Biomedical subjects

J Fleury

Publications and source records attributed to J Fleury.

At least 73 records · Page 4Linked to original sources

PubMed1994

The hematopoietic stem cell transplantation in Hodgkin's disease: questions and controversies.

Most patients with Hodgkin's disease (HD) are cured with chemotherapy and/or radiotherapy. However, half of those with advanced stage disease (IIIB, IV) do not respond adequately to treatment or relapse. Salvage therapy used in such cases gives from 10% to 50% complete remission but only 10% long term survival. The results of bone marrow transplantation reported in acute leukemia and non-Hodgkin's lymphoma encouraged some authors to develop this new therapeutic strategy in Hodgkin's disease. In the early 1980's promising results were achieved when refractory and relapsed patients were selected to receive myeloablative therapy followed by bone marrow transplantation. Today, high dose chemotherapy with hematopoietic stem cell transplantation (HSCT) is used more and more often in poor prognosis Hodgkin's disease. After a review of the literature concerning the results of transplantation in Hodgkin's disease, we develop the numerous problems associated with this procedure which remain to be solved such as: the optimal indication, the timing of HSCT, the type of graft, the conditioning regimen, the place of radiotherapy and the optimal use of hematopoietic growth factors. We conclude with future prospects.

Age Factors↗

PubMed1994

[Prognostic value of beta-2-microglobulin in Hodgkin disease in young adults].

From 1977 to 1989, we measured serum beta-2-microglobulin (beta 2-MG) levels from 64 unselected and untreated patients, between 18 to 50-year-old, affected by Hodgkin's disease. Serum beta 2-MG level was measured by radioimmunoassay (Phadebas beta 2 microtest). Then, all patients received a chemotherapy such as MOPP or alternating MOPP/ABVD followed or not by radiotherapy. Elevated serum beta 2-MG level (> 2.4 mg/l) is associated with advanced stage disease (stage III-IV), presence of systemic symptoms and bulky tumor. Nevertheless, a multivariate analysis shows that the serum beta 2-MG level is the most significant prognostic indicator for disease free survival. The prognostic value of serum beta 2-MG is demonstrated for myeloma and non Hodgkin's lymphoma. A few authors have evaluated the prognostic impact of serum beta 2-MG in Hodgkin's disease. This study requires confirmation by multicentric and prospective trial.

Adolescent↗

PubMed1994

The Index of Readiness: development and psychometric analysis.

This article describes the development and initial psychometric evaluation of a measure of individual appraisal of readiness to initiate health behavior change. Items were developed from inductively generated data to index dimensions of individual appraisal of readiness. Quantification of Index of Readiness content validity was established through the ratings of 10 experts, following criteria established by Imle and Atwood (1988). The instrument was tested in successive steps with 146 individuals who were participating in an outpatient cardiac rehabilitation program, for reliability and validity, including internal consistency reliability, and three forms of validity assessment (content validity, criterion-related validity, and construct validity). The three subscales of Reevaluation of Lifestyle, Identification of Barriers, and Goal Commitment demonstrated internal consistency. Criterion-related and construct validity were substantiated. With refinement, this measure will provide a basis for nursing interventions designed to enhance individual motivation in relation to specific health behaviors.

Adult↗

PubMed1993

In vitro effects of recombinant human interferon gamma on human mesothelioma cell lines.

Malignant mesothelioma is a tumor arising from serous surfaces and often related to asbestos exposure. Malignant mesothelioma is resistant to various forms of therapy. Radiotherapy, surgery or chemotherapy only slightly improve prognosis. IFN-gamma produces complete or partial responses in stage-I patients with malignant mesothelioma. The in vitro biological effect of IFN-gamma on malignant mesothelioma cells remains poorly elucidated. In the present study, 32 well-characterized human mesothelioma cell lines (HMCL) were treated with r-hu IFN-gamma at 4 doses and cell growth was determined by a colorimetric method (MTT assay). Among the 32 HMCLs tested, II exhibited significant cell-growth inhibition; 16 were insensitive to r-hu IFN-gamma, and 5 were slightly inhibited. The sensitive cell lines were strongly inhibited by r-hu IFN-gamma. Our results show that HMCL exhibit a large range of responses to r-hu IFN-gamma, some of which can be compared with those obtained in vivo in humans.

Aged↗

PubMed1993

Infection due to Klebsiella rhinoscleromatis in two patients infected with human immunodeficiency virus.

