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Biomedical subjects

C Christides

Publications and source records attributed to C Christides.

At least 37 records · Page 2Linked to original sources

Coronary artery damage during mitral valve replacement.

An anatomic study of 15 hearts has assessed the existing correlations between the mitral annulus and coronary arteries. The circumflex artery is sometimes located very close to the mitral annulus, as close as one millimetre, hence there is a risk of injury during mitral valvular replacement. This risk is especially when coronaries have a prevailing left anatomic position or a balanced coronary system.

Cadaver↗

[Prognostic effect of diverse surgical parameters in significant stenoses of the left coronary trunk. Retrospective study of 185 cases].

A retrospective study of 185 cases of left main coronary artery stenosis operated between 1980-01-01 and 1991-06-15 at the Limoges University Hospital Center was performed. The influence of operative procedures: cardiopulmonary bypass and aortic cross clamping times, type and number of coronary grafts, time between coronary surgery and coronary angiography, on early (before the 30th days after surgery) and late postoperative vital prognosis was studied. This study confirms in our study the poor early postoperative prognosis of: 1) cardiopulmonary bypass time over 140 min; 2) coronary bypasses in an emergency context (surgery less than 24 h after coronary angiography); 3) incomplete coronary revascularization. The nature of grafts and the aortic cross clamping time have no influence. The actuarial survival studies confirm the poor long-term postoperative prognosis of incomplete coronary revascularization; the other surgical procedures have no influence.

Adult↗

Clinical screening for narcolepsy/cataplexy in patients with fibromyalgia.

We report two cases of fibromyalgia occurring during the course of a long-standing narcolepsy/cataplexy. This association is probably not fortuitous and we propose an easy clinical procedure to search for narcolepsy/cataplexy in these patients. Narcolepsy/cataplexy is a treatable condition requiring drugs that in turn may improve in the long-term symptoms of fibromyalgia.

Aged↗

[The causes of intracranial hemorrhagic complications induced by antivitamins K].

Cerebral haemorrhage is the main life-threatening complication of oral anticoagulant therapy. In order to identify a means of prevention, the authors undertook a retrospective study of 68 consecutive cases of anticoagulant-related intracerebral haemorrhage. The mortality was 38.5%. The respective frequency of intracerebral haemorrhage, subarachnoid haemorrhage, acute and chronic subdural haematomas was 63.2, 16.2, 10.3 and 10.3%, respectively. On admission, nearly half the patients (53%) had prothrombin ratios inferior to 25%. A predisposing factor was found in 58% of cases: hypertension (30.6%), head injury (14.5%), alcoholism or drug interaction (11.2%), and one case of intracerebral aneurysm. A history of a transient ischaemic attack or of a cerebrovascular accident was found in 10.2% of cases and 11.7% had a previous anticoagulant related extracranial haemorrhage. The initial indications for oral anticoagulation were ischaemic heart disease (32%), atrial fibrillation (20.5%), secondary prevention of venous thromboembolic disease (17.6%) and primary prevention of venous thrombosis (11.7%). The duration of treatment for isolated ischaemic heart disease was over 6 months in all cases: the average duration of treatment was 12.4 months in phlebitis and pulmonary embolism. A critical review of the indications of treatment in the light of recent recommendations showed that if inappropriate indications were rare, the sometimes unnecessary prolongation of treatment was more common. Nearly half of these cases were receiving anticoagulants when the potential benefits were questionable at the time of the haemorrhagic complication. Clinical and biological follow-up is necessary for patients on anticoagulants; minor bleeding complications may be the prelude to major haemorrhage. Biological follow-up is based on control of the international normalised ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Hydroxycoumarins↗

[Popliteal venous aneurysm. Apropos of 2 cases].

The authors report two cases of primary popliteal venous aneurysm. This condition is rare. The lesion may be clinically asymptomatic and may remain unrecognised since it is discovered most often during the investigation of thrombo-embolic complications. The diagnosis is based upon ultrasonography and phlebography. Asymptomatic forms should merely be monitored. Apart from anticoagulants, the treatment of symptomatic forms is surgical. Methods remain controversial.

