Acute severe mitral regurgitation during first attacks of rheumatic fever: clinical spectrum, mechanisms and prognostic factors.

Background And Aim Of The Study: The study aim was to describe the clinical spectrum and mechanism of acute severe mitral regurgitation (MR) observed during first episodes of rheumatic fever (RF), and to identify prognostic factors related to the short-term outcome.

Methods: Since 1990, 44 patients (mean age 9.2 +/- 0.

Postprandial duodenojejunal motility in health and idiopathic severe gastroparesis: from conventional analysis to nonlinear dynamics analysis.

Our aim was to compare the results of the analysis of postprandial duodenojejunal motor patterns provided by a conventional computer-aided analysis with those provided by the new nonlinear mathematical method borrowed from 'chaos theory for determining how nonlinear analysis can improve fed motor pattern analysis and detect organization of postprandial contractions. Ten patients who had been explored for an idiopathic gastroparesis, and 20 healthy volunteers underwent duodenojejunal manometric recording for 3 h after a 750 kcal meal. Computer-aided analysis on each half-hour of the postprandial recording period calculated the number of waves (NW) and the area under the curve (AUC).

Hypothesis: hyperstructures regulate bacterial structure and the cell cycle.

A myriad different constituents or elements (genes, proteins, lipids, ions, small molecules etc.) participate in numerous physico-chemical processes to create bacteria that can adapt to their environments to survive, grow and, via the cell cycle, reproduce. We explore the possibility that it is too difficult to explain cell cycle progression in terms of these elements and that an intermediate level of explanation is needed.

[Spontaneous ventilation in positive expiratory pressure in cardiogenic pulmonary edema. Prospective study].

New equipment facilitating the use of spontaneous ventilation with positive expiratory pressure (PEP) has become available in France since January 1996. This technique was applied in 38 patients with severe cardiogenic pulmonary oedema and persistent respiratory distress despite high flow classical oxygen therapy and standard treatment. After 1 hour of ventilation with a flow of 220 l/min of 100% oxygen with an average PEP of 7.

Internal right atrial cardioversion of chronic atrial fibrillation: effects of low-energy biphasic shocks.

This study evaluates the efficacy and safety of internal right atrial cardioversion of atrial fibrillation using a defibrillation right atrial catheter and 2 thoracic patches with low-energy biphasic shocks.

[Internal atrial defibrillation after failure of attempted pharmacological and electrical cardioversion. Mid- and long-term outcome].

Cardioversion of atrial fibrillation by an endocavitary electrical shock was first proposed during the 1980s. The authors studied the efficacy of this technique at short and medium term in a population of 36 patients (28 men and 8 women) in whom atrial fibrillation persisted despite attempts to reduce it by antiarrhythmic drugs and external electrical cardioversion. The immediate success rate was high : 34 out of 36 patients (94%) and, at medium term, the number with sinus rhythm was comparable to that of studies evaluating the medium-term efficacy of external electrical cardioversion; 19 out of 33 patients (57%) were in sinus rhythm at 6 months and 9 out of 27 patients (33%) at 12 months.

Safety of high energy internal cardioversion for atrial fibrillation.

High energy internal cardioversion has been proposed as an alternative method to cardiovert drug refractory or external cardioversion refractory atrial fibrillation. However, the safety of this technique has not been clearly evaluated. We reviewed findings in 53 patients who underwent 55 sessions of high energy internal cardioversion (2 patients underwent 2 sessions) for termination of longstanding atrial fibrillation.

Long-term prognosis in patients with alcoholic cardiomyopathy and severe heart failure after total abstinence.

We prospectively evaluated the long-term prognosis of 14 patients with alcoholic cardiomyopathy and severe end-stage congestive heart failure after total abstinence. Improvement was very significant after 6 months of follow-up in most patients, and continued thereafter.

[Angiographic course over 10 years of giant aneurysm of the circumflex artery].

Pathological dilatations of the coronary arteries are not exceptional and are called megadolichoartery, aneurysm or ectasia. Cases of marked arterial dilatation, although much rarer, are regularly reported following their discovery due to the impressive angiographic, echocardiographic or autopsy findings. However, their course, particularly in the long term, remains unclear.

[Mortality and morbidity in the acute phase of myocardial infarction. Comparison of 3 patient cohorts admitted to hospital over 10 years].

The management of acute myocardial infarction has been transformed over the last thirty years by a number of therapeutic innovations. The authors decide to compare the outcomes of three cohorts of unselected patients admitted to hospital at 10 year intervals, to evaluate the impact of these innovations on morbidity and mortality. Six hundred and sixty one patient admitted to the Coronary Care Unit for acute myocardial infarction were included: Group I comprised 223 patients admitted consecutively during the period 1972-1973; Group II comprised 243 patients admitted between 1982-1983 and Group III comprised 195 patients admitted between 1992-1993.

Accuracy and mean duration of different protocols of head-up tilt testing.

Based on the results of our study, > 95% of patients with a positive passive tilt test are also positive during 3 micrograms/min, and especially 5 micrograms/min, isoproterenol tilt test. A proposed time-saving protocol would be to initiate the test with an isoproterenol infusion and to perform a 45-minute passive tilt only in those patients with a positive 5 micrograms/min (an infusion rate reported to have an excessive low specificity) isoproterenol tilt test, and to consider only those with symptoms associated with objective changes during this latter test as "finally positive." An alternative option would be to perform a 45-minute passive tilt only in those patients with a negative 3 micrograms/min isoproterenol tilt test.

[Contribution of doppler echocardiography to the diagnosis of the first attack of acute rheumatic fever].

Since 1944, the Jones criteria for the diagnosis of acute rheumatic fever have been regularly revised to integrate technical and diagnostic innovations. Echographic and Doppler criteria, however, remain unrecognised due to valvular insufficiency in healthy subjects. The aim of this study was to determine the cardiac lesions occurring in acute rheumatic fever and the diagnostic value of Doppler echocardiography.

Unstable periodic orbits and templates of the Rossler system: Toward a systematic topological characterization.

The Rossler system has been exhaustively studied for parameter values (a in [0.33,0.557],b=2,c=4).

[Rupture and extravascular migration of a vena cava filter. Apropos of a case].

The authors report the case of a 68 year old woman who underwent implantation of a Greenfield vena caval filter for recurrent pulmonary embolism. Migration of the filter out of the vena cava into the perivenal fat was discovered two years later during another embolic episode. One of the spokes of the filter had migrated into the iliac fossa.

Computations of the g(n) coefficients in the generalized Lorenz-Mie theory using three different methods.

Three different methods can be used to numerically compute the g(n) coefficients in the generalized Lorenz-Mie theory. Two of them are rigorous and involve (i) numerical evaluation of quadratures and (ii) numerical evaluation of finite series. The third way relies on the so-called localized interpretation that we discussed in previous papers.