Two cases of rhinoscleroma in patients infected with the human immunodeficiency virus (HIV) who had stayed in an area of endemic Klebsiella rhinoscleromatis are reported. One of the patients presented with oropharyngeal lesions, an unusual clinical picture. Both patients suffered from a major cellular immune deficiency. The importance of Klebsiella rhinoscleromatis infection in AIDS-related oropharyngeal pathology and the possible treatment of such infection in HIV-positive patients are not yet clearly established.

AIDS-Related Opportunistic Infections↗

PubMed1993

Preserving qualitative meaning in instrument development.

This article presents the process through which qualitative meaning can be preserved in instrumentation. Examples illustrating this process are taken from the development of the Index of Readiness, a scale designed to assess and evaluate individual appraisal of readiness to initiate health behavior change. The generation of scale items from qualitative data and the initial steps taken to assess instrument reliability and validity as a way of preserving the meaning inherent in qualitatively generated data are described. The creation of measurement scales that reflect the uniqueness of individual experience and meet criteria for psychometric testing challenges nurse researchers to continue to devise more effective ways of representing and investigating the complexities of human experience. The use of qualitative data for instrument development is an important aspect of such scale development.

Health Behavior↗

PubMed1993

[Subretinal proliferation and rhegmatogenous retinal detachment].

We reviewed the clinical files of 314 patients (341 eyes) affected by rhegmatogenous retinal detachment who were operated on before any failed attempt to reattach the retina. The study was conducted to elucidate the clinical and prognostic value of subretinal proliferation. Clinical evidence of subretinal proliferation visible at preoperative examination was more frequent in eyes with retinal detachments related to retinogenic retinal breaks (oral dialyses, atrophic holes in lattice) (32.35%) as compared to retinal detachments associated with horse-shoe tears (4.60%) (P < 0.001). The mean duration of retinal detachments with subretinal proliferation was 12 months (range: 3 months to 5 years). Postoperative proliferative vitreoretinopathy occurred in 2.27% (1/44 eyes) of retinal detachments with subretinal proliferation compared with 6.73% (20/297 eyes) of retinal detachments without subretinal proliferation. Permanent retinal reattachment was achieved in all eyes with subretinal proliferation. However postoperative visual acuity of 20/40 or better was obtained in only 34% (15/44 eyes) of eyes with subretinal proliferation compared with 58% (160/275 eyes) of retinal detachments without subretinal proliferation (P < 0.01).

Eye Diseases↗

PubMed1992

Mesothelioma in rats following intrapleural injection of chrysotile and phosphorylated chrysotile (chrysophosphate).

Pathological effects of asbestos are probably dependent on the size and surface properties of the fibers. Surface-modified chrysotile fibers were injected into the pleural cavity of rats to investigate the potency of the fiber to induce mesothelioma. Chrysotile fibers were modified by a phosphorylation process, resulting in the presence of phosphorus at the fiber surface. Phosphorylated samples were characterized by enhanced durability and reduced affinity for biological macromolecules. Five samples were tested: 1 untreated and 4 phosphorylated. ChrP1, ChrP2 and ChrP3 corresponded to phosphorylated samples obtained by first, second and third passages through an Alpine classifier; Pm was defibrillated ChrP1. The number of fibers per microgram and the size distribution were determined by transmission electron microscopy and classified in 4 size groups. Groups of 35 rats were inoculated with 20 mg of fibers suspended in 0.9% NaCl solution. No mesothelioma was found in the saline controls. All fiber samples were proficient in producing mesothelioma; the percentages were different between groups and untreated chrysotile but not significantly so. The differences may be explained on the basis of the number of fibers injected which were greater than 8 microns in length and less than 0.25 microns in diameter. The findings of a proficiency of long fibers to produce mesothelioma, previously reported by others for glass fibers, could be applied to chrysotile.

Animals↗

PubMed1992

[Lung abscess caused by Rhodococcus (Corynebacterium) equi in HIV infection. Two cases].

