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Biomedical subjects

A Fabre

Publications and source records attributed to A Fabre.

At least 55 records · Page 3Linked to original sources

[Chemotherapy at home. A new methodology].

Evolution in concepts relative to administration of cytotoxic drugs has reinforced interest in the use of continuous infusion therapy, a method providing a twofold increase in upper respiratory and digestive tract cancer response. A new method, developed by the authors since early 1985 allows the use of chemotherapy over 5 to 10 days in the patient's home. Preliminary results show an increase in efficacy of the therapy, and a marked improvement in the patient's comfort, suggesting that the indications for this new method should be enlarged.

Antineoplastic Combined Chemotherapy Protocols↗

[Epitheliomas of the piriform sinus. Therapeutic orientation. Apropos of 642 patients].

On the basis of 642 patients treated and followed up since 1961 at Laennec Hospital, the authors compare the results of radiotherapy, of surgery and of surgery with subsequent radiotherapy. Surgery followed by radiotherapy gives the best 3 and 5 year survival rates and the lowest local and lymph node recurrence rates. The introduction since 1970 of induction chemotherapy shows an improvement in local prognosis and 5 year survival. There has been a more marked improvement since the introduction of cisplatinum and the use of continuous infusions of cisplatinum and of fluoro-5-uracil with or without bleomycin.

Adult↗

[Laryngeal lesions after prolonged intubation. Anatomo-pathologic study].

Laryngeal lesions produced during prolonged intubation were studied in 11 larynxes from consecutive patients dying during intensive care. A constant finding was ulceration of the vocal process, combined in 7 cases with inter- or pre-arytenoidal subglottic ulcerations. Histology failed to reveal signs of lesions of the cricoarytenoid joint or chondritis of the posterior arch of the cricoid cartilage.

Adult↗

[Epidemiology of postoperative infections in cervicofacial surgery].

Post-operative infections are studied about 150 patients distributed in five groups according to type of surgery (total pharyngolaryngectomy, hemilaryngectomy, bucco-pharyngectomy, cordectomy, cervicotomy). An antibiotic prophylaxis by penicillin G and metronidazole was prescribed for all groups excepted the last. Only sixteen patients (seven of whom in bucco-pharyngectomy group) developed a local infection, therefore these antibiotics are indicated until mucosa cicatrisation. Systematic bacteriologic study of cervical drains is useless because they are frequently positive with non-pathogenic germs and in case of local infection the responsible germ is different of the germ obtained by culture of drain.

Anti-Bacterial Agents↗

[Urban and rural malaria in Niger. The case of the Department of Maradi].

In Niger, two communities, a urban one (Maradi) and a rural one (Tarna), living in a same malarious Soudano-Sahelian climatic area, were compared during wet and dry seasons by different methods (spleen rate, parasite rate, parasite count, level of immunity). During wet and dry season, spleen rates (0.7% and 2.6%) and parasite rates (1% and 1.6%) are considerably lower at Maradi than those observed at Tarna (spleen rates: 38% and 42%; parasites rates: 10% and 22.5%). It is shown that seroconversion occurs later in urban sector (100% between 20 and 29 year age) than in rural sector (100% between 10 and 15 year age). All malarious indicators were negative in a high percentage of Maradi-born children under 9 (79% during wet season and 81% during dry season) against respectively 28% and 31% at Tarna. Better paludometric index in urban community is a favourable sanitary indication. But epidemiological control must be prosecuted since the number of non-immune subjects is increased.

Adolescent↗

[Approaches to the infra-spleno-temporal fossa and the lateral wall of the nasopharynx].

The authors suggest replacement of the term "infra-temporal fossa" (indicating in the international anatomical nomenclature the pterygo-maxillary fossa) by the term "infra-spheno-temporal fossa" which would seem anatomically more appropriat. In the context of an operation performed in this region for a recurrence of a nasopharyngeal angiofibroma, a review and anatomical study of the different approaches has been undertaken and a classification established. The antero-inferior approach via the cervico-trans-oral route would seem to be of particular interest, offering good exposure of the anatomical features of the region and avoiding the parotid bed ans dissection of the facial nerve.

Adolescent↗

[Early diffuse hypertrophic osteitis recurrence. Unexpected and consternating development after a large évidement cavity. Apropos of 15 cases].

