ingested. Such discordance may be related not only to predominantly intracellular fixation, but also to low intestinal absorption. The effectiveness of haemoperfusion was estimated in terms of the amount of toxic substance extracted, measured either indirectly by repeated calculation of the arteriovenous difference multiplied by the flow rate through the column, or directly by elution of the column. This method for the removal of toxic substances would not appear to be life-saving, is too costly for the extraction obtained and is not free from specific complications. Thrombocytopaenia remains an epiphenomenon, but the frequency of infection is significantly higher than with haemodialysis. An effective and safe method for the vascular extraction of poisons, particularly one favourising removal of toxic substances from intracellular localisation, remains to be found.

Antidepressive Agents, Tricyclic↗
PubMed1976

[Determination of colchicine in biological fluids].

The authors described a fluorimetric method of estimation of colchicine applicable to biological fluids, during treatment and, especially, during acute poisoning. Blood and urinary concentrations confirm the data in the literature.

Colchicine↗
PubMed1975

[Circadian variations of the effects of ethanol and of blood ethanol values in the healthy adult man. Chronopharmacological study].

Six healthy young men (22 to 26 years) who had fasted for 12 hours volunteered for this study (subject synchronization: diurnal activity from 07(00) to midnight and nocturnal rest). A set dose of ethanol (0.67 g/kg body weight) was ingested at the fixed (and random) hours of 07(00), 11(00), 19(00) and 23(00), with a week between tests. A set of physiological variables: psychological tests (selft-rating of mood, of physical vigor and of ebriety, tempo, random number addition test); physical variables (heart rate, systolic and diastolic blood pressure, peak expiratory flow, oral temperature and grip strength); blood variables (plasma ethanol, cortisol, lactic acid, pyruvic acid, glucose and erythrocyte K+) and urinary variables (volume, epinephrine, nor-epinephrine and 5-HIAA) were documented at least at 4 hourly intervals and set times. The cosinor method was used for chronobiological statistical analyses. The parameters characterizing the ethanol pharmacokinetics (chronopharmacokinetics) demonstrated a circadian rhythm (p less than 0.05): e. g. the peak height of ethanolemia is greater when ethanol is ingested at 07(00) than at other times. Also a circadian rhythm in biosystems susceptibility can be demonstrated (p less than 0.05) (chronesthesy) with a peak time not necessarily corresponding either to that of ethanolemia or to that of other variables. The overall circadian changes in ethanol effects (chronergy) can be viewed as a combination of both ethanol chronesthesy and chronokinetics.

Adult↗
PubMedDate not supplied

Evaluation of liver iron content by computed tomography: its value in the follow-up of treatment in patients with idiopathic hemochromatosis.

The therapeutic management of patients with idiopathic hemochromatosis (IH) implies the evaluation of excess hepatic iron. This work was undertaken to confirm the value of computed tomography for the assessment of liver iron overload in such patients and to evaluate this technique during the course of treatment by phlebotomy. The study included 24 patients with initially untreated IH and 7 patients previously treated by phlebotomy for 10 months to 7 years. Follow-up was obtained in 15 subjects. In patients with untreated IH, liver attenuation coefficient (LAC) was always markedly increased (92.4 +/- 7.1 Hounsfield units) as compared with LAC of subjects with normal liver (60.2 +/- 3.1 Hounsfield units) and that of patients with chronic liver disease (53.8 +/- 4.8 Hounsfield units), and was found to be specific for liver iron overload. LAC decreased progressively during phlebotomy, and this diminution was correlated with the amount of mobilized iron (r = 0.79, p less than 0.001); it returned to normal values only after complete removal of iron overload. LAC was closely correlated with liver iron concentration (r = 0.83, p less than 0.001), better than usual biochemical parameters, especially serum ferritin (r = 0.70, p less than 0.01). This study confirms that the determination of LAC on computed tomography provides a reliable index of hepatic iron stores in patients with IH, without requiring a liver biopsy, and shows that this noninvasive method is of particular interest for the follow-up of patients treated by phlebotomy.

Adult↗
PubMedDate not supplied

4-Methylpyrazole may be an alternative to ethanol therapy for ethylene glycol intoxication in man.

4-Methylpyrazole (4 MP) is a strong inhibitor of alcohol dehydrogenase. Its use in acute ethylene glycol (EG) or methanol intoxication has been suggested in experimental studies about its efficacy and safety. We report three cases of accidental intoxication with ethylene glycol in man treated orally with 20 mg/kg/day of 4 MP. The treatment was maintained until plasma EG concentrations became unmeasurable. The patients were admitted early during the course of the poisoning. Their neurological status was good. A slight metabolic acidosis observed in two cases was easily corrected and did not recur. Renal function remained normal in all cases. No patient underwent hemodialysis. On admission plasma EG concentrations were 24.2 mmol/l, 13 mmol/l and 9.7 mmol/l respectively. Plasma EG half-lives were 14.5, 11.5 and 14.75 hours respectively. Plasma oxalate concentrations and the rate of urine oxalate elimination, determined in two patients, were high on admission but quickly returned to normal. Concerning possible side effects of 4 MP, a skin rash was observed in one patient and a possible eosinophilia in the others. These three cases suggest that 4 MP may decrease the metabolic consequences of EG poisoning in man and may be of therapeutic value when administered early during the course of the intoxication before coma, seizures and organic renal failure have occurred.

Adult↗
PubMedDate not supplied

[The importance of software for the planning and adjusting of dosage. Application with aminoglycosides].

We are presenting a Mac Intosh--Apple computer program (Excel*) for the aminoglycosides (AG) drug monitoring useful in the following situations: --initiation of an AG's dosing regimen depending on the desired peak and through concentration (AG's pharmacokinetic parameters have been calculated according to the AG's literature values). --an adequate dosing regimen after revision of the patient's parameters (calculated with the observed concentrations). The technique has been validated comparing desired (des. C) and measured concentrations (mes. C). --either at the beginning of the treatment, --or after revision of the individual parameters. In the first case, the correlation coefficient obtained between 14 des C and 14 mes. C is equal to 0.91 and is improved when individual parameters are calculated (0.94).

Adolescent↗
PubMedDate not supplied

[Guidelines for prescription of the assay of digitalis glycosides by immunologic methods].

Digoxin, digitoxin and acetyldigitoxin are the most widely prescribed of cardiotonic glycosides. Analytical exploration can be performed by a single assay when only one compound is prescribed or by multiple assays in cases of imprecise prescription or when several glycosides are given concomitantly. In addition, the metabolic transformation of digitoxin into digoxin and the presence of endogenous "digitalis-like compounds" mean that a number of precautions must be taken during prescription. These examples underline the ambiguity of the so-called "digitalinaemia" prescriptions and the need for biologists to be supplied with maximum information by clinicians.

Acetyldigitoxins↗