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Biomedical subjects

R Favre

Publications and source records attributed to R Favre.

At least 19 recordsLinked to original sources
PubMed1992

[Medical treatment of chylous effusions in newborn infants. Apropos of 3 cases].

BACKGROUND: Chylous effusions are the most frequent cause of non immunologic hydrops fetalis. They can be recognized antenatally by ultrasonography. Their evacuation is sometimes necessary and medical treatment often effective. CASE REPORTS: Case n. 1: fetal ascites was detected by ultrasonography at the 30th week of gestation. Paracentesis was performed at 36 weeks, followed 3 days later by spontaneous delivery. The newborn was fed milk formula. A second paracentesis showed a milky fluid, rich in cholesterol, triglycerides and chylomicrons. The child was fed formula rich in medium-chain triglycerides and the chylous ascites disappeared completely within 2 weeks. Case n. 2: a diagnosis of bilateral hydrothorax and hydramnios was made at the 27th week of gestation. An in utero evacuation of the hydrothorax performed at the 30th week was ineffective and a pleuro-amniotic drainage was performed 2 weeks later. The baby was born at the 35th week, and presented a moderate respiratory distress due to the hydrothorax and ascites. Aspiration of the thoracic fluid confirmed its chylous origin. The chylous effusions completely disappeared when the child was fed a high medium chain triglycerides diet. A lymphedema of legs appeared at the age of 1 month. Case n. 3: ascites, hydramnios, hydrothorax and peripheral edema were found at the 21st week of a third pregnancy (the 2 first pregnancies were complicated by lethal hydrops fetalis). Bilateral hydrothorax and peripheral edema were found again after birth at the 37th week. Diuresis and albumin-infusion led to recovery, but chylothorax and chylous ascites reaccumulated after introduction of milk formula, despite repeated evacuations and feeding medium-chain triglycerides formula. The thoracic fluid remains chylous at the age of 9 months. CONCLUSIONS: In utero, and sometimes post-natal, evacuation of fluid present in the thoracic and peritoneal cavities can be necessary, depending of the functional tolerance. Medical management including feeding a low fat and/or high medium-chain triglycerides diet, and sometimes temporary total parental nutrition, is necessary, together with salt restriction, diuresis and albumin infusion as required. Most cases recover spontaneously or as a result of therapy within a few weeks.

Chylothorax↗
PubMed1991

Pharmacokinetics of navelbine after oral administration in cancer patients.

The pharmacokinetic behavior of navelbine was investigated in 19 patients presenting with advanced cancers (mainly women with breast cancer). Navelbine was given orally at seven dose levels of up to 200 mg/week. For a given dose, patients received four successive weekly treatments. Five subjects also received two different doses. After drug administration, plasma was collected for 48 or 72 h and monitored for navelbine concentration by radioimmunoassay. Absorption of navelbine was very rapid after oral administration: maximal drug concentrations were reached within the first 1 or 2 h (Tmax, 0.9-1.75 h; cmax, 70.9-832.6 ng/ml), with absorption constants ranging from 0.85 to 2.42 l/h. A comparison of dose-normalised plasma concentration profiles revealed significant time dependence in six evaluable patients (P less than 0.001). Only four subjects who received low doses (less than or equal to 100 mg/week) exhibited time-independent kinetics. All of the five patients who were treated at different doses displayed apparent dose dependence (P less than 0.001). No individual profile was characterised by both time- and dose-independent pharmacokinetics. In all, 18 patients presented biphasic plasma concentration-decay patterns, and only 1 subject exhibited monophasic decay kinetics. The navelbine pharmacokinetic parameters obtained following oral administration were similar to those observed after i.v. bolus injection and were characterised by high oral clearance (0.43-1.45 1 h-1 kg-1), a large apparent volume of distribution (27.4-45.9 1/kg), and a long terminal half-life (24.2-56.5 h). Large intra- and inter-individual variations in pharmacokinetic parameters were observed. Moreover, after a high dose of 200 mg, an enterohepatic cycle and/or a delay in navelbine's absorption at a distal intestinal site as evidenced by a marked plasma level rebound was observed.

