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Biomedical subjects

H Guidicelli

Publications and source records attributed to H Guidicelli.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Sympathectomy and microcirculation: physiopathologic reflections].

Sympathectomy provokes vascular motor denervation, and drastically modifies the vasomotor equilibrium of the limbs which is also dependent on metabolic, humoral and myogenic factors. Therapeutic efficacy of sympathectomy is related to the state of activity and reactivity of these other factors. The fall in peripheral resistance resulting from the opening up of cutaneous arteriovenous anastomoses increases flow through a stenosis or bypass, with the tendency for development of the collateral circulation. Positive effects may be obtained also when trophic disorders exist, but there is the risk of a nutritional circulation steal in the presence of blood hyperviscosity, with the need for associated rheologic treatment. Indications are few in Raynaud's disease, except for digital arterial disease.

Arteriovenous Anastomosis↗
PubMed1985

[Amelioration of the diagnostic possibilities of irrigraphy by a new index, I0].

Irrigraphie (segmental impedance plethysmography) is a reliable non invasive method for the positive and topographic diagnosis of arterial occlusive disease and for its prognosis (5, 8, 9, 12, 13). The method is based on pulse volume recordings at six different positions of the leg (from 1 = proximal to 6 = distal). The amplitude of the signal is related to heart rate and to the basic impedance of the segment of the leg. The diagnosis of aorto-iliac disease is proposed when the upper extremity index (I1MS) over the lower extremity proximal index (I1) ratio (ITA) is increased (greater than 1.4), or when the I1 value is lower than 1.9. The diagnosis of femoro-popliteal disease is proposed when there is a significant drop between I1 and the above knee index I3. However in a recent study we found that I1 value drops when there is a severe femoro-popliteal lesion. In this case, irrigraphie proposes erroneously the diagnosis of aorto-iliac and femoro-popliteal diseases. In order to improve the method, we thought that a new electrod position (I0) over the iliac region would give to irrigraphie a more reliable topography diagnosis possibility. In this study 32 patients were analysed with angiography and irrigraphy, and divided into 3 groups: group I = isolated iliac disease (19); group F = isolated femoral diseases (22); group IF = ilio-femoral diseases (12). We observe from the ROC analysis, that I0 has a sensitivity of 84% and a specificity of 86%, when the iliac lesions are isolated whereas I1 and ITA give a lower specificity (52%). However, when aorto-iliac lesions are combined with femoro-popliteal lesions the irrigraphie is a little less sensitive (71%). In conclusion I0 index is more reliable for the topographical diagnosis of obstructive disease of the iliac artery than I1 index and we suggest to replace I1 by I0 whenever it is possible.

Arterial Occlusive Diseases↗
PubMed1983

[Acute thrombosis of the aortic bifurcation caused by heparin allergy. Apropos of 5 cases].

Five patients with humoral intolerance to heparin developed acute thromboses, with a fatal outcome in two cases from failure to establish the diagnosis, marked sequelae in one case, and recovery without complications in the other two. Accidents of this type may occur in 0.6 p. cent of patients on heparin therapy and are almost always fatal if administration is not discontinued. They result from a severe immunoallergic. Thrombocytopenia which may lead to the formation of arterial clots. Arterial thrombosis during heparin therapy is suggestive of the diagnosis and tests for diminished platelet counts are necessary. Apart from surgery, treatment involves the immediate cessation of heparin therapy.

Acute Disease↗
PubMed1983

[Axillary-subclavian injuries. Apropos of 11 cases. Procedural problems].

Tactical problems raised by treatment of injuries involving the axillary-subclavicular region were studied by analysis of 11 cases treated in a Grenoble hospital since 1975. The majority of patients had multiple injuries, and it was possible to perform pre-operative angiography in all cases. Lesions involving the mobile post-vertebral segment of the subclavian artery were treated by pre-sternocleidomastoid cervicotomy through a deltopectoral approach enlarged in L. Functional prognosis was related to the frequency and severity of associated neurological lesions.

Accidents, Occupational↗
PubMed1980

[Lateroterminal arteriovenous fistula with "safety valve" for haemodialysis (author's transl)].

We describe a new type of arteriovenous fistula for haemodialysis, aimed at controlling arterial spasms which contribute to thrombosis. A laterolateral fistula is created, and the artery is sectioned below the anastomosis. A Fogarty catheter inserted through this "safety valve" relieves the spasm without interfering with the arteriovenous shunt. Mere ligature of the distal segment of the artery transforms the fistula from terminolateral into terminoterminal.

Arteriovenous Shunt, Surgical↗
PubMed1980

[Strangulated retrocostoxiphoid hernia. Review of the published literature and report on two cases (author's transl)].

Two cases of strangulated retrocostoxiphoid hernia (Morgagni-Larrey hernias) are reported. This is a relatively rare complication, as only 66 cases have been reported, and it has a poor prognosis. The clinical picture includes three main symptomatological groups: occlusion of the colon, gastric volvulus, and small intestine occlusion. Radiological examination of the lungs by frontal and profile films is usually sufficient to establish the diagnosis rapidly, and whether surgery is indicated. In some cases, however, the symptoms are such that opacification with water soluble agents is required. Reduction of the visceral hernia and closure of the orifice is carried out after laparotomy, resection of viscera being rarely required.

Aged↗