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H Bensadoun

Publications and source records attributed to H Bensadoun.

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

[Cancer of the kidney, prognostic value of nuclear grading for the early diagnosis of metastasis].

OBJECTIVES: Since immunotherapy or surgery can sometimes lead to remission of metastatic renal cell carcinoma, it is important to recognize factors predicting metastasis. We therefore evaluated the usefulness of nuclear grading in predicting metastasis of renal cell carcinoma. METHODS: We retrospectively reviewed 95 patients (69 males, 26 females; mean age 63.9 years) who successively underwent surgical exeresis of a renal cell carcinoma. The TNM classification was established on the basis of preoperative work-up (thoraco-abdominal computed tomography, bone scintigraphy) and pathology examination of the surgical specimen. Nuclear grading was performed by a pathologist who was unaware of the histology results. Outcome was evaluated on the basis of physical examination and computed tomography results 6 months after surgery. RESULTS: There were 34 cases of clear cell carcinoma, 10 granulosus tumours, 2 oncocyte tumours and 16 renal cell carcinomas of undetermined type. Mean tumour diameter was 70.3 +/- 37.8 cm. Tumour classification gave (< 5 cm, n = 23; > 5 cm, n = 26; local invasion, n = 28; invasion of neighbouring organs, n = 2). Metastases had been identified in 11 patients before surgery. Nuclear grading according to the Führman scale gave F1 (n = 3), F2 (n = 28), F3 (n = 34) and F4 (n = 24). Tumour size and the TNM classification were correlated with the observed nuclear grading scores. Within one year of surgery, metastasis was observed in 6 patients whose Führman grades were F3 (n = 1) and F4 (n = 5). Metastasis occurred in 26% of the patients with a Führman grade 4. CONCLUSION: Nuclear grading can be used to identify patients who should be closely followed after surgical removal of renal cell carcinoma in order to improve early diagnose of metastasis.

Adenocarcinoma↗
PubMed1994

Long-term treatment of benign prostatic hyperplasia with alfuzosin: a 24-30 month survey. BPHALF Group.

OBJECTIVE: To address the long-term results of alfuzosin, an alpha 1-antagonist, in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: A 6-month, placebo-controlled study involving 518 patients was followed by two successive one-year, open extensions. Only centres who wished to continue the trial participated in the extensions; 131 patients entered the first extension, with 50 continuing into the second year extension. The results of the second year follow-up are presented here. RESULTS: Depending on their initial randomization to either the placebo or alfuzosin arm, patients were treated with alfuzosin for 24 (n = 50) or 30 months (n = 22). The data collected on those 50 patients in comparison to baseline confirmed that the clinical efficacy observed in short/medium-term studies was maintained. A clinically significant improvement in urinary symptoms was observed; the Boyarsky score decreased from 8.7 (+/- 0.3) at baseline to 5.2 (+/- 0.3) at 24 months, with no deterioration in the objective parameters. In patients treated for 30 months (n = 22), symptomatic assessment and urodynamic parameters remained stable, indicating the sustained effectiveness of therapy. No serious or unexpected side-effect related to long-term exposure to alfuzosin was observed. No complications associated with BPH occurred. Two patients (4%) reported dizziness, neither of whom withdrew from the study. In this population, where 40% of patients were receiving concomitant cardiovascular therapy, no clinically significant change in standing systolic blood pressure, diastolic blood pressure or heart rate was apparent between baseline data and those at 24 months. CONCLUSION: These data demonstrate the usefulness of long-term treatment with alfuzosin in patients with uncomplicated, moderate BPH.

Adrenergic alpha-Antagonists↗
PubMed1994

[Cytopuncture: an alternative to pelviscopy in the diagnosis of lymphatic metastases of urologic pelvic tumors].

119 patients with prostatic or vesical tumours without metastases were studied by lymphography-aspiration cytology to detect lymph node metastases. 12% of aspiration cytologies were uninterpretable, corresponding to N-patients. 12% of the 105 interpretable cases were positive. Some of the patients with negative biopsies were treated nonsurgically. 28 bladder tumours were treated intravesically. 11 prostatic cancers were treated by radiotherapy and 63 patients underwent surgical resection. These 63 patients had an interpretable aspiration cytology and surgical control. Aspiration cytology was falsely negative in 7 cases: 4 microscopic metastases and 3 macroscopic metastases. The sensitivity of aspiration cytology after lymphography is 66% and its specificity is 100%. The positive predictive value is 100% and the negative predictive value is 92.3%. These 7 false-negative results included 3 macroscopic metastases already identified on CT scan and 4 micrometastases in which surgical resection was legitimate.

