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Biomedical subjects

J F Henry

Publications and source records attributed to J F Henry.

At least 163 records · Page 9Linked to original sources
PubMed1978

Antihypertensive therapy in patients above age 60. Third interim report of the European Working Party on High blood pressure in Elderly (EWPHE).

Three hundred forty nine hypertensive patients above the age of 60 have entered the double-blind multicentre trial of the European Working Party on High blood pressure in the Elderly (EWPHE). After stratification and randomisation half were treated with one or two capsules containing 25 mg hydrochlorothiazide and 50 mg triamterene and if blood pressure control was insufficient methyldopa was added up to 2 g daily; the other half received matching placebo. No significant differences between the groups were present prior to randomisation. A significant blood pressure difference of 25/10 mm Hg was obtained between the groups and maintained during two years of follow-up. No major disturbances in serum potassium or serum sodium were noted with the present drug combination. However, during the initial phase an increase in serum creatinine and serum uric acid was noted in the actively treated group, which was maintained for two years. Also glucose tolerance was impaired after 2 years in the actively treated group. A favourable influence on prognosis by active treatment can be expected on the basis of the blood pressure reduction and in the absence of major electrolytes disturbances. But this benefit must be proven by observed statistical differences in terminating events between the groups. Therefore the patients are being followed for a longer period of time and more patients are admitted into the trial.

Aged↗
PubMed1977

[Septicemia in the elderly (author's transl)].

Out of 1,251 patients above 65 years of age staying at the Charles Foix Hospital (prolonged hospitalization) and the St. Joseph Hospital (acute cases), 168 had one or more positive blood cultures. Urinary tract infection is a major source of septicemia due to gram negative bacilli. It is important to stress cases of septicemia due to pneumococcal pneumoniae, eschars, and other skin lesions. Mortality varies between 33 and 36%, depending upon the hospital. Collapse, although infrequent, still portends a grave prognosis (61% of cases of collapse led to death at Charles Foix Hospital). The combination of more than two risk factors considerably worsens the prognosis. Hypoproteinemia and dementia are every bit as grave as diabetes and cancer. A better isolation of the microorganisms involved in cases of septicemia in the elderly will lead to a more judicious choice of antibiotics. The administration of chemotherapy immediately after the samples were obtained remains the main guarantee of successful therapy.

Aged↗
PubMed1977

[Prognosis of visceral and osseous metastases of differentiated thyroid cancers. 24 cases].

Twenty four cases of differentiated thyroid carcinoma with distant metastases are analysed. Prolonged survival periods are possible. The best prognosis in papillary forms is stressed. Metastases fixing I131 progress more slowly, as a result of treatment with radioactive iodine but apparently also by virtue of the higher degree of differentiation of such metastases. One case of apparent cure of pulmonary metastasis after treatment with radioactive iodine is described. Surgery and external radiotherapy retain a place of choice in the treatment of metastases. In our experience, chemotherapy has been disappointing.

Adolescent↗
PubMedDate not supplied

Thyroperoxidase immunodetection for the diagnosis of malignancy on fine-needle aspiration of thyroid nodules.

We have previously demonstrated that in 95.6% of malignant thyroid tumors the enzyme thyroid peroxidase (TPO) presents antigenic changes detectable by a monoclonal antibody termed MoAb47. The aim of this study was to investigate the interest of TPO immunodetection for the diagnosis of malignancy on fine-needle aspiration biopsy (FNAB) of thyroid nodules. The study was performed on 300 patients. Slides of FNAB aspirate were air-dried and stained by anti-TPO-MoAb47. According to the percentage of TPO-positive epithelial cells, patients were divided into two groups: benign (> 80%) and malignant (< 80%). In 279 cases additional slides were available for Giemsa stain and standard cytology. All the patients were operated on, and the final diagnosis was recorded as benign in 248 cases (183 macrofollicular nodules, 23 microfollicular adenomas, 18 atypical adenomas, 11 oncocytomas, 11 thyroiditis, 2 Graves' disease) and malignant in 52 cases (44 papillary carcinomas and 8 follicular carcinomas). Samples from 215 of 248 benign nodules yielded 80% to 100% TPO-positive cells, whereas samples from all malignant tumors yielded less than 80% positive cells. The sensitivity of TPO staining for diagnosis of malignancy was thus 100%, its specificity 86.7%, and its overall accuracy 89%. With conventional cytology, sensitivity, specificity, and accuracy were 91.6%, 79.2%, and 81.0%, respectively. We conclude from this study that TPO staining with MoAb47 should become an essential adjunct in the preoperative cytologic diagnosis of thyroid nodules.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Results of reoperations for persistent or recurrent secondary hyperparathyroidism in hemodialysis patients.

Among 258 patients operated on for secondary hyperparathyroidism (HPT II) from 1971 to 1988, a total of 33 had one or more reoperations for persistent or recurrent HPT II. These reoperations did not induce any mortality or significant morbidity. After inadequate parathyroidectomy (25 cases), 15 patients were reoperated. Twelve of these had undergone initial surgery at another institution. Three patients died of causes unrelated to their HPT II. The other 12 patients are disease-free. After successful subtotal parathyroidectomy (79 cases), 2 patients (2.5%) had a recurrence 5 and 6 years later, respectively. Currently, the 2 patients remain disease-free. After total parathyroidectomy with autotransplantation (152 cases), 16 patients (10.5%) had reoperations on the grafts. The mean time before reoperation was 2 1/2 years. Hypertrophy of grafted fragments was observed in 4 cases (2.6%), but only 2 of these 4 patients were cured by removal of the grafts. Residual parathyroid tissue or a supernumerary gland in the neck or the mediastinum was suspected in 5 patients, but this could not be confirmed because one had already been reoperated on in the neck without success, another still refuses reoperation, and 3 died. In 6 other patients, the recurrence was debatable and HPT II was not confirmed. In the last 3 patients, the diagnosis was incorrect and aluminum intoxication was proved later. Results of reoperations for persistent or recurrent HPT II depend, first, on a correct diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Expression of proliferating cell nuclear antigen in follicular thyroid tumors: correlation with clinicopathological findings.

