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Biomedical subjects

S Delpierre

Publications and source records attributed to S Delpierre.

At least 19 recordsLinked to original sources
PubMed2006

Same efficacies of ipratropium and salbutamol in reversing methacholine-induced bronchoconstriction.

Efficacy of salbutamol (S) was compared to that of ipratropium (I) or to their association, after methacholine challenge testing (MCT). MCT was performed in 4 groups of 10 patients suspected to suffer from asthma; mean changes in FEV1, maximal midexpiratory flow rate (MMFR), and airway resistance (Raw) were the same in all groups. After MCT, the group 1 patients inhaled S and then I, 10 min later; both drugs were given in the reverse order to the group 2 patients. The group 3 patients inhaled a mixture of both drugs just after MCT; the group 4 patients were not given any bronchodilator till the 20th min after MCT, when they inhaled S. Short-term (10 min) bronchodilator effects of S, I or S + I on spirometric variables were of the same magnitude and Raw returned to its baseline value. Further improvement (10-20 min) in FEV1 was mainly due to spontaneous recovery, whereas further increase in MMFR was due also to bronchodilator actions of drugs. It is concluded that ipratropium could be proposed as an alternative bronchodilator to salbutamol after MCT.

Adult↗
PubMed2001

Exercise-induced inflammatory reaction affects electromyographic changes in skeletal muscle during dynamic contractions in humans.

In order to assess the role of exercise-induced inflammatory reactions on electromyographic (EMG) changes in humans, we have recorded, during a 3-min dynamic handgrip exercise at a high strength (112 w), the surface EMG and the compound evoked muscle action potential (M-wave) in control conditions, and this after ingestion of a well known cyclooxygenase blocker i.e. acetylsalicylic acid (ASA), either as a single dose treatment (10 mg/kg) and as a 3-day treatment (30 mg/kg per day). The power spectrum density function of EMG allowed us to compute both the median frequency (MF) and the energies in a low- and a high-frequency band. We estimated the lactic acid concentration from blood samples drawn from an antecubital vein and we noted that its production was not affected by ASA (single dose or 3-day treatment). We observed at the end of exercise that no change in M-wave duration and conduction time occurred though the median frequency always fell. However, we noted that the slope of the MF vs. time regression line was halved after the 3-day ASA treatment which may indicate that inflammatory reactions are elicited by exhausting contractions and affect the EMG changes.

Action Potentials↗
PubMed2000

Value of bronchial challenge in scuba diving candidates.

Bronchial challenges were effected with carbachol in 76 subjects who were candidates for a scuba diving group. Bronchial reactivity was assessed through airway resistance and forced expiratory volume in 1 sec (FEV1) measurements. Medical interrogation had revealed symptoms of recent (RA) or ancient (AA) asthma, or allergic rhinitis (AL). Nearly half of the subjects (47%) presented bronchial hyperresponsiveness (BHR), which was much more frequent in the RA group, but whose strength did not depend on clinical presentation. Prevalence of BHR was fairly high (36%) in the AL group. BHR constituted a contraindication to scuba diving because it may promote pulmonary barotrauma.

Adult↗
PubMed1999

[Systemic infection due to implanted leads of a cardiac pacemaker. Apropos of a case and review of the literature].

Systemic infection related to transvenous pacemaker-leads are rare, but their diagnosis is difficult. We report the observation of a 78-year-old patient whose recurrent Staphylococcus aureus septicemias linked to endocarditis related to an endovascular lead only on a third observation, characterized by an infectious bone localization. Transoesophageal echocardiography appears as the reference diagnostic method. The treatment lies in the surgical ablation of the pacing system and a prolonged antibiotic therapy. The heavy mortality caused by these pathologies leads us to reconsider the interest of a prophylaxis, particularly for elderly patients.

Aged↗
PubMed1998

Resistive loading reduces ventilatory response to strychnine in anesthetized rabbits.

Breathing through an inspiratory resistance induces a hypoventilation in mammals despite an increased diaphragmatic activity. We showed in previous works that an increase in GABA and endogenous opioid release in the central respiratory network could explain in part the inadequate increase in the inspiratory drive during inspiratory loading. In the present experiment, we speculated about an additional role of glycine, another inhibitory neurotransmitter. The ventilatory effects of the glycine antagonist strychnine were evaluated in two groups of anesthetized rabbits, breathing either through an inspiratory resistive load (IRL) or not (control group). In the control group, strychnine raised (+7%, P < 0.05) the minute ventilation, V, and the rate of increase in integrated diaphragmatic discharge (Edi peak/T peak: +29%, P < 0.01). In the IRL group, strychnine did not change V and produced a lesser increase in Edi peak/T peak (+9%, P < 0.05). In both groups, strychnine induced a tonic diaphragmatic discharge. These data show that there is a weak inhibition of inspiration by glycine during resistive loading, but the effect is modest compared with that observed during unloaded ventilation. Thus, it seems that IRL breathing reduces the efficacy and/or the release of this neurotransmitter in the central nervous system, in this experimental situation.

