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Biomedical subjects

Y Houdas

Publications and source records attributed to Y Houdas.

At least 19 recordsLinked to original sources
PubMed1992

Cold exposure and ischemic heart disease.

Exposure to cold causes a vasoconstriction and a tachycardia, both resulting in a rise of blood pressure and cardiac work. This last effect may have a deleterious influence on people suffering from ischaemic heart disease (IHD). Moreover, coronary artery spasm could occur if vasoconstriction extends to the heart vessels. Epidemiologic studies have shown that mortality from IHD was correlated to the ambient temperature. There will be more deaths per day in the winter, and fewer in the summer. However, the daily number of deaths also increases during the heat waves. During a cold test, the coronary blood flow remains normal or slightly increased in normal subject. There is never a coronary artery spasm. Subjects who suffer from angina but have normal coronary arteries behave in the same way as normal subjects. Patients with IHD show a decrease in coronary blood flow. In a few cases, those patients may exhibit a coronary spasm with chest pain and even myocardial infarction. It is concluded that people with normal cardiovascular function are unaffected by cold stress whereas those with IHD may be crippled, although rarely, by exposure to cold, especially if they perform a physical work.

Blood Pressure↗
PubMed1992

[Left intraventricular gradients measured by Doppler echocardiography at rest, during exercise and during isoproterenol test in hypertrophic cardiomyopathy].

Doppler echocardiography has been shown to be an accurate method of assessing left ventricular outflow obstruction in hypertrophic cardiomyopathy (HCM). One of the characteristics of this pressure gradient is its variability and, therefore, we measured this parameter during dynamic exercise testing in 33 patients. The results were compared with those recorded during isoproterenol infusion, the reference stress test for patients with HCM. Submaximal exercise in the recumbent position is usually well tolerated and resulted in a 43% increase in heart rate and a 47% increase in pressure gradient. There was a significant correlation between resting and exercise outflow obstruction (r = 0.90; p = 0.001). Moreover, exercise echo revealed obstruction in 26% of patients without resting pressure gradients (latent obstruction). The interpretation of results obtained with isoproterenol infusion is more difficult: this test resulted in an important increase in the left ventricular pressure gradient (231%) and "revealed" obstruction in 84% of cases. Therefore, we believe that exercise is more physiological and better tolerated than isoproterenol stress infusion and should be adopted as the investigation of choice in HCM even without obstruction at rest. If it is not possible to perform the exercise or no outflow tract obstruction can be demonstrated, an isoproterenol infusion may be used but this is not always well tolerated and the results should be interpreted with caution.

Cardiomyopathy, Hypertrophic↗
PubMed1991

Influence of ventilation of the face on thermoregulation in man during hyper- and hypothermia.

It has been suggested that a thermal countercurrent exchange may occur in the cerebral vascular bed of humans, thereby creating for the brain a state of relative thermal independence with regard to the rest of the body. However, worrying questions have arisen concerning this suggestion. Experiments were carried out on seven young male volunteers. Hyper- and hypothermic conditions were produced by immersion in water at 38.5 degrees C and 25 degrees C, respectively. During the last few minutes of immersion, the face was cooled or warmed by ventilation with a 200 l.min-1 air flow at 5 degrees C or 40 degrees C, respectively. Internal and peripheral temperatures were recorded. Blood flow in the anastomotic vessels between face and brain was measured by Doppler techniques associated with computerized frequency analysis. The general responses were as classically described, i.e. an increase in peripheral and central temperatures during immersion in the warm bath and a decrease in these variables in the cold bath. The reactions produced by cooling or warming the face were small and easily explained by the direct changes of the heat load they induced. Whatever the thermal conditions, the blood flow in the anastomotic vessels between the vascular bed of the face and that of the brain was never reversed. It was concluded that there was no experimental evidence for an efficient thermal counter-current exchange in the vascular bed of the human head.

Adult↗
PubMed1990

[Blood flow measurement in arteriovenous fistula. Comparison of 2 ultrasonic methods, direct and indirect by compression of the fistula].

Measuring blood flow in arteriovenous fistulae in patients under chronic dialysis is of interest to evaluate the repercussions of the fistula on the heart. The apparently simplest method is direct measurement of the mean blood flow velocity by the pulsed doppler technique and ot the cross-section area by ultrasonography, the product of these two values being the blood flow rate. Another method has been proposed, which consists of measuring the cardiac output before and after compression of the fistula, the difference between the two values being supposed to represent the blood flow rate in the fistula. A comparative study of these two methods was conducted in 17 patients aged from 2 to 21 years (mean: 14 years). The direct method gave a figure of 475 ml.min-1.m-2 (SD = 240), while the figure obtained with the indirect method was 471 ml.min-1.m-2 (SD = 227); the difference was statistically not significant. In terms of concept, however, the indirect method is open to much more severe criticism than the direct method, and whenever possible the latter should be preferred when measuring blood flow in arteriovenous fistulae.

Adolescent↗
PubMed1990

[Constrictive pericarditis: study by Doppler echography of blood flow in the supra-hepatic veins].