Aged↗

[Isolated iliac aneurysms. Sixty-seven cases in forty-eight patients].

77 pure iliac aneurysms where detected in a group of 48 patients along a period of 21 years, and represented 12.3% of all patients having aortic, iliac, or aorto-iliac aneurysms. The study group comprised 42 men and 6 women, 48-86 years old (mean 67.8 years). The aneurysm was located on the right side in 51.9%, on left side in 48.1%. The affection of the common iliac arteries (70.1%) was more frequent than it was on the internal iliac arteries (18.2%), or in the external iliac arteries (11.7%). The diameter was from 2 to 10 cms. 44 patients out of 48 (91.6%) where symptomatic, and 15 presented a rupture syndrome (31.3%). 10 patients (20.8%) had a pulsating mass. The etiology was unknown in 8 cases (16.7%); 2 patients had a mycotic aneurysm (4.2%). The remaining 38 patients (79.1%) had an aneurysm of atheromatous origin. 5 arteritic patients (10.4%) did not have any cure for their aneurysm, because it was considered threatening for 4 of them. The fifth patient was not treated because the artery was so calcified that it could not be clamped. A lumbar sympathectomy on the same side of the lesion was realised, in addition to the peripheral surgical act for arteritis. One patient had an endoaneurysmorrhaphy, another had an exclusion by ligature section of the aneurysm. For the remaining 41 patients (83.1%) the aneurysms where flattened, and vascular continuity was re-established by a prosthesis. 7 patients (12%) decreased post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Listeria monocytogenes femoral aneurysm].

Secondary infection of arterial aneurysms being a constantly possible complication, the bacteriological examination of peroperative specimens appears to be appropriate. Among responsible organisms, the presence of Listeria monocytogenes is very rare since only 13 cases have been reported in the literature. It is for this reason that it was felt to be of interest to report a new, entirely similar case of femoral aneurysm.

Aged↗

[Cannonball pulmonary hamartochondroma. Apropos of a case--review of the literature].

Chondroid hamartomas disseminated in both lung fields were discovered in a 76 year old man presenting with recurrent haemoptysis. In view of this metastatic cannonball appearance and the negative investigations, exploratory thoracotomy was performed, revealing the correct diagnosis. Although classical, this form of hamartoma is rare and warrants a case report.

Aged↗

[Bacterial endocarditis complicated by popliteal and mesenteric aneurysms].

The authors report about one case of bacterial endocarditis complicated by fungal aneurysms in a superior mesenteric and a popliteal site. While the diagnosis was easy for the popliteal aneurysm, it was not so for the mesenteric aneurysm. Arteriography must have wide indications. The treatment of such aneurysms must always be medical, but surgical as well. The surgical tactics must be carefully discussed, and the restoration of vascular continuity with autologous venous material through an extra-anatomic course should be preferred.

Adult↗

[Necrotizing fasciitis: a medical and surgical emergency. Apropos of a case].

We report about a 66-years-old obese and diabetic female patient, treated with anti-inflammatories for osteoarthritis of the hip and operated for varices of the lower limbs by a bilateral stripping of the internal saphenous veins, who presented with a mortal necrotizing fasciitis during the postoperative period. Necrotizing fasciitis is a severe, infrequent disease jeopardizing the vital prognosis, in which an appropriate and early treatment (medical, using antibiotics, and surgical by extensive debridement) can prevent a fatal outcome. The most often involved germs are streptococci (45%). The association of anaerobic and aerobic germs sometimes causes mixed cellulitis. The vital prognosis is always threatened by postoperative fasciitis. The mortality rate ranges from 50 to 75%, the main causes of death being a septic shock or pulmonary embolism. The functional prognosis of the surviving patients depends on the extent and quality of surgery.

Aged↗