Adenocarcinoma↗
PubMed1994

Incidence of vascular complications in kidney transplantation: is there any interference with the nature of the perfusion solution?

Two non-randomized groups of 100 kidney transplants each were compared in relation to the flush-out solution used. The two groups were similar with the exceptions of the number of multiple artery kidneys and the proportion of kidneys procured in our center. The rate of vascular complications such as arterial venous thrombosis and renal artery stenosis was higher in the Eurocollins (19) group than in the UW group (4) p < 0.01, even if the multiple artery kidneys are excluded. These results need to be confirmed by a randomized study but it is clear that the use of the UW solution leads to a better arterial flow with fewer vascular complications.

Adenosine↗
PubMed1993

[Acute pyelonephritis in women. Short-term hospitalization].

One-hundred women suffering from acute pyelonephritis were hospitalized for less than 4 days on average, in order to make a diagnosis based on bacteriology and computerized tomography (CT) and to bring fever down with a 21-day antibiotic therapy. In cases of acute pyelonephritis due to a urinary tract obstacle, endoscopic uereteral drainage was added to the antibiotic treatment. In the absence of obstacle, medical treatment was sufficient to obtain apyrexia. Fluoroquinolone therapy made it possible to reduce the hospital stay to 2 or 3 days, depending on whether the lesions observed at CT were triangular or round.

Acute Disease↗
PubMed1993

[Emergency treatment of calculi of the lower ureter].

Two-hundred patients were hospitalized as an emergency for lower ureteral calculi. Eighty-two of these patients has a less than 6 mm wide calculus which was evacuated by medical treatment; 5 had stagnant infected urine which was drained by endoprosthesis; 113 had an obstructive calculus which resisted medical treatment and was treated by ureteroscopy: the stone could be removed by means of a basket catheter in 58 cases, but this method failed in the other cases and the calculus has to be broken by laser. There were 6 failures due to the nature of the stone (monohydrated oxalate) in 3 cases and to technical laser problems in 3 cases. The success rate of ureteroscopy (basket catheter or laser) was 95 percent in patients whose pain had persisted under medical treatment.

Adult↗
PubMed1993

Gastrointestinal complications in renal transplantation.

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and/or pancreatic complications in the following distribution: 9.6% gastroduodenal, 1.3% pancreatic, 4% colonic, and 0.4% small bowel. None of the patients presenting a gastroduodenal ulcer had perforation or bleeding. Fifty-five percent of the patients with this complication had a past history of eso-gastroduodenal disease, compared to 19.6% in recipients without gastroduodenal complications. Some 4.4% of the patients had a small bowel or a colonic complication and four died of peritonitis due to bowel perforation. Mortality was 35% in those having intestinal resection and/or perforation with peritonitis. Sixteen percent of patients with colonic complications had a known history of diverticula, compared to 3% for those without colonic complications. The incidence of GI and/or pancreatic complications in renal transplant recipients remains high and has caused 1.1% of the deaths in our series. Mortality is essentially due to upper GI bleeding, peritonitis following perforation, and infectious colitis. Better detection of gastroduodenal and colonic disease before transplantation seems to be mandatory. Prevention with histamine H2 receptor antagonists and early surgical treatment of complicated colonic diverticula help to reduce the morbidity and mortality in kidney graft recipients.

Adult↗
PubMed1993

Long-term treatment of benign prostatic hyperplasia with alfuzosin: a 12-18 month assessment. BPHALF Group.

In order to assess the efficacy and safety of alfuzosin, an alpha-1 blocker, in symptomatic patients with benign prostatic hyperplasia (BPH), 131 patients who had completed a 6-month placebo-controlled trial conducted on parallel groups entered a 12-month open study; 122 patients were treated with alfuzosin for 12 months and 56 patients for 18 months. After 12 months, all obstructive and irritative symptoms assessed according to the Boyarsky scale were significantly improved, as were peak flow rates in obstructed patients and mean flow rates and residual urine in the whole population. Voiding symptoms showed sustained improvement after treatment for 12 to 18 months. Only 5.3% of patients experienced vasodilatory side effects, none of which led to withdrawal from the study. No side effect related to long-term administration was reported. Alfuzosin has a beneficial effect on voiding symptoms in patients with BPH and can be safely used in long-term administration.

Adrenergic alpha-Antagonists↗
PubMed1993

[Calculi of the ilio-pelvic ureter: therapeutic approach and importance of ureteroscopy regarding 200 cases].

