Search PubMed⌕ Search

Biomedical subjects

D Thomas

Publications and source records attributed to D Thomas.

At least 1,117 records · Page 62Linked to original sources
PubMedDate not supplied

Live-donor liver transplantation: the USC experience.

BACKGROUND: Liver transplantation is currently the standard of care for patients with end stage liver disease. However due to the cadaveric organ shortage, live donor liver transplantation (LDLT), has been recently introduced as a potential solution. We analyzed and support our initial experience with this procedure at USC. MATERIAL AND METHODS: From September 1998 until July 2000, a total of 27 patients underwent LDLT at USC University Hospital and Los Angeles Children's Hospital. There were 12 children with the median age of 10 months (4-114) and 15 adults with the median age of 56 years (35-65). The most common indication for transplantation was biliary atresia for children and hepatitis C for adults. RESULTS: All donors did well postoperatively; the median postoperative stay was five days (5-7) for left lateral segmentectomy and seven days (4-12) for lobar donation. None of the donors required blood transfusion, re-operation or postoperative invasive procedure. However, five of them (18%) experienced minor complications. The survival rate in pediatric patients was 100% and only one graft was lost at nine months due to rejection. Two adult recipients died in the postoperative period, one from graft non-function and one from necrotizing fascitis. 37% of adult recipients experienced postoperative complications, mainly related to biliary reconstruction. Also 26% of the recipients underwent reoperation for some of these complications. CONCLUSION: LDLT is an excellent alternative to cadaveric transplantation with excellent results in the pediatric population. However, in adult patients it still carries a significant complication rate and it should be used with caution.

Adult↗
PubMedDate not supplied

Team nursing.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

[Birth anomalies of coronary arteries. Responsibility in myocardial ischemia].

Anomalous origin of the left or right coronary artery from the contralateral sinus of Valsalva with coursing between the aorta and the pulmonary trunk way cause angina, myocardial infarction or sudden death. This anomaly should be suspected especially when ischemic symptoms occur in young patients without risk factor for atherosclerosis. We believe that surgical operation after demonstration of myocardial ischemia is indicated to prevent severe myocardial ischemia or sudden death.

Adolescent↗
PubMedDate not supplied

[Blood pressure control after a one year follow-up in high risk subject screened in occupational medicine].

OBJECTIVE: To identify factors predicting the success or the failure of intervention on blood pressure in a population estimated at high risks. METHODS: The program "Coeur 2001" has analysed the absolute cardiovascular risk (ACVR Framingham) in 107 371 voluntary French railways employees. In the company, were considered at high risk (HR), subjects for whom risk was > or = to the 95th percentile of the distribution of the observed ACVR by age range: ACVR > or = 4.5% before 35 years, 12% between 35 and 45 years and 19% beyond 45 years, i.e. a total of 4 190 subjects. These subjects were warned about their risk and advised to choose and consult a physician. A two-year follow up was planned. Identical data (risk factors, ACVR, type of management and therapies) were collected during the first consultation with the occupational physician (T0), one year later (T1) and two years later (T2). RESULTS: Our work concerned 2376 employees at HR, consulting at T1. At T1, 54% of subjects were in the hight risk group (SHR) [48% when BP at T1 was < 140/90 mmHg and 62% when the BP was > or = 140/90 mmHg]. The mean decrease of the systolic BP (SBP) was 4 mmHg in the whole sample, 7.7 mmHg in subjects with normalised ACVR, and it remained stable in the group still at HR (-0.7 mmHg). At T0, blood pressure (BP) was > or = 140/90 mmHg in 55.8% of the patients and 38.4 at T1. This high BP was associated with higher frequency of diabetes (14 vs 7%) and overweight (BMI > or =30 kg/m2; 32.8 vs 19.7%). The percentage of treated hypertensive subjects had increased from 35 to 62% but one third of uncontrolled hypertensive subjects was treated by mono therapies at T1. CONCLUSION: To keep BP under control is a difficult task in routine medicine. At T1, despite a more aggressive treatment, 38% of subjects at high risk were still hypertensive subjects.

Adult↗
PubMedDate not supplied

Bromobenzene metabolism in vivo and in vitro. The mechanism of 4-bromocatechol formation.

