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Biomedical subjects

P Chiche

Publications and source records attributed to P Chiche.

At least 19 recordsLinked to original sources
PubMed1981

Jugular pulse and flow velocity anomalies: a diagnostic clue to an obstructive tricuspid prosthetic dysfunction.

Report of a case of obstructive dysfunction of a tricuspid Starr-Edwards (6120) ball prosthesis, diagnosed on phonocardiographic (PCG) diastolic anomalies with abnormal diastolic pattern of the jugular pulse, abnormal jugular flow velocity curve, and confirmed by cinefluoroscopy. The thrombotic origin of the obstruction was assessed on the regression of PCG and cinefluoroscopic anomalies under fibrinolytic therapy.

Female↗
PubMed1980

[Are nitrate compounds effective when administered orally? Results of pharmacokinetic and hemodynamic studies].

Several reports had concluded that nitrates were not efficacious when administered by the oral route, on the basis of experiments which had shown a rapid denitration by the liver enzyme glutathion-organic nitrate reductase. Recent data demonstrate the efficacy of nitrates on parameters measured at cardiac catheterisation and echocardiography on condition that adequate doses are used. Doses commonly used up to now are often inadequate. The demonstration in the blood, after oral administration of adequate doses, of concentration of non-metabolized nitrates which are of the same order as those obtained after sublingual administration of clinically efficacious doses, confirms the efficacy of nitrates administered by the oral route.

Administration, Oral↗
PubMed1979

[Nitroglycerin infusion in patients with or without cardiac failure. Demonstration by multifactorial analysis (analysis of correspondences) of three types of hemodynamic response dependent upon the initial state (author's transl)].

The effects of nitroglycerin on systemic vascular resistance and cardiac output are highly debated. This study demonstrates that these effects depend on the initial haemodynamic condition, and explains the conflicting results previously reported. 31 patients presenting initially with a fairly wide spectrum of various haemodynamic parameters underwent cardiac catheterisation with measures of parameters before and after nitroglycerin infusion. Multifactorial statistical analysis by correspondence analysis identifies 3 types of haemodynamic responses and demonstrates the association of each response with a particular haemodynamic profile. It is demonstrated that systemic vascular resistance is decreased only when it is initially elevated and cardiac output is increased only when initial pulmonary wedge pressure and systemic vascular resistance are elevated and cardiac output is low. The effects of nitroglycerin on cardiac output, systemic vascular resistance, heart rate and arterial pressure differ significantly according to the presence or not of cardiac insufficiency and depend mainly on the initial value of three parameters: systemic vascular resistance, pulmonary wedge pressure and cardiac output.

Adult↗
PubMed1979

[Ascending aortic aneurysm with mucoid infiltration of the media and aortic leaflets. Pathogenic hypotheses- surgical consequences].

The theoretical and practical problems posed by aneurysms of the ascending aorta with mucoid infiltration of the Media and the aortic leaflets are discussed with reference to two suggestive cases. These histological changes are not specific for Marfan's syndrome, the relation with which is very inconstant. Incomplete replacement of the affected tissues risks a recurrence which is especially serious when the sinus of Valsalva is involved. Therefore, total replacement of the ascending aorta with aortic valve replacement and reimplantation of the coronary arteries is generally indicated. Histology of the excised tissues should be performed routinely with specific stains for mucopolysaccharides. Close follow-up of operated patients with this condition is recommended, especially those with only partial replacements.

Adult↗
PubMed1978

[Use of digitalis glycosides in severe disorders of intra-ventricular conduction].

The use of digitalis in severe disorders of intra-ventricular conduction is debatable, and some consider it contra-indicated. Once it had been shown that the latter attitude is at best based on contraversial theoretical arguments, two types of study were undertaken: 1. Nine patients with bilateral bundle branch block had intracavitary recordings made of the HV interval both before and for one hour after the administration of lanatoside C (0.8 to 1.6 mg). In no case was this interval found to be increased, indicating that there was no increase in the original conduction defect. 2. Thirty four patients with complete right bundle branch block and associated left antero-superior hemiblock were digitalised, and followed up for an average of 16 months; only 2 complete atrio-ventricular blocks occurred (5.9%). The risk of complete atrio-ventribular block occurring within a year (4.5% in our series) does not differ significantly from that in an identical control group of 38 patients with the same conduction defect, but who were not digitalised (6%). Three patients had a therapeutic overdose of digitalis with no observed increase in their atrio-ventricular block. The authors conclude that it is perfectly in order to digitalise a patient with a severe intra-ventricular conduction defect.

Aged↗
PubMed1977

[The treatment of recent myocardial infarction by prolonged infusion of trinitrin (author's transl)].

Seventy four clinically comparable cases of myocardial infarction, admitted on average at the 10th hour were divided at random in two groups: thirty nine were treated with a prolonged intravenous infusion of trinitrin lasting for 24 hours in 12 cases and during 5 at 7 days in 27 cases: 35 served as controls. The results showed the following: a) the good tolerance of the drug used in this way; b) on the basis of precordial cartography, a reduction of 56.2 +/- 14.5% to 30 +/- 7.3% in the index of secondary extension of necrosis; c) clinical signs of left ventricular failure developed in 60% of the controls as compared with 45.8% of the treated group; d) the prevalence of rhythm disturbances was also lower in those treated; e) overall mortality during the first 4 weeks was 8 amongst the 35 controls and 2 of the treated patients (p less than 0.05).

Aged↗