The blood flow rate in the supra-hepatic veins has been measured by Doppler ultrasound in 11 subjects suffering from more or less advanced constrictive pericarditis; the results were compared to those obtained with normal subjects. In all the pathological cases, the flow rate curve shows the following modifications: a slight decrease in the X peak, which is related to the blood "demand" caused by the decrease in the ventricular volume during the ejection, and a correlative increase in the Y peak, contemporaneous of the ventricular filling up. In the patients in which the pericarditis has not reached a marked stage of constriction, the intra-thoracic ventilatory pressure variations still exert a certain influence on the supra-hepatic blood flow rate; on the other hand, this influence is suppressed when the constriction is complete. These phenomena are parallel to the pressure modifications observed by catheterism and to those of the mitral and tricuspid transvalvular flow. The advantage of measuring the blood flow rate in the supra-hepatic veins lies in the fact that the access, for ultrasound analysis, to these vessels is quicker and more constant than to the heart valves. This method seems therefore to be an interesting one to assess the stage of development of the constricting pericarditis.

Hepatic Veins↗
PubMed1988

[Doppler effect in cardiology. Continuous Doppler, pulsed Doppler, Doppler color].

Echocardiography has contributed to the exploration of the heart by providing much information, and it has even given rise to new semiological concepts. However, abnormalities of intracardial blood flow, notably shunts and regurgitations, could only be diagnosed indirectly from their effects on cardiac cavities. A new step forward was the advent of pulsed and continuous doppler ultrasound, since from that moment it has been possible to demonstrate abnormal blood flows, to measure their velocity and to determine, albeit with some reservation, such crucial values as pressure gradients. Yet even when these two techniques were combined in the doppler-echotomography systems blind areas persisted, and a blood flow of strongly abnormal direction could in fact escape doppler velocimetry. This is where another development came to the rescue, for it enabled both normal and abnormal flows to be visualized in colours. Owing to this visualization, and provided all possible projections are used, it has become exceptional to "miss" an abnormal blood flow. The diagnosis is now easier and more accurate, and in a second stage the flow can be quantified by pulsed or continuous doppler ultrasound. The colour-coded doppler technique therefore has not superseded the previous one: one may say that it has merely increased diagnostic reliability, but is this not a decisive improvement?

Cardiology↗
PubMed1988

[Pulmonary valve endocarditis caused by Streptococcus D bovis in a patient with a colorectal adenocarcinoma].

A case of pulmonary endocarditis caused by Streptococcus D bovis in a female patient with colorectal adenocarcinoma is reported. The M-mode and two-dimensional echocardiographic and pulsed doppler ultrasound findings are described. A review of the literature shows that Streptococcus D bovis pulmonary endocarditis is rare. Any septicaemia or endocarditis caused by this organism calls for invasive exploration of the digestive tract, and especially the colon.

Adenocarcinoma↗
PubMed1987

Effect of voluntary dehydration on thermoregulatory responses to heat in men and women.

The effects of dehydration prior to heat exposure on sweating and body temperature were tested in 8 men and 8 women, dehydration being 1.3 and 1.0% of body weight, respectively. The subjects were exposed to 40 degrees C for 60 min. Compared with controls (C), in the dehydrated men (D) there was a longer delay in the onset of sweating (C, 7.8, D, 11.6 min, p less than 0.05), a lower total sweat loss (C, 153, D, 127 g X m-2 X h-1, p less than 0.001), and a greater increase in Tre (C, 0.31, D, 0.43 degree C, p less than 0.002). In women, dehydration did not influence the control time course of sweating significantly, nor were these significant body temperature increases during heat exposure. Delay in the onset of sweating in women (C, 18.1, D, 18.7 min) was generally longer than in men (C, 7.8, D, 11.6 min), [F(1,14) = 7.41, p less than 0.05]. A significant correlation was found between the inertia time of sweating and delta Tre in both control and dehydration conditions in the men (r = 0.81, p less than 0.01). The rectal temperature increases in men were also related to the inertia time of electrical skin resistance (r = 0.83, p less than 0.01). It is concluded that dehydration affects sweating and body temperature in men more severely than in women.

Adult↗
PubMed1985

Dynamics of sweating in men and women during passive heating.

The dynamics of sweating was investigated at rest in 8 men and 8 women. Electrical skin resistance (ESR), rectal temperature (Tre) and mean skin temperature (Tsk) were measured in subjects exposed to 40 degrees C environmental temperature, 30% relative air humidity, and 1 m X s-1 air flow. Sweat rate was computed from continuous measurement of the whole body weight loss. It was found that increases in Tre, Tsk and mean body temperature (Tb) were higher in women than in men by 0.16, 0.38 and 0.21 degrees C, but only the difference in delta Tb was significant (p less than 0.05). The dynamics of sweating in men and women respectively, was as follows: delay (td) 7.8 and 18.1 min (p less than 0.01), time constant (tau) 7.5 and 8.8 min (N.S.), inertia time (ti) 15.3 and 26.9 min (p less than 0.002), and total body weight loss 153 and 111 g X m-2 X h-1 (p less than 0.001). Dynamic parameters of ESR did not differ significantly between men and women. Inertia times of ESR and sweat rate correlated in men (r = 0.93, p less than 0.001), and in women (r = 0.76, p less than 0.02). In men, delta Tre correlated with inertia time of sweat rate (r = 0.81, p less than 0.01) as well as with the inertia time of ESR (r = 0.83, p less than 0.001). No relation was found between delta Tre and the dynamics of sweating in women. It is concluded that the dynamics of sweating plays a decisive role in limiting delta Tre in men under dry heat exposure. The later onset of sweating in women does not influence the rectal temperature increase significantly. In women, delta Tre is probably limited by a complex interaction of sweating, skin blood flow increase, and metabolic rate decrease.

Adult↗