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S Etienne

Publications and source records attributed to S Etienne.

30 records · Page 2Linked to original sources
PubMed1997

Management of acute myocardial infarction in intensive care units in 1995: a nationwide French survey of practice and early hospital results.

OBJECTIVES: This survey sought to determine actual practices in the management of acute myocardial infarction on a nationwide scale. BACKGROUND: Few data are available regarding the adoption of clinical trial results of treatment of myocardial infarction into "real-world" clinical practice. METHODS: Of 501 intensive care units in France, 373 (74%) collected data from all patients with myocardial infarction admitted within 48 h of symptom onset during November 1995. RESULTS: Data from 2,563 patients (71% men; mean age [+/-SD] 67 +/- 14 years) were included. Time from symptom onset to admission was <6 h in 1,467 patients (62%). Thrombolysis was used in 822 patients (32%) and primary angioplasty in 330 (13%). The use of reperfusion therapy decreased markedly with age. During the first 5 days, heparin was prescribed in 96% of patients, aspirin in 89%, nitrates in 87%, beta-adrenergic blocking agents in 64%, angiotensin-converting enzyme inhibitors in 46% and calcium antagonists in 17%. Coronary angiography was performed in 33% of patients, and 58% had echocardiographic assessment of left ventricular ejection fraction (LVEF). Median LVEF was 50%. The 5-day mortality rate was 7.7% compared with 12.1% in a previous French survey carried out in 1984. By multivariate analysis, independent predictors of mortality were age, anterior infarction, history of stroke and heart failure and, when added to the model, Killip class and LVEF. CONCLUSIONS: This survey shows that the results of therapeutic trials have largely translated to clinical practice, resulting in improved early outcome compared with the early 1980s. However, continuous efforts should be made to shorten the time delay before hospital admission and to increase the proportion of elderly patients receiving reperfusion therapy.

Aged↗
PubMed1997

[Characteristics of patients hospitalized for myocardial infarction in France with respect to left ventricular dysfunction. Results of the USIK study].

Patients admitted in coronary care units, in november 1995, for confirmed acute myocardial infarction within 48 hours of symptoms onset were included in this study. The choice of measurement of left ventricular ejection fraction (LVEF) was left to the physician in charge. Only investigations performed within the first 8 days were taken into consideration. In cases with multiple investigations, the following order of preference was applied: a) angiographic LVEF, b) isotopic LVEF, c) echocardiographic ejection fraction by Simpson's method, d) echocardiographic ejection fraction by Berning's method, e) semi-quantitative visual echocardiographic evaluation. 2563 patients were included (1827 males and 736 females, mean age 67 years). A quantitative evaluation of LVEF was obtained in 1477 patients (57%) whereas 2 053 patients (80%) underwent at least a semi-quantitative evaluation. The average LVEF was 50% and 17% of patients had an ejection fraction < or = 35%. Patients with LVEF < or = 35% were older, less likely males, non smokers and diabetics. Prior heart failure, previous myocardial infarction and anterior location in infarction were more frequent. Heart failure was more frequent in patients with LVEF < or = 35% (75 vs 23%, p < 0.001). One hundred and ninety-seven patients (7.7%) died in the five first days following the onset of symptoms. A left ventricular ejection fraction < or = 35% multiplied the risk of death by 8.1 (Confidence interval: 5.7-11.4, p < 0.001). The presence of clinical heart failure increased the risk even more.

Aged↗
PubMed1997

[Epidemiology of myocardial infarction in France. Regional specificities].

A national epidemiological study undertaken in November 1995 recensed the data of 2563 patients admitted to 373 Intensive Care Units for acute myocardial infarction. There were 1827 men and 736 women with an average age of 67 years. Seventeen per cent of patients had left ventricular ejection fration (LVEF) < or = 35%. The mortality rate at 5 days was 7.7%. Clinical heart failure (Killip > 1) was observed in 34.4% of patients. 63% of patients were admitted before the 6th hour. Forty-six per cent of patients underwent early revascularisation by thrombolysis and/or angioplasty. The most widely used drugs in the first 5 days were heparin (96%), aspirin (89%), betablockers (65%), and angiotension converting enzyme inhibitors (46%). The influence of region on the demographical features, morbidity, mortality and therapeutic practice was studied. France was divided into 6 regions. In the Centre, the patients were older, with increased morbidity and mortality compared with the national average. Patients in the North East were similar and had a higher incidence of obesity. In the Ile de France, patients were generally younger with a higher incidence of tobacco consumption and their infarcts were generally less severe. Finally, in the South East, the mortality was particularly low. In multivariate analysis living in this region was good prognostic factor whereas low LVEF (< or = 35%) and age > or = 65 years were poor prognostic factors. This study, for the first time in France, describes the clinical features of myocardial infarction admitted to the Intensive Care Unit with respect to criteria of severity (LVEF, Killip) and region of origin of the patients. Its confirms large regional variations in the severity of acute myocardial infarction.

Adolescent↗
PubMed1994

Pharmacokinetics and suction blister fluid penetration of a semisynthetic injectable streptogramin RP 59500 (RP 57669/ RP 54476).

