PubMed HealthSearch

Biomedical subjects

R Sambuc

Publications and source records attributed to R Sambuc.

At least 19 recordsLinked to original sources

[Epileptic crisis during and after cerebrovascular diseases. A clinical analysis of 78 cases].

Seventy-eight patients with post-stroke seizures were studied retrospectively to determine the clinical, EEG and CT features of these seizures and their prognosis. There were 57 cerebral infarctions and 21 hemorrhages. Twenty-eight (36%) initial seizures occurred within one month after the stroke (0-24 hours in 19 cases) and were classified as early-onset seizures. Fifty (64%) initial seizures occurred more than 3 months after the stroke (3-12 months in 33 cases) and were classified as late-onset seizures. Compared with a population of 1938 strokes admitted during the same period, the proportion of patients with alcohol abuse, infarction in the anterior cerebral artery territory, watershed infarcts and lobar haemorrhages was significantly greater in our series. The proportion did not vary with the nature of the stroke (infarction or hemorrhage), except for early onset seizures in which the proportion of hemorrhages was significantly greater. Nor did it vary with the cause of hemispheric infarctions (cardioembolism or atherothrombosis or others). Ninety-five percent of the lesions affected the cerebral cortex or the subcortical white matter or both. Of all 78 initial seizures, 64% were partial motor (simple or secondarily generalized); 32% were primarily generalized, and 4% were partial not motor; status epilepticus was seen in 14% of the cases. An initial EEG, performed in 76 patients was normal in 7. Among the remaining 69 patients EEG showed focal or diffuse slowing down in 63% and epileptic features in 37% (including 10 cases of PLEDs). Early post-seizure EEG and repeated recordings significantly increased the specificity of EEG.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis

[Extracellular and intracellular activity of sparfloxacin against Mycobacterium avium complex and Mycobacterium xenopi].

Activity of the new fluoroquinolone sparfloxacin against 30 strains of M. avium complex and 25 strains of M. xenopi was tested in vitro. Sparfloxacin was used alone (determination of MICs and MBCs) and in combination with ethambutol and rifabutin. Synergy studies with determination of the FIC and FBC indices showed that the sparfloxacin-ethambutol combination was synergistic against 10 M. avium complex strains and 12 M. xenopi strains. With the three-drug combination (sparfloxacin-ethambutol-rifabutin), synergy was found against 12 M. avium and 14 M. xenopi strains. Studies of intracellular bacteria showed that the decrease in viable bacteria with the three-drug combination was 1 log for M. avium and 2 log for M. xenopi.

Acquired Immunodeficiency Syndrome

[The significance of quantified EEG in Alzheimer's disease. Changes induced by piracetam].

One study was performed in 12 patients with presenile Alzheimer's disease (group I), the other one in 16 patients with mild senile dementia of Alzheimer type (group II). In each study, patients were divided into two randomized parallel groups, one receiving placebo, the other piracetam (9 g daily in group I piracetam and 2.4 g daily in group II piracetam) during three months, piracetam induced a decrease in EEG power on the 2-6 Hz range (group I piracetam), 3-5 Hz and 7 Hz (group II piracetam) and an increase of EEG power in the 9-11 Hz range (group I piracetam) and in the 10 Hz and 13 Hz frequencies (group II piracetam). There was also a significant improvement in the Trail Making Test part A in group II piracetam. Correlations between decreased EEG low frequency components and improvement in some psychometric tests were found significant in the two groups. It seems that the main effect of piracetam was to induce increased alertness. The same results were found in both studies; the good reproducibility suggests that EEG spectral analysis is a reliable tool in the assessment of psychotropic drug effects.

Aged

[Neonatal screening for phenylketonuria and hypothyroidism. An optimizing system].

Screening for phenylketonuria and hypothyroidism in neonates is currently performed on blood samples collected on the 5th day of life. The efficacy of blood-sampling is evaluated subsequently. Double-sampled and non-sampled children are not always identified. We present a system which provides complete control of child, and was tested experimentally over one year on the 4,260 births in a maternity hospital. The sampling done by the maternity hospital as very thorough: only 0.47% of the children were not sampled spontaneously (ET = 1.07 10(-3)). The sampling of children transferred to pediatric units before the 5th day was a little less rigorous: 6.06% were not sampled before the telephone reminder (ET = 1.86 10(-2)). After a year our system ensured a 100% sampling after identification and telephone reminder for non sampled children, and allowed us to spot and count cases of double-sampling.

Hospital Information Systems

[Anonymity in epidemiological surveys: study and initiation of a new method].

