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Biomedical subjects

F Clement

Publications and source records attributed to F Clement.

At least 37 records · Page 2Linked to original sources
PubMed1995

Aortic valve replacement in the elderly: a comparative assay of potential risk factor modification.

From January 1989 to October 1992, 208 consecutive patients underwent isolated aortic valve replacement for calcified aortic stenosis in our department. Since the mean age of this patient population was 70 +/- 9 years, a retrospective clinical study was completed to assess the potential influence of advanced age on the independent predictors of early and late mortality. Hospital mortality was 6.2% (13 patients). Total follow up was 422.5 patient-years with a mean of 26 months. Nineteen patients died during the follow up period, equivalent to 4.5% per patient-year late mortality rate. Survival including hospital death was 88 +/- 2%, 86 +/- 2% and 79 +/- 4% at one, two and three years respectively. Eighteen variables as potential predictors of early and late mortality were studied. Predictors of hospital mortality were determined by logistic regression analysis, and those of late mortality by Cox proportional hazard model. Results were expressed as odds ratio (OR) or relative risk (RR). Age greater than 70 years (OR = 9.8, 95% CI = 1.2 to 80) and emergency surgery (OR = 8, 95% CI = 2.1 to 31) appeared as independent predictors of hospital mortality in multivariate analysis. Age above 75 years (RR = 3, 95% CI = 1.1 to 8.3), preoperative acute pulmonary edema (RR = 2.9, 95% CI = 1.1 to 7.7) and emergency surgery (RR = 4.2, 95% CI = 1.2 to 15) were independently associated with decreased late survival. Advanced functional class (NYHA III-IV) was shown to be an independent predictor of early or late mortality only in univariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

[The treatment of acute dissections of the aorta by circulatory arrest under deep hypothermia and retrograde cerebral perfusion].

The use of profound hypothermia with retrograde cerebral perfusion was described by Ueda in 1988. The innovation of this technique was the retrograde perfusion of oxygenated blood at a temperature of 15 degrees C and a pressure of 25 mmHg via the superior vena cava during the circulatory arrest period. Between february 1993 and march 1994, this technique was used in 12 patients in our department, with acute dissection of the aorta present in 8 cases. In this series of 8 patients, 3 females and 5 males aged 47 to 73 (mean age 60 years)--there were 7 type I acute dissections, one of which occurred on an annulo-aortic ectasia, and 1 type III retrograde dissection with hemopericardium. Treatment consisted of 7 supracoronary tubes one of which extended as a tongue along the inner curvature of the aortic arch, and 1 Cabrol's procedure. Mean times were: extracorporeal circulation: 148 +/- 50 minutes, core cooling: 60 +/- 20 min., circulatory arrest: 34 +/- 9 min., core rewarming: 69 +/- 27 min. Average flow of retrograde perfusion was 440 +/- 350 ml/minute. Mean post operative bleeding was 650 +/- 150 ml for the first 48 hours. No patient awoke with signs of neurological deficiency. Seven patients were weaned from mechanical ventilation either on day 1 or day 2. They presented normal neurological examination. One patient in whom minor post operative disturbance postponed mechanical ventilation weaning to day 4, was neurologically intact upon examination prior to hospital discharge. One patient with no initial post operative complication, died of thrombosis of the Cabrol prosthesis at day 8.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Dissection↗
PubMed1994

[Associated lipid pneumonia and bronchiolo-alveolar carcinoma].

The authors report a new case of bronchio-alveolar carcinoma which developed on a background of iatrogenic exogenous lipid pneumonia; this association is extremely rare (less than 20 cases in the literature) and poses the problem of possible cancer developing in the centre of the lipid pneumonia.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1994

The Y graft: myocardial revascularization with both internal thoracic arteries. Evaluation of eighty cases with coronary angiographic assessment.

