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Biomedical subjects

F Lacaine

Publications and source records attributed to F Lacaine.

At least 91 records · Page 5Linked to original sources

[Percutaneous drainage of intra-abdominal abscesses guided by real-time ultrasonography].

From October 1982 to October 1984, a percutaneous drainage under realtime ultrasound guidance was performed in 53 patients with abdominal abscesses. The location of the abscesses was subphrenic (23), retroperitoneal (16), and intrahepatic (14). A safe access route was found by using ultrasound and fluoroscopy in 53 out of 55 patients (96 p. 100). Percutaneous drainage failed in 8 patients and 3 of these patients died. The causes of death were: cerebral abscess (1), renal failure after surgery for correction of a duodenal fistula (1), and pancreatic abscess (1). The other five patients were cured by surgical drainage. Two complications were observed: one case each of pneumothorax and purulent peritonitis. Forty-five patients were healed by percutaneous drainage without operation. The duration of the catheter drainage was 14 days +/- 13 (m +/- 1 SD). Our results suggest that percutaneous drainage under realtime ultrasound guidance is an efficient and safe way to treat abdominal abscesses.

Abdomen↗

Surgical and radiological decompression in malignant biliary obstruction: a retrospective study using multivariate risk factor analysis.

We performed a retrospective computer-aided statistical study of 228 patients who received treatment for malignant biliary obstruction to compare survival rates after surgical or radiological biliary decompression. To adjust for the selection bias produced by the clinical choice of surgical vs. catheter drainage, we examined differences in survival rates after controlling for various clinical and laboratory factors, which are predictive of short and long-term survival. These factors were selected by multivariate analysis. Short-term survival was significantly correlated with preoperative metabolic status as reflected in serum albumin, and blood urea nitrogen (BUN) levels. Elevated serum bilirubin values had no additional negative effect on survival. Long-term survival was influenced mainly by the extent of the primary cancer and the preoperative presence of leukocytosis. Although there was a difference in the raw data for hospital mortality between patients who underwent surgical drainage (11%) and those who underwent radiological drainage (30%), we found no real effect produced by the form of therapy after controlling for prognosis variables, i.e., eliminating selection bias. We propose a simple statistical model to predict short-term hospital survival. The application of objective risk factor analysis according to accepted statistical methods should permit the assessment of new radiologic therapeutic techniques with greater clinical validity.

Aged↗

[Surveillance of patients operated on for cancer of the stomach].

Recurrence following curative excision of gastric cancer occurs in 9 cases out of 10 during the 5 years following surgery. Repeat operations are of benefit in 20 p. cent of cases of recurrence, and postoperative follow-up surveillance of these patients should be routinely conducted for at least 5 years. As the recurrence level is highest during the first 2 years, examinations are probably necessary every 4 months during this period, followed by yearly examinations up to the end of the fifth year. Complementary investigations include biological tests and morphology.

Adenocarcinoma↗

[Acute abdominal pain syndrome. The computer as an aid to diagnosis (author's transl)].

With a bank of data collected locally and a probability program of diagnostic aid, the computer is capable of making the correct diagnosis in 79% of acute abdominal pain syndromes. Its performance in this respect is somewhat superior to that of clinicians (73.5%). Including a computer program in diagnostic procedures would reduce the number of errors by excess or omission. In abdominal emergencies computerization would help either by increasing the reliability of clinical diagnoses or by suggesting that other possibilities should be investigated.

Abdomen, Acute↗

Hepatic metastases in gastrointestinal cancer: diagnostic value of biochemical investigations.

The results of biochemical estimations in 116 patients with known gastrointestinal cancer but no clinically detectable metastatic hepatic disease have been analyzed statistically. The most sensitive and the most specific tests for the presence or absence of hepatic metastasis were measurements of alkaline phosphatase and gamma-glutamyl transpeptidase. The predictive value for the absence of hepatic metastasis when the test results were normal was about 90% for alkaline phosphatase, gamma-glutamyl transpeptidase, lactate dehydrogenase, and serum aspartate aminotransferase. The best predictive value for the presence of hepatic metastasis (80%) was given by abnormal results of combined estimations of gamma-glutamyl transpeptidase and lactate dehydrogenase, and of gamma-glutamyl transpeptidase and serum aspartate aminotransferase.

Alkaline Phosphatase↗