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Biomedical subjects

B Chevallier

Publications and source records attributed to B Chevallier.

At least 127 records · Page 7Linked to original sources
PubMed1989

[An unusual echographic evolution of an adrenal hematoma in a newborn infant].

We report a case of adrenal hematoma whose ultrasound features ran an unusual course suggestive of a neuroblastoma. Surgical removal was finally performed at two months of age. We describe the unusual ultrasound features in this case and emphasize the value of ultrasonographic monitoring that is the only means for eliminating other diagnoses, particularly a neuroblastoma.

Adrenal Gland Diseases↗
PubMed1989

[Mitral valve prolapse and Willebrand disease. Study of 16 cases of Willebrand disease].

We studied mitral valve morphology and kinetics in 16 children aged 3 to 15 years with documented von Willebrand disease. Mitral valve prolapse was demonstrated in four cases (25%); this result is consistent with findings of similar studies in adults. This non-random association between mitral valve prolapse and von Willebrand disease, as well as embryologic evidence and reports of other conditions found in patients with von Willebrand disease, suggest that mesenchymal dysplasia is the underlying anomaly. Patients with von Willebrand disease and mitral valve prolapse may be at increased risk for cerebrovascular events.

Adolescent↗
PubMed1989

[Acute chorea revealing lupus erythematosus disseminatus].

A case of systemic lupus erythematosus (SLE) is reported in a 12 year-old girl who presented with chorea. This rare manifestation of SLE was previously recorded as a mode of presentation in half of the 51 reported cases. In view of the relative rarity of rheumatic fever in economically advanced countries, SLE should be entertained as a manifestation of chorea. The possible pathophysiologic mechanisms of this central nervous system involvement are discussed.

Child↗
PubMed1989

[What are the prognostic factors in operable breast cancer without histologic axillary lymph node invasiveness. Results of an uni- and multifactorial analysis].

Between October 1977 and December 1983, 379 consecutive patients have been treated for unilateral, non metastatic breast cancer, either with conservative (n = 205) or radical surgery (n = 174), with axillary dissection in all the cases. None of them had histologically proved lymph node involvement. Adjuvant radiotherapy was given in 268 cases. Estrogen receptor (ER) and progesterone receptor (PR) levels were measured on each tumor. Levels greater than 5 fmoles/mg cytosolic protein were considered as positive for both ER and PR. At 5 years, overall survival (OS) and disease-free survival (DFS) are respectively 88% and 79%. Unifactorial analysis using KAPLAN and MEIER estimates and Logrank test revealed that OS was significantly related to age, tumor size, histopathological grading, ER and PR. DFS was significantly related to the same factors. Menopausal status, number of intra mammary tumor foci, previous familial history of breast cancer were not significant. Multifactorial analysis revealed that DFS was significantly related to age (bad prognosis [bp]: less than or equal to 37 years old), tumor size, histopathological grading (bp: SBR = 3) and that OS was significantly related to tumor size and PR (bp: PR less than or equal to 5 fmoles/mg protein). A prognostic score was obtained which sampled our patients into 3 significantly different (P less than 0.0001) groups with high, intermediate and low risk of relapse. These results suggest that tumor size, histopathological grading and PR have their own prognostic weight in histologically node negative breast cancer. Grouping these factors together allows to define a high risk relapse group that could benefit from adjuvant treatment.

Actuarial Analysis↗
PubMed1989

[Late diagnosis of a bronchial fracture after thoracic injury].

We report a case of bronchial fracture diagnosed in a child who had sustained a chest injury two and a half months earlier. Immediately after the injury, clinical and roentgenographic findings usually suggest the diagnosis, which is then confirmed by fiberoptic endoscopy. Because latent forms are frequent (10%), fiberoptic bronchoscopy should be widely used in patients having sustained a motor vehicle accident responsible for a significant chest injury. A follow-up visit two months after the injury ensures prompt detection of secondary complications.

Adolescent↗
PubMed1988

[Human calcitonin in neoplastic hypercalcemia. Results of a prospective randomized trial].

Forty patients with hypercalcaemia (2.75 to 3.5 mmoles/l) due to bone metastases or to a neoplastic syndrome were treated with synthetic human calcitonin after previous hyperhydration. On entering the study, the patients were allocated at random to either an 0.5 mg dose or a 1 mg dose of the compound administered 6-hourly by the intravenous route. Calcemia was measured every 6 hours: if it became normal, treatment was discontinued 12 hours later, but if after 3 injections the blood calcium level had not been reduced by more than 0.4 mmoles/l, incremental doses of calcitonin were given. Synthetic human calcitonin reduced calcemia by more than 0.4 mmoles/l in 22 patients (group 1) and brought it down to normal value in 18 of these 8 hours on average after the first injection. A new rise in calcemia was observed in 12/18 cases 44 hours on average after treatment was discontinued. Reduction of calcemia by less than 0.4 mmoles/l was observed in 11 patients (group 2). Treatment was ineffective in 7 patients (group 3). There were no significant differences between the 3 groups in mean values and variances of the initial blood calcium levels. Whatever the initial dose of calcitonin, the therapeutic effect was obtained within the first 24 hours of treatment. In patients with incomplete results increasing the dosage did not result in a further reduction of calcemia. No hypocalcaemia was observed. This study confirms that synthetic human calcitonin has a normalizing effect on calcemia. This effect is not dose-dependent, and blood calcium levels rise again after treatment is discontinued.