RP 59500 is a new semisynthetic injectable streptogramin with excellent activity against most gram-positive bacteria. In order to assess its potential for the treatment of tissue infections, the pharmacokinetics and penetration into suction blister fluid were studied in a pilot phase I study in six male volunteers following a single infusion of 12 mg/kg over 1 h. Plasma and suction blister fluid concentrations were determined by microbiological assay. The mean peak concentration in plasma was 8.65 mg/l at the end of infusion. The mean plasma elimination half-life was 1.48 h. The mean peak concentration in interstitial fluid was 2.41 mg/l and was reached after 1 h in two volunteers and after 2 h in the other four. The mean percentage penetration for the interval 0-6 h was 82.5%. RP 59500 was still detectable in interstitial fluid at 6 h at a mean concentration of 0.92 +/- 0.25 mg/l. The data of this pilot study demonstrate good penetration of RP 59500 into non-inflammatory interstitial fluid.

Adult↗
PubMed1993

Salen-manganese complexes are superoxide dismutase-mimics.

Complexes of manganese have previously been shown to exhibit SOD activity. In this study, we tested the ability of several (salen)-manganese complexes to scavenge O2.. Both neutral and cationic complexes were determined to be SOD-mimics. The activity of the complexes was not affected by the presence of bovine serum albumin in the assay. For most compounds, the activity was inhibited by the addition of EDTA. The stability and high catalytic activity of some of these molecules suggest that they might have potential use in a variety of conditions which involve overproduction of oxygen free radicals.

Edetic Acid↗
PubMed1990

[Glucocorticoids: mode of action and pharmacokinetics].

Glucocorticoids are used in therapeutics for their anti-inflammatory, anti-allergic and immunosuppressant activities. These effects are partly due to the ability of glucocorticoids to inhibit cell activation, since they block the transmission of cell stimulation signals through the cell membrane. They also inhibit the release of numerous cellular mediators, such as interleukins, prostaglandins, leukotrienes, etc. which intervene in immunological reactions. Finally, their cytostatic effect justifies their inclusion in many chemotherapeutic regimens. Although glucocorticoids have been widely used for several decades, many questions concerning their pharmacokinetics and mechanism of action remain unanswered.

Anti-Inflammatory Agents↗
PubMed1986

[Inappropriate secretion of antidiuretic hormone disclosing acute intermittent porphyria].

The authors report a case of acute intermittent porphyria in a 31-year old woman, revealed by inappropriate secretion of the antidiuretic hormone, a diagnosis confirmed by radioimmunoassay. Measurements of red cell urosynthetase made the diagnosis of porphyria certain and showed that the disease was familial, although clinically asymptomatic. Antidiuresis is not the only cause of hyponatraemia in acute intermittent porphyria. Similarly, psychic disorders are frequent in SIADH, but they are not necessarily due to acute intermittent porphyria.

Acute Disease↗
PubMedDate not supplied

[Evaluation of the effect of tobacco on trandolapril tolerance].

The objective of this study was to evaluate the impact of smoking habits on safety of trandolapril assessed by interrogation and by visual analogue scales (VAS). A total of 3402 hypertensive smokers (> or = 1 cigarette/d for at least 6 months) and non-smokers (no smoking or ceased at least 6 months previously) received trandolapril 2 mg/d for 4 weeks. The safety profile of trandolapril was assessed by both interrogation and by VAS. The VAS completed by the patients at D0 and D28 explored the following symptoms: asthenia, nausea, cough, headaches and dizziness. A significant change in cough VAS was previously defined by an at least 19 mm change. VAS analysis was performed on 2840 patients (1296 smokers and 1544 non-smokers), mean age 59 +/- 12 years. Smokers and non-smokers were significantly different for age 56 +/- 12 years vs. 62 +/- 12 years, sex ratio 74 per cent males vs. 45 per cent, history of hypertension 4.5 +/- 6.1 years vs. 5.3 +/- 6.5 years and cough VAS score at D0 35 +/- 26 mm vs. 20 +/- 21 mm. In the total population, 214 adverse events were reported by 177 patients (5.2 per cent). The most frequent adverse events were a cough (2.1 per cent), bronchitis (0.6 per cent), headaches (0.5 per cent), rhinitis (0.4 per cent), nausea (0.4 per cent) and asthenia (0.3 per cent). Cough was reported by 23 smokers (1.5 per cent) and by 49 (2.6 per cent) non-smokers (p = 0.02). In the VAS population, 151 adverse events were reported by 130 patients, 47 smokers (3.6 per cent) and 83 non-smokers (5.4 per cent, p = 0.03). The difference between the two groups was mainly due to a cough: 15 smokers (1.2 per cent) reported a cough vs. 38 non-smokers (2.5 per cent, p = 0.01) and 77 smokers (5.9 per cent) presented a significant change of cough VAS score vs. 124 non-smokers (8.0 per cent, p = 0.03). In this large scale study, 1.9 per cent of patients treated with trandolapril exhibited a cough. Smokers were less likely to present a cough. Use of VAS confirmed this trend.

Adult↗
PubMedDate not supplied

Anticonvulsant activity of diphenylhydantoin: pharmacological evidence for an alpha-adrenergic mechanism of action.

Several studies have shown that the noradrenergic system, or more precisely the alpha-adrenergic system, is implicated in the mechanism of action of DPH (Rudzik et al., 1966). In the present study we have demonstrated that prazosin, a relatively specific blocker of post-synaptic alpha-adrenergic receptors, antagonized the anticonvulsant activity of DPH on 3 models of convulsions: convulsions in the quaking mouse, convulsions induced by pentylenetetrazol, convulsions provoked by electroshock. The psychotropic properties of DPH have not been clearly demonstrated in man. It would, therefore, be of interest to perform controlled clinical studies in order to predict possible consequences of treatment in epileptics who are treated at the same time with antagonists of alpha-post-synaptic receptors.

Animals↗