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Biomedical subjects

F Baud

Publications and source records attributed to F Baud.

At least 37 records · Page 2Linked to original sources
PubMed1994

Long-term of patients receiving an aorto-bi-femoral prosthesis for atherosclerotic occlusive disease of the aortic bifurcation.

Over a 14-year period (1975-1989), 547 patients with a mean age of 57 years received an aorto-bi-femoral prosthesis for atherosclerotic occlusive disease (AOD) and underwent regular follow-up over a 13-year period. Immediate post-operative mortality was 2.5% with few deaths due to cardiovascular causes (0.5%). The long-term mortality was significantly elevated at 5 years (10% higher than controls) and at 10 years (16%). These deaths were due to the AOD and its surgical treatment (10%), other cardiovascular disease (30%) and cancer (41%). Approximately 5% of patients required an immediate post-operative, or delayed amputation, compared to 33% which had a threatened limb before the operation. Thrombosis of the prosthesis was relatively rare. At 5 years, 81% of the survivors remained largely improved; at 10 years, 67% and at 13 years, 62%. The benefit of this intervention is therefore unquestionable with regards to the functional state and survival. Also, in avoiding immobility due to the disabling intermittent claudication or amputation, it considerably improves the quality of life which largely compensates for the low mortality rates and subsequent complications of the prosthesis.

Aged↗
PubMed1993

Crystal structure of hydrophobic protein from soybean; a member of a new cysteine-rich family.

X-ray diffraction methods have been used to determine the structure of the 8.3 kDa hydrophobic protein from soybean and to refine the atomic co-ordinates to a crystallographic R-factor of 18.7% at 1.8 A resolution. The molecule is a four-helix bundle, which together with the connecting loops and a twisted beta-strand form a spiral. The surface contains 70% apolar atoms, and the crystal packing is dominated by hydrophobic interactions, producing a two-dimensional sheet of protein molecules. Most of the 59 water molecules located are involved in hydrophilic contacts and their structural organization does not seem to be affected by the high hydrophobicity of the molecule. From the protein fold it appears that three of the four disulphide bridges are important for keeping the amino and carboxyl-terminal segments in place in the native form, while the central part of the molecule is stabilized by many hydrophobic interactions. Although the protein function is not known, a number of possibilities can be excluded on experimental grounds and by comparison with other members of the family.

Amino Acid Sequence↗
PubMed1993

[Bilateral aorto-iliac prosthesis. Long-term results].

Over a 12-year period (1975-1987), 565 patients (male: 94.5 percent; female: 5.5 percent) underwent aorto-iliac bilateral reconstruction. The operations were performed by the same surgical team and all patients were followed up for 13 years. The patients' mean age was 59.4 years; 16.6 percent were over 70; 16 percent had a non-fissured aneurysm. The postoperative mortality rate was 2.8 percent, with relatively few deaths of cardiovascular origin (0.5 percent). The late mortality rate was significantly higher than that of an age-matched control population. Arteritis and its surgical treatment accounted for a low proportion of late deaths: 10.7 percent as opposed to other cardiovascular diseases (33 percent) and chiefly to cancer (39 percent)--a figure not found in other reports. Five percent of the patients had to be amputated soon after the operation or later; this is a low figure compared with the 33 percent of patients who had one limb threatened before reconstructive surgery. After the aorto-iliac reconstruction 81 percent of the patients remained considerably improved at 5 years and 67 percent at 10 years. Long-term arterial patency was satisfactory (95 percent at 5 years, 90 percent at 10 years). This type of surgery, therefore, benefits the patients' functions and their life: it avoids rupture of aneurysms and sedentarity due to a disabling intermittent claudication, and it considerably increases the duration of life.

Aged↗
PubMed1990

[Survival and causes of secondary mortality in patients undergoing coronary bypass. Comparison with a same age control population].

