[Perioperative heart rate in patients taking beta-blockers: reality and efficiency of the treatment]. / Analyse des fréquences cardiaques durant la période péri-opératoire chez des patients prenant des bêtabloquants: réalité et efficacité du traitement.

OBJECTIVE: To compare perioperative heart rate (HR) control of patients chronically exposed to beta-blockers (BB) with those of patients whom BB treatment was initiated one week preoperatively. METHODS: HR was noticed at three successive time periods: the anaesthesia visit, just before induction of anaesthesia, and during surgery (maximum and minimum HR). HR, presented as mean+/-SD, was compared among 3 groups of patients: BB chronic treatment, preoperative BB, and a control group not taking BB. RESULTS: Four hundred (and) six patients were included: 181 chronic BB patients, 20 preoperative BB, and 205 control patients. As compared to the control group, HR of chronic BB patients were lower (P<0.05) than those of the control group at the three time period of the study. In the preoperative BB patient group, one week BB treatment resulted in a mean 30% reduction of HR. Just before induction of anaesthesia, HR of preoperative BB patients was lower than that of chronic BB patients (55+/-11 vs 67+/-13 b/min; P<0.05). CONCLUSION: Beta-blockers treatment initiated one week before surgery could be more effective on perioperative HR control than chronic BB treatment.

[Perioperative administration of betablockers: a practice survey]. / Administration périopératoire de bêtabloquants: enquête de pratique.

OBJECTIVES: To evaluate the anaesthesiologists' attitude concerning the perioperative administration of betablockers (BB), especially prophylactic BB, in order to prevent postoperative cardiac complications. METHODS: A questionnaire including 20 items was sent to 700 anaesthesiologists of 4 French departments (Ain, Isere, Loire et Rhone). RESULTS: The response rate was 30%. Eighty-eight percent of respondents prescribed the BB with the premedication, on the day of the surgery in patients who were on regular BB. Before major surgery, 37% percent of respondents always or usually introduced prophylactic BB in patients with high cardiac risk. Atenolol was the drug of choice for 68% of perioperative BB users. Seventy-one percent of anaesthesiologists using prophylactic BB asked for a cardiologic opinion before starting BB therapy. CONCLUSION: In practice, anaesthesiologists continued BB during the perioperative period in patients who were on chronic treatment with BB. However, prophylactic perioperative administration of BB in patients with high cardiac risk is still inadequate and dependent on a cardiologic opinion.

Expresión de una proteína relacionada al receptor de estrógeno (p29), en carcinoma primario de la mama: análisis metodológico, anatomoclínico y del contenido de ADN / Expression of a estrogen related protein (p29) in primary breast carcinoma: methodological, anatomoclinical and DNA contents analysis

The aim of this work was to assess the immunohistochemical detector of a estrogen receptor related protein (p29) in 48 histological samples of primary mammary carcinoma and its relationship to clinical, morphological and ADN content parameters. p29 protein was positive in 62.5 per cent of samples. Over 50 per cent of samples had moderate or intense immunohistochemical staining (staining index over 16) and 77 per cent has a heterogenous expression of p29 protein. Sevently six per cent of p29 positive and 53 per cent of p29 negative tumors had a proliferation fraction over 10 per cent (determined by the fraction with flux cytometry). No relationship between p29 expression and the analyzed anatomoclinical variables was found. These results highlight this immunohistochemical method as an alternative to more complex and difficult biochemical thechniques. On the other hand the good results obtained in formalin fixed tissues allow retrospective studies in mammary carcinoma samples

Cancer de mama y citometría de flujo: estudio comparativo del patrón de ploidia de ADN con parámetros anatomoclínicos / Breast cancer and flow cytometry: comparative study of DNA ploidy pattern with anatomoclinical parameters

There is evidence that DNA quantization and histopathological classification of breast cancer may be useful for its therapeutic management. DNA flow cytometry clinical and anatomopathological features of 60 paraffin embedded primary breast cancer tissue samples were studied. The aneuploidy percentage was 67 per cent . There was a correlation between DNA index and degree of cellular pleomorphism, degree of diferentiation and the fraction of cells in S phases. Likewisw a correlation was found between the degree of cellular pleomorphism and the mitotic index. DNA cytophotometry was useful to solve cases of difficult diagnosis with flow between aneuploidy, percentage of cells in phase S, degree of cellular atypia and mitotic degree with clinical stage, degree of lymph node involvement, tumoral size or age. It is suggested that these variables may have an independent behavior