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A Picard

Publications and source records attributed to A Picard.

At least 19 recordsLinked to original sources
PubMed2004

[Vincristine treatment for function- and life-threatening infantile hemangioma].

AIM: To evaluate the efficacy of vincristine treatment for function- and life-threatening hemangiomas. PATIENTS AND METHOD: Nine infants, eight girls and one boy, received vincristine treatment (VCR) for endangering hemangiomas. In six cases, the hemangiomas involved head and neck in a segmental unilateral or bilateral distribution (3/6 also had laryngeal and 2/6 tracheal location causing respiratory distress, 5/6 had eyelid and orbital involvement); one infant had disseminated neonatal hemangiomatosis (skin, liver, kidney); two infants had liver hemangiomas with cardiac failure. VCR was prescribed after failure of high-dosage corticosteroid treatment in six, and of both corticosteroids and interferon alpha 2b (5 months) in one; two infants received VCR as first line treatment. RESULTS: A dosage of 1 mg/m(2) IV injection was delivered, with weekly injections first, and then tapering, increasing the interval between injections, depending on the clinical response. The nine infants received from 5 to 25 injections (average: 16), for a length of treatment of 1.5-8 months (average: 5.5 months). In seven patients a clear clinical response was observed at the end of the first month of treatment, while a slow protracted response was noted in two. Transient mild side effects were present in four patients. DISCUSSION: Corticosteroid treatment, although a worldwide recognized treatment of problematic hemangiomas, cannot always control the growth of alarming hemangiomas. Interferon alpha 2a and 2b have proven a 90% effectiveness: treatment for cortico-resistant, function- and life-threatening, hemangiomas.

Antineoplastic Agents, Phytogenic↗
PubMed2003

[Evaluation of an education program of patients undergoing oral anticoagulation treatment].

OBJECTIVE: To evaluate the therapeutic impact of an education program on patients undergoing oral anticoagulation treatment, within the hospital of Annecy (France). MATERIAL AND METHODS: Groups of 10 patients were invited to participate to two meetings. The education was carried out by two nurses. Thanks to this prospective study, we compare the population before and after education in terms of treatment knowledge and stability. RESULTS: Within 9 months 88 patients have been included, amongst which 55 have attended the two meetings. The average of correct answers to the knowledge evaluation questionnaire distributed before and after 6 months of education were, respectively, 6.63/12, 10.09/12 (P < 0.0001). Through INR controls within the 6 months preceding (424 controls) and the 6 months following the education (619 controls), we observe: an increase of the total INR average in therapeutic zone, from 45% to 61% (P < 0.0001); a decrease of the difference average per patient between the INR value observed and the one targeted: 0.54 before education, 0.40 after education (P = 0.0016); at last, the average phasing per patient under the therapeutic zone increases after education, from 49% to 65% (P < 0.001). CONCLUSION: The education improves objectively the knowledge of patient undergoing AVK. If the size of patient sample is not large enough to prove any consequence on hemorrhagic or thrombotic complications, the education program still improves significantly the treatment stability.

Acenocoumarol↗
PubMed2003

[Long-term usefulness of an information programme on practices in surgical antimicrobial prophylaxis].

INTRODUCTION: In France, numerous concordant studies show that there are some discrepancies between guidelines on surgical antibiotic prophylaxis and the current practice. In a previous study, conducted in April-June 2001, we found that the rate of appropriateness of surgical antimicrobial prophylaxis was approximately 40%. An information programme was implemented and the purpose of this paper was to present the short- and long-term usefulness of this campaign. METHODS: A total of 13 pairs of surgeons/anaesthetists participated in data collection during the three periods of the study. Prescriptions were observed in order to answer to five questions. Five variables describing practices concerning antibiotic prophylaxis in surgery were compared to national recommendations (updated in 1999): did the surgical procedure require antibiotic prophylaxis and was this carried out? Was the antibiotic used appropriate? Was the timing of the first injection optimal? Was the total duration of the treatment correct? Was the dose correct? RESULTS: The overall compliance with recommendations was significantly improved during the third period (P = 0.0002). This improvement was particularly marked for antimicrobial prophylaxis duration. CONCLUSION: It seems that sequential surveillance of antimicrobial prophylaxis, including numerous surgical teams, could considerably improve the practices, if it was associated to informations that allowed physicians to appropriate the procedures.