Administration, Oral↗
PubMed1991

Standard curves of cerebral Doppler flow velocity waveforms and predictive values for intrauterine growth retardation and fetal acidosis.

Cerebral Doppler measurements seem to be a future method to evaluate the degree of fetal hypoxemia. The aim of this study was (1) to elaborate standard curves for the different cerebral vessels in our own population, and (2) to describe the predictive value of Doppler measurements for intrauterine growth retardation (IUGR) and fetal acidosis. We recorded cerebral flow velocity waveforms from 71 normal pregnancies to establish standard curves for the following vessels: proximal middle cerebral artery, distal middle cerebral artery and posterior cerebral artery. Finally, we calculated the cerebroplacentar index (CPI) for each case. The predictive values from the different vessels were determined in 24 patients with IUGR and 17 cases with fetal acidosis. The poor sensitivity and the low positive predictive value of each cerebral vessel is probably explained by the rather long interval between the last Doppler assessment and delivery (22 +/- 23 days). Reducing the interval to less than 7 days, the distal middle cerebral artery and the CPI were pathological in 4 cases out of 5 fetuses that underwent cesarean section for fetal distress. These latter results have encouraged us to use cerebral Doppler flow velocity to detect fetal hypoxemia. In conclusion, the middle cerebral artery blood flow in its distal part seems to be the finest parameter to predict fetal acidosis, and this vessel should be used to optimize obstetrical management of high-risk pregnancies.

Acidosis↗
PubMed1991

[First clinical evaluation of the CHUV ballistic lithoclast].

The authors present the first clinical evaluation of the ballistic lithoclast CHUV based upon results of 55 treated patients. Their conclusion is that the lithoclast CHUV is a simple, reliable, easy to use, efficient and patient-friendly machine.

Equipment Design↗
PubMed1991

[Middle cerebral artery fetal velocimetry: criteria for extraction in severe growth retardation].

Traditional fetal extraction criteria based on the cardiotocogram (group 1) probably occur too late to serve as extraction criteria in cases of severe growth retardation. We suggest that Doppler ultrasound of the middle cerebral artery (M.C.A.) (group 2) would be used to assess the optimal moment for fetal extraction. This method has enabled us to modify perinatal mortality from 37% to 0% (p less than 0.01). The percentage rate of cerebral hemorrhage and/or neurological sequelae was 41% (9/22) in the first group whereas no infant in group 2 or 3 (control group) had these complications. The percentage rate of neonatal complication was 67% in group 1 versus 28% in group 2 (p less than 0.01). Group 1 spent 53 days (+/- 35) in intensive neonatal care unit versus 43 days (+/- 22) for group 2. Neonatal outcome was quite similar between group 2 and the control group. Cerebral Doppler could allowed us to extract severe IUGR fetuses just before cerebral ischemia and irreversible tissue damage.

Cardiotocography↗
PubMed1979

[Non-lymphoblastic acute leukaemia: maintenance therapy by trial of a combination of chemo- and immunotherapy (author's transl)].

A trial of immunotherapy in the maintenance treatment of non-lymphoblastic acute leukaemias led to a comparison of 2 groups of patients in complete remission. Group C (14 patients) received only monthly reinduction chemotherapy. Group C + I (17 patients) received identical chemotherapy together with weekly immunotherapy combining BCG and irradiated leukaemic cells. Whilst the duration of the first remission was unmodified, the overall survival and above all survival after the first recurrence were prolonged in group C + I. These results were all the more marked when a homogeneous patients having received the same induction chemotherapy is considered.

Acute Disease↗
PubMed1979

High-dose methotrexate: preliminary evaluation of a pharmacokinetic approach.

