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Biomedical subjects

S Boileau

Publications and source records attributed to S Boileau.

At least 37 records · Page 2Linked to original sources
PubMed1986

Haemodynamic and respiratory effects of post-operative doxapram and almitrine in patients following pneumonectomy.

Respiratory analeptics have been shown to give important increases in pulmonary vascular resistance and pulmonary arterial pressure in hypoxaemic respiratory failure patients, but no studies have been carried out in the post-operative recovery period. The aim of this study was to compare the haemodynamic and respiratory effects of doxapram and almitrine infusion given over 1 h in patients who had just undergone pneumonectomy. Two hours after the end of anaesthesia, three groups of randomly selected patients were therefore given 3 mg kg-1 doxapram (n = 10), 1 mg kg-1 almitrine (n = 10) or placebo (n = 10). Measurements were made before and 15, 30, 60, 90, 120 and 180 min after the beginning of the infusion. There was an immediate 15-20% fall (P less than 0.01) in PaCO2 and a 20% rise in PaO2 (P less than 0.005), identical for both drugs; the variations in the placebo group became significant only after 60 min. Heart rate and cardiac index did not change. Mean arterial pressure did not change with doxapram, but decreased by 20% during the infusion of almitrine (P less than 0.01), remaining low until the 90th min (P less than 0.05). This hypotension was due to a decrease in peripheral arterial resistance (P less than 0.05) and a small decrease in right atrial pressure (P less than 0.05). The mean pulmonary arterial and wedge pressures were increased before starting the infusion, and did not vary significantly. Pulmonary arterial resistance increased with both analeptics but only significantly with the doxapram (P less than 0.05) at 5, 60 and 90 min; however, there was no significant difference between doxapram and almitrine. The post-operative respiratory efficiency of these drugs has been confirmed, there being no difference between almitrine and doxapram. The haemodynamic effects were moderate, especially with almitrine. Both of these drugs, therefore, may be recommended for use after lung surgery.

Almitrine↗
PubMed1985

Concentration and purification of influenza virus from allantoic fluid.

A simple procedure which enables the concentration and purification of influenza virus, using an angular rotor, is described. Virus is concentrated over a sucrose step gradient. The same gradients are reused and volumes up to 4 liters are concentrated in 1 day. The concentrated virus is further purified by a simplified density-gradient technique. No host cell protein is detectable in the final product. The technique offers a broad application potential for concentrating and purifying other viruses.

Allantois↗
PubMed1985

[Risk factors in anaphylactoid reactions to muscle relaxants. A retrospective study of 103 cases of shock].

A homogeneous series of 103 cases of shock due to muscle relaxants has been used to identify the risk factors in anaphylactoid shocks due to either true anaphylaxis or to non-specific histamine release. Clinical atopy (asthma) and sub-clinical atopy as shown up by skin tests with mites and pollens, as well as a history of IgE-dependent drug allergy, were present with a significantly greater frequency in the history of patients presenting with anaphylaxis. Abnormal histamine release and reactivity to histamine, as assessed by skin tests with 48/80 and histamine, were often found in those patients who presented with non-specific histamine release induced by muscle relaxants. Whatever the mechanism for the shock, the frequency of spasmophilia was increased. A history of non-immunological intolerance to acetyl salicylic acid and other non-steroid anti-inflammatory drugs was more often found than in the reference drugs was more often found than in the reference population. However, 25% of the patients studied did not have any of these risk factors. Several possibilities of preventing anaphylactoid reactions are given, if one or more of these risk factors are found in the history: a better choice of anaesthetic drugs, in the light of previous anaesthetic protocols, the relief of anxiety by appropriate premedication, antihistamine premedication and the prevention of bronchospasm.

Anaphylaxis↗
PubMed1985

[Reassessment of the respective risks of anaphylaxis and histamine liberation with anesthetic substances].

A search of the French and English language literature of the last 20 years (1964-1984) yielded 975 cases of immediate anaphylactoid reactions due to anaesthetic drugs given parenterally. The accident mechanism was confirmed in only half the patients, and nearly always at a later date. The immunoallergological tests most often used in the diagnostic process were skin tests and Prausnitz-Küstner tests. Although all drugs could be responsible for an anaphylactic reaction, the greatest number of cases was due to muscle relaxants (51%) and hypnotic drugs (42.3%). The signs most often described were cutaneous, cardiovascular, respiratory and occasionally gastro-intestinal. Whilst hypnotic drugs were responsible for cutaneous signs, muscle relaxants gave cardiovascular signs. A past history of drug allergy was found in 37% of cases, and atopy in 38%; virtually all patients had already had one or more anaesthetics.