Antibiotic Prophylaxis↗
PubMed2003

[Uterine liposarcoma invading abdominal wall and inguinal region. Immediate reconstruction using a pedicled anterolateral thigh flap].

The anterolateral thigh flap is a particular flap of the vastus lateralis musculocutaneous flap (perforator flap). This flap was used as a pedicled flap to reconstruct the abdominal wall and to cover the inguinal region following the resection of a voluminous tumor of the womb invading the abdominal wall, the femoral vessels and the skin. The flap included a large facial paddle nourishing a skin island and a little muscle paddle including the perforator vessel. This medially positioned facial paddle allowed to increase the area of useful flap. So it was possible to reconstruct a 10x15 cm abdominal wall defect, and to cover the vascular decking in inguinal region with this only flap. In spite of the harvesting of a small muscular paddle of vastus lateralis (with conservation of the motor nerve) the function of thigh extension has been preserved. Besides the subtlety described to increase the "solid" surface of the fragment, it seems that the anterolateral thigh flap is perfectly useful to cover defects of soft tissues in inguinal region after vascular surgery, indication which was not reported to our knowledge in spite of the high frequency of these losses defects.

Abdominal Wall↗
PubMed2002

An endogenous hybrid mRNA encodes TWE-PRIL, a functional cell surface TWEAK-APRIL fusion protein.

TWEAK and APRIL are two recently identified tumour necrosis factor (TNF) ligand family members, implicated in angiogenesis and immune regulation, respectively. TWEAK is a transmembrane protein expressed on the cell surface, whereas APRIL acts solely as a secreted factor. In this report, using RACE, RT-PCR, cDNA library screening and an RNase protection assay, we characterize a hybrid transcript between TWEAK and APRIL mRNAs. The encoded TWE-PRIL protein is composed of TWEAK cytoplasmic and transmembrane domains fused to the APRIL C-terminal domain. TWE-PRIL mRNA is expressed and translated in human primary T cells and monocytes, and endogenous TWE-PRIL protein was detected in primary human T lymphocytes and monocytic cell lines. TWE-PRIL is membrane anchored and presents the APRIL receptor-binding domain at the cell surface. It is a biologically active ligand, as it stimulates cycling in T- and B-lymphoma cell lines. Much like membrane-bound and secreted TNF-alpha, the different cellular localizations of TWE-PRIL and APRIL suggest that they exert distinct biological roles.

Amino Acid Sequence↗
PubMed2002

[Angiomatous lips].

After defining vascular malformations and tumors, the authors approach specific problems of these lesions involving the lips. Careful planning and assessment are necessary throughout the clinical course and evolution. Therapeutic management concern the vascular anomaly but the functional, cosmetic and psychological repercussions as well. The rules of surgical treatment are discussed in this labial location. Capillary malformations can be treated by pulsed dye laser for the skin involvement, but sometimes by reconstructive surgery in case of soft tissue and bony overgrowth. Venous malformations require percutaneous sclerotherapy, partial or total removal surgery, reconstructive surgery, with or without previous embolization, according to the size and functional repercussions. Lymphatic malformations involving the lip are based upon conservative and observing treatment or surgery according to impairment and psychological impact. There is a strong tendency for these lymphatic microcystic malformations to invade and to recur after surgery. The new lasers (diode, Nd Yag) have to be assessed in this area. Arterio-venous malformations are the most severe anomaly. When the lesion is cosmetically and functionally acceptable, the authors propose conservative management waiting for therapeutic progress expected from genetics research. Otherwise management require embolization and complete surgical treatment with lip reconstruction. The first-line treatment of hemangiomas is medical and pharmacological (local medical care, corticosteroids, interferon, vincristine) but surgery may be indicated in three situations. In urgent cases with severe complications surgery is performed after failure of medical management. Early surgery is recommended to prevent functional or cosmetic disturbance or serious psychological distress. Ultrasound dissection (Dissectron) an significantly contribute to the surgical outcome. Late surgery retains its classical cosmetic and functional indications and techniques to treat the residual after-effects. Three key-words dominate the rules of therapeutic management of all types of vascular anomalies: multidisciplinary approach, experience and carefulness.