The authors report 15 cases collected over a period of 13 years (1972 - 1984) of a particularly serious eventuality affecting certain evacuation cavities: Early recurrence of diffuse hypertrophic osteitis (E.R.D.H.O.). This is a rare complication, occurring in 1.5% of cases of chronic otitis. However, the fact of having operated upon 7 cases in 1984 alone, whilst during the previous 12 years, only 8 had been seen, raised the alarm. The classical pattern of this complication occurs in 3 stages, each involving surgical operation: at the outset, chronic otitis with cholesteatoma or osteitis, most often mixed, for which an "inadequate" surgical procedure is performed. then, after a variable period which may exceed 10 years, a very large evacuation cavity was created by the authors. finally, 3rd and final stage: within 6 months, this cavity filled progressively and, at operation, the authors discovered a cavity virtually completely filled with a "fantastic" "moist sugar" osteitis, requiring a new evacuation cavity, even larger than that created before. In all cases, a successful result was obtained within a varying period, sometimes accompanied by spectacular improvement in general condition. The most plausible etiopathogenic hypothesis advanced to attempt to explain this phenomenon is that of secondary infection by a varied microbial flora, including, on the one hand, aerobic organisms usually discovered in such cases (pseudomonas pyocyaneus, proteus mirabilis) and, secondly, this being of essential importance, "anaerobic" bacteria, the bacteriological diagnosis of which requires application of a strict protocol. The authors have taken three decisions following their bibliographic investigations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Osteomatous chronic otitis. 27 new cases. 2 new forms].

The authors report 27 new cases of osteomatous chronic otitis, with (15) or without (12) cholesteatomas, with perforated (13) or intact (14) drum, the latter sometimes having a very atypical appearance (2), frankly purulent or simply inflammatory. This results in a wide range of clinical appearances. There are two macroscopic forms: the diffuse attico-antral form and localized forms (drum - C.S.C.L.). The authors emphasize: the primordial interest of tomography (or CT scan), the keystone of their discovery, as well as the dangers of their surgical treatment. In addition to review of these known concepts, two forms have been identified: 1) Osteomatous attico-chain monoblock, where the ossicles of the ear are adherent in their entirety, either to the external attical wall or, much more rarely, to the medial attical wall. They describe 13 cases, the pattern of which is very different, according to whether the diagnosis is one of cholesteatomatous chronic otitis or not. In the absence of cholesteatoma (8 cases), the clinical picture is suggestive of otospongiosis or of chronic otitis with intact drum. The surgical procedure is related to these findings: 1 completion of myringoplasty, 7 piston-malleus. In cases of cholesteatomatous chronic otitis (5 cases), the picture is completely different, the cholesteatoma developing at leisure, behind the impenetrable osteomatous shield. Once again, the surgical procedure is modified: 4 vast evacuation cavities and one mastoatticotomy for giant cholesteatoma with intact drum. 2) Diffuse and "progressive" osteomatous stenosis of the walls of the E.A.M. The authors describe 6 cases occurring either during cholesteatomatous chronic otitis, or within a few weeks, simulating chronic otitis with intact drum.

Adolescent↗

[Rare diseases of the ear: fibrous dysplasia of the tympanic bone, extensive papillomatosis, ceruminoma, aspergilloma, spontaneous évidement of the tympanic bone].

The authors report six cases of rare ear diseases: fibrous dysplasia of the tympanum mimicking an partially obstructive osteoma of the external auditory canal. The authors draw a parallel between the rarity of these monostotic forms of the temporal bone which are strictly localised to a single region (tympanum-mastoid-atrium) and the diffuse forms which involve several regions at the same time; extensive papillomatosis of the external and middle ear, a rare condition with serious repercussions; two ceruminomas with very different clinical presentations and outcomes; an atrial pseudo-tumoral aspergilloma which was easily excised ans repaired with a myringoplasty with a good long term result; hypoplasia of the tympanum, which constituted a spontaneous évidement, discovered at operation for an attic cholesteatoma. This finding was sufficiently unusual to warrant reporting.

Adenocarcinoma↗

[Approach to the pterygomaxillary region by the Lefort I osteotomy].

Approach to the pterygomaxillary fossa under the base of skull, a difficult operation, has been facilitated by the use of a technique derived from the Lefort I osteotomy. Satisfactory access to the fossa and to the posterior-base region is obtained and esthetic or functional sequelae avoided.

Arteriovenous Malformations↗

[Cancer of the mobile tongue. Therapeutic development and results].

The authors analyse the results of treatment of 84 squamous cell carcinomas of the mobile portion of the tongue treated between 1961 and 1982. 64% of the patients treated were Stage I or II. The local recurrence rate was 13% at 5 years (6/43) for T1, T2. Recurrences were more frequent after interstitial radium therapy (17% at 5 years: 5/28) than after partial glossectomy performed at the outset (6.6% : 1.15). The treatment of stage NO remains controversial. The frequency of lymph node recurrences remains proportional to lymph node involvement by histology (NO, N-: no recurrences; NO, N+: 18.1%: 6/33) but seemed to be independent of the initial treatment of the regional nodes: no treatment, neck dissection with or without subsequent external radiotherapy. It is important to emphasize that lymph node recurrences contralateral to the tumour always occurred in the presence of initial homolateral lymphadenopathy with capsular rupture. Other oncological failures were frequent (35% : 20/56) at 5 years, grouping together visceral metastases (14.3% : 8/56) and second primary cancers in the upper respiratory/digestive tract (21.4% : 12/56).

Adult↗