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Biomedical subjects

J Godard

Publications and source records attributed to J Godard.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Cervical chordoma. Apropos of a case].

The chordomas are malignant tumors arising from the remnants of the posterior spinal chord. The chordomas of the cervical spine are rare (5% of the spinal chordomas). A new case of spine chordoma at C5 level in a 76 years old woman is reported. The diagnosis depends on the results of the histological studies and especially the studies of the labelled elements as Protein S100 or Cytokeratin. Firstly a double osteosynthesis was realized by an anterior and posterior approach. There was no radiotherapy after this operation. A new operation for a fracture of odontoid process was necessary one year later. There was no recurrence. The patient was complaining from pains, two years after the first operation in relation to lateral recurrence. A third operation by an anterior approach was realized. A radiotherapy of 50 Gy was applied on the same level. The first osteosynthesis was with acrylic cement and the second one with an autologous bone graft and a