Rhodococcus (Corynebacterium) equi is a well-known Gram positive bacillus which is usually pathogenic in farm animals but rarely causes diseases in humans. Only 30 cases of human infection have been reported in the literature. R. equi has recently been added to the list of opportunistic agents in severe HIV infection. Its most common manifestation in immunocompromised is a slowly progressive pneumonia which may cavitate. R. equi pulmonary infections are difficult to treat: they usually require prolonged parenteral antibiotic therapy and often need surgical treatment. Two cases of cavitary pneumonia in patients with severe HIV infection are reported here. In one case the disease was associated with pulmonary Kaposi sarcoma and pneumocystis pneumonia; the other case was the first opportunistic infection in the course of HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Prognostic value of new retinal tears associated with the development of postoperative proliferative vitreoretinopathy.

We prospectively evaluated for the presence of new retinal tears 60 eyes of 60 patients who developed recurrent retinal detachment complicated by proliferative vitreoretinopathy (PVR) after surgery for primary rhegmatogenous retinal detachment. New retinal tears associated with the development or recurrence of postoperative PVR were disclosed in 27 eyes (45%). New tears were categorized into two distinct groups: (1) peripheral new tears and (2) posterior new tears. Peripheral new tears were disclosed in 11 eyes. They were invariably located at the posterior edge of the vitreous base and showed a prevalence in the inferior quadrants. The prognosis for permanent retinal reattachment after reoperation was not influenced by the presence of peripheral new tears. Posterior new tears were disclosed in 19 eyes. They were located in the mid-periphery or close to the posterior pole. They were more frequent in grade D PVR (57.7%) compared with grade C PVR (11.7%) (P less than 0.01). Posterior new tears were associated with a poor prognosis. In grade D PVR the anatomic success rate following repeated surgery was only 13.3% (2/15 eyes), whereas all eyes with grade D PVR and no posterior new tears were successfully reattached (P less than 0.001). Failures to reattach the retina were related to recurrent PVR. It is concluded that the development of posterior new tears in postoperative PVR reflects a severe and active PVR process.

Adolescent↗

PubMed1992

The application of motivational theory to cardiovascular risk reduction.

The level of motivation sustained by an individual has been identified as a primary predictor of success in sustained cardiovascular risk factor modification efforts. This article reviews the primary motivational theories that have been used to explain and predict cardiovascular risk reduction. Specifically, the application of the Health Belief Model, Health Promotion Model, Theory of Reasoned Action, Theory of Planned Behavior and Self-efficacy Theory to the initiation and maintenance of cardiovascular health behavior is addressed. The implication of these theories for the development of nursing interventions as well as new directions for nursing research and practice in the study of individual motivation in health behavior change are discussed.

Attitude to Health↗

PubMed1992

Long-term management of the patient with stable angina.

Advances in the pharmacologic, medical, and surgical treatment of ischemic heart disease have led to the recognition of new goals in the treatment of patients with stable angina, including the relief of symptoms, treatment of underlying causes, and the enhancement of their quality of life. As research continues to provide more information about the pathophysiologic process of ischemic heart disease, new procedures, diagnostics, and management techniques will continue to emerge. In considering the long-term management of patients with stable angina, the primary role of the nurse is in providing relevant information regarding the management of anginal symptoms and related lifestyle modifications. Integrating knowledge of the disease process and its treatment into nursing practice will achieve a comprehensive plan of nursing care that addresses the physiologic, psychosocial, and educational needs of the patient and family members.

Adrenergic beta-Antagonists↗

PubMed1992

[Adhesive capsulitis of the shoulder: a comparative study of arthrography with intra-articular corticotherapy and with or without capsular distension].

A double-blind, prospective study of 45 patients with adhesive capsulitis of the shoulder compared the therapeutic efficacy of distensive and nondistensive arthrography in combination with the intra-articular injection of corticosteroids. After 1 and 3 months there was no significant difference between the two treatments in the degree of pain or of limitation of movement experienced by the patients. More than 80% of the patients who experienced pain at rest and nocturnal pain improved under both treatment regimens. Scapulohumeral mobility increased significantly but only partially within the first month of treatment. Articular capacity and the duration of symptoms before treatment were of no prognostic value.

Adrenal Cortex Hormones↗

PubMed1992

[Late macular pseudo-hole after surgical peeling of a premacular membrane].

We present three clinical cases showing a pseudo macular hole that developed late after an uneventful surgical removal of an epiretinal membrane. The pseudo macular hole developed 3 to 19 months postoperatively. The macular changes seen in all cases showed stricking differences when compared with pseudo macular holes associated with epiretinal membranes. A hypothesis is suggested for the pathogenesis.

Diagnosis, Differential↗

PubMed1991

Management of retinal detachment after penetrating eye injury.