The metabolism of bromobenzene has been examined in isolated hepatocytes and liver microsomes from phenobarbital-induced rats and in phenobarbital-induced rats in vivo. The metabolite profile produced upon incubation of isolated rat hepatocytes with bromobenzene differed with the hepatocyte concentration. At a low hepatocyte concentration (0.5 x 10(6) cells/ml), 4-bromophenol was the major metabolite, while at higher hepatocyte concentrations (2.0 and 5.0 x 10(6) cells/ml) bromobenzene-3,4-dihydrodiol was the major metabolite. 4-Bromophenol was the primary metabolite in incubations with rat liver microsomes. In vivo, 3- and 4-bromophenol were more predominant, with very little dihydrodiol formed. 4-Bromocatechol, a potentially toxic metabolite of bromobenzene, was formed in vivo as well as in isolated hepatocytes and microsomes. However, the mechanism of catechol formation differed, as determined by the retention of a deuterium label at the para position of bromobenzene. In microsomes, 4-bromophenol was the predominant precursor metabolite of 4-bromocatechol. In isolated hepatocytes, although the relative contribution of 4-bromophenol as the bromocatechol precursor differed with hepatocyte concentration, bromobenzene-3,4-dihydrodiol was the predominant precursor at all concentrations. In vivo, as in isolated hepatocytes, 4-bromocatechol was formed primarily via bromobenzene-3,4-dihydrodiol.

Animals↗
PubMedDate not supplied

[Somatosensory disorders in patients with extrapyramidal pathology: the effect of a stereotaxic intervention].

The authors compared somatosensory evoked potentials (SSEP) recorded in 16 patients with infantile cerebral paralysis (ICP), 16 patients with parkinsonism (P), 18 patients with torticollis (T), and 15 healthy individuals. Structural changes of SSEP were found in all patients with ICP and in most patients with P and T. The structural changes of SSEP in these patients were mainly associated with the absence or suppression of one or two components of SSEP of a healthy individual. It is assumed that one and the same pathological process underlies these three diseases, but it differs in the degree of manifestation in each one. Two groups of patients with parkinsonism which differed in age were distinguished, which represent, probably, two different pathological processes. Certain normalization of the muscular tonus and inhibition of hyperkinesia in most patients as the result of stereotaxic operation was not attended by normalization of the SSEP structure.

Adolescent↗
PubMedDate not supplied

[Early postoperative thrombosis of an aortic Saint-Jude prosthesis. Success of fibrinolytic treatment].

We are reporting the case of a 63 year-old woman presenting an early thrombosis of a mechanical aortic Saint-Jude prosthesis, on the 21st post-operative day, following an insufficient anti-coagulant treatment and discovered by the presence of a well tolerated murmur of aortic insufficiency. The treatment consisted in fibrinolysis using urokinase, administered intravenously at a dose of 4,400 IU/kg/hour, for 12 hours. The clinical, ultrasound and radiocinematographic control performed on the 75th day, were normal; the patient, at that time being treated with anti-vitamin K and platelets anti-aggregates. No complication was observed. This case demonstrates the advantages of fibrinolytic treatments in early thrombosis following insertion of a valvular prosthesis.

Aortic Valve↗
PubMedDate not supplied

[Criteria of selection of mitral valve prolapse truly pathological].

Considering the high frequency of mitral valve prolapse in the general population and the frequent errors concerning its diagnosis, we have attempted to select a few criteria in order to differentiate the forms which are really pathological. This selection, in light of the data from the literature, is based on the clinical context and ultrasound results.

Echocardiography↗
PubMedDate not supplied

[Holter monitoring in patients with focal cerebral ischaemic attacks (author's transl)].

One hundred patients with focal cerebral ischaemic attacks of suspected embolic origin were investigated by Holter monitoring to determine whether paroxysmal arrhythmia may have been responsible for the episodes. There were 57 men and 43 women aged from 16 to 79 years (mean 50 years). Ninety-seven had residual focal neurological deficits and 3 had transient ischaemic attacks. The neurological lesions were verified by cerebral angiography in 68. Twenty-one had arterial hypertension and 9 had old myocardial infarction or angina. Nine had a history of palpitations. None had cardiac valve disease. All patients were in sinus rhythm, 4 had ventricular extrasystoles on routine ECG, and 4 had supraventricular extrasystoles. None of the patients were receiving anti-arrythmic drugs at the time of investigation. Holter monitoring was performed for 18 hours in 91 cases and for 24-54 hours in the remaining ones. The interval between the cerebral ischaemic attack and the monitoring was less than one month (mean 20 days) for 50 patients and longer for the others. Cardiac arrythmias were found in 36 patients. Sixteen had more than 10 supraventricular extrasystoles per hour, 13 had runs of 3 to 8 beats of supraventricular tachycardia, 1 had an episode of atrial fibrillation. Eighteen subjects had more than 5 ventricular extrasystoles per hour, 1 had accelerated ventricular rhythm, 2 had runs of 4 to 7 beats of ventricular tachycardia. Two patients had second degree A.V. block. None had palpitations during monitoring. Arrythmias were increasingly frequent with age. Our findings are similar to those obtained with monitoring in ambulatory asympatomatic subjects of the same age without apparent heart diseases reported by other authors. On the other hand, the frequency of arrythmia was unrelated to the time elapsed between the ischaemic attack and Holter monitoring. In conclusion, Holter monitoring performed several weeks after suspected cerebral embolism failed to reveal arrythmias likely to be responsible for a focal cerebral ischaemic attack.