Adult↗
PubMed1988

Prognostic value of estrogen and progesterone receptors in operable breast cancer. Results of a univariate and multivariate analysis.

From October 1977 to December 1983, estrogen receptor (ER) and progesterone receptor (PR) levels were measured in 645 tumors from women with primary, unilateral, nonmetastatic breast cancer. All of them were treated surgically. Some received adjuvant radiotherapy, adjuvant chemotherapy, or adjuvant hormonotherapy. A level of greater than 5 fmol/mg cytosolic protein was considered as positive for both ER and PR. Unifactorial analysis, using Kaplan and Meier estimates and the log-rank test, revealed that disease-free survival (DFS) and overall survival (SV) were both strongly related to age, tumor size, nodal status, nodal effraction, histopathologic grading (SBR), ER, and PR. Menopausal status and number of intramammary tumor foci were not significant. Multifactorial analysis, using Cox's model, revealed a strong relationship between SV and age (poor prognosis [pp]: less than or equal to 37 years old), menopausal status (pp: postmenopausal) tumor size, nodal status (pp: N+ greater than 3), nodal effraction, ER (pp: less than or equal to 5 fmol/mg), histopathologic grading (pp: SBR = 3), and PR (pp: less than or equal to 5 fmol/mg). Similarly, multifactorial analysis revealed a strong correlation between DFS and age, tumor size, nodal status, nodal effraction, histopathologic grading, and PR. A prognostic score taking into account these prognostic factors was calculated for DFS and SV. Analysis of this score allowed us to divide our patients into four significantly different (P less than 0.0001) groups with high, intermediate, and low risk of relapse. Our procedure was then validated using the sample test technique. These results show that both ER and PR have their own prognostic weight and should be considered, among other classic prognostic factors, when adjuvant therapies are indicated after surgical treatment of breast cancer.

Adult↗
PubMed1988

[Chemotherapy combining vindesine, thiotepa and methotrexate in metastatic breast cancer after failure of a combination containing anthracycline. Results of a prospective phase II trial].

Twenty-six patients with metastatic breast cancer where treated, after failure of a first line chemotherapy including an anthracycline, with a second line combination of vindesine, methotrexate and thiotepa. Overall tolerance of this treatment was good. There were one complete response and two partial responses. The authors conclude that this treatment has a marginal activity.

Adult↗
PubMed1988

[Prognostic value of estrogen and progesterone receptors in the operable breast cancer: results of a uni- and multifactorial analysis].

This study concerns 645 patients first treated with surgery for unilateral, non metastatic, invading breast cancer. Intratumoral estrogen receptor and progesterone level were determined in every case. Level greater than 5 fmoles/mg cytosolic protein was considered as positive for both receptors. Univariate analysis has pointed out a significant linkage between overall survival and the following factors: age, clinical size of the tumor, histopathological grading SBR, clinical and histological lymph node involvement, capsular tear, RO and RP status. Statistical significance of menopausal status is borderline. Number of tumor foci is not significant. Likewise, disease free survival was correlated to the same factors. Multivariate analysis (Cox), secondarily pointed out that overall survival was strongly related to age, size of the tumor, lymph node involvement, capsular tear, histopathological grading SBR, menopausal status and RP. Multivariate analysis of the disease free survival revealed that it was strongly related to age, tumor size, lymph node involvement, capsular tear, grading SBR and RP. An interaction has been pointed out between Ro and menopausal status: Ro greater than 5 fmoles/mg cytosolic protein carry its own prognostic weight (Cox) and lengthen overall survival only for post menopausal women. A prognostic score, taking into account all of these factors has been calculated for both overall survival and disease free survival, and enabled us to isolate 4 groups of patients with good, intermediate and bad prognosis. These 2 models have been validated on an independent group of patients according to the sample test procedure. This results indicate that hormonal receptors carry their own prognostic weight in operable breast cancer (only for postmenopausal women for RO), and should be taken into account when adjuvant therapies are indicated after surgical treatment for breast cancer, in association with other more usual prognostic factors.

Adult↗
PubMed1987

Inflammatory breast cancer. Determination of prognostic factors by univariate and multivariate analysis.

Between January 1977 and June 1983, 64 consecutive patients were treated for unilateral inflammatory nonmetastatic breast cancer. Our protocol included three or four courses of induction chemotherapy, then locoregional irradiation therapy with Co-60, followed by maintenance chemotherapy only if induction chemotherapy had proven effective. Eight patients with a residual tumor after radiotherapy underwent a modified radical mastectomy. Actuarial 3-year overall survival for the whole group was 38%, and the median disease-free survival time was 19 months. The effect of 17 factors on overall survival or disease-free survival was analyzed. With univariate analysis, eight factors were found to affect overall survival or disease-free survival: extent of initial erythema, size of initial edema, lymph node involvement, erythema present at the end of initial chemotherapy, erythema present at the end of radiotherapy, tumor size at the end of induction chemotherapy, residual breast tumor at the end of maintenance chemotherapy, and performance of a radical mastectomy. Age at diagnosis, menopausal status, type of chemotherapy, and date of appearance of inflammatory signs did not influence prognosis. Multivariate analysis using the Cox proportional hazard model isolated three bad prognosis factors: erythema involving the whole breast at initial diagnosis, erythema present at the end of initial chemotherapy, and lymph node involvement.

Actuarial Analysis↗