The use of bilateral in situ internal thoracic arteries is restricted by the risk of sternal devascularization, the length of the pedicle, and the necessity to avoid crossing the midline. The aim of this study is to evaluate Y grafts achieved by anastomosing the proximal end of the free right internal thoracic artery to the side of the attached left internal thoracic artery. Y grafts were performed in 80 patients, aged 41 to 74 years (mean age 58.6 years) between May 1991 and September 1992. Two different techniques were used. Thirty-four patients were included in group 1 and 46 in group 2. Seventy-nine grafts were performed from the left internal thoracic artery to the left anterior descending artery. The right internal thoracic artery was anastomosed to the diagonal artery (5 times), the marginal branch (67 times), the circumflex artery (7 times) and the right coronary artery (2 times). Seventy-five complementary saphenous vein bypasses were performed in 58 patients. Operative mortality was 2.5%. Two patients had perioperative myocardial infarcts (2.5%) on nonbypassed sites. Three patients had sternal wound infections (3.7%). Sixty-two patients (80%) were reexamined by angiography at month 6-25 in group 1 and 37 in group 2. Sixty left internal thoracic artery bypass grafts (97%) were patent versus 39 right internal thoracic artery bypass grafts (63%). In group 1, 23 of 25 left internal thoracic artery bypass grafts were patient (92%) versus 12 right internal thoracic artery grafts (48%). In group 2, all 37 left internal thoracic artery bypass grafts were patent (100%) versus 27 right internal thoracic artery grafts (73%). With this procedure, particular attention must be paid to the length of the right internal thoracic artery, and extensive training is required.

Adult↗
PubMed1993

[Infarct of the tongue and hyperlipidemia].

We describe a case of a 49 year-old woman, predisposed to arteriosclerosis, who developed and infarct of the tongue caused by hyperlipidaemia. Treatment and differential diagnoses, including giant cell arteritis, are discussed.

Diagnosis, Differential↗
PubMed1992

[Value of sophisticated explorative techniques of the pulmonary function in the preoperative evaluation of respiratory risk].

In order to estimate the preoperative evaluation of the respiratory risk, a well adapted clinical examination associated with a routine pulmonary function test (VC, FEV1) can be sufficient. Although some patients with cardiopulmonary disorders or candidates to lung resection need more complex assessments: the flow-volume loop to detect small airways obstruction (MEF 50%, MEF 25%), measure of bronchial hyperreactivity to predict bronchospasm during anaesthesia, residual volume for the diagnosis of emphysema, diffusing capacity (DCO) to discover lung fibrosis: these parameters disruption always make the pronostic worse. It is also useful to couple together preoperative function test and pulmonary scintigraphy to predict post-operative values after lung resection. But, these criteria for operability are not always a good indicator of post-operative complications. So it is possible to use in addition the results of exercise testing to determine cardio-respiratory performances and maximal oxygen consumption (VO2MAX) which seem better correlated with mortality and post-operative lung surgical complications. Preliminary results of our study concerning thirty patients hospitalized in Besancon-St-Jacques Hospital, agree with the hypothesis that exercise testing is an important criterion in the pre-operative evaluation and to predict post-operative mortality and morbidity of patients candidates to thoracic surgery.

Humans↗
PubMed1990

[Menstrual pneumothorax and pelvic endometriosis. Discussion of pathogenesis].

The authors report a new case of menstrual pneumothorax and pelvic endometriosis which was discovered at this time. In this case (because of the presence of lesions suggesting the condition on thoracotomy) the probable mechanism thought to cause this pneumothorax would be the cyclical shedding of pleural endometriotic lesions. The authors review the characteristics of this unusual syndrome and base their review on an analysis of the hundred cases reported in the literature. They show that there are two theories of pathogenicity classically held. The first is the existence of congenital gaps in the diaphragm which allow air to pass into the pleura during the periods, the other is the possibility of endometriotic pleural lesions damaging the cortex of the lung as they shed their cells during the period.

Adult↗
PubMed1989

[Value of repeated thoracic scanning in the surveillance of operated bronchial cancers].

The authors report three cases of endothoracic tumour recurrence in patients who have been operated on for primary lung cancer revealed by CT scanning, carried out systematically in the respiratory unit to a pre-established protocol. There were no other clinical, fibre-optic, or radiological signs of these recurrences before their discovery using CT scanning. The authors discuss the value of thoracic scanning in the systematic follow up of operated cases of bronchial cancer.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1987

Uptake of selected antibacterial agents in Mycobacterium avium.