Between December 1981 and April 1989 the authors operated on 61 eyes presenting with retinal detachment after penetrating eye injury. Air or expanding gases were used for retinal tamponade. The follow-up between complete gas absorption and last examination ranged from 8 months to 8 years (mean, 29 months). Retinal reattachment was achieved in 50 eyes (81.9%). Anatomic success was achieved by a single operation in 43 eyes (70.5%). A postoperative visual acuity of 20/40 or better was achieved in 46% of the eyes. The factors found to influence the postoperative outcome adversely include (1) association of severe blunt trauma (P less than 0.05), (2) anterior proliferative vitreoretinopathy (PVR) involving two or more quadrants (P less than 0.01), and (2) retinotomies (P less than 0.007).

Adolescent↗

PubMed1991

Histiocytic medullary reticulosis occurring with small cell lung carcinoma.

Haematophagocytic activity is a salient feature of malignant histiocytic medullary reticulosis. This potency has also been observed as an aberrant property of non-histiocytic malignant cells or as a benign histiocytic process in response to infections or malignancies. We report the case of a patient who presented simultaneously with a limited stage small cell lung carcinoma and a fatal reactive form of histiocytosis. We conclude that such a haematophagocytic syndrome may occur in the setting of small cell lung carcinoma s previously described in other malignancies.

Aged↗

PubMed1990

Effects of local anaesthetics (lidocaine) on the structure and function of ciliated respiratory epithelial cells.

Sampling for nasal or bronchial ciliated cells requires the use of anaesthetic agents, but such drugs may interfere with the morphological or functional results. Lidocaine is the most frequently used local anaesthetic. In order to study the morphological and functional effects of lidocaine hydrochloride, we designed an experimental study on ciliated cells from guinea pig and bovine trachea. On guinea pig tracheal specimens, different lidocaine concentrations (0.05, 0.25 and 1%) were tested. Tracheal rings were immersed in either culture medium alone (control) or in different lidocaine concentrations. Measurements of ciliary beat frequency (CBF) were performed by the stroboscopic method. Tracheal rings were consecutively incubated in culture medium alone and a second set of measurements was performed. Tracheal rings were studied by light microscopy after incubation in either 1% lidocaine or in culture medium alone. On bovine tracheal specimens, a cotton wool swab impregnated with different lidocaine concentrations (0, 0.25, 1, 2.5 and 5%) was placed in contact with the tracheal mucosa. Three different kinds of samples were collected: the first one was used to study CBF, the second one (0.1 and 5%) was studied by scanning electron microscope (SEM) and the third (0.1 and 5%) by transmission electron microscopy (TEM). The results on guinea pig specimens show a significant but reversible CBF diminution for concentrations of 0.25 and 1% lidocaine and cellular lesions for the concentration of 1%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1990

[Retinal detachment and massive vitreoretinal proliferation: clinical study of 60 cases].

Perfluoropropane gas as an adjunct to vitreoretinal microsurgery in the management of proliferative vitreoretinopathy. Pure perfluoropropane gas was used as an adjunct to vitreoretinal microsurgery in 60 eyes of 60 patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. 0.3 ml to 1.8 ml (average 0.9 ml) of pure perfluoropropane gas were used. The surgical procedure included a vitrectomy and a scleral buckling procedure in all patients. The follow-up after complete gas absorption ranges from 6 months to 3 years in the successful eyes. Total retinal reattachment was achieved in 41 eyes (68.3%). The anatomical success rate was 88% (22/25 eyes) in grade C1-C2 PVR cases, 68.7% (11/16 eyes) in grade C3-D1 PVR cases, and 42% (8/19 eyes) in grade D2-D3 PVR cases. Visual acuity of 0.1 or better was achieved in 80% of eyes with grade C PVR and 61% of eyes with grade D PVR. Visual acuity of 0.4 or better was achieved in 26.9% of eyes with grade C PVR. Macular changes were revealed by fluorescein angiography in 53% of successful eyes. We recommend the use of C3F8 rather than SF6 in the management of rhegmatogenous retinal detachment complicated by PVR. In our experience the anatomical success rate achieved with C3F8 is approximately the same as that achieved with SF6. However permanent retinal reattachment was achieved with a single operation in 87.8% of successful eyes of the present series of patients manages with C3F8 as compared to only 12% of successful eyes of a previous series of patients managed with SF6.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