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Biomedical subjects

A Bazin

Publications and source records attributed to A Bazin.

41 records · Page 3Linked to original sources
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[Fractionated stereotactic radiotherapy: results in hypophyseal adenomas, acoustic neurinomas, and meningiomas of the cavernous sinus].

PURPOSE: In order to optimize cerebral benign tumor irradiation, fractionated stereotactic radiotherapy allows a focused-volume irradiation (2.1 cm3, 16 mm diameter) under standard fractionation conditions. Results of a retrospective and multicentric analysis are presented. PATIENTS AND METHODS: Fractionated stereotactic radiotherapy uses the ballistic principles of the radiosurgery: stereotactic localization, multi-beam irradiation, secondary collimation, three-dimensional dosimetry. Standard fractionation is possible with a re-locatable non-invasive stereotactic device. The technique has been used for treating pituitary adenomas (86 patients), acoustic neuromas (32 patients) and cavernous meningiomas (26 patients). RESULTS: 1) pituitary adenomas: cumulative tumoral objective-response rates (42 patients) were respectively 42%, 69% and 88% at 24, 48 and 60 months. The cumulative endocrinologic objective-response rates (32 patients) were respectively 53%, 75% and 85% at 24, 48 and 60 months. The cumulative risk of radio-induced hormonal deficiency varied from 18% (growth hormone [GH]) to 42% for TSH (thyroid stimulating hormone) at 48 months. No other complication was observed; 2) acoustic neuromas: 33 tumors, < 25 mm in diameter, were treated in 32 patients. Tumor control was observed in 29/33 tumors: 14 were stable, 15 decreased and three progressed. Useful hearing was maintained in 9/10 patients. Only three patients (9%) presented persistent complications; 3) cavernous meningioma: 17/19 clinical responses were noted, 20 tumoral stabilisations, one partial response and one progression (22 magnetic resonance imaging [MRI] evaluable patients). One unilateral radio-induced blindness was observed. CONCLUSION: For these benign tumors, the focused target volume obtained by the fractionated stereotactic radiotherapy seems to be better adapted to the treatment of limited benign tumors than standard radiotherapy. The use of standard fractionation reduces the risk of severe normal tissue damage, sometimes observed for radiosurgery and inherent in the use of single fraction.

Adenoma↗
PubMedDate not supplied

[Perceptions of quality in health sectors and impact on quality assurance].

According to the ordinances dated April, 24.1996, clinics and hospitals should launch an internal accreditation process. There are many organizations which are about to develop a quality improvement process in order to be prepared to such an evaluation. The success of such approach lies on the involvement of the members of the organization concerned. This survey intends to sort out the actors' perceptions of quality, in order to adapt the process development to the internal cultural context. The data collection was realized through thirty pre-oriented interviews with physicians, nurses, administrative managers and private consultants in charge of implementing the quality process in health structures. The recorded interviews were later on analyzed in order to determine meaningful categories of perceptions of quality. The analysis reveals that quality is perceived in different ways. Three categories of perception can be found: Quality related to "a mean to change the organization" Quality as a "tool to control and limit the expenses" Quality as a way "to improve the relationship with the patients". Administrative managers rather consider the quality process as an expense control tool, whereas physicians and consultants perceive it as a mean to change the organization. Nurses rather adopt the quality process as a way to improve the relationship with the patient. The understanding of how the quality concept is perceived by the different personnel categories helps to initiate appropriately the improvement quality process in services.

Accreditation↗