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T Mardelle

Publications and source records attributed to T Mardelle.

12 recordsLinked to original sources

Silent coronary artery disease in black African diabetic patients. A prospective study of 50 patients.

Silent coronary heart disease (CHD) has been researched among a sample of 50 black African diabetic patients in a prospective study. The diabetic patients were chosen on the following criteria: male sex, age ranging from 40 to 60 years, absence of history of CHD, normal EKG. A stress test was performed in all cases. A coronary arteriography was done each time the exercise test was positive, doubtful or non-conclusive. This study has shown a prevalence of 10% CHD:31 exercise test negatives, 17 exercise test non-conclusives, 2 exercise test positives, 5 coronary arteriography with significant narrowing. There were 3 patients with one vessel disease (LDA: 2 cases, CFX: 1 case), one patient with double vessel disease (CFX, RCA) while another had a triple vessel disease (RCA, LDA, CFX). Proximal lesions were encountered in 5 cases and distal lesions in 3 cases. The authors conclude that CHD exist in a silent state among black African diabetics. Its prevalence is lower than in white diabetics. The coronary lesions are mostly limited. Proximal narrowing and one vessel disease were mostly encountered.

Adult

[Isolated replacement of the tricuspid valve with a bioprosthesis. Apropos of 22 cases in Abidjan].

The authors reviewed the operative and function results of 24 isolated tricuspid valve replacements with bioprostheses in 22 patients. The patient population was young (average age 15 +/- 8 years). The surgical indication was massive tricuspid regurgitation due to chronic parietal endocarditis in 19 cases and to bacterial endocarditis in 3 cases. Tricuspid valve replacement was associated with 19 right ventricular endocardectomies, 2 direct closures of ventricular septal defects, 2 Wooler mitral valvuloplasties and 1 pericardectomy. The operative mortality was 13.5% and the secondary mortality 13.5%. Of the 16 survivors, 13 are in the NYHA Class I with no regular medical therapy. Their cardiothoracic ratio has slightly decreased. Two patients have permanent atrial fibrillation, and 12 have acquired definitive complete right bundle branch block. Eight of these patients had significant improvement of atrial and right ventricular pressures, of Yu's index and cardiac index at postoperative catheterisation. Three of the 16 patients developed progressive calcific degeneration of their bioprostheses. They are among the 6 patients who have been followed up for more than 3 years. There was no mortality at reoperation. Isolated tricuspid valve replacement by bioprosthesis was chosen despite the young age of these patients because of the disadvantages of mechanical prostheses which are associated with a much higher mortality related to incarceration and thrombosis of the prosthesis. The relatively high operative and secondary mortality in this series of isolated tricuspid valve replacement compared to mitral, aortic or micro-aortic valve replacement, is related to the gravity of the underlying causal pathology.

Adolescent

[Hypertrophic myocardiopathy and tetralogy of Fallot. Study of 2 cases].

The authors report two observations of concentric hypertrophic cardiomyopathy associated with Fallot's tetralogy in one case and with pulmonary atresia complicated by atrial septal defect in the other. The association of Fallot's tetralogy with hypertrophic cardiomyopathy is rare, as only 5 cases have been reported in the literature. In this connection, the mechanism of myocardial hypertrophy and the therapeutic problems posed by this association are discussed.

Adolescent

[Pulmonary artery aneurysms in patent ductus arteriosus].

Two cases of pulmonary artery aneurysm are reported in patients with persistent ductus arteriosus (PDA). The first was a mycotic aneurysm complicating staphylococcal pneumonia; the other was a calcific aneurysm of the right pulmonary artery. The mycotic origin was confirmed in the first case. The aetiological roles of pulmonary hypertension and previous endocarditis are discussed in the second case. Based on these two observations, the authors analyse the aetiology and evolution of mycotic aneurysms and review the therapeutic problems posed by their association with PDA.

Adolescent

[Early coronary atherosclerosis in a malignant pheochromocytoma. Apropos of a case].

