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P Bechtel

Publications and source records attributed to P Bechtel.

52 records · Page 3Linked to original sources

[The effects of heparin in underdevelopment of the fetus due to maternal vascular conditions (author's transl)].

The use of heparin to interfere with the appearance of fetal maldevelopment (or to correct it) is logical but the results are difficult to prove because it is difficult to be certain of early diagnosis at the time when therapy has the best chances of being efficacious. The authors compare two groups of pregnant women in whom the muscular vascular tone of the cervix is abolished. The second group was treated with heparin. The results are statistically significant and prove that treatment with heparin is well based in cases of underdevelopment of the fetus when it is due to abnormalities in the maternal microscopic circulation (acute atherosis). They confirm that the enzyme, hormone and ultrasound parameters return to normal from the beginning of treatment with heparin.

Arteriosclerosis↗

[Collection of familial data in pharmacogenetics. Methodological problems].

The purpose of this paper is to show the problems with family data collection in a pharmacogenetic study, the aim of which was to study the genetic polymorphism of inducibility of cytochromes P4501A by polycyclic aromatic hydrocarbon (PAH). Data were collected from 76 smoker nuclear families (315 volunteers). A caffeine test, a blood sample and answers to a questionnaire were obtained from each healthy volunteer. It was a crucial problem to recruit nuclear families with healthy smoker father and/or mother and 2 smoker children. On 127 answers, 22 families were not eligible, 27 refused and 10 had a single child, that meant secondary refusals. Problems differed with origin of the recruitment. Included were 40 families obtained from 3 antismoking outpatient departments, 29 from general practitioners but 6 only from students. The family rates with 2 parents/2 children were significantly higher with general practitioners (p < 0.01). This emphasized their part in epidemiologic studies. Problems with the use of methodology were bound to acceptability of the tests which were better in females (p < 0.05), and a change in caffeine form could improve this acceptability. Lastly, difficulties with laboratories constraints required a very good coordination between families, nurses and laboratories.

Cytochrome P-450 Enzyme System↗

[Methodology of preparing a list of educational objectives: example of application to pharmacology. Groupe Objectifs Pédagogiques de L'Association des Enseignants de Pharmacologie].

Using a structured approach to categorize pharmacological knowledge and a systemic analysis of prescribing practice, we identified the knowledge needed to optimally prescribe and manage treatments with drugs. The approach consisted in finding the branched chains of knowledge beginning with each operation required to solve each problem which arises in prescribing and managing drugs at the most elementary level. This elementary knowledge is then transformed into educational objectives. The next step is to share the educational objectives between basic medical training, continuing medical education and acquisition of therapeutic knowledge. The method could be applied in other medical teaching domains.

Educational Technology↗

[Maprotiline versus fluvoxamine: comparison of their effects on the hypothalamo-hypophyseal-thyroid axis].

The TRH test has been used in psychiatry these last 20 years. One of the most promising results is that concerning the possibility to use it to identify the best moment to stop a treatment after clinical recovery of the depressive episode. For that it is necessary to demonstrate an absence of intrinsic action of antidepressants on the HPT axis physiology. This overt, randomized study has compared the actions on T3, T4, basal TSH and its response to the TRH test after 75 mg/day of maprotiline and 100 mg/day of fluvoxamine, both administrated in depressed patients during 28 days. Forty patients (20 men and 20 women) were studied, 20 patients per treatment. The inclusion criteria were those of DSM III-R for major depression and dysthymia as well a minimum score of 25 at MADRS scale. Blood samples for T3, T4 and basal TSH dosages were made before TRH intranasal administration (2 mg) at days 1 and 28 of the treatment. We haven't observed any difference before treatment between the 2 groups for clinical and biological studied parameters. After treatment both antidepressants produced equivalent improvement of depression evaluated by MADRS (fluvoxamine:dMADRS = 16.95 +/- 7.11; maprotiline: dMADRS = 17.10 +/- 6.84. t = 0.07, NS). T3 and T4 variations between the beginning and the end of the study weren't also significantly different between the 2 groups. Basal TSH was increased in the maprotiline group but decreased in the fluvoxamine group resulting in a significant difference (fluvoxamine: dTSH = 0.31 +/- 0.76 mUI/l. Maprotiline : dTSH = -0.23 +/- 0.66 mUI/l. t = 2.40, p < 0.02). The TSH response to TRH was decreased in the fluvoxamine group (ddTSH = 0.24 +/- 6.65 mUI/l. dAUC = 103.98 +/- 596.84 mUI/l) while it was increased in the maprotiline group (ddTSH = -3.59 +/- 5.88 mUI/l. dAUC = -355.80 +/- 505.67 mUI.min/l). The difference between the 2 treatments was not significant when evaluated by ddTSH (t = 1.53, NS) but it became significant if evaluated by dAUC (t = 2.63, p < 0.01). As we could demonstrate an absence of influence of the clinical evolution between both groups in the hormonal variations observed, we concluded to a intrinsic difference action on HPT axis between fluvoxamine and maprotiline. This difference could be linked to the different aminergic action of these 2 antidepressants.

Adult↗