Clinical pharmacologic studies have been carried out in patients with head and neck tumors following 36-h continuous infusions of high-dose MTX (1.5 g/m2). The results indicated considerable variation in the amount of MTX in the blood of individual patients. To control these variations, a modified protocol was set up to try to attain the same MTX blood level in all subjects. The protocol has a pharmacokinetic basis and involves determination of the MTX kinetics in each patient. The information thus obtained allows us to compute a 36-h infusion dose so that the MTX plasma levels never exceed a threshold beyond which there is a risk of toxicity to the host. The computation is validated by taking a blood sample 6 h after the beginning of the infusion. If the MTX concentration is higher than its expected value, the infusion rate can then be immediately reduced. Analytical methods that will allow such a computation, the results of the clinical application of this pharmacokinetic approach, and some implications of such a method are discussed.

Aged↗
PubMed1978

[Solitary secreting plasmocytoma in a femoral localization in a young man (author's transl)].

A pathological fracture in 20-year-old man led to the discovery of a right femoral plasmocytoma. Immunoelectrophoresis revealed the existence of a monoclonal Kappa IgG. After tumour reduction by radiotherapy and chemotherapy, surgical excision was possible with the insertion of a reconstructive prosthesus. Functional recovery was complete. The dysglobulinaemia completely disappeared and, with a two year follow-up, no dissemination of the plasmocytoma has been found.

Adult↗
PubMed1978

[Telemetric measurement of intracranial pressure with the help of an electromagnetic detector implanted within the epidural space. Tolerance and reliability verified in 16 cases (author's transl)].

After a detailed description of the technique the authors report the clinical results obtained in a series of 16 patients upon whom the new detector has been implanted and comparative measurements of the intracranial pressure by lumbar puncture were effected. The length of implantation of the detector which was of the order of several months in a majority of cases permitted to verify the stability and tolerance of the device as well as its long-term reliability since the length of functionning was of more than 6 months in half of the patients. Quantitatively, the instantaneous value of the intracranial pressure could be evaluated with the standard deviation of 17 mm of water in comparison to the values obtained by lumbar puncture. While being acceptable in clinical practice, this margin of error can be reduced in the future. The authors intend to utilize this detector at first for the monitoring of intracranial pressure before advocating its use in prolonged surveillance of intracranial pressure.

Dura Mater↗
PubMed1977

A surface antigen associated with Hodgkin's disease: brief communication.

We used an indirect immunofluorescence technique to detect a surface antigen that may be associated with Hodgkin's disease (HD). A heteroantiserum raised in a rabbit given an injection of cells obtained from an HD lymph node (Stage I, classification of Lukes and Butler) allowed us to detect an antigen on the surfaces of HD-derived cells in 25 of 27 instances. Benign and malignant non-HD-type lesions (both lymph node and spleen) did not have this antigen. The nature of this antigen and the type of cells bearing it are unknown.

Antigens, Neoplasm↗
PubMed1977

The use of hybrid cells in immunotherapy.

HARRIS et. al. isolated somatic hybrid cells (A9/SEWA) between polyoma-induced tumor and mouse fibroblast cell lines. Although these hybrid cells were no longer tumorigenic, we found that their immunogenicity was conserved. It therefore seemed to us that these antigenic, non transplantable, living cells would be an ideal tool for immunotherapy experiments. In our first experiments we assessed the immunoprotection afforded by A9/SEWA cells in both the SEWA tumor/A.SW mouse and C3HPy/C3H mouse systems. However, the efficiency of immunization with hybrid cells is dependent on the stability of the cells, especially in respect to the expression of the TATA. So we also tried to evaluate the immunogenicity as a function of the number of subcultures undergone by the hybrid line. In both systems, the immunogenicity was very good in the early subcultures but, in the C3HPy tumor/C3H mouse system, a loss of immunogenicity was observed as the number of subcultures increased. Thus any clinical application or immunization by hybrid cells would necessitate the verification of the presence of the tumor-associated antigens at each subculture. We are at present experimenting with various in vitro techniques for detection of the expression of these antigens.

Animals↗