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Biomedical subjects

C Martin

Publications and source records attributed to C Martin.

At least 73 records · Page 4Linked to original sources
PubMed2003

[Paraneoplastic opsoclonus-myoclonus syndrome associated with small-cell lung cancer].

Opsoclonus-myoclonus syndrome was observed in a patient treated for small-cell lung cancer. Opsoclonus presented as anarchic involuntary eye movements associated with myoclonies of the limbs and trunk. Opsoclonus-myoclonus is exceptional and a specific expression among several paraneoplastic manifestations described in small-cell lung cancer. These manifestations develop late after diagnosis of cancer. Presence of anti-neuronal antibodies in the serum (inconstant) is a factor of very poor prognosis.

Aged↗
PubMed2003

[Advantage of virtual endoscopy in the evaluation of the ossicular chain].

PURPOSE: Our study consists of a comparison of traditional computed tomography (CT) data sets with 2 views of virtual endoscopy in the preoperative evaluation of various diseases of the middle ear. MATERIALS AND METHODS: We studied 59 patients, all sent for conductive hearing loss with normal eardrum who underwent a complete CT examination: axial helical acquisition and coronal incremental acquisition: virtual endoscopy with selection of two reproducible views: an external one of the auditory canal and a lower one of the hypotympanum. Reading was performed by 2 independent radiologists. All patients were subsequently operated by the same surgeon. Results were compared with surgical reports. RESULT: Virtual endoscopy is valuable for the evaluation of ossicular and prosthesis dislocations, morphological anomalies of the malleus, incus, and stapes superstructure. Nevertheless, standard axial and coronal CT images remain necessary as confirmed by the poor results of virtual endoscopy in cases of attic obstruction, cholesteatomas and otospongiosis. CONCLUSION: Virtual endoscopy is a valuable technique of the evaluation of some ossicular chain pathologies but it cannot be used alone.

Adolescent↗
PubMed2002

Ultrasharp magnetization steps in perovskite manganites.

We report a detailed study of steplike metamagnetic transitions in polycrystalline Pr0.5Ca0.5Mn0.95Co0.05O3. The steps have a sudden onset below a critical temperature, are extremely sharp (width <2x10(-4) T), and occur at critical fields which are linearly dependent on the absolute value of the cooling field in which the sample is prepared. Similar transitions are also observed at low temperature in non-Co doped manganites, including single crystal samples. These data show that the steps are an intrinsic property, qualitatively different from either previously observed higher temperature metamagnetic transitions in the manganites or metamagnetic transitions observed in other materials.

Journal Article↗
PubMed2002

Microphase separation in Pr0.67Ca0.33MnO3 by small-angle neutron scattering.

We have evidenced by small-angle neutron scattering at low temperature the coexistence of ferromagnetism (F) and antiferromagnetism (AF) in Pr0.67Ca0.33MnO3. The results are compared to those obtained in Pr0.80Ca0.20MnO3 and Pr0.63Ca0.37MnO3, which are F and AF, respectively. Quantitative analysis shows that the small-angle scattering is not due to a mesoscopic mixing but to a nanoscopic electronic and magnetic "red cabbage" structure, in which the ferromagnetic phase exists in the form of thin layers in the AF matrix (stripes or 2D "sheets").

Journal Article↗
PubMed2002

Optical pulsations from the anomalous X-ray pulsar 4U0142+61.

Anomalous X-ray pulsars (AXPs) differ from ordinary radio pulsars in that their X-ray luminosity is orders of magnitude greater than their rate of rotational energy loss, and so they require an additional energy source. One possibility is that AXPs are highly magnetized neuron stars or 'magnetars' having surface magnetic fields greater than 10(14) G. This would make them similar to the soft gamma-ray repeaters (SGRs), but alternative models that do not require extreme magnetic fields also exist. An optical counterpart to the AXP 4U0142+61 was recently discovered, consistent with emission from a magnetar, but also from a magnetized hot white dwarf, or an accreting isolated neutron star. Here we report the detection of optical pulsations from 4U0142+61. The pulsed fraction of optical light (27 per cent) is five to ten times greater than that of soft X-rays, from which we conclude that 4U0142+61 is a magnetar. Although this establishes a direct relationship between AXPs and the soft gamma-ray repeaters, the evolutionary connection between AXPs, SGRs and radio pulsars remains controversial.

Journal Article↗
PubMed2002

[Motives for the prescription of antibiotics in the emergency department of the University Hospital Center in Nice. A prospective study].