Arteriovenous Malformations↗
PubMed2002

[Evaluation of practices in surgical antimicrobial prophylaxis in the Franche-Comté before and after implementation of an information program].

OBJECTIVES: To assess the practices of surgical antimicrobial prophylaxis in the Franche-Comté region of France before and after the implementation of information program. STUDY DESIGN: Prospective multicenter transversal study type before/after. The information program included a feedback on the observed results during the period before and a meeting with opinion leaders. PATIENTS AND METHODS: Data were collected by 28 pairs of surgeons/anaesthetists. Prescriptions were analysed to answer five questions about antibiotic prophylaxis practices in surgery: did the surgical procedure require antibiotic prophylaxis and was this carried out? Was the appropriate antibiotic used? Was the timing of the first injection optimal? Was the total duration of the treatment correct? Was the dose correct? Our data were compared to national recommendations (updated in 1999). RESULTS: The overall frequency of conformity was about 40% both before and after the implementation of an information/awareness campaign. Only the conformity of the total duration of the prophylaxis was significantly higher after the action, but only for interventions that lasted less than two hours. [RR = 2.09 (1.32-3.31), p = 0.001]. This improvement in the total duration of regulation seemed to be related to the more frequent use of written protocols in the surgical units. CONCLUSION: Our study confirms that information campaign have little effect within the framework of the good use of antibiotics. We agree with the experts who claim that only an overall strategy including organization, education and restriction will really improve the frequency of conformity of the practices of surgical prophylaxis.

Anti-Bacterial Agents↗
PubMed2002

[Early surgery of immature hemangiomas with the aid of an ultrasonic scalpel. Apropos of 81 cases].

BACKGROUND: The natural course of immature hemangiomas in infants is well-known. A rapid phase of growth from 6 to 8 months is followed by a period of stability then regression. Since approximately 70% of these immature hemangiomas resolve spontaneously, abstention is generally the rule. The volume or localization of certain lesions may nevertheless have a serious functional or morphological impact. MATERIAL AND METHODS: This retrospective study included 81 children who underwent surgery between October 1994 and March 2000. The children were aged 2 to 38 months at the time of surgery. Orbital localizations predominated (33 children). The indication for surgery was based on two criteria: risk of a functional impairment or risk of morphological sequela. All children with orbital hemangiomas with a functional risk of amblyopia were initially treated with corticosteroids. Surgery was performed in case of failure. The CAVITRON was used for 77 children and DISSECTRON for 4. These two ultrasound devices allowed easy dissection with little hemorrhage. RESULTS: There were no peroperative hemorrhagic complications. Few postoperative complications were observed. After resection of the orbital hemangiomas there was little functional impact and the postoperative ophthalmologic examinations were normal within several weeks. Mean follow-up was 12 months after surgery. Use of an ultrasound dissector allowed early and safe treatment of immature hemangiomas. DISCUSSION: Certain voluminous or poorly localized hemangiomas, particularly on the face, can have a serious function, morphological or psychological impact. Medical treatment is not always active and surgical resection may be required before the development of definitive sequelae. Ultrasound dissection, not previously used in this indication, can contribute significantly to the surgical outcome as demonstrated in these children operated on early. This technique is safe and shortens operative time. In light of these results, we believe early resection of immature hemangiomas should be reevaluated. It should not be considered as a last resort but rather as a complementary treatment.

Age Factors↗
PubMed2002

[Anterolateral thigh free flap. Surgical technique].