The purpose of this study was to correlate proliferating cell nuclear antigen (PCNA) immunostaining with clinicopathological findings in 60 follicular thyroid tumors. Mean proliferative index (PI) was significantly higher for carcinoma (73%) than microfollicular adenoma (19.6%) (p<0.0001). For atypical and oncocytic adenomas, intermediate PI values (64% and 50%) correlated with size and cytological atypia but not with sex and age. PCNA immunostaining is of limited value for differential diagnosis of malignant and atypical tumors but could be useful for identification of actively growing atypical follicular thyroid nodules on fine needle aspiration biopsies.

Adenoma↗
PubMedDate not supplied

[Video-assisted minimally invasive parathyroidectomy with lateral approach in patients with primary hyperparathyroidism].

INTRODUCTION: Different minimally invasive techniques of parathyroidectomy have been described. We performed a retrospective study to evaluate the indications and results of video-assisted parathyroidectomy (VAP) in the management of patients with primary hyperparathyroidism (PHPT). MATERIALS AND METHODS: Between 1998 and 2002, 528 patients were operated on because PHPT. VAP was proposed for patients with sporadic PHPT, without associated goiter and previous neck surgery, in whom a single adenoma was localized. VAP was performed by lateral approach with insufflation for patients with adenoma located deeply in the neck and by gasless midline approach for anteriorly located adenomas. A quick parathyroid (qPTH) assay was used during the surgical procedure. Calcemia, phosphoremia and PTH were systematically evaluated after surgery. RESULT: Of 528 patients with PHPT, 228 (43%) were not eligible for VAP because associated nodular goiter (99 cases), previous neck surgery (42 cases), suspicion of multiglandular disease (25 cases), lack of preoperative localization (48 cases), and miscellaneous causes (14 cases). VAP was performed in 300 patients with sporadic PHPT: 282 lateral access, 17 midline access and one thoracoscopy. Mean operative time was 50'. Conversion to conventional parathyroidectomy was required in 14% of cases. One patient presented a definitive recurrent nerve palsy. One persistent and one recurrent PHPT were observed. CONCLUSION: VAP can be proposed for patients with PHPT. Immediate results of VAP are similar to those obtained with conventional parathyroidectomy; no conclusions can be drawn in terms of influence of VAP on the outcome of the patients operated for PHPT.

Humans↗
PubMedDate not supplied

[Writing the clinical trial report].

The clinical study report is a key document, representing as it does one of the elements of the drug registration file. The authors propose here a general design for a controlled trial which offers the advantage of a methodical approach covering most clinical study situations.

Clinical Trials as Topic↗
PubMedDate not supplied

[Surgical treatment of secondary hyperparathyroidism in hemodialyzed patients with chronic renal failure. Results and choice of a technic].

Results are reported of surgical treatment of hyperparathyroidism secondary to chronic renal failure in 231 patients who had undergone 250 operations over 16 years: 152 total parathyroidectomies associated in 151 cases with an autotransplant, 58 subtotal parathyroidectomies, 9 incomplete parathyroidectomies, I white cervicotomy and 39 repeat operations for persistent or recurrent hyperparathyroidism. Results were evaluated clinically, biologically and radiologically after a mean follow up of 4 years, and were rated good in 71.4% of cases. The quality of the results was independent of the type of parathyroidectomy practised: 71% good results after total parathyroidectomy with autotransplantation and 69% after subtotal parathyroidectomy. No significant difference was demonstrated between the two techniques with respect to mortality, postoperative morbidity and late complications. The only divergence seen was in relation to recurrences: recovery surgery at the cervical level after subtotal parathyroidectomy leaving a clearly identified glandular stump associated with a better result than repeat operation on grafts at brachial level after total parathyroidectomy and autograft. These results led to the adoption of a surgical routine for hyperparathyroidism secondary to chronic renal failure using subtotal parathyroidectomy combined with bilateral thymectomy. The operation of total parathyroidectomy without immediate autotransplant is reserved for cervical recovery surgical procedures. Whatever the technique used, frozen storage of removed tissue is the indispensable complement of parathyroidectomy.

Follow-Up Studies↗
PubMedDate not supplied

[The nonrecurrent inferior laryngeal nerve. Apropos of 19 cases including 2 on the left side].

Nineteen cases of non-recurrent inferior laryngeal nerve were identified during 3791 cervicotomies for thyroid or parathyroid excision over the last 7 years, the nervous anomaly being of vascular anomaly origin in all cases. Predisposing factors for its onset during aortic arch development are discussed, together with possible symptomatology and means for preoperative diagnosis. Frequency in the cases reported was 0,54% from 3098 dissections on the right and 0,07% from 2846 dissections on the left. Although rare on the right and exceptional on the left, an aberrant non-recurrent pathway for the inferior laryngeal nerve represents a major, surgical risk during thyroid or parathyroid excision.

Aorta, Thoracic↗