The authors report their experience of 200 consecutive emergency admissions for iliopelvic uteric stones. 82 patients (41%) eliminated their stones with medical treatment. 118 patients (59%) required ureteroscopic treatment either by immediate basket extraction (n = 58) or by contact fragmentation (pulsed laser = 57, ultrasound = 1, electrohydraulic catheter = 2). 6 failures were observed and one case of distant ureteric stenosis was successfully treated by balloon dilatation. This therapeutic approach cured 187 (93.5%) of the patients of their stones within an average of 8 days (82 "spontaneous", 105 "endourological") with a mean hospital stay of 2.3 days and 2.7 days, respectively. Ureteroscopy had a success rate of 95% and appears to be the most effective treatment, but the medical option remains the basic treatment for stones of the lower ureter.

Adult↗
PubMed1993

[Ectopic prostatic polyp in the bladder. Report of 2 cases].

An ectopic prostatic polyp situated in the bladder is a rare cause of terminal haematuria. The authors present an extensive review of the literature concerning this lesion which must be recognised not only by histologists, responsible for establishing the diagnosis, but also by urologists, who must be aware of its benign nature.

Aged↗
PubMed1992

[Diagnosis of lymphatic metastases in pelvic urologic tumors. Value of puncture biopsy].

In 119 patients with pelvic urogenital tumours the diagnosis of lymph node metastasis was made by lymphography-guided fine needle biopsy. The results of this technique, performed without anaesthesia and devoid of morbidity, could be interpreted in 88 percent of the cases. In the search for micro- and macroscopically invaded lymph nodes fine needle biopsy had a sensitivity of 66 percent, a specificity of 100 percent, a positive predictive value of 100 percent and a negative predictive value of 92.3 percent. In cases with macroscopically invaded nodes its sensitivity was 82.3 percent.

Adult↗
PubMed1992

Prophylactic use of the IL-2 receptor-specific monoclonal antibody LO-Tact-1 with cyclosporin A and steroids in renal transplantation.

LO-Tact-1 is a rat anti-human monoclonal antibody which is directed to the 55-kDa alpha-chain of the interleukin 2 (IL2) receptor. We conducted a pilot trial in 15 first-time cadaveric renal transplant patients undergoing for immunosuppression a 14-day course of LO-Tact-1 (10 mg i.v. daily) together with cyclosporine, low dose steroids (0.5 mg/kg) and azathioprine. Results showed a good immunosuppressive effect, as measured by the similar incidence of acute rejection episodes (0.6 per patient) when compared with 20 patients treated during the same period with our standard quadruple prophylactic combination with higher initial doses of steroids (2 mg/kg) and antilymphocyte globulin (ALG) instead of LO-Tact-1 (0.4 per patient). At 2 years post-transplant, graft survival was 93%, and only 1 patient lost his kidney by rejection. No local or general adverse effect of antibody administration was encountered, and haematological changes remained of minor importance. Local bacterial infection was observed in 3 patients, but viral diseases (including cytomegalovirus, CMV) remained exceptional. In contrast, severe clinical CMV infections occurred in 3 patients (15%) treated by ALG. Nine of 15 patients developed rat-specific antibodies, but only 4 before the completion of LO-Tact-1 treatment, without any correlation with the further development of acute rejection. Patients who suffered rejection had lower LO-Tact-1 levels and higher soluble IL2 receptor levels during the period of infusion, suggesting the crucial importance of pharmacokinetic monitoring to adjust individual doses.

Adrenal Cortex Hormones↗
PubMed1991

[Demonstration of tissue hypoxia due to defective peripheral extraction of oxygen (O2) during brain death].

Adequate oxygenation of potentially transplantable tissues must be maintained in patients in a state of cerebral death. An analysis of the relationship between oxygen consumption and arterial oxygen supply shows that proven tissue hypoxia occurs associated with high lactate in almost all patients in a state of cerebral death, even before haemodynamic parameters (blood pressure, heart rate) reach alarming levels. This tissue hypoxia, which exists even though arterial supply remains high, would suggest that there is a defect in peripheral oxygen extraction during the state of cerebral death. Intensive units should take this into account when maintaining these patients.

Adult↗
PubMed1991

[Arterial stenosis in the renal graft. Indication for endoluminal dilatation].

One hundred and thirty eight patients with renal transplant artery stenosis were reported in a series of 1200 renal transplants. These cases included 47 patients in whom hypertension was well controlled by means of hypotensive drugs, 39 patients treated by surgical repair (SR) and 49 treated by percutaneous angioplasty (PTA). The long-term success rate was 81.5 percent in the SR group compared with 40.8 percent in the PTA group. PTA morbidity was greater than that of SR, and we believe that after the initial optimism, the results of this technique should be reevaluated according to the anatomical pattern of the renal artery stenosis.

Adolescent↗