16 results on '"GUILLOU, Y.-M."'
Search Results
2. Bêta 2-mimétiques intraveineux pour tocolyse au cours de la prééclampsie : deux cas d’œdème aigu du poumon
- Author
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Eliat, C, Lassel, L, Guillou, Y.-M, and Le Bouar, G
- Published
- 2002
- Full Text
- View/download PDF
Catalog
3. Value of Early Blood Th-1 Cytokine Determination in Predicting Severity of Acute Pancreatitis.
- Author
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HERESBACH, D., LETOURNEUR, J.-P., BAHON, I., PAGENAULT, M., GUILLOU, Y.-M., DYARD, F., FAUCHET, R., MALLÉDANT, Y., BRETAGNE, J.-F., and GOSSELIN, M.
- Subjects
PANCREATITIS ,CYTOKINES ,TUMOR necrosis factors - Abstract
Background: Early evaluation of the severity of acute pancreatitis (AP) requires measurement of many variables within 48 h after admission. Septic complications (SC) are frequent, and preliminary studies have highlighted the value of prophylactic antibiotherapy; however, single and reliable predictive markers of sepsis are not yet available. The aim of this study was to assess the value of determining early blood Th-1 cytokines and their natural antagonists (interleukin-6 (IL-6), IL-1, IL-1ra, and the soluble form of tumor necrosis factor (sTNF) receptors RI and RII) to predict the severity and SC during AP. Methods: Thirty-seven patients with AP were prospectively included; 25 of them had severe AP, including 8 with SC. Serum cytokines were measured 48 h and 72 h after the onset of AP with an enzyme-linked immunosorbent assay. The optimal severity or SC diagnostic thresholds was determined using receiver operative curves. Results: Severe AP in accordance with the Atlanta criteria were better predicted by C-reactive protein and IL-6 serum determination, albeit these levels could not predict absolutely the death of two patients. In severe AP cases (n = 25) the IL-1 to IL-1-ra ratio was lower in cases further complicated by sepsis ((6 ± 4) 10 versus (34 ± 13) 10, P < 0.05); moreover, sTNF RI (2497 ± 270 pg/ml versus 2133 ± 611 pg/ml, P < 0.05) and RII (3751 ± 400 pg/ml versus 3045 ± 509 pg/ml, P < 0.05) were higher in AP characterized by further SC. The IL-1 to IL-1-ra ratio and IL-1 concentration were dramatically decreased within the first 48 h ((0.4 ± 0.4) 10 versus (30 ± 11) 10, P < 0.05, and 0.3 ± 0.3 versus 15 ± 3 ng/l, P < 0.05) in patients with further infection of the pancreatic necrosis (n = 3). The SC diag-nosis was better anticipated by an IL-1 to IL-1-ra ratio lower than 5 × 10 or by an sTNF RI higher than 1750 pg/ml and sTNF RII higher than 2750 pg/ml, and the infection of the pancreatic necrosis by an IL-1 concentration <2 ng/l or an IL-1 to IL-1-ra ratio <2 × 10. Conclusion: Besides severity markers, IL-1, IL-1-ra, and sTNF RI and RII should be considered in base-line AP assays and, if confirmed by larger studies, could help to screen patients at risk for SC and candidates for prophylactic antibiotherapy with a good negative predictive value. [ABSTRACT FROM AUTHOR] more...
- Published
- 1998
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4. Pancreatitis after blunt abdominal trauma
- Author
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Bleichner, J. P., Guillou, Y. M., Martin, L., Seguin, P., and Malledant, Y.
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- 1998
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5. Impact sur la perfusion gastrique de la noradrenaline utilisee pour optimiser la pression arterielle chez le traumatise cranien grave
- Author
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Bleichner, J. P., Seguin, P., Guillou, Y. M., and Malledant, Y.
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- 2000
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6. Beta2-adrenergic agonists to tocolytic therapy in pre-eclampsia: two cases of pulmonary oedema
- Author
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Eliat, C., Lassel, L., Guillou, Y.-M., and Le Bouar, G.
- Subjects
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EDEMA , *BODY fluid disorders , *LUNG diseases , *PREECLAMPSIA - Abstract
Two cases of pulmonary oedema during beta2-adrenergic agonist therapy in pre-eclampsia pregnant patients are reported. In our first case, the pulmonary oedema was exceptionally severe, because the patient (twins at 26 SA) had to be intubated and ventilated, but the caesarean section was performed only 6 weeks later. These two clinical observations underline the fact that B2 adrenergic agonist are not indicated for the treatment of preeclampsy. Furthermore they suggest that such patients should be rapidly admitted to intensive care units. [Copyright &y& Elsevier] more...