The anterolateral thigh free flap is a cutaneous or fasciocutaneous flap vascularised by one or several perforating arteries arising from the descending branch of the lateral circonflex femoral artery. Venous drainage occurs via the perforators or a similar route to the deep femoral system or the femoral vein. This flap is commonly used in Asia (China, Japan) where for certain teams, it replaces the classical radial forearm flap or the rectus abdominis myocutaneous flap for the reconstruction of head and neck defects after tumor ablation. We briefly describe the anatomy and vascularization of this flap and present the harvesting technique as well as the properties of the flap.

China↗
PubMed2001

A new determination of G using two methods.

We present the results of a measurement of G made with a torsion-strip balance used in two substantially independent ways. The two results agree to within their respective uncertainties; the correlation coefficient of the two methods is -0.18. The result is G = 6.675 59(27)x10(-11) m(3) kg(-1) s(-2) with a standard uncertainty of 4.1 parts in 10(5). Our result is 2 parts in 10(4) higher than the recent result of Gundlach and Merkowitz.

Journal Article↗
PubMed2001

[Antibiotic prophylaxis and surgery. Prescription compliance in Franche-Comté with the national reference system].

AIM OF THE STUDY: To evaluate the practice of antibiotic prophylaxis for surgery in the Franche-Comté region of France. MATERIALS AND METHODS: A total of 36 surgical teams (72 pairs surgeons/anaesthesists) participated in data collection. Five variables describing practices concerning antibiotic prophylaxis for surgery were compared to national recommendations: did the surgical procedure require antibiotic prophylaxis and was it carried out? Was the antibiotic used appropriately? Was the timing of the first injection optimal? Was the total duration of the treatment correct? Was the dose correct? RESULTS: Among the 687 operations for which data were collected, 513 (74.7%) that corresponded to class 1 or 2 Altemeier operations for which the Société Française d'Anesthésie et Réanimation (SFAR) had drawn up recommendations were analysed in order to answer these questions. The overall frequency of conformity with the regulations was 40% for these 513 operations. Of the 156 patients who did not receive the recommended antibiotic, 133 (85.5%) received an antibiotic with an activity range wider than that of the recommended antibiotic. The duration of prophylaxis was longer than recommended in 80 (87.9%) out of the 91 patients for whom the duration of antibiotic prophylaxis did not respect the recommendations. CONCLUSIONS: This prospective surveillance showed that less than 50% of patients received an antibiotic prophylaxis that was conformed to the regulations. To ensure the efficiency of prophylaxis and to prevent deleterious effects, such as the emergence of antibiotic-resistant bacteria, the recommendations must be regularly respected. Frequent audits of practices should be carried out by the teams responsible for fighting nosocomial infections.

Adult↗
PubMed2001

Inhibition of the acute effects of angiotensin II by the receptor antagonist irbesartan in normotensive men.

Irbesartan (SR 47436, BMS 186295) is an imidazole derivative that specifically binds to the angiotensin type 1 receptor. The purpose of this study was to assess the inhibitory effect of irbesartan on the pressor action of exogenous angiotensin II in healthy subjects, to evaluate the dose dependency and duration of this inhibition, and to determine the effect of irbesartan on plasma components of the renin-angiotensin system. Forty-two healthy male volunteers maintained on ad libitum sodium intake were enrolled in a randomized, double-blind, placebo-controlled, parallel-design, dose-ranging study. On 2 study days 1 week apart, volunteers were given either a placebo or the active drug at one of the chosen doses (5, 25, 50, 75, 100, 150, or 300 mg). The pressor effects of an individually titrated test dose of exogenous angiotensin II as well as plasma levels of angiotensin II, active renin, aldosterone, and treatment drug were determined before and throughout the 24 h after drug administration. The inhibitory effect of irbesartan on the pressor response to angiotensin II was observed within 1 h after dosing, peaked between 2 and 4 h, and lasted more than 24 h for doses of 25 mg and more. The effect was clearly dose related. Two and 24 h after administration of irbesartan, 300 mg, the response of arterial blood pressure (systolic and diastolic) to a given dose of angiotensin II was reduced by approximately 100% and 60%, respectively. Plasma concentrations of angiotensin II and active renin increased markedly after irbesartan administration, whereas plasma concentrations of aldosterone decreased. No evidence was found that the high levels of circulating angiotensin II observed after irbesartan administration could override the inhibitory effect of irbesartan on any of the measured parameters up to 24 h after dose. In conclusion, irbesartan appears to be a well-tolerated, orally active, potent antagonist of the renin-angiotensin system in men.