Adolescent↗
PubMedDate not supplied

[Right coronary ostial stenosis in homozygotic hypercholesterolemia. Coronarographic and echocardiographic diagnosis].

Ostial stenosis of the right coronary artery was discovered in 2 patients with homozygous familial hypercholesterolaemia. The lesion was confirmed in one case at post-mortem examination and in the other case by cross-sectional echocardiography. In both patients the stenosis could not be visualized at coronary arteriography when the right coronary vessel was selectively injected, but the lack of reflux of the contrast medium into the aortic sinus proved very useful for the diagnosis. To recognize this sign is important since the other criteria of ostial stenosis are not always present, notably in essential hypercholesterolaemia where post-stenosis dilatation is absent due to diffuse parietal lesions of the arteries. In addition, ostial stenoses are associated with a characteristic stenosis localized to the proximal aorta above the coronary ostia. Owing to the dangers of overlooking ostial stenoses, echocardiography and aortography should be performed before coronary arteriography, and the lack of reflux of the contrast medium should be acknowledged as a diagnostic sign.

Adolescent↗
PubMedDate not supplied

[Pathogenic role of anaerobic bacteria in postoperative patients with digestive system surgery].

The cases of patients with anaerobic organisms were collected for a period of one year from the results of bacteriological examinations sent to the Bacteriology Laboratory and from the file of operation reports of all the gastrointestinal surgery performed at the University Surgical Clinic of Amiens. The authors wanted to determine whether the anaerobic bacteria were really responsible for the infections observed, whether they acted alone or in association, what antibiotics should be used specifically against them, and what was the incidence of the initial infection in the discovery of the anaerobic organisms. It was found that the rate of infectious complications was higher in men than in pre-menopausal women and higher in emergency operations than in routine scheduled operations. Overall, it seems that the anaerobic bacteria, considered individually, do not have an important pathogenic action. They are widespread saprophytes which are present before the post-operative immune depression. It is their extraordinary development under certain local conditions and their association with other organisms which explain their pathological emergencies.

Adult↗
PubMedDate not supplied

[Kinetic study of the antibodies in OF 1 and C57Bl mice infected with Chlamydia trachomatis and Chlamydia psittaci. Its application to the interpretation of the serological results in human chlamydioses].

The kinetics of antibodies to C. trachomatis and C. psittaci was studied in OF 1 and inbred C 57 Bl mice, inoculated intravenously (IV) or intraperitoneally. Antibodies were detected by a micro-immunofluorescence (MIF) test. Antibody kinetics depends on many factors (genetic particularities of the mice, route of inoculation, chlamydial strain). The response is more specific when mice are inoculated with C. trachomatis than with C. psittaci; heterospecific antibodies appear later in C 57 Bl mice than in OF 1 mice inoculated IV with C. trachomatis. These results are used to explain the serological findings in 6 cases of human chlamydial infections. The type, species and genus specificities of antibody responses to chlamydial infections are discussed.

Animals↗
PubMedDate not supplied

Sonography for fluid collections in the leg.

Ultrasound may be used in the diagnosis and follow-up of fluid collections in the soft tissues of the leg. As in all parts of the body, anatomy dictates the fundamental sonographic approach. It is suggested that an examination carried out following the guidelines above will ensure a thorough and replicable study.

Edema↗
PubMedDate not supplied

A comparative study of auranofin, gold sodium thiomalate, and D-penicillamine in rheumatoid arthritis: a progress report.

We compared auranofin (AF) in a single blind multi-centre study with gold sodium thiomalate and D-penicillamine in the treatment of rheumatoid arthritis. Adult patients with disease duration 6-60 months without previous treatment with gold salts with persistent active disease, were included. Thirty-nine patients, 13 in each treatment group, have so far been entered. Cumulative toxicity data and some results of efficacy assessments in those completing 9 months of treatment are presented. AF is very well tolerated, judgment concerning efficacy must await the end of the trial.

Arthritis, Rheumatoid↗