The antibacterial action of 64 drugs against Mycobacterium avium ATCC 15769 was screened in Middlebrook 7H9 liquid medium. The most active drugs were ansamycin, rifampicin, clofazimine, and pristinamycin. The antibacterial action of the selected drugs was confirmed by testing clinical isolates on Middlebrook 7H10 agar medium. The antibacterial actions were not related with the hydrophobicities and molecular weights of the drugs. However, all the active drugs were highly hydrophobic molecules of low polarity. These drugs dissolved into the lipids forming the outer layers of the bacterial envelope and they appeared to interact with the surface amphiphils.

Animals↗
PubMed1986

[Estimation of the costs of radiographic and endoscopic examinations in gastroenterology using monographic studies].

This study is devoted to the study of rate-setting and cost price of fifteen radiological and endoscopic examinations in gastroenterology as based on monographic studies. In rate-setting the costs are the examinations actually performed in the department. In contrast, the cost price allocated to include only the expenses incurred by each examination and not those related to the time running between them. Both estimations converge when rooms and equipment are used maximally. Our results show that the amounts reimbursed by the Social Security system were always lower than those obtained from monographic studies, except for two radiological examinations for which expenses were adequate. However when cost prices are considered, all reimbursements would have to be increased for endoscopic examinations, but for Radiography, only those of cholangiography, cholecystography and small bowel barium series should be adjusted.

Costs and Cost Analysis↗
PubMed1980

Effects of antituberculosis and antileprosy drugs on mycobacteriophage D29 growth.

The minimal inhibitory concentrations of antituberculosis and antileprosy drugs were determined for Mycobacterium aurum. The concentrations that reduced the final yield of bacteriophage D29R1 by 50% and the time during the replication cycle at which the drugs completely inhibited phage production were estimated. THe 50% inhibitory concentration/minimal inhibitory concentration ratios were close to 1.0 for clofazimine, colistin, rifampin, and streptomycin; these ratios were high for dapsone (diaminodiphenylsulfone) and isoniazid. Ethambutol (minimal inhibitory concentration, 1.0 micrograms/ml) was without effect on viral growth.

Antitubercular Agents↗
PubMed1977

Stability of bacteriophage type of Mycobacterium tuberculosis: absence of variation caused by experimental chemotherapy in mice and analysis of spontaneous variation.

The bacteriophage typing of 54 strains isolated from the tissues of mice infected with the strain H37Rv of Mycobacterium tuberculosis and treated with isonazid and rifampin showed that the bacteriophage type did not change. The fluctuation analysis of populations of the tubercle bacilli demonstrated that the rate of mutation from sensitivity to resistance in respect to the bacteriophage DS6A was less than 1.3 X 10(-8) mutations per bacterium per generation.

Analysis of Variance↗
PubMedDate not supplied

Efficacy of an aqueous and a powder formulation of nasal budesonide compared in patients with nasal polyps.

Nasal polyps are commonly treated surgically. Intranasal administration of topical corticosteroids has gained increased acceptance as a treatment alternative. The aim of our study was to compare the efficacy of treatment of two formulations of budesonide with placebo on nasal polyps. At four Danish clinics 138 patients suffering from moderate or severe nasal polyps were randomized to a twice daily treatment with Rhinocort Aqua 128 micrograms, Rhinocort Turbuhaler 140 micrograms or placebo (Astra Draco, Sweden) for 6 weeks. Polyp size (primary efficacy variable), nasal symptoms, sense of smell, and patients' overall evaluation of treatment of efficacy were assessed by scores. Polyp size was reduced significantly in both budesonide treated groups compared with placebo, but there was no statistical difference between the two actively treated groups. Patients' nasal symptom scores was significantly more reduced in the Aqua compared to the Turbuhaler treated group, and both reduced symptom scores were significantly better compared to placebo. Sense of smell was significantly improved in the actively treated groups compared to placebo. The proportion of patients rating substantial or total control over symptoms after 6 weeks treatment was 60.9% and 48.2% in the Aqua and Turbuhaler-treated groups, respectively, which was significantly better compared with 29.8% in the placebo-treated group. Rhinocort Aqua and Rhinocort Turbuhaler were equally well tolerated.

Administration, Intranasal↗