During 10 years, 867 patients in whom the same surgical team had performed coronary bypass were followed up regularly without any of them being lost sight of. Moreover, the cause of all deaths in this group could be determined fairly accurately. A comparison of mortality between these patients and an age-matched control population studied longitudinally, year after year, showed that the mortality rate in the surgical group was slightly higher than in the control group (84 vs 77). Conversely, when the operative mortality was discounted, it appeared that the patients who survived coronary bypass had a much better survival than the control population (47 vs 77). Without any doubt, the prognosis for life is improved by surgery. In particular, patients with three-vessel disease (58 per cent), tight stenosis of the common coronary artery (10-25 per cent) or altered ventricular ejection fraction (about 30 per cent) would probably have died without myocardial revascularization. However, this study produced a rather astonishing result: compared with the control population, the decrease of long-term mortality in patients who survived coronary bypass was due not only to the decrease of cardiovascular deaths (16 vs 24) but also of deaths due to cancer (15 vs 27) or to other causes (16 vs 26). This suggests that a more hygienic life and a correct medical follow-up contribute to a large extent to the long-term survival of these surgical patients.

Actuarial Analysis↗
PubMed1990

A cocaine body packer with normal abdominal plain radiograms. Value of drug detection in urine and contrast study of the bowel.

Drug packets are usually detected by ordinary abdominal radiographs, which is of major importance in the apprehension and prosecution of drug body packers, but false negatives may occur. We report the case of a cocaine body packer who had used the prograde route and in whom the initial abdominal plain films were normal. The diagnosis of cocaine body packing was assessed by seldom-described complementary methods of detection, including drug detection in the urine and contrast study of the bowel.

Adult↗
PubMed1989

[Long-term clinical results of coronary surgery. Apropos of 400 patients followed for 5 to 11 years].

Between 1976 and 1982 four hundred consecutive patients underwent coronary artery bypass surgery and were operated by the same surgical team: 345 men (88.5%) and 46 women (11.5%). The average age was 56 years (7.5% were over 75 years of age); 86% of patients were infunctional classes III and IV; 46% had triple vessel disease and 9.25% had severe stenosis of the left main stem. Left ventricular ejection fractions were decreased in 26% and very poor in 4.5% of patients. The average number of bypass grafts was 1.72 per patient and the operative mortality was 3.5%. The 10 year survival rate was 81% and 75% of these patients still thought that their condition had been improved by surgery although only 30% were completely asymptomatic and had had no further coronary event. A comparison with a control population of the same age showed better survival in the surgical group in patients surviving operation. Contrary to traditional thinking, the surgical patients suffered relatively few deaths of cardiac causes but as many, if not more, of cancer. The operated patients died of approximately the same diseases as the control population of the same age but in lower proportions for each cause of death (17 cardiovascular deaths in the control population compared with 13 in the operated group; 18 versus 10 deaths of cancer, and 18 versus 8 deaths of other causes in the control and operated patients, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1988

[Surgery of the aortic arch in coronary patients. 400 surgically treated patients].

Out of 400 consecutive patients who underwent aorto-iliac surgery 45 (11.25 per cent) were known to have coronary disease at the time of the operation. Pre-operative coronary arteriography was carried out in the 11 patients (2.75 per cent) who had unstable or recently worsened angina. Aorto-coronary bypass was performed preventively in 7 patients (1.75 per cent of surgical patients). Mortality from preventive aorto-coronary bypass and secondary aorto-iliac surgery was nil. A study of post-operative mortality (2.75 per cent overall) showed that only one patient (0.25 per cent of surgical patients) died of myocardial infarction. The low rate of post-operative morbidity and mortality of coronary origin therefore does not incline to extend the indications for preventive aorto-coronary bypass. However, it seems desirable to improve the indications for pre-operative coronary arteriography by performing thallium 201 myocardial scintigraphy with dipyridamole infusion in all coronary patients about to undergo aorto-iliac surgery when no exercise electrocardiogram can be obtained because of intermittent claudication. This type of examination will probably broaden the indications for pre-operative coronary arteriography and preventive aorto-coronary bypass, though presumably to a very small extent. Among these 400 patients who underwent aorto-iliac surgery and were all followed up for 2 to 12 years, only a few (0.25 per cent) benefited secondarily from coronary surgery, no doubt because the physiological age of that population was often too high. In fact, these patients were mainly at risk of cancer aggravated by both alcohol and smoking, for in this study, and rather in contrast with most publications, cancer was responsible for 44 per cent of secondary deaths, i.e. more than twice the percentage (20 per cent) of secondary deaths of cardiac origin.