An observation of adrenergic myocarditis with clinical and electrical signs of coronary failure is reported. The patient had electrical and enzymatic manifestations of acute anteroseptal necrosis, complicated at the acute stage by complete atrioventricular block and fatal vasoplegic circulatory collapse. Post-mortem examination showed obstructive atherosclerosis of the anterior interventricular artery without anatomic signs of infarction. Pathogenesis of this coronary failure is discussed. In this case, functional coronary insufficiency produced by catecholamine release was associated with coronary atherosclerosis.

Adrenal Gland Neoplasms

[Blood prolactin levels in male hypogonadism (author's transl)].

Prolactin levels were measured in 84 patients aged 20 years with hypogonadism, both under baseline conditions and after stimulation with TRH. In those with impuberty from delayed puberty or gonadotropin insufficiency, baseline blood prolactin levels were normal but the response after stimulation was reduced in a significant manner. In patients with Klinefelter's syndrome, both baseline and reserve blood prolactin levels were increased. No correlation was observed between these abnormal levels and the usual clinical and biological disturbances found in this disorder (gynaecomastia, diabetes, hyperinsulinism, changes in 5-alpha-reduction). The significance of this hyperprolactinaemia remains obscure.

Adolescent

Coronary heart disease in the diabetic African: frequency clinical and angiographic features.

The frequency and clinical and coronarographic features of coronary heart disease (CHD) in black African diabetic patients were assessed in a two-part study. The aim of part I was to determine the frequency of CHD in 50 diabetic patients selected by the following criteria: male, age between 40 and 60 years, diabetes history less than 20 years, no history of CHD and normal E.K.G. All 50 of these patients underwent a stress test and those who failed or for whom results were inconclusive were submitted to coronary arteriography. Part II was a retrospective study of 104 patients with CHD. Its aim was to compare the clinical and coronarographic features of CHD patients with (27 cases) and without (77 cases) diabetes mellitus. The frequency of CHD in the 50 diabetics selected for this study was 10% (31 negative exercise tests, 19 inconclusive exercise tests, 5 coronary arteriographies with significant narrowing). Of these 5 diabetics with CHD, 3 had single vessel involvement (left descending artery: 2 cases, circumflex artery: 1 case), 1 patient had double vessel involvement (right coronary circumflex artery) and 1 had triple vessel involvement (left descending, circumflex, and right coronary artery). In the retrospective study the clinical profile of the diabetic and non-diabetic CHD patients was the same with respect to sex, age, angina, myocardial infarction, and death rate. As regard the risk factors, blood cholesterol level was higher in diabetics while cigarette smoking was higher in non-diabetics. The frequency of hypertension was the same in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Primary congestive cardiomyopathies of the adult in a tropical environment: nosologic, diagnostic and developmental data].

The authors describe the cases of 86 black african patients (75 males and 11 females), affected by a congestive primitive cardiomyopathy (CMP), confirmed by echocardiography. Echocardiographic investigation revealed, in all cases, stigmas of a developed CMP: cavitary dilatation, hypokinesia and thinness of walls, offsetting and miniaturization of the valvula mitralis. Pericardial effusion was associated in 20 cases, and thrombosis of left cavities was recognized through bi-dimensional investigation. Angiography and hemodynamics performed in 15 patients pointed out in all cases a significant falling off of the pumping function and the muscular function. Angiography, in 8 cases, displayed a left ventricular cavity distended and hypokinetic, with a moderate mitral incompetency. Evolution was characterized by the following complications: heart failure: 68 cases--systemic thromboembolism: 5 cases--pulmonary embolism: 2 cases--auricular rhythmic irregularity: 20 cases--ventricular rhythmic irregularity: 42 cases--second or third degree atrioventricular blocks: 5 cases. Death rate was 25% (22 patients). Taking into account these 86 cases, the position of the congestive CMP defined among the tropical CMP and its classification studied as well as its echocardiographic and evolutive peculiarities.

Adult