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Biomedical subjects

D Simon

Publications and source records attributed to D Simon.

485 records · Page 27Linked to original sources
PubMedDate not supplied

Treatment of dogs with lymphoma using a 12-week, maintenance-free combination chemotherapy protocol.

BACKGROUND: Treatment of lymphoma in dogs by long-term chemotherapy has favorable results. However, the efficacy of short-term, maintenance-free treatment protocols on remission and survival times in dogs has not been determined. HYPOTHESIS: That treatment using a 12-week chemotherapy protocol would be associated with satisfactory treatment outcome in dogs with lymphoma. ANIMALS: 77 dogs with histologically or cytologically confirmed diagnosis of lymphoma. METHODS: Prospective clinical trial in which dogs were treated with a 12-week chemotherapy protocol consisting of L-asparaginase, vincristine, cyclophosphamide, doxorubicin, and prednisolone. RESULTS: Complete remission rate was 76.3%. Multivariate logistic regression analysis revealed that clinical substage (P = .006) and immunophenotype (P = .003) had a significant influence on the likelihood of a dog achieving complete remission. Median duration of first complete remission was 243 days (range 19-1,191 days). The 6-month, 1-year, and 2-year remission rates were 68%, 28%, and 16%, respectively. In the multivariate analysis of patient variables, immunophenotype (P = .022) revealed a significant influence on first remission duration. Toxicosis was mild with the exception of 1 treatment-associated death. CONCLUSIONS AND CLINICAL IMPORTANCE: In this group of dogs the 12-week maintenance-free chemotherapy protocol was well tolerated and had satisfactory results.

Animals↗
PubMedDate not supplied

Leg ulcer care: an audit of cost-effectiveness.

Our objective was to establish an audit mechanism to determine the cost and effectiveness of leg ulcer care across two Health Authorities. Following identification of all patients with active ulcers over a two-month period, leg ulcer treatment, costs and outcome were prospectively audited over three months. We found that leg ulcer care is currently expensive and appears to be largely ineffective, especially when compared to the community clinic approach.

Cost-Benefit Analysis↗
PubMedDate not supplied

Parkinson syndrome. A significant risk factor in the patient with acute surgical disorder.

Ten Parkinsonic patients presenting with acute surgical disease were studied to determine the effects of both conditions on each other and the patient's outcome. Severe motion and communication disturbances led, invariably, to a delay in seeking medical assistance, with most of the patients' presenting symptoms and signs being non-specific and misleading. As a result half the patients presented already in a state of septic shock, and a correct preoperative diagnosis could be achieved in three patients only. The functional status significantly deteriorated in six patients, in four of whom a prolonged rehabilitation course was necessary. Although there was no immediate perioperative mortality, morbidity was significant as 50% and 100% major "surgery-related" and "Parkinson-related" complications accordingly. It is concluded that the coexistence of acute surgical disease with Parkinson syndrome has a profound adverse effect on the patient's outcome. High index of suspicion, early mobilisation, intense physiotherapy and early resumption of the anti-Parkinson drugs are the key points in the management of these patients.

Aged↗
PubMedDate not supplied

Hand gangrene in diabetic patients on chronic dialysis.

To determine whether any potentially reversible variables are related to the development of hand gangrene in diabetic patients on dialysis, the authors compared 15 patients with hand gangrene (group A) to three control groups of diabetics on dialysis: 20 patients with foot gangrene (group B); 31 patients without gangrene of the extremities (group C); and 20 patients without hand arterial calcifications (group D). All patients in groups A-C had medial arterial calcifications of the hands. Group A patients started dialysis at an earlier age (p less than 0.05), were treated for end-stage renal disease (ESRD) for a longer time period (p less than 0.05), and had a lower mean serum albumin concentration during the dialysis period (p less than 0.05) than the patients in the control groups. Hand gangrene also appeared to be associated with the presence of a functioning arterio-venous fistula in the extremity with the gangrene, with loss of function of renal transplant, and with hyperaluminemia. Other variables, including serum parathormone, were not different for the four groups. Logistic regression showed that the following were risk factors for hand gangrene: hypoalbuminemia, long duration of ESRD treatment, hyperphosphatemia, high insulin dose, hypercholesterolemia, and hypoglycemia. In diabetics on dialysis, gangrene develops in hands with medial arterial calcifications, but does not correlate with measures of calcium or phosphorous metabolism. Predictors of hand gangrene include certain potentially reversible clinical and biochemical variables.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

[Analysis of diabetes-related mortality in France (1970-1987) from multiple causes of death].

The aim of this study was to analyse the characteristics and the mortality rate of diabetic patients, in France, between 1970 and 1987, as well as the association between diabetes and other pathologies at death. These results are based on both the underlying and the associated causes of death registered on the death certificate, in contrast to most studies which use only the underlying cause. In 1987, there were 16,790 deaths in France for which diabetes was mentioned on the death certificate (as the underlying cause in 38% of cases). There was a higher mortality in male diabetic subjects then in female, for all ages except over 75 years. Between 1970 and 1987, the mortality decreased for both sexes, except for the oldest age group. The death rate varied greatly between geographical regions. A particularly high mortality occurred in the Nord-Pas-de-Calais, Lorraine and Alsace. Diabetes was significantly associated, at death, with other diseases and pathologies. The most frequent were vascular diseases (ischaemic heart disease, cerebral diseases and hypertension) and diseases of the genitourinary system. It if of note that 5% of the death certificates of these diabetic subjects indicated diabetic coma as a cause of death.