Adult↗
PubMed1988

[Intracorporeal concealment of narcotics. Experience of medicolegal emergencies at the Hôtel-Dieu Hospital in Paris: 100 cases].

One hundred cases of intracorporeal concealment of narcotic drugs were observed over a 6-month period at the medico-judicial emergency centre of the Hotel-Dieu hospital, Paris. Twelve cases concerned dealers who had ingested packs at the time they were arrested. The other subjects had been carrying the drug in their digestive tract, rectum or vagina for transportation. The illicit drugs thus transported were cocaine in 20 cases (ingestion), heroin in 65 cases (ingestion 7, rectal or vaginal cavity 58) and cannabis in 3 cases. Packs for sale being fragile, the dealers were particularly exposed to overdosage. Their management prior to intoxication was the same as that of acute ordinary drug poisoning, i.e. washing out of the stomach. In carriers, the risk of severe poisoning was associated with ingestion. The lack of antidote makes cocaine poisoning particularly dangerous. Surgical extraction is now reserved to cases with intestinal mechanical complications and to those increasingly rarer cases of fragile transportation packs.

Adult↗
PubMed1988

[Double coronary revascularization using the internal mammary arteries. Mid-term results of 74 cases].

This study reports our experience of 74 multiple coronary artery bypass, using either the two internal mammary arteries (IMA) (43 cases), or the left internal mammary artery (LIMA), alone for sequential bypass (31 cases). Comparison with a series of 200 patients operated upon in a previous period (1981-83), when the LIMA was used alone for single bypass, showed that post-operative mortality, post-operative infarction and mediastinitis were significantly more frequent with double bypass using the two IMA; similarly, the mid-term results seemed to be less satisfactory with the double IMA bypass technique. This difference was due to the fact that using the right and left IMA means longer dissection time, greater problems of haemostasis, stronger surgical trauma and prolonged exposure of the sternum, which is a source of infection. In addition, the right internal mammary artery (RIMA) being further away from the sites of coronary grafting lends itself less readily than the LIMA to this type of bypass, and it is often used for the right and marginal coronary artery which is less suitable for surgery. Using the LIMA alone for sequential bypass does not seem to produce more complications than using that vessel for single bypass. On the basis of the results obtained, we consider that the double IMA bypass should only be used when the internal saphenous vein bypass is contraindicated (past history of stripping, varices, fragile aorta forewarning of difficult grafting).(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗
PubMed1987

[Left internal mammary artery. Choice graft for coronary bypass].

The left internal mammary artery is a vessel with relatively constant anatomical features and which in almost all subjects is congruent with their own anterior interventricular artery. In addition, atheromatous lesions of this artery are exceptional; when grafted onto the anterior interventricular artery, it adjusts itself to the diastolic coronary flow. Finally, and this is remarkable, once grafted onto the anterior interventricular artery it virtually never undergoes long-term alterations in contrast with the internal saphenous vein. For these reasons, the left internal mammary artery should be used as often as possible to revascularize the anterior intraventricular artery. Preoperative angiography of the left internal mammary artery to evaluate its quality does not seem to be necessary; what is important in the choice of a graft is the quality of the spurt after the vessel is dissected and its distal end is severed. However, the left internal maxillary artery is smaller and more friable in women, in hypotrophic subjects and in elderly people, especially when hypertensive. In these cases, it should be used with caution or not at all, particularly for bypass with a fairly wide, atheromatous and calcified anterior intraventricular artery. Accounting for these restrictions and with some experience at least 90% of anterior interventricular arteries can be revascularized by the left internal mammary artery.

Coronary Artery Bypass↗
PubMed1987

[The low-profile Liotta valve. Mid-term results].