Anaphylaxis↗
PubMed1984

[Comparative study of intravenous midazolam and diazepam used as sedative agents during gastroscopy].

Midazolam was compared with diazepam for the intravenous sedation of gastroscopy patients. 0.1 mg X kg-1 midazolam were given to patients less than 65 years old, and 0.085 mg X kg-1 after that age; diazepam doses were 0,2 mg X kg-1 and 0.15 mg X kg-1 respectively. The effect and duration of action of both drugs were similar. The main differences between them were as follows: the intravenous injection of midazolam was not painful, and virtually no venous complications were seen; amnesia and patient contentedness were more frequent with midazolam; gastric secretion was reduced with midazolam. Neither drug had clinically significant cardiovascular effects.

Benzodiazepines↗
PubMed1982

Adverse reactions to intravenous agents in anaesthesia in France.

One hundred severe peranesthetic accidents occurring in hospitals in the eastern part of France were tested between 1975 and 1980 at the Immunological Unit of the University Hospital in Nancy. Tests were carried out "a posteriori"; mean time: three weeks after the accident (extremes: one week to one year). A second battery of tests was carried out in 35%, and a third one in 8% of the patients. Anaphylaxis was differentiated from anaphylactoid reactions be means of the tests. Responsible drugs were determined by intradermal testing, by the human basophil degranulation test and P.K. tests. Predisposing factors were studied: atopy (IgE dosage), increase of histamine release (intradermal testing with 48/80), abnormal receptivity to histamine (intradermal histamine), spasmophilia (electromyography recordings). The results show that 42 accidents were due to true anaphylaxis (one of them due to IgG); 48% of the reported accidents were due to succinylcholine. Some of the predisposing factors, in the tested population, are found in a higher proportion than in the French population as a whole; atopy, hypersensitivity to histamine, previous drug allergy, spasmophilia.

Adjuvants, Anesthesia↗
PubMed1982

[Anaphylactic shock induced by suxamethonium].

The authors have studied 18 cases of anaphylactic shock due to suxamethonium which occurred in eastern France during the period 1972-1980. The drug responsible was succinyl iodide in 15 cases and succinyl chloride in 3. Significant contributing factors were previous drug allergy, spasmophilia and skin hypersensitivity to histamine. Five subjects had never been previously anaesthetized. The predominant clinical symptoms were cardiovascular collapse (72 p. cent), cutaneous and mucous symptoms (72 p. cent) and bronchospasm (33 p. cent). Cardiac arrest was observed in 5 patients; it was postanoxic in 3 cases and primary in 2. The diagnosis of anaphylaxis was based on the simultaneous positivity of at least two of the specific immunoallergic tests: intradermal reaction to a 10(-5) to 10(-3) dilution of the drug; Prausnitz-Küstner test with Parish's variant and human basophil degranulation test. If only one test was positive, this had to be confirmed on two or even three occasions. Thus, 6 patients were tested once, 9 patients were tested twice and 3 patients were tested 3 times. In case of genuine anaphylaxis, suxamethonium must definitely be avoided, and the subject should be provided with an allergy card.

Adolescent↗
PubMed1981

[Changes in skin reactivity to phytohemagglutinin caused by general anesthesia].

Cellular immunity is studied by intradermal reaction to phytohaemagglutinin (four concentrations: 1, 2, 5 and 10 infinity g), the response to which at the 24th hour gives information concerning macrophage power and at the 48th hour the functional value of the T lymphocytes. Such a study was carried out in three groups of patients: 1st group (n = 20): general anaesthesia without surgery, duration less than 30 minutes; 2nd group (n = 10): general anaesthesia without surgery, duration greater than 2 hours; 3rd group (n = 20): general anaesthesia with surgical procedure, duration greater than 2 hours. In all groups, the results showed highly significant immune depression at the 24th hour, certainly linked to a depression of macrophage power. This depression persisted at the 48th hour, but less markedly and less significantly, which could not be interpreted as definite evidence of depression of the T lymphocytes. Surgery would not appear to have played any additional role to anaesthesia in this immune depression, nor did the duration of anaesthesia. In a 4th group (n = 10) treated with vitamin A and undergoing anaesthesia with surgery lasting for more than two hours, no immune depression was seen.