Airway Resistance↗
PubMed1998

Blood ammonia and ventilation at maximal exercise.

This study, intended to evaluate the role of ammonia (NH3) as a ventilatory stimulus, was conducted in three groups of subjects: 14 sedentary individuals, 12 triathletes, 5 patients with a glycolytic deficiency (Mc Ardle disease). All subjects performed maximal exercise tests on a cycle ergometer. Ventilation measured at maximal oxygen consumption (VE 100%) was correlated with lactatemia (lactate 100%) and ammonemia (NH3 100%) in the sedentary group, but only with ammonemia in triathletes, although NH3 100% and lactate 100% were correlated in both groups, which suggests that correlation between VE 100% and NH3 100% is not a false correlation. In patients with Mc Ardle disease, unable to produce lactate during exercise, VE 100% was correlated with NH3 100%. NH3 may act indirectly by increasing the production of lactate in cereberal tissue. Another hypothesis rests on the fact that the catabolism of ammonia leads to an increase in intracerebral glutamate which may act as a ventilatory stimulus.

Adult↗
PubMed1997

GABA(B) receptor blockade reduces resistive loading-induced hypoventilation in anesthetized rabbits.

We hypothesized that hypoventilation induced by resistive loaded breathing may result in part from the inhibition of central respiratory-related structures by gamma-aminobutyric acid (GABA), through the stimulation of GABA(B) receptors. In that case, ventilatory depression should be minimized by GABA(B) receptor blockade. To test this assumption, the ventilatory effects of a GABA(B) receptor antagonist (CGP 35348) were evaluated in two groups of urethane anesthetized rabbits, breathing either through an inspiratory resistive load (IRL group) or not (Control group). CGP 35348 did not modify baseline ventilation in the Control group. On the other hand, it partially reversed IRL-induced hypoventilation through a higher respiratory rate and central inspiratory drive. These data suggest that, unlike GABA(A) receptors, GABA(B) receptors would not play a part in eupneic breathing, but that they could participate in the hypoventilation resulting from an acute increase in the work of breathing.

Anesthesia, General↗
PubMed1997

Impairment of muscle energy metabolism in patients with sleep apnoea syndrome.

Impairment of muscle energy metabolism has been demonstrated in normal subjects with chronic hypoxaemia (altitude chronic respiratory failure). The purpose of this study was to verify the hypothesis that a comparable condition could develop in patients with sleep apnoea syndrome (SAS), considering that they are exposed to prolonged and repeated hypoxaemia periods. Muscle metabolism was assessed in 11 patients with SAS performing a maximal effort on cycloergometer. In comparison with normal subjects, SAS patients reached lower maximal loads [144 +/- 7 vs. 182 +/- 10 W (P < 0.005)] and lower peak oxygen uptakes [26.4 +/- 1.2 vs 33.2 +/- 1.4 ml kg-1 min-1 (P < 0.005)]. Abnormal metabolic features were found: maximal blood lactate concentration was significantly lower than in normal subjects [0.034 +/- 0.004 vs. 0.044 +/- 0.002 mmol l-1 W-1 (P < 0.05)]; and lactate elimination rate, calculated during a 30-min recovery period, was reduced [0.127 +/- 0.017 vs, 0.175 +/- 0.014 mmol l-1 min-1 (P < 0.025)]. The extent of these anomalies correlated with the severity of SAS. The patients also showed higher maximal diastolic blood pressures than normal subjects [104 +/- 5 vs. 92 +/- 4 mmHg (P < 0.05)]. These results can be interpreted as indications of an impairment of muscle energy metabolism in patients with SAS. Decrease in maximum blood lactate concentration suggests an impairment of glycolytic metabolism, while decrease in the rate of lactate elimination indicates a defect in oxidative metabolism. Since no respiratory pathology apart from SAS was found in this group of patients, it seems legitimate to link the genesis of these impairments to repeated bouts of nocturnal hypoxaemia.

Ammonia↗
PubMed1996

Cardiorespiratory response to bicuculline during resistive loaded breathing in anesthetized rabbits.