- Published
- 2002
7. SARS-CoV-2 replicates in the human testis with slow kinetics and has no major deleterious effects ex vivo .
- Author
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Mahé D, Bourgeau S, da Silva J, Schlederer J, Satie A-P, Kuassivi N, Mathieu R, Guillou Y-M, Le Tortorec A, Guivel-Benhassine F, Schwartz O, Plotton I, and Dejucq-Rainsford N
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- Humans, Male, Leydig Cells virology, Sertoli Cells virology, SARS-CoV-2 physiology, Testis virology, Virus Replication
- Abstract
Importance: SARS-CoV-2 is a new virus responsible for the Covid-19 pandemic. Although SARS-CoV-2 primarily affects the lungs, other organs are infected. Alterations of testosteronemia and spermatozoa motility in infected men have raised questions about testicular infection, along with high level in the testis of ACE2, the main receptor used by SARS-CoV-2 to enter host cells. Using an organotypic culture of human testis, we found that SARS-CoV-2 replicated with slow kinetics in the testis. The virus first targeted testosterone-producing Leydig cells and then germ-cell nursing Sertoli cells. After a peak followed by the upregulation of antiviral effectors, viral replication in the testis decreased and did not induce any major damage to the tissue. Altogether, our data show that SARS-CoV-2 replicates in the human testis to a limited extent and suggest that testicular damages in infected patients are more likely to result from systemic infection and inflammation than from viral replication in the testis., Competing Interests: The authors declare no conflict of interest. more...
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- 2023
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8. [Intravenous beta-2-adrenergic agonists for tocolytic therapy in pre-eclampsia: two cases of acute pulmonary edema].
- Author
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Eliat C, Lassel L, Guillou YM, and Le Bouar G
- Subjects
- Adult, Blood Pressure drug effects, Cesarean Section, Critical Care, Female, Humans, Pregnancy, Respiration, Artificial, Twins, Adrenergic beta-2 Receptor Agonists, Adrenergic beta-Agonists therapeutic use, Pre-Eclampsia drug therapy, Pulmonary Edema drug therapy, Tocolytic Agents therapeutic use
- Abstract
Two cases of pulmonary oedema during beta 2-adrenergic agonist therapy in pre-eclampsia pregnant patients are reported. In our first case, the pulmonary oedema was exceptionally severe, because the patient (twins at 26 SA) had to be intubated and ventilated, but the caesarean section was performed only 6 weeks later. These two clinical observations underline the fact that B2 adrenergic agonist are not indicated for the treatment of preeclampsy. Furthermore they suggest that such patients should be rapidly admitted to intensive care units. more...
- Published
- 2002
- Full Text
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9. [The measurement of end-tidal carbon dioxide (PETCO2) is not a significant parameter to monitor in patients with severe traumatic brain injury].
- Author
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Seguin P, Bleichner JP, Branger B, Guillou YM, Feuillu A, and Mallédant Y
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- Adult, Carbon Dioxide blood, Humans, Middle Aged, Prospective Studies, Brain Injuries metabolism, Carbon Dioxide analysis
- Abstract
Purpose: To evaluate the agreement between end-tidal carbon dioxide (PETCO2) and arterial CO2 (PaCO2) in patients with traumatic brain injury and to document the course of the (PaCO2-PETCO2) gradient over time., Methods: Twenty one traumatic brain injury patients (Coma Glasgow Scale < or = 8) were included in this prospective observational study over a period of six months. Simultaneous determinations of PaCO2 and PETCO2 (by infrared capnometry) were recorded. Agreement between PaCO2 and PETCO2 was determined by the statistical method described by Bland and Altman. Changes in PETCO2 over time were compared with changes in PaCO2. Factors likely to explain a gradient superior to +/- 4 mmHg were explored., Results: One hundred and eleven data pairs were obtained. The bias was 5.5 mmHg with a precision of 5.1 mmHg and limits of agreement ranged from -4.5 mmHg to 15.5 mmHg. The latter exceeded the predefined limits of agreement established to determine interchangeability between methods (+/- 4 mmHg). PETCO2 and PoCO2 changed in opposite directions in 20% of 90 consecutive measurements. Only the duration of ventilation was found to be significantly associated with a gradient superior to +/- 4 mmHg., Conclusions: In this selected population of patients with severe traumatic brain injury, measurements of PETCO2 and PaCO2 are not interchangeable. Further the PoCO2-PETCO2 gradient is not stable over time and cannot predict variations of PaCO2. The use of PETCO2 instead of PaCO2 could be deleterious in patients in whom strict control of PaCO2 values is required. more...
- Published
- 2001
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10. Evaluation of a new semi-continuous cardiac output system in the intensive care unit.