Adult↗
PubMed2001

Evidence for a role of the (alpha)-tubulin C terminus in the regulation of cyclin B synthesis in developing oocytes.

Microinjected mAb YL1/2, an (alpha)-tubulin antibody specific for the tyrosinated form of the protein, blocks the cell cycle in developing oocytes. Here, we have investigated the mechanism involved in the mAb effect. Both developing starfish and Xenopus oocytes were injected with two different (alpha)-tubulin C terminus antibodies. The injected antibodies blocked cell entry into mitosis through specific inhibition of cyclin B synthesis. The antibody effect was independent of the presence or absence of polymerized microtubules and was mimicked by injected synthetic peptides corresponding to the tyrosinated (alpha)-tubulin C terminus, whereas peptides lacking the terminal tyrosine were ineffective. These results indicate that tyrosinated (alpha)-tubulin, or another protein sharing the same C-terminal epitope, is involved in specific regulation of cyclin B synthesis in developing oocytes.

Amino Acid Sequence↗
PubMed2001

[Development of the maxilla in patients with complete unilateral cleft palate surgically treated by a periosteal transplantation technic. A retrospective study of 15 surgical cases with an 18 year follow-up].

PURPOSE: The aim of this study was to assess retrospectively the long-term growth of the maxilla in subjects with unilateral total cleft treated initially with the tibial periosteal graft technique. PATIENTS AND METHODS: The study group included 15 patients with a mean 18 years follow-up (range 15-20 years). All patients had been operated on by the same surgeon. Only patients in stage DP3, one to two years after peak growth were retained for review. Delaire's architectural analysis was used to study anteroposterior and vertical growth of the maxilla. Transverse growth was studied with the Mars occlusal score. Bone generation induced by the periosteum was studied using the Björk Holmgren analysis. The quality of the palatine and nasal repair was studied using Pruzansky's criteria. RESULTS: Anteroposterior and vertical growth led to a normal maxilla in 53.3% of the cases and a moderate to severe retromaxilla (> 5 mm) in 46.7%. Complete symmetry was achieved for the nasal fossae in 20% of the cases and marked asymmetry was noted in 26%. The height of the nasal fossae was symmetrical in 60% of the cases with marked asymmetry in 26%. Mean production of alveolar bone reached 58% of the height of the alveolar bone filling. It was good in 46.6% of the cases, fair in 26.7% and weak in 26.7%. The occlusal score evidenced crossed occlusion in 33.3% of the cases for a hemisection and in 46.7% of the cases for an anterior section. Normal occlusion was achieved in 20%. The quality of palatine repair was found to be good with a normal mucosa in 86.7% of the cases. A fistula was present in 13.3%. CONCLUSION: The preoperative objectives of periosteal graft repair of unilateral complete clefts were achieved. This technique provides a closed scar-free palate. Nasal repair favored the development of an ample and functional airway. The periosteal graft produced bone in the anterior portion allowing a harmonious premaxillary region and stable nose support.

Adolescent↗
PubMed2001

[Early implant treatment of a child with anhidrotic ectodermal dysplasia. Apropos of a case].

The purpose of this article is to report the clinical course and follow-up of a child with ectodermal dysplasia who was treated with implants surgery very early. Different possibilities for prosthetic restoration in the anodontic child are reviewed. Tolerance was excellent. Good cover of the implant was achieved at four years. We propose early implantation reconstruction surgery for these exceptional cases. A prospective multicentric study of this condition would be useful.

Anodontia↗