PubMed Health⌕ Search

Biomedical subjects

P E Valere

Publications and source records attributed to P E Valere.

At least 19 recordsLinked to original sources
PubMed1996

Screening of renal artery stenosis: assessment with magnetic resonance angiography at 1.0 T.

The results of MR angiography at 1.0 T with digital intraarterial angiography in the screening of patients with suspected renal hypertension were compared. In this first phase of the study, 10 volunteers underwent examination with both two-dimensional (2D) with traveling saturation time-of-flight (TOF) magnetic resonance angiography (MRA) with various parameters to develop a protocol for evaluation of the renal arteries. In the second phase, 36 patients with suspected renovascular hypertension underwent both 2D TOF MRA and intraarterial digital angiography to evaluate the clinical value of MRA. The degree of stenosis was graded with a two-point scale. In volunteers, using 2D acquisitions C/N ratios indicated the best flip angle as being 55 degrees (p = .02). MRA showed 100% (70/70) of all main arteries and 86% (6/7) of all accessory renal arteries seen on angiography. MRA had a sensitivity of 94% (15/16) and a specificity of 98% (60/61) for detection of stenoses of greater than 50% present in 14 patients. 2D-TOF MRA at 1.0 T shows promise in the noninvasive diagnosis of patients with suspected renovascular hypertension.

Adult↗
PubMed1995

Pulmonary time-of-flight MR angiography at 1.0 T: comparison between 2D and 3D tone acquisitions.

The purpose of this study was to compare the performance of 2D vs. 3D time-of-flight (TOF) methods in imaging the normal pulmonary arteries with commercially available 1.0 T equipment. The study was conducted in 20 volunteers and 7 patients with suspected pulmonary embolism (PE). To reduce artifacts caused by cardiac and respiratory motion, MR images were acquired in volunteers using two-dimensional (2D), gradient-recalled echo (GRE), breath-hold techniques, and three-dimensional (3D) acquisitions. Sagittal thin (6-MM) segmented k-space 2D sections obtained with cardiac gating during systole (turboFLASH, TR/TE9/6 ms, 14 segments of 9 lines) and incremented flip-angles (TONE), and 50-mm 3D volume TONE acquisitions with 32 partitions (FISP, TR/TE34/10ms) were successively performed. In the second phase of the study, patients were examined only with the 3D technique. Images of volunteers were qualitatively and quantitatively analyzed. S/N ratios were statistically compared by means of the paired-sample Wilcoxon ranked-signed test, a value of p < .05 being significant. In volunteers, 3D acquisitions displayed significantly more segment-order pulmonary arteries on average than did 2d acquisitions displayed significantly more segment-order pulmonary arteries on average than did 2D acquisitions (2.95 +/- 0.64 vs. 2.2 +/- 0.85, respectively; p < .01). Moreover, the signal intensity of arteries within the lungs was less homogeneous in the 2D than in the 3D technique, with a signal intensity ratio between peripheral and proximal arteries of 63% +/- 7% and 73% +/- 2%, respectively (p < .05). In patients, no erroneous diagnoses were obtained using the 3D technique. 3D images of normal lungs provide MR angiograms of better quality than do 2D images, and require less contribution from subjects because they are performed in free breathing. Ongoing improvements in MR sequences and further studies are now necessary to assess the value of 3D TONE MRA in the diagnosis of PE.

Adult↗
PubMed1990

Mesenteric infarction in Takayasu's disease.

Obstructive lesions of the visceral arteries in Takayasu's disease are common but rarely symptomatic. This report concerns two patients with Takayasu's disease who died of mesenteric infarction due to superior mesenteric artery thrombosis. Prophylactic revascularization of the visceral arteries in Takayasu's disease remains controversial, and lesions can be more severe than classically recognized.

Adolescent↗
PubMed1988

[Significance of exercise-induced arrhythmias].

Four personal cases of exercise-induced conduction defects occurring during stress testing are reported. The significance of these changes is discussed in the light of the authors' observations and of the cases published in the literature. The development of atrioventricular block is usually related to pre-existing disease of the conduction system, whilst left anterior or posterior hemiblock is usually due to transient ischaemia related to significant stenosis of the coronary artery responsible for the vascularisation of the relevant bundle branch (usually a proximal stenosis of the left anterior descending artery). Complete left bundle branch block may be due to a number of conditions (including chronic ischaemic heart disease).

Aged↗
PubMed1988

[Influence of the distribution of collateral circulation on left ventricular segmental kinetics].