- Author
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Seguin P, Colcanap O, Le Rouzo A, Tanguy M, Guillou YM, and Mallédant Y
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- APACHE, Aged, Bias, Critical Illness, Equipment Design, Evaluation Studies as Topic, Humans, Ice, Prospective Studies, Reproducibility of Results, Respiratory Distress Syndrome physiopathology, Shock physiopathology, Shock, Cardiogenic physiopathology, Shock, Septic physiopathology, Cardiac Output physiology, Catheterization, Swan-Ganz instrumentation, Critical Care, Monitoring, Physiologic instrumentation, Thermodilution instrumentation
- Abstract
Purpose: A new semi-continuous thermodilution cardiac output (CCO) system has been developed recently (Opti-Q and Q-vue Abbott critical care system). The aim of this study was to compare the accuracy and reproducibility of this new device with conventional ice-bolus thermodilution cardiac output (BCO)., Methods: Fifteen critically ill patients who needed pulmonary artery catheterization were prospectively investigated. Eighty seven paired data using BCO and CCO methods were compared. Reproducibility was assessed from 90 BCO and 87 CCO determinations by calculation of the mean standard error (SEM) and according to Bland and Altman methodology., Results: The BCO and CCO ranged from 2.46 to 11.20 L.min-1 and from 1.75 to 10.05 L.min-1 respectively. Bias (mean difference between BCO and CCO) was null (0.002 L.min-1, P = 0.98), precision (SD of the bias) was 0.74 L.min-1 and the limits of agreement (mean difference +/- 1.96 SD) ranged from -1.45 to 1.45 L.min-1. The threshold to consider two cardiac outputs as different (3 x SEM) was equivalent for BCO and CCO (0.54 and 0.465 L.min-1 respectively). According to the Bland and Altman method, reproducibility of CCO was greater than that of BCO; bias of repeated measurements of BCO and CCO were 0.15 L.min-1 (P < 0.05) and 0.047 L.min-1 (NS), respectively., Conclusion: Compared with BCO, this new device was accurate but cannot be considered as interchangeable regarding the limits of agreement. Reproducibility of CCO was superior to BCO. more...
- Published
- 1998
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11. -Pancreatitis after blunt injuries to the abdomen-.
- Author
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Bleichner JP, Guillou YM, Martin L, Seguin P, and Mallédant Y
- Subjects
- Adult, Amylases blood, C-Reactive Protein analysis, Contusions etiology, Drainage, Female, Humans, Liver injuries, Middle Aged, Pancreatitis diagnostic imaging, Pancreatitis enzymology, Pancreatitis therapy, Rupture, Tomography, X-Ray Computed, Treatment Outcome, Abdominal Injuries complications, Pancreas injuries, Pancreatitis etiology, Wounds, Nonpenetrating complications
- Abstract
Three cases of pancreatitis occurring after a trauma to the pancrease are reported. They emphasize the difficulty of diagnosis at the initial phase of the condition. In all cases, computerized tomography (CT) scan was the main diagnostic method. Applying the same therapeutic strategy for pancreatitis as for other aetiologies facilitated a favourable outcome. more...
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- 1998
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12. [Mesenteric vein infarction associated with congenital antithrombin III (ATIII) deficiency].
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Guillou YM, Bleichner JP, Gobron F, Leroux A, Le Calvé JL, and Mallédant Y
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- Adult, Deficiency Diseases congenital, Humans, Ileostomy, Infarction surgery, Jejunum blood supply, Jejunum surgery, Male, Mesenteric Vascular Occlusion surgery, Thrombosis surgery, Antithrombin III Deficiency, Deficiency Diseases complications, Infarction etiology, Mesenteric Vascular Occlusion complications, Mesenteric Veins, Thrombosis complications
- Abstract
A venous mesenteric infarction in a 27-year-old patient is reported. This patient presented a genetic quantitative AT-III deficiency without anticoagulation therapy. Ultrasonography revealed portal vein thrombosis and laparoscopy showed mesenteric vein infarction. Laparotomy was performed mmediately and revealed segmental infarction of 60 cm of the jejunum which was resected; the portal vein was considered to be partially occluded on palpation. No strangulation or mechanical factors were identified. Immediately postoperatively the patient received therapeutic doses of heparin with AT-III concentrates to increase AT-III levels; no recurrent thrombotic episode was observed. A systematic second-look operation 24 hours postoperatively showed good bowel viability. Five days later, long-term anticoagulation with acenocoumarol was decided. Twelve days later, ultrasonography showed complete portal revascularization which was confirmed by a third surgical operation on D60. more...
- Published
- 1996
13. [Massive entero-mesenteric infarction. A possible role of ostial stenosis of digestive arteries].