Anesthesia, General↗
PubMed1980

[Effects of a respiratory analeptic with peripheral action-almitrine on ventilation immediately after surgery].

After a brief review of the advantages and disadvantages of the postoperative administration of a respiratory analeptic with a central action, the authors study the effects of almitrine (respiratory analeptic with a peripheral action) on alveolar ventilation following thoracic surgery. Two groups of 10 patients were distinguished: the patients of the first group received almitrine (1.5 mg/kg-1 over a period of one hour) thirty minutes after their return from the operating room, whilst those of the second group received no respiratory analeptic. Blood gases were measured 30 minutes after the return from the operating room (immediately before the start of the infusion of almitrine) then 1 hour, 2 hours and 3 hours later. The improvement in blood gases after almitrine was significant: whilst arterial pCO2 was a mean of 5.78 kPa (44.46 mmHg) in the control subjects, it fell 4.99 kPa (38.4 mmHg) by the end of the infusion in the tested subjects and subsequently remained at a mean of 5.04 kPa (38.79 mmHg). Arterial pO2 measured with FIO2 in all patients remained stable in the control subjects during the three hours postoperatively (mean = 15.11 kPa (116.26 mmHg). In the tested subjects, it improved progressively and significantly, rising from 11.08 kPa (85.2 mmHg) before almitrine to 14.05 kPa (108 mmHg) at the end of the infusion, then to 15.95 kPa (122.7 mmHg) 1 hour later and to 16.51 kPa (127 mmHg) 2 hours later. The authors concluded that almitrine is effective in the treatment of early alveolar hypoventilation after thoracic surgery in patients receiving moderate doses of oxygen (FIO2 = 0.40).

Adult↗
PubMed1980

[Acute post-stress pancreatitis (apropos of 7 cases)].

The authors report 7 cases of acute non-primary pancreatitis occurring in trauma patients without any initial abdominal injury. Six of the patients were male and the age range 38 to 80 years. Four were hospitalized for trauma with a severe state of shock on admission. In 5 cases there was a thoracic trauma. The complication developed within a period of 3 to 45 days. The clinical picture was scanty, examination of the patient invariably revealing abdominal distension. The diagnosis was based above all on laboratory findings: high blood glucose, independent of carbohydrate instake and insulin therapy. Treatment should first be medical, but if clinical and laboratory abnormalities persist after 12 hours treatment should be surgical: pancreatectomy of adequate extent to deal with the lesions. Pancreatic findings are characterised by their necrotico-haemorrhagic appearance. Lesions of the gland were partial, total or multifocal. The pathogenesis is not defined. Numerous factors have been suggested. The prognosis is grave: five deaths amongst the seven cases.

Acute Disease↗
PubMed1980

[Acute post-stress cholecystitis (apropos of 4 cases)].

The authors report four cases of acute cholecystitis occurring during intensive therapy. The patients, three male, among the four patients, were aged between 12 and 70 years. They had been hospitalised for surgery with a complicated and septic postoperative course (3 cases), or for acute decompensation of chronic respiratory failure (1 case). The complication developed within a period of 10 to 24 days. The clinical picture was that of an inflammatory obstruction with swelling of the right hypochrondrium. Treatment consisted of cholecystectomy in all four cases. Gall bladder lesions ranged from obstruction to total necrosis. In one case, calculi were found but could not be considered as having been solely responsible. The bile always had a frankly septic appearance. One patient died postoperatively as a result of septicaemia. The pathogenesis remains to be defined. Two components, mechanical and infectious, are most probable.

Acute Disease↗
PubMed1979

DDT in northern pike (Esox lucius) from the Richelieu River, Québec, Canada, 1974-75.

Concentrations of DDT, TDE, DDE, and sigma DDT were determined in homogenized whole fish samples of 129 northern pike (Esox lucius). These fish were netted between June 1974 and June 1975 in the first 10 km of the Richelieu River flowing in Canadian territory. Two years after the banning of DDT, sigma DDT levels ranged from 0.2 ppm fresh body weight in two-year-old specimens to 1.5 ppm in a six-year-old pike. Residues increased greatly with age, and significant seasonal variations in the sigma DDT levels were found in five- and six-year-old pike.

Aging↗
PubMed1979

[Indications for normovolemic hemodilution].

So long as normovolaemic conditions are respected and the haematocrit is not reduced to less than 30 per cent, there are a large number of surgical and even medical indications for deliberate haemodilution. Amongst the several contraindications, coronary insufficiency must be considered as being formal.

Blood Viscosity↗