Correlations between left ventricular segmental kinetics and collateral circulation patterns were studied in 292 patients with coronary disease (182 women, 274 men: mean age 54 years). Left ventricular segmental kinetics were analyzed qualitatively by angiography (10 segments were individualized on RAO and LAO projections) and rated as normal, hypokinetic, akinetic or aneurysmal. The type of collateral circulation observed (contralateral, homocoronary and homolateral) and the number of collateral vessels were recorded. Collateral circulation was present in 49 p. 100 of the patients and in 29 p. 100 of the 587 pathological arteries (i.e. more than 50 p. 100 stenosis) identified. 89 p. 100 of the occluded arteries were revascularized by collateral circulation, the latter being effected by 213 collateral vessels (mean: 1.41 +/- 0.36 vessel per occluded artery). Collateral circulation through 1, 2 or 3 collateral vessels was noted in 62 p. 100, 35 p. 100 and 3 p. 100 respectively of the cases. Collateral circulation was contralateral in 51 p. 100, homocoronary in 33 p. 100 and homolateral in 16 p. 100 of the cases. Normal or hypokinetic segments in the territory of an occluded artery were more frequent in the presence (43 p. 100) than in the absence (31 p. 100) of collateral circulation, but the difference was not significant. They were also more frequent in three-vessel patients (59 p. 100) than in one-vessel (21 p. 100; p less than 0.01) or two-vessel (37 p. 100; p less than 0.05) patients in the presence of collateral circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Collateral Circulation↗
PubMed1987

Fifty cases of late prosthetic valve endocarditis: improvement in prognosis over a 15 year period.

The clinical course, prognostic factors, and management of 50 cases of late prosthetic valve endocarditis, occurring more than two months after valve replacement, were reviewed. Twenty nine cases that presented from 1971 to 1980 were compared with 21 cases that presented from 1981 to 1985. Apart from an appreciable decrease in the frequency of neurological complications between the first period (38%) and the second period (10%) no differences in clinical or bacteriological features were seen. Seventeen (59%) of the 29 cases in the earlier period and four (19%) of the 21 cases in the later period died. The rationale for antimicrobial treatment was similar during both periods. Cardiac surgery was performed in eight of 29 cases between 1971 and 1980 and in 11 of 21 between 1981 and 1985; the mean (SD) time between diagnosis of endocarditis and operation was 28 (19) days and 43 (44) days respectively. Six of the eight cases operated on in the first period died as did two of the 11 operated on in the second period. Twenty seven of the 29 cases presenting between 1971 and 1980 were treated with anticoagulants--either warfarin (15 of 27) or heparin sodium (12 of 27). Sixteen of the 21 cases presenting later were given anticoagulants and 15 of these cases were given heparin sodium. Control of anticoagulation was inadequate in nine of the 27 cases treated with anticoagulants during the first period and in only two of 16 treated during the second period. During the first treatment period neurological complications were more frequent when control of anticoagulation was inadequate.

Adult↗
PubMed1985

Clinical and echocardiographic observations in pulmonary valve endocarditis.

Clinical and echocardiographic data from 12 patients with pulmonary valve endocarditis are described. Seven patients had isolated pulmonary endocarditis and in 5 patients other valves were infected (aortic, tricuspid, mitral or all 3). Two patients were heroin addicts and 4 had underlying heart disease (congenital heart disease in 3 and aortic regurgitation in 1 patient). The organisms involved were alpha streptococci in 3 patients (all with underlying heart disease), Staphylococcus aureus in 4, Streptococcus D bovis in 1 patient and Candida guillermondii in 1. M-mode and 2-dimensional echocardiography was performed in 10 patients and revealed vegetations in 8. Pulsed Doppler echocardiography was performed in 6 patients and revealed pulmonary regurgitation in all 6. Seven patients had pulmonary emboli. Four patients underwent surgery. Four patients died, including 1 after cardiac surgery. Five patients, including the patient infected with Candida guillermondii, recovered with antibiotic treatment.

Adolescent↗
PubMed1982

[Cardiac toxicity of ajmaline. Comparison of acute voluntary poisoning with complications of the ajmaline test].

A comparative and retrospective study of 59 cases of acute voluntary self-poisoning observed at the Toxicology Department of Fernand Widal Hospital, and 15 cases of complications of the Ajmaline test observed in the Cardiology Department of Bichat Hospital showed a similarity in the cardiac effects of high dosage regardless of the mode of administration of the antiarrhythmic. Acute suicidal poisoning in adults or accidental poisoning in children caused toxic effects at doses over more than Ig: they are characterised by their sudden onset after a latent period of 1 to 2 hours and their short duration (no effects after the 12th hour). The ECG changes included:--First degree atrioventricular block (15 p. 100).--Intraventricular conduction defects were observed in almost all cases. They were proportional to the dose taken and were of prognostic interes (no cardiac arrests when the QRS remained less then 0,2 sec).--ST-T wave changes were observed in all patients. They lasted longer and were of no prognostic importance.--Extrasystoles and ventricular tachycardia are nearly always associated with poor hemodynamic tolerance (70 p. 100 of cardiac arrests, compared to only 16 p. 100 in this absence). This intoxication is serious with a mortality of 24 p. 100 of the reported cases and of 9 p. 100 of cases admitted to an Intensive Care Unit.--The complications of the Ajmaline test were similar, the time of apparition being a few minutes instead of a few hours. There were no deaths or serious hemodynamic complications in this series. This is without doubt related to the observation of the contraindications and the fractional administration of the Ajmaline. We conclude that oral Ajmaline, though well tolerated at therapeutic does may cause severe toxic overdose effects. Although its use remains justified in the treatment of arrhythmias, it should not be used for the symptomatic treatment of palpitations and neurovegetative imbalance.