Adult↗
PubMedDate not supplied

[Assessment of the use of hemoglobin AIc in diabetes mellitus screening].

A population of 495 volunteer subjects who applied to the screening diabetes Centre of Hôtel-Dieu hospital in Paris has been studied and divided into two samples. In the first 300 subjects sample the sensitivity and the specificity of different fasting blood glucose threshold values, of different glycosylated hemoglobin threshold levels and of various combinations of the above mentioned parameter have been evaluated as a test for diabetes diagnosis defined by a 2-hr OGTT value greater than or equal to 200 mg/dl. The predictive values for both positive and negative diagnosis were also evaluated. The combination of a fasting blood glucose greater than or equal to 120 mg/dl with a glycosylated hemoglobin greater than 5.8% was found to be the best association with a good relative specificity (97.9%), a fair sensitivity (64.7%) and a fair predictive value for a positive diagnosis (64.7%). A second sample includes 195 subjects. These were classified according to either the above criterion or either the 2-hr OGTT value greater than or equal to 200 mg/dl. A great majority of subjects (95.4%) was classified in concordance by the two methods. The characteristics of the subjects that were identically classified as diabetic subjects (n = 5) were compared to those of differently classified subjects (n = 9). Longitudinal surveys are needed in order to assess the validity of HbA1c measurement as a tool for diabetes screening by reference to unquestionable criteria of the disease.

Adult↗
PubMedDate not supplied

Duodenostomy revisited.

Four patients were admitted to the Surgical Ward because of massive bleeding from a duodenal ulcer. In three the ulcer was induced by non-steroid anti-inflammatory drugs. On operation, following pylorotomy and suture of the bleeding artery, neither drainage nor stump closure could be affected safely. Partial gastrectomy with vagotomy, or high subtotal gastrectomy with gastroenterostomy were performed. The duodenum was dealt with by means of a tube duodenostomy. There was no mortality among these patients. Morbidity was related mainly to the extent of preoperative bleeding and associated pathology (e.g. perforation). Patient data is presented in Table I.

Aged↗
PubMedDate not supplied

[Gonadotropic function in female Cushing syndrome (author's transl)].

A study of 38 female Cushing syndromes showed decreased levels of FSH and LH, with normal LH-RH stimulation in most adrenal hyperplasia and benign adenoma, and absent stimulation in carcinoma. The levels were normalized by suppression of hypercorticism. This suggests a blunted gonadotropic function, in female Cushing syndrome, probably at the hypothalamic level. The predominant respective roles of hyperandrogeny in carcinoma and of hypercortisolism in adrenal hyperplasia and benign adenoma seem probable.

Adenoma↗
PubMedDate not supplied

[Psychic symptoms and personality of 50 patients with Cushing's syndrome (author's transl)].

To determine whether patients with hypothalamo-pituitary Cushing's disease (HPC-D) can be distinguished on psychological grounds from these presenting with adrenal Cushing's syndrome (AC-S) or with ectopic ACTH syndrome, an in-depth psychological study including full personal, family and socio-professional history and a psychological interview was carried out in 50 patients with endogenous hypercortisolism. The results showed that psychiatric symptoms, such as anxiety and depression, are virtually constant in patients with either HPC-D or AC-S. They are, however, more pronounced in patients with HPC-D, and the latter condition is more likely to develop in subjects with either "psychosomatic" or pre-morbid depressive neurotic personality.

Adult↗
PubMedDate not supplied

[Primary hyperparathyroidism. Relationships of symptoms to age, sex, calcemia, anatomical lesions and weight of the glands].

OBJECTIVES: Primary hyperparathyroidism is a polymorphic disease. We evaluated the effect of different factors on clinical expression. METHODS: Clinical expression in 259 patients who underwent surgery for primary hyperparathyroidism were analyzed as a function of patient age, sex, calcium level, anatomic lesions and weight of the diseased glands. RESULTS: Behaviour disorders and bone images were more frequent in women and urinary lithasis and gastric ulcers were more frequent in men. Behaviour disorders, bone images, chondrocalcinosis, renal failure and acute episodes were more frequent in elderly patients. Inversely, urinary lithiasis was more frequent in young subjects. The prevalence of asymptomatic forms was not related to the level of calcaemia, even for very high levels. Calcium levels above 3.5 mmol/l led to a significantly higher rate of behaviour disorders and acute episodes. Moderately elevated calcium levels were associated most frequently with urinary lithiasis. There was no evidence that anatomic lesions were related to symptomatology, particularly cancer which was not related with more frequent or more severe forms. Finally, nephrocalcinosis, renal failure and acute episodes were particularly frequent when the weight of the parathyroid tissue was greatest. CONCLUSION: The main therapeutic conclusion concerned primary hyperparathyroidism with moderately elevated calcium levels: since there is no difference between the clinical expression of primary hyperparathyroidism with moderately elevated calcaemia, the same surgical approach is recommended.

Adenoma↗