The authors propose a system of registering epidemiological data which ensures strict observation of anonymity. Data are made anonymous at the source: the practitioners who possess the medically confidential information themselves compute the code number creating anonymity through a nonreversible calculation formula: it is impossible to work back from the number to the patient's identity, even if one has the formula and powerful computer resources. This method differs from simple data encoding whose key could either be discovered or revealed: it requires neither keys nor a secret but effects a definitive and irreversible transformation. In compliance with the recommendations of the committee on Ethics, of the French "Ordre des Médecins" and of the Law on Data Processing and Liberties, the method was subjected to a double test for reliability, experimental and theoretical.

Computers

Comparison of once and twice daily administration of captopril plus hydrochlorothiazide on 24 h blood pressure levels.

The anti-hypertensive effect of captopril 50 mg plus hydrochlorothiazide 25 mg, given once or twice daily, was investigated by 24 h monitoring in hypertensive patients in a controlled, randomized, double-blind, cross-over trial. Ten patients with blood pressure (BP) greater than 160 and/or 95 mm Hg after a 15 day placebo period, were randomly assigned to one of two treatments, in which they either received the combination once daily in the first month, twice daily in the second and once daily in the third (Treatment Group A) or twice daily in the first month, once daily in the second month and twice daily in the third month (Treatment Group B). The anti-hypertensive effect of the drug combination was assessed by 24 h monitoring using a Dinamap 845 to establish mean BP levels and circadian curves. After 1 month the twice daily administration was more effective than the once daily, but after 2 months, and throughout the third month, there was no difference in the anti-hypertensive efficacy of the combination given either once or twice daily.

Blood Pressure

Neurologic complications following carotid artery surgery: pathophysiology and predictive factors.

This study analyzes the results of 457 carotid artery operations done in 416 patients by the same surgeon during a five-year period. A total of 27 central neurologic complications were observed, 14 were transient and 13 were permanent neurologic deficits, nine of which resulted in death. The causes of these accidents were: embolism (12), intolerance to clamping (7), carotid thrombosis (3), and reperfusion injury (2). In three cases no cause could be found. Preoperative predictive factors for these complications were analyzed statistically by multivariate analysis techniques. A high-risk group was identified, characterized by diffuse atherosclerotic disease and by the presence of a previous neurologic deficit. The prevention of neurologic complications in carotid surgery goes far beyond the controversy of whether or not a temporary inlying shunt should be used. In our opinion indications for shunting are limited. Neurologic complications can be prevented by maintaining awareness of certain temporary contraindications in patients with permanent neurologic deficits and by exacting operative techniques.

Carotid Artery Diseases

[A new thyrotoxicosis index. (Calculation Basis and applications)].

A new thyrotoxicosis index (pointer) is calculated according to frequency of signs and symptoms in a well documented population of 189 thyrotoxicosis and pseudo thyrotoxicosis cross maintained patients. Applied to a computerized population of 3 596 thyroid complained patients, this index provides four groups. Index greater than equal to 8,5 : thyrotoxicosis is quite sure (92.5%), 8,5 less than equal to index less than equal to 5 : 3 of 5 patients are thyrotoxicosic 5 less than index less than -- 1 : 1 of 5 patients is thyrotoxicosic (rough thyrotoxicosis, index less than equal to -- 1 : thyrotoxicosis can be refuted (98%).

Humans

[Surgery of tetralogy of Fallot in the first year of life (author's transl)].

Despite the very good results published by B. Barrat Boyes and A. castaneda with early correction of Tetralogy of Fallot in the first year of life, the authors prefer palliative surgery for this group. They have operated upon 47 infants less than one year of age, 15 of them being less than 2 weeks of age. The overall mortality is 4%, the only two deaths being in the neonate group, which is usually a very small group in the published series with early correction. Since all the children with S.P. Shunt performed for Tetralogy of Fallot can wait 2 to 4 years before complete correction, and since the mortality of corrective surgery at 4 years of age is almost nil, the authors think that the two stages approach give as good results than one stage surgery, despite the possibility of neurological complications which may occur between operations. They argue that with early correction, surgeons are obliged to put more transannular patches which result in more pulmonary insufficiency cases, and that the mortality in this age group is still very high in some publications. They have also compared the percentage of low cardiac output syndrome after correction and found that children with a previous S-P shunt have smoother post-operative course. Finally they think that it is possible to obtain a global mortality around 7% for the 2 stages approach and that this kind of surgery is technically easier than early correction and must be very useful for the majority of cardiac centers interested in congenital heart disease.

Age Factors