Acute Disease↗
PubMed1981

Tandem coarctation of the thoracic aorta. An unusual congenital anomaly.

The coarctation involving the aortic isthmus, with hypoplasia of the upper aortic segment, was satisfactorily repaired in a 15-year-old girl. The technique used was subclavian flap arterioplasty followed by reimplantation of the distal subclavian artery into the left carotid artery. Suprisingly weak femoral pulses were noted postoperatively and prompted a control angiogram. This showed an intraluminal diaphragm 2 cm below the site of the previous repair, with a 100 mm Hg gradient. At reoperation, a centrally performed fibrous diaphragm was excised, and the aorta was enlarged with a small Dacron patch. The postoperative course was uneventful.

Adolescent↗
PubMed1978

[The treatment of myocardial infarct with streptokinase].

The current situation concerning the use of Streptokinase in the treatment of recent myocardial infarction does not make it possible to draw any definite conclusions with regard to its therapeutic value:--mortality would not appear to be significantly modified in the majority of series;--the occurrence rate of major complications during the acute phase is not notably altered but it seems possible that the electrocardiographic course of the necrosis is more favourable under the influence of Streptokinase when treatment is begun early. The long term course cannot be assessed. Finally, it is certain that the tolerance of Streptokinase therapy has been good in all the published series. In particular, Streptokinase does not appear to have been associated with severe haemorrhagic complications nor a higher prevalence of cardiac rupture.

Blood Viscosity↗
PubMed1976

[Pericarditis in recent myocardial infarct].

Epistenocardial pericarditis, usually associated with anterior infarct, was noted in 64/400 myocardial infarct subjects admitted to an intensive care unit. No significant difference was observed with respect to this group in the case of mortality (20.6% as opposed to 26.2% in the controls) or complications of the acute stage, such as cardiac insufficiency and arrhythmia, though atrial fibrillation was more frequent (25% as against 15%). In all but one case, anticoagulant management was suspended on the appearance of pericarditis. In spite of the high frequency of atrial fibrillation, thromboembolic complications were not more frequent during brief (48-72 hr) suspension of anticoagulants. Dressler's syndrome was noted in 7 cases (1.7%), with epistenocardial pericarditis (4/7) or ventricular ectasia (3/7). Haemopericardium occurred in the case where anticoagulant management was not suspended.

Acute Disease↗
PubMed1976

[Pericarditis and fresh myocardial infarction (author's transl)].

Among 400 patients with myocardial infarction who had been admitted to the intensive care department, pericarditis was observed in 64 cases (16%). It occurred more frequently with anterior wall infarctions. The influence of the pericarditis on the mortality and complications threatening in the acute period were particularly investigated: There was no significant difference with regard to the mortality (20.6% in the group with pericarditis, 26.2% in the control group) or the occurrence of cardiac insufficiency or arrhythmias as complications. Atrial flutter, however, is more frequent (25% against 15%). Anticoagulant therapy was discontinued when pericarditis appeared, with one exception. In spite of the high frequency of atrial flutter, embolic complications were not more frequent after discontinuing the anticoagulant therapy. A postmyocardial infarction syndrome was observed seven times (1.7%), it was frequently found in a pericarditis with angina pectoris (4/7) and with ventricular aneurysm (3/7). Hemopericardium occurred in one patient in whom anticoagulant therapy had not been discontinued.

Acute Disease↗
PubMed1975

[Echography in heart valve diseases].

The authors discuss the value of echorcardiography in cardiac valvular disease. Exploration of the mitral valve gives very precise data concerning diagnosis and evaluation of the degree of mitral stenosis. It may be of value in the diagnosis of certain complications such as intra-atrial thrombosis and gives reliable information in postoperative surveillance. In mitral insufficiency, echocardiography sometimes permits the recognition of certain mechanisms such as rupture of the cordae, ballooning of the lesser cusp and abnormal kinetics in obstructive cardiomyopathy. Exploration of the aortic valve is less informative. Aortic insufficiency gives scarcely any direct signs, whilst echocardiography is of value in aortic stenosis. Ultrasonic study also is useful in surveillance of the kinetics of valvular prostheses. The total absence of risk makes repeated studies possible, rendering echocardiography an essential element in the study of valvular disease.

Aortic Valve Insufficiency↗