OBJECTIVES: Since April 1999, we have set-up an infectious disease consultation in the emergency unit of the University Hospital in Nice. Unjustified antiobiotherapy is often initiated. We therefore conducted a survey to study the motives and validity of antibiotic prescriptions. METHOD: This prospective study was conducted in two phases. The first consisted in asking the emergency physicians prescribing antibiotics to fill-in a questionnaire giving information on the diagnosis established and the antiobiotherapy proposed. In the second phase, the diagnoses and corresponding treatments were submitted to 4 experts who assessed the acceptability of the diagnoses and the antibiotics prescribed. The experts only had access to the clinical and para-clinical data available. Moreover, their therapeutic judgement was based on previously published consensuses. RESULTS: The 6-month survey collected 117 questionnaires that could be analysed. The rate of error in diagnosis was of 33% (39/117). Thoracic x-rays could not be interpreted in 11% of cases. In single variant analysis, factors of erroneous diagnosis were due to its interpretation by an internist, the diagnostic category of "broncho-pulmonary infections" and the lack of documentation. In multi variant analysis, only the lack of documentation was related to erroneous diagnosis (OR = 5.5; IC 95% (2.03; 15.30), p < 0.0002). The rate of antibiotherapy not adapted to the diagnosis made by the physician was of 32% (37/117). In 24 cases the modalities of the prescription were incorrect and in 13 cases the prescription was unjustified. Only the status of the prescriber (internist) was statistically associated with an antibiotherapy not adapted to the diagnosis (OR = 2.2; IC 95% (0.93; 5.26), p < 0.05). CONCLUSION: Unjustified antibiotherapy in an emergency unit is generally due to erroneous diagnosis of infection. The lack of documentation and inexperience of the prescribers appear to be the two elements contributing to unjustified antibiotherapy.

Anti-Bacterial Agents↗
PubMed2002

The combination of a heat and moisture exchanger and a Booster: a clinical and bacteriological evaluation over 96 h.

OBJECTIVE: To determine whether the combination with a new device (Booster ) for active humidification improves the efficacy of a hydrophobic heat and moisture exchanger (HME). DESIGN AND SETTING: Prospective, interventional study in the ICU of a university hospital. PATIENTS: Consecutive patients requiring controlled mechanical ventilation INTERVENTIONS: Patients were ventilated with a HME, and a Booster was added for 96 h to the ventilatory circuit. MEASUREMENTS AND RESULTS: During the inspiration phase the following factors were measured: peak and mean airway pressures, maximal (beginning of inspiration), minimal (end of inspiration), and mean values of temperature of inspired gases, and relative and absolute humidity of inspired gases. Microbiological samples were obtained from the Booster, the ventilator side of the HME, and the tracheal secretions on days 1 and 4. Minimal and mean temperatures were increased as soon as the Booster was used and this increase was maintained for 96 h until the Booster was withdrawn. Then the temperature returned to baseline values. Absolute humidity values followed the same course. There was also some indirect evidence of very little, if any, changes in the HME resistance. The ventilatory side of the HMEs remained sterile in each patient, and the Booster was colonized by the same bacteria as those in the tracheal secretions. CONCLUSIONS: Adding the Booster to a hydrophobic HME improved the heat and water preservation of ventilatory gas.

Bacteria↗
PubMed2002

A French study of the Dominic Interactive.

INTRODUCTION: The Dominic Interactive was developed in North America to assess a child's perception of her/his own symptoms, which is critical to balance parents' and school professionals' perception. It is a computerized, DSM-IV-based pictorial questionnaire akin to a video game, for children aged 6-11. A strengths and competencies scale displays positive situations. Most children complete the Dominic Interactive 90 situations within 10-15 min. OBJECTIVE: Because of the cultural differences between North American and French children, a study of the appropriateness of the instrument to assess French children was required. METHODS: The CD-ROM-based Dominic Interactive was completed by 253 community children, and by 150 children from outpatient clinics in four French cities. The latter also received clinical diagnoses. Prevalence estimates yielded by the Dominic Interactive in the general population and referred children, relationships between prevalence estimates based on the Dominic Interactive and clinical judgments, and differences between Dominic Interactive scores in sub-samples of children with and without a clinical diagnosis were studied. RESULTS: Significant differences between clinically referred and non-referred children were found for every diagnosis, and between Dominic Interactive scores of referred children with and without a clinical diagnosis with the exception of oppositional disorder. Parental acceptability of the instrument was never a problem, children like it, and clinicians' comments were positive. DISCUSSION: Reference and clinical judgment both indicate that the Dominic Interactive is appropriate to assess child mental health in France. Clinical judgment discrepancies between sites and small numbers are the limitations of this study. CONCLUSION: The instrument performed well in the French context. The potential advantages of using the Dominic Interactive (children enjoy the activity, parents approve of it, it is relatively cost-effective, etc.) suggest its applicability in other settings.

Child↗
PubMed2002

High duplication of the internal jugular vein: clinical incidence in the adult and surgical consequences, a report of three clinical cases.

Duplication of the internal jugular vein (IJV) is a rare malformation. Three intraoperative cases are reported. In our personal experience, the clinical incidence of the anomaly is approximately 4 per 1,000 unilateral neck dissections. The venous duplication is at a variable height, affecting the superior part of the IJV. The lateral branch of the accessory nerve (XI) always passes medially to the anterior vein and laterally to the posterior vein, between the venous duplication. This is most often unilateral but sometimes bilateral. The IJV may be normal, dilated or ectatic. The discovery of this anatomical variation has practical implications during cervical lymph node clearance, either functional or radical, during oncological surgery necessitating viewing the IJV and its affluents and the lateral branch of the accessory nerve. The embryological explanation suggests a topographical "conflict" between the development of the IJV and the lateral branch of the accessory nerve. The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer LINK server located at http://dx.doi.org/10.1007/s00276-002-0020-y.

Aged↗
PubMed2002

[Arnold-Chiari II malformation and basilar impression. Report of one case (a literature review)].

OBJECTIVE: To tell the rare association of Arnold-Chiari II malformation and basilar impression and to describe an exceptional clinical state with a particular surgical approach. MATERIALS AND METHODS: To analyse a case of a patient suffering from this congenital malformation, her progressive clinical state, the surgical approach. RESULTS: N.G. a 42-year-old woman, suffers from a cerebello-spino-medullar disturbance responsible for a major dependence and respiratory insufficiency with a risk of death. The results of the surgical treatment meant to decompress the craniovertebral junction are exceptional. DISCUSSION: The analysis of the literature show the special feature of this case as much for the rarity of the diagnosis as for the progressive clinical state and the remarkable post operative result. CONCLUSION: The association of these two malformations is seldom alluded to in the literature and such a post operative result has apparently never been described. In addition, this case tends to prove that a second operation's worth considering if the first has shown its short-fall whichever the patient's clinical state.

Adult↗
PubMed2002

[Strategies diagnosis of polytraumatized adult patients with coma].

OBJECTIVE: To review the diagnostic strategy of management of multiple trauma patient during the first hours. DATA SOURCES: Extraction from Pubmed database of French and English articles on the management of multiple trauma patient published for ten years. DATA SELECTION: The collected articles were reviewed and selected according to their quality and originality. The more recent data were selected. DATA SYNTHESIS: The first hours of management of multiple trauma patients are a particular challenge. The first dilemma is to drive the patient toward an adequate structure. In case of poor haemodynamic tolerance, the patient will be drive in the nearest hospital. When haemodynamic parameters are restored, multiple trauma patient has to be receive in a high level hospital by a trained medical team with an anesthesiologist, intensivist, neurosurgeon, general surgeon and radiologist. The initial assessment may have two priorities: quality and speed. The total body CT scan is actually the answer to these priorities.

Coma↗
PubMed2002

[Antibiotic combinations in Staphylococcus aureus infections: arguments against].

In a case of severe infection due to Staphylococcus aureus, generally accepted practice involves the use of a combination of antibiotics. This article examines the type and quality of the experimental and clinical data which has been collected in this context. Published findings suggest that the arguments in favour of combinations are usually theoretical, and that a demonstration of the superiority of combinations has never been made by comparative, randomised studies.

Anti-Bacterial Agents↗
PubMed2002

Patient preference and pharmacokinetics of oral modulated UFT versus intravenous fluorouracil and leucovorin: a randomised crossover trial in advanced colorectal cancer.

The aim of this study was to determine the patient's preference for oral UFT/leucovorin (LV) or intravenous (i.v.) 5-fluorouracil (5-FU)/LV chemotherapy in metastatic colorectal cancer and to compare 5-FU exposure with these two treatment options. A total of 37 previously untreated patients with advanced colorectal cancer were randomised to start treatment with either oral UFT 300 mg/m2/day plus oral LV 90 mg/day for 28 days every 5 weeks or i.v. 5-FU 425 mg/m2/day plus LV 20 mg/m2/day for 5 days every 4 weeks. For the second treatment cycle, patients were crossed-over to the alternative treatment regimen. Prior to the first and after the second therapy cycle, patients were required to complete a therapy preference questionnaire (TPQ). The pharmacokinetics of 5-FU were determined by taking blood samples on days 8, 15 or 22 and 28 for UFT and on days 1 and 5 for i.v. 5-FU. 36 patients were eligible. 84% of the patients preferred oral UFT over i.v. 5-FU. After having experienced both treatment modalities, patients indicated taking the medication at home, less stomatitis and diarrhoea, and pill over injection as the most important reasons for their preference. The area under the plasma concentration curve (AUC) for 5-FU after UFT administration was 113 microM x min on day 8, 114 on day 15 and 98 on day 28; the peak levels (Cmax) were 1.2, 1.3 and 1.0 microM, respectively. The AUC for the 5-FU/LV courses was 3083 microM x min for day 1 and 3809 for day 5 (P=0.002). The Cmax was 170.1 and 196.2 microM (P=0.06) and the clearance 2.6 and 1.9 l/min, respectively (P=0.002). Patients with metastatic colorectal cancer clearly preferred oral over i.v. chemotherapy treatment. This choice was most importantly influenced by convenience and toxicity considerations. Although i.v. bolus 5-FU leads to higher peak 5-FU concentrations and AUC values compared with oral UFT, this pharmacokinetic advantage of i.v. 5-FU seems to translate mainly into higher toxicity as seen in large randomised studies comparing oral UFT/LV with i.v. 5-FU/LV. Oral UFT/LV compares favourably with i.v. 5-FU/LV in terms of toxicity and patient's preference and leads to prolonged 5-FU exposure, which is comparable to continuous i.v. 5-FU treatment.

Adenocarcinoma↗
PubMed2002

Developmental trajectories of adolescents' depressive symptoms: predictors of change.

In a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolescent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined.

Adolescent↗