We hypothesized that hypoventilation induced by resistive loaded breathing may result in part from an increase in gamma-aminobutyric acid (GABA) concentration in the central nervous system. Accordingly, ventilatory depression should be minimized by GABA receptor blockade. The effects of subseizure doses of the GABAA receptor antagonist bicuculline on the cardiorespiratory variables and cortical activities were evaluated in two groups of urethane anesthetized rabbits, breathing either through an inspiratory resistive load (IRL) or not. Bicuculline induced cardiorespiratory changes which consisted mainly of an augmented respiratory rate, through shortening of expiratory duration, and of bradycardia. Bicuculline effects did not significantly differ between both groups and were accompanied by high amplitude delta rhythmic cortical activities. These data show that GABAA receptors may exert a tonic depressive effect on the respiratory circuit and suggest that endogenous GABA release is not augmented by an acute increase in the work of breathing.

Airway Obstruction↗
PubMed1995

Role of vagal afferents in the ventilatory response to naloxone during loaded breathing in the rabbit.

It was previously shown that inspiratory resistive loading (IRL) increases the cerebrospinal fluid (CSF) level of beta endorphin in awake goats, and also that the slower ventilation induced by injection of this substance into the CSF of anesthetized dogs is suppressed after vagotomy. In the present study, performed on anesthetized rabbits, we evaluated the part played by vagal afferents in the ventilatory response to IRL after opioid receptor blockade by naloxone. During unloaded breathing, naloxone injection did not modify baseline ventilation. Conversely, naloxone partially reversed IRL-induced hypoventilation through an increase in respiratory rate. This effect was abolished after either vagotomy or cold blockade of large vagal fibers, but it persisted after procaine blockade of thin vagal fibers. These results suggest that pulmonary stretch receptors, which are connected to some large vagal afferent fibers, would play a major role in the ventilatory response to IRL under opioid receptor inhibition.

Animals↗
PubMed1994

Effects of serotonin receptor blockade by methysergide on loaded breathing in the rabbit.

Previous works demonstrated that the excitatory role of serotonin (5-hydroxytryptamine, 5-HT) on ventilation is mediated by 5-HT1,2 receptors stimulation. We hypothesized that load-induced hypoventilation could be minimized by a central release of 5-HT. Conversely, blockade of 5-HT receptors should accentuate hypoventilation. We compared the ventilatory effects of methysergide (MS), a 5-HT1,2 receptors antagonist, in 3 groups of anesthetized, spontaneously breathing rabbits: (1) a group of animals breathing for 60 min through a 370 cm H2O.liter-1.s inspiratory resistive load (IRL group), whose paCO2 increased with IRL; (2) a Control group; (3) a Control + CO2 group, made hypercapnic to assess the possible effect of this stimulus on the ventilatory responses to MS. In the 3 groups, i.v. injection of MS induced the same ventilatory changes, characterized by a rapid shallow breathing with a shorter integrated diaphragmatic activity. This confirms the tonic facilitatory effect of 5-HT on ventilation and suggests that IRL would not increase 5-HT release in the sites close to the respiratory nuclei.

Animals↗
PubMed1993

[Bronchial provocation tests. Comparison of 2 inhalation methods].

This study was performed to compare two methods of aerosols delivery and inhalation in a bronchial provocation test with carbachol : the stocked method (S) where the aerosol is previously stocked in a spirometer bell before inhalation and the dosimeter method (D) where the aerosol is directly inhaled after nebulization. Fourteen subjects (seven normal and seven asthmatic) underwent bronchial challenges with the two techniques. Bronchial sensitivity was calculated on SRaw-dose response curves to carbachol. SGaw-dose response curves were also constructed and the slopes of these curves were used to measure bronchial reactivity. Within subjects sensitivity values were lower with the D method than with the S method (40 +/- 5 micrograms (S E) versus 450 +/- 50 micrograms respectively in asthmatics, 340 +/- 30 micrograms versus 2350 +/- 130 micrograms respectively in healthy subjects). Reactivity values were higher with the dosimeter method (2,7 +/- 0,7 x 10(-5) versus 27 +/- 4 x 10(-5) in healthy and 10 +/- 1 x 10(-5) versus 106 +/- 16 x 10(-5) in asthmatics). The dosimeter method had greater efficacy, was less time consuming and appeared to be a useful method for carrying out standardised non-specific bronchoprovocation test.

Adult↗
PubMed1993

Comparisons among external resistive loading, drug-induced bronchospasm, and dense gas breathing in cats: roles of vagal and spinal afferents.