- Author
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Guillou YM, Bleichner JP, Héresbach D, Maurus F, and Mallédant Y
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- Adult, Colectomy, Constriction, Pathologic, Duodenostomy, Female, Humans, Infarction surgery, Intestines surgery, Parenteral Nutrition, Total, Reoperation, Infarction etiology, Intestines blood supply, Mesenteric Arteries abnormalities, Mesentery blood supply
- Abstract
A case is reported of a 35-year-old woman who sustained a massive intestinal infarction requiring a total resection of small intestine and the colon, with a terminal duodenostomy. Preoperative arteriography and intraoperative findings at laparotomy showed a thrombosis of coeliac trunc, superior and inferior mesenteric arteries, originating possibly from a non atheromatous ostial stenosis of these vessels. The blood supply to stomach, duodenum, liver and spleen was maintained through collaterals from diaphragm. Postoperatively a dehiscence of duodenostomy suture occurred with a spontaneous favourable outcome. The closure of external duodenostomy orifice required an endoscopic aspirational gastrostomy. The patient was discharged with the perspective of intestinal transplantation, her nutrition being provided through an ambulatory parenteral nutritional support unit. A symptomatology of chronic mesenteric ischaemia should lead to an angiography of digestive arteries not only with a diagnostic but also a possible therapeutic goal using angioplasty techniques. more...
- Published
- 1995
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14. [Bilateral phrenic nerve paralysis after heart surgery].
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Guillou YM, Malledant Y, Bleichner JP, Louvard V, and Leguerrier A
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- Aged, Female, Humans, Respiration, Artificial, Respiratory Paralysis therapy, Aortic Valve, Heart Valve Prosthesis adverse effects, Phrenic Nerve, Respiratory Paralysis etiology
- Abstract
A bilateral phrenic nerve paralysis after open heart surgery with cold cardioplegia in a 78-year-old patient is reported. This injury is observed after aortic valve replacement without use of an ice slush around the pericardium and no surgical or other direct nerve trauma. The diagnosis of clinical and radiologic abnormalities suggestive of phrenic dysfunction is assisted by portable sonography and measurement of the diaphragmatic compound muscle action potential after cervical transcutaneous phrenic nerve stimulation. This bilateral phrenic nerve paralysis required prolonged mechanical ventilation for 68 days with incomplete regression of the neuropathy five months after surgery. more...
- Published
- 1994
15. [Post-traumatic hemiplegia in a patient with fibromuscular dysplasia of the carotid artery].
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Bleichner JP, Guillou YM, Le Bouquin V, Fleureaux O, and Mallédant Y
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- Adult, Hemiplegia drug therapy, Heparin, Low-Molecular-Weight therapeutic use, Humans, Male, Platelet Aggregation Inhibitors therapeutic use, Brain Injuries complications, Carotid Artery Diseases complications, Fibromuscular Dysplasia complications, Hemiplegia etiology, Intracranial Embolism and Thrombosis etiology
- Abstract
A 44-year-old patient, without remarkable medical history, was admitted with a head trauma with initial loss of consciousness and a thoracic trauma. The initial treatment included the insertion of a chest drain for evacuation of a pneumothorax and intrapleural analgesia with bupivacaine. The day after admission, the patient experienced a generalized epileptic crisis, without prodomes. Later, a left proportional hemiplegia with aphasia was recognized. The CT scan obtained immediately after the crisis, as well as the carotid Doppler ultrasonography and echocardiography were normal. The bilateral carotid angiography showed an image of fibromuscular dysplasia of the extracranial segment of the right internal carotid artery. The migration of a carotid thrombus initiated by the trauma was hypothetized. A treatment with a platelet aggregation inhibiting drug was started and associated 20 days later with low molecular weight heparin. The patient recovered a normal motility within 10 days; only the aphasia remained. Trauma of the carotid artery is not a frequent cause of cerebrovascular accident. The occurrence of the latter is favoured by a pre-existing lesion of this artery. This case demonstrates that in a trauma patient not all central nervous system manifestations are initiated by a head trauma. more...
- Published
- 1993
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16. [Spontaneous rupture of an adenoma of the liver during pregnancy].
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Estebe JP, Malledant Y, Guillou YM, Saint-Marc C, Bouteloup PY, Launois B, Lecerf C, and Vallee P
- Subjects
- Adult, Emergencies, Female, Humans, Pregnancy, Pregnancy Trimester, Third, Rupture, Spontaneous, Adenoma complications, Liver Neoplasms complications, Pregnancy Complications, Neoplastic
- Abstract
Must often reporting to an hepatic subcapsular hemorrhage with pre or true eclampsia, Spontaneous rupture of adenoma of the liver during pregnancy is unusual entity. Very exceptionally cases of rupture of anatomic hepatic lesion underlying had been reported. About a new case, diagnosis, physiopathologic and management problems are approached. more...
- Published
- 1988
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