We report the mid-term results obtained with 279 "low profile" Liotta xenografts implanted at the Hôpital de la Pitié, Paris, in 257 patients between February, 1981 and November, 1984. There were 86 aortic, 138 mitral, 11 triscupid and 22 mitral-aortic valve replacements. The wavy suture ring of the prosthesis makes it "low profile". The Liotta valve is of particular interest in certain anatomical situations such as aortic annulus more dilated than the supra-coronary aorta, or small right and left ventricular cavities. The overall operative mortality rate was 8.6%. The 236 survivors were followed up for 3 to 48 months, a total of 374.3 patients-years. The overall actuarial survival rate at 3 years is 92.2%. Although there were few thromboembolic accidents, about one-third of the patients remain under anticoagulant therapy (0.86 episodes for 100 patients-years). Globally, 98.1% of the patients are free of any thromboembolic accident. Deterioration occurred 29 and 44 months respectively after implantation in two patients aged 9 and 20 years (0.57 episodes for 100 patients-years). Three cases of endocarditis on prosthesis were observed. Altogether, almost 91.2% of the patients have had no complication for 3 years, and indeed they functionally improved, most of them now being in class I or II (aortic valve 97%, mitral valve 87.2%). Thirty-eight patients underwent repeated catheterization at rest and during exercise. Mean transvalvular gradient was 12.4 mmHg in aortic valve patients and 5.9 mmHg in mitral valve patients. Mean functional valve area was 1.6 cm in aortic valve patients and 2.1 cm in mitral valve patients, and it clearly increased during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Follow-up angiography of 100 revascularizations of the anterior interventricular artery by the left internal mammary artery].

One hundred and fifty patients who underwent revascularisation of the left anterior descending artery (LAD) by the left internal mammary artery (LIMA) between 1981 and 1983 were recalled for control coronary angiography one year after surgery. One hundred patients gave consent. The patency rate in these 100 patients was 90 per cent. The presumed causes of the 10 thromboses observed were: for LAD (5 cases), technical problems (3 cases), competitive flow (2 cases). Ten per cent of the patent LIMA grafts were abnormal: moderate stenosis of the anastomosis (5 cases), small LIMA (3 cases), stenosis of the middle segment of the LIMA (1 case). In addition, we observed 7 cases of competitive flows: 3 cases with a LAD which was not sufficiently stenotic, 4 cases with a large saphenous diagonal bypass graft. If a diagonal artery bypass is necessary, it is better to revascularize by either a latero-lateral anastomosis with the LIMA or by using the right IMA. Ninety per cent of the patent grafts were quite satisfactory ar 1 year: regular, supple, and perfectly congruent with the bypassed artery which was injected massively. As a number of North American teams have shown, this good patency rate seems to be maintained at long term, which is not the case with saphenous vein bypass grafts.

Coronary Angiography↗
PubMed1986

[Heart transplantation 1985. Experience of the Pitié].

Heart transplant surgery has come of age over the last four years, after 17 years of clinical application: indications have been specified, techniques systematized and treatment and post-operative follow-ups have been clarified. The results are remarkable: survival at four years is more than 80 per cent, with normal socio-familial and often professional reintegration for almost all heart transplant patients. Increased application of heart transplant surgery in the months to come will transform prognosis in patients presenting irreversible cardiac lesions, but will raise the problem of the supply of donor organs.

Adult↗
PubMed1986

A radioimmunoassay for the antimalarial drug chloroquine.

We describe a 3H-based RIA for the antimalarial drug chloroquine (CLQ), the most commonly used antimalarial drug. In the assay a monoclonal antibody is used that is directed against 4-amino-7-chloroquinoline conjugated to keyhole limpet hemocyanin by the glutaraldehyde method. Besides CLQ, this antibody also recognizes with good affinity the 4-aminoquinoline homologs, hydroxychloroquine and amodiaquine. No extraction step or sample preparation is required, and the method can detect as little as 10 micrograms/L, the lower concentration in plasma of humans who are taking CLQ as a preventive measure. The between-assay CV is less than or equal to 10%, the within-assay CV less than or equal to 3%. Results correlate with those by liquid chromatography (r2 = 0.96). The speed and simplicity of the RIA method make it useful in evaluating the CLQ concentrations in acutely toxic patients.

Antibodies, Monoclonal↗