In anesthetized cats, breathing spontaneously, increase in lung resistance (RL) was induced by either external resistive loads (ERL) or internal loading produced by dense gas breathing (sulfur hexafluoride, SF6) or serotonin (5-HT)-induced bronchoconstriction. The 3 test agents were used in each animal. Arterial blood gases were maintained in the normal range. Ventilatory and cardiovascular responses were studied in 3 groups of animals: intact, vagotomized, or spinalized at C8 level, a condition that preserved diaphragmatic afferents. In intact or spinal animals, ERL as well as SF6 inhalation lengthened the inspiratory and/or the expiratory periods, whereas 5-HT injections elicited rapid shallow breathing. The changes in ventilatory timing with either type of load were not observed in vagotomized cats. In all animals, ERL breathing or 5-HT injections increased the moving-time average of diaphragmatic EMG measured at constant time (Edi 0.1 and 0.5 secs), but this was not observed during SF6 inhalation, a condition in which the magnitude of RL increase was less than in the 2 other situations. The changes in systemic arterial blood pressure and/or cardiac frequency were mostly associated with 5 HT-induced bronchoconstriction. They persisted in spinalized cats, but were not observed or reversed in vagotomized ones. These observations demonstrate that vagal afferents play a major role in the changes in ventilatory timing and cardiovascular function in response to both external or internal moderate resistive loading. The existence of Edi changes in the 3 groups of cats suggests also that diaphragmatic afferents, preserved in both situations, are involved in this response.

Abdominal Muscles↗
PubMed1993

Pulmonary function changes 100 days and one year after bone marrow transplantation.

The pulmonary function of patients receiving autologous or allogeneic bone marrow transplantation (BMT) was studied before, 100 days after and 1 year after BMT. The 117 patients studied before transplantation showed a slight reduction in average total lung capacity (TLC) and transfer coefficient (KCO). These reductions were related to haematological disease, previous pulmonary disease or irradiation, or use of toxic lung chemotherapy. Studies 100 days after BMT showed TLC and KCO decreases of 5% and 8%, respectively. These decreases were related to different factors in autologous and allogeneic BMT. The results were influenced by previous pulmonary status in autologous BMT patients and the occurrence of GVHD in allogeneic BMT patients. Seventy patients underwent pulmonary function testing 1 year after BMT. The decrease in TLC values was greater in autologous BMT than in allogeneic BMT patients (107 +/- 3% to 100 +/- 3% versus 113 +/- 3% to 112 +/- 2%, respectively) although TLC remained normal in both groups. KCO values dropped significantly in both populations. Relapse of the initial disease was an important factor impairing lung function in the autologous group. TLC and KCO changes were strongly related to mortality in both groups. These results emphasise the need for frequent pulmonary function tests after BMT to detect and quantify lung function changes.

Adult↗
PubMed1991

Effects of breathing dense gas mixtures on cardiovascular function and EEG rhythms.

Gas mixtures containing oxygen and nitrogen or dense inert gases (sulfur hexafluoride, SF6, or argon, Ar) were inhaled by anaesthetized, artificially ventilated rabbits and cats. SF6 and Ar were compared to nitrous oxide (N2O), a dense inert gas well known for its anaesthetic properties. Concentrations in these gases were 50% (SF6) and 60% (Ar or N2O). In cats, there was a significant increase in total lung resistance with SF6 or Ar associated with a slight but significant drop in arterial blood pressure and heart rate (-5% and -10% with SF6 and Ar, respectively), with no change in electrocardiogram activity. N2O induced in some cats a slower electroencephalographic (EEG) pattern constituted by delta waves of higher amplitude, whereas neither SF6 nor Ar changed the EEG rhythms in this species. In the rabbits, the unsteadiness of the EEG rhythms did not make it possible to assess the cortical effects observed with SF6 or N2O.

Administration, Inhalation↗
PubMed1991

[The contribution of effort tests in the evaluation of factors related to dyspnea in pneumonology].

Forty nine patients suffering from respiratory disorders underwent an exercise test carried out on a bicycle ergometer (n = 45) or by walking rapidly on flat or inclined ground (n = 4). The respiratory restrictions on effort were correlated with a degree of dyspnoea (stages 1 to 4) established by a questionnaire. The analysis of the effort test had consequences of practical importance: in effect, in this study, nearly half the patients benefited from advice orientated in particular towards the level of activity which would be suitable for them, and to reduction in their weight.

Adult↗