Biomedical subjects
Publications and source records attributed to C Mercier.
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BACKGROUND AND OBJECTIVES: The effectiveness of EMLA eutectic mixture of local anesthetics, (ASTRA Co, France) cream in minor surgery on the penis and its acceptability in unpremedicated outpatients were assessed. METHODS: EMLA cream was applied 1 hour before surgery (fremulum plasty, circumcision or dorsal section for phimosis, and condyloma accuminatum) in addition to a subcutaneous infiltration of lidocaine 1%, just before incision in cases of circumcision. Verbal Rating Scale (VSR) was assessed during the surgery and the acceptance 15 days later by a questionnaire. RESULTS: Thirty-two patients included. In all of the cases, the application of EMLA cream was sufficient, with the exception of one (fremulum plasty). General anesthesia was used for this patient unable to tolerate the proprioceptive sensations (VRS = 0). In cases of circumcision, the subcutaneous infiltration was not experienced as painful. Eighty-eight percent of patients who answered the questionnaire confirmed that if they had to be reoperated on, they would opt for this technique of anesthesia. CONCLUSION: EMLA cream is effective in minor penile surgery in adult patients, and it is associated with subcutaneous infiltration of local anesthetic in the case of circumcision.
We report a case of primary diffuse leptomeningeal gliomatosis documented by MR. The radiological findings guided the surgical biopsy toward the area involved. Pathological examination confirmed the diagnosis. The patient could consequently benefit from treatment, i.e., radiation therapy, which was followed by clinical relief.
To realize significant and sustained improvement in quality and in overall performance, hospitals must have the support and participation of the medical staff. Although it sometimes is difficult to recruit busy physicians to join the effort, they will become champions if their experience is productive and results in improved patient care. This article outlines a number of straightforward approaches that will help healthcare quality professionals obtain physician involvement in the improvement effort.
Prostacyclin (PGI2) and prostaglandin E2 (PGE2) production was investigated in human aortas (five controls and 27 with atherosclerotic lesions). The specific activities of PGI2 and PGE2 synthetase were studied using radioimmunoassays of PGE2 and 6-keto-PGE1 alpha of aortic microsomes incubated in the presence of additional substrate and cofactors. The atherosclerotic lesions were examined under the light microscope and were classified as Stage 1 when the disease was restricted to the intima and as Stages 2 and 3 when there were moderate or advanced lesions. Prostaglandin production for the control group (n = 5), Stage 1 (n = 7), Stage 2 (n = 10), and Stage 3 (n = 10) were as follows: 454 +/- 15, 162 +/- 81, 92 +/- 90, and 65 +/- 61 pmol 6-K-PGF1 alpha/50 mg protein/10 minutes; and 15 +/- 12, 399 +/- 406, 227 +/- 174, and 366 +/- 362 pmol PGE2/50 mg protein/10 minutes (mean +/- SD) respectively. We conclude that: 1) In normal aortas, PGE2 production was low, while PGI2 synthesis activity was elevated. The reverse situation was observed in aortas with atherosclerosis lesions (p less than 0.05). 2) There was an inverse relationship between PGE2 and PGI1 production (p less than 0.05). 3) There was a direct histologic relationship between lower PGI2 production and atherosclerosis progression. A decided decline in 6-K-PGF1 alpha production was detected in aortas in the early stages (65% of control values). 4) By contrast, a progressive increase in PGE2 production was found in Stage 2 and Stage 3 groups (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Sharps injuries are the primary route through which health care workers acquire blood-borne diseases occupationally (Lynch et al, 1992). In order to reduce the incidence of such injuries effectively within a hospital, it is vital to first ascertain the frequency and types of injuries and then implement a risk-reduction programme based on the specific problems identified.
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The records of 850 children hospitalized during a 10 years period (1965--1975) in the surgical pediatric unit shows: --A greater frequency of male over female children in all age groups of the study (64.4 p. 100). --A predominance of the 1--3 year age group over the other age group (46.3 p. 100). --A greater frequency of male over female children in all age groups of the scaldings were predominant (55.9. 100), flameburns (11.7 p. 100). Most burn accidents occurred at meal-time and during week-end and holidays. According to the burned area was as follows: 5 p. 100 = 214 cases; 5 a 10 p. 100 = 340 cases; 10 a 25 p. 100 = 142 cases; exceeding 15 p. 100 = 102 cases. 283 children had suffered some complications. Infection was most prevalent. The frequency of gastro-intestinal was lessened by continuous feeding and systematic sulpiride prescription (12 gastro-intestinal hemorragie). Of the 26 fatalities (2.7 p. 100 of hospitalized children) infection was listed as the cause of death for 14 cases. For 10 of them no cause was definitevely elicited. All (26 children) were burned over 25 p. 100, 15 area exceeding 40 p. 100. Mean of hospitalisation times was 30.8 days (63.6 days for burns exceeding 25 p. 100 area). Result in 392 children followed up burns shows high disability: 11.2 p. 100 functional disabilities and 27.7 p. 100 esthetic disabilities which are being treated by plastic surgery.
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Appropriate surgery on venous ulcers (Linton's operation) is an efficient therapeutic method. In 110 of these operations, rapid healing of the ulcer was achieved in 90% of cases, with 10% affected by necrosis and infection of the cutaneous incision. The result held without relapse for three years for 85% of the 52 patients who were able to be reviewed after this length of time. The operative technique has to adhere to two imperatives: a long incision up to the ulcer, and very exact skin closure. Ulcerous relapse, and ulcers failing to respond to routine treatment are the prime indications of surgery; indications can be extended to certain pre-ulcerous conditions.
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