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Biomedical subjects

P Bouletreau

Publications and source records attributed to P Bouletreau.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Acute tricyclic antidepressant intoxication. Evaluation of severity and treatment. A study of 16 patients with cardiovascular manifestations (author's transl)].

Among the 94 tricyclic antidepressant intoxications received in 3 years in the intensive care unit of Edouard Herriot Hospital, 16 with cardio-vascular manifestations are studied. The criteria of selection is the presence on the electrocardiogram (ECG) of a ventricular trouble in conduction excitability or automaticity. Eight times, the ingested dose exceeds 20 mg/kg. 10 times several toxics are taken explaining the severity of coma and the rarity of convulsions. 2 collapses, 1 shock, 1 cardiac arrest occur. The most frequent ECG abnormalities are: T modifications, (90 p. 100), prolongation of QT interval (60 p. 100), right bundle branch block (50 p. 100) or left one (25 p. 100). Only one death occurs; (1 p. 100 of this series). Ventricular dysrythmia or myocardial failure represent the main criteria in the evaluation of severity of the tricyclic antidepressant intoxication. For the treatment, a complete digestive evacuation is needed, Hemodialysis, plasmapheresis, or hemoperfusion cannot be actually recommended. The treatment of cardiac troubles involves essentially sodium. and eventually intra-cardiac pace maker.

Adolescent↗
PubMed1981

[Changes in barbiturate self-poisoning during the last ten years. A comparison between two series of cases (author's transl)].

The study compared two homogenous series of attempted suicide with barbiturates: 1012 patients from November 1967 to July 1969, and 327 patients in 1977. During these ten years there was a 10% decrease in the incidence of barbiturate intoxications to the benefit of intoxications with benzodiazepines. A similar trend was seen in the use of medium - or long - acting barbiturates alone as compared with association with other drugs. There also was a remarkable shortening of the delay in admission to hospital: 66% of the patients were admitted within 6 hours of poisoning in 1977, as against 56% in 1967-69) to 1% (3 deaths out of 327 cases in 1977).

Acute Disease↗
PubMed1981

[Glucose intolerance in injured patients (author's transl)].

Glucose intolerance occurring in injured patients is known to be a part of the general response to injury described by Cuthbbertson: early "ebb phase" with a decrease of energy production, then "flow phase" with hypermetabolism. Several processes can be responsible for the abnormalities observed: 1) Alterations in peripheral glucose uptake. 2) Absolute or relative insulin lack in connection with increased catecholamine release which is know to inhibit insulin secretion. 3) Decreased sensitivity and responsiveness to insulin in connection with increased levels of counter regulatory hormones (catecholamines, glucagon, growth hormone). 4) Non-suppressibility of hepatic gluconeogenesis by glucose. Glucose intolerance decreases glucose utilisation and leads to increased proteolysis always unfavorable for patients.

Glucose↗
PubMed1981

[Fulminant hepatitis B virus associated with acute pancreatitis. Report of two cases (author's transl)].

Viral hepatitis affections are sometimes associated with endocrine or exocrine pancreatic disorders. An acute necrotizing hemorrhagic pancreatitis seems to be the prerogative of the fulminating forms. The demonstration of HBS fluorescence in the pancreatic acini cells in one patient suggests the possible etiopathogenic role of HB virus in some cases, apart from the other factors involved.

Acute Disease↗
PubMed1979

Accidental amikacin overdose in man: emergency therapy by extrarenal dialysis.

Three accidental overdoses of amikacin (6, 6.5 and 8 times the normal dose) are reported. Emergency haemodialysis therapy was given and the serum levels monitored. No toxic effects were encountered. The need for such emergency haemodialysis seems to be limited to patients with impaired renal function or to cases where little time has elapsed between intake and detection of overdose.

Accidents↗
PubMed1977

[Variation of plasma amino acids in severe hepatitis with encephalopathy 10 cases].

Plasma levels of different amino acids were observed in 10 patients with severe hepatitis, 9 viral in origin and 1 toxic, over the course of the disease. There would appear to be a close relationship between the onset of encephalopathy and the appearance of a particular pattern in plasma amino acid equilibrium, characterised by a significant fall in the molar ratio existing between ramified amino acids (valine, leucine, isoleucine) and aromatic amino acids (phenylalanine and tyrosine). The role of these disturbances in the physiopathology of the encephalopathy and their effects on the synthesis of normal neurotransmitters and the intracerebral accumulation of false neurotransmitters is discussed.

Acute Disease↗
PubMed1977

[Mendelson's syndrome].

Mendelson's syndrome is discussed with a review of the literature and presentation of 27 personal cases studies. Accidental aspiration of gastric fluid occurs primarily during anesthesia, in cranial trauma victims, and in toxic coma patients. Tissue damage is proportional to the acidity and the quantity of aspirated fluid. The initial clinical manifestations are often serious, sometimes leading to acute respiratory distress syndrom with pulmonary edema. Frequent infectious complications, often with anaerobic microbes, are deciding factors in the prognosis. Artificial ventilation with positive pressure (sometimes continuous) is often necessary. Administration of corticosteroids at high doses is likely favorable. Prophylactic administration of antibiotics is initially directed against anaerobic agents. The prevention of this serious syndrome should be a primary concern of anesthesiologists and physicians treating comatous patients.

Adrenal Cortex Hormones↗
PubMed1976

[Stress ulcer and acute postoperative renal insufficiency. An attempt at preventive treatment with Solcoseryl and proglumide].

The study grouped 68 patients treated for severe post-operative or post-traumatic renal insufficiency, having survived over 7 days after being admitted into the Reanimation Department. A group of 32 patients were given systematic preventive treatment for nervous ulcers witch Solcoseryl and Proglumide. A control group of 36 patients received no specific treatment. Nervous ulcerations (showing up in gastrocopy) are found in three patients in the group receiving treatment, as compared with seven in the control group. This preventive treatment appears to be of interest, especially as other local or neuroleptic treatments are difficult to use in the group of patients concerned here.

Actihaemyl↗
PubMed1976

[Corticosteroids and septic shock].

According to the data in the literature, the authors attempted to sum-up present attitudes on the value of corticoids in the treatment of septic shock. If their cardiovascular effects after a period of enthusiasm, are presently rather controversial, their cellular and sub-cellular actions, on the lysosomal membranes, capillary permeability and perhaps the intimate mechanisms of cellular oxygenation seem to be more real. However, the contra-indications which persist in the results of clinical works have resulted in the fact that the exact place of cortico-steroids in the therapeutic arsenal of septic shock still remains to be specified.

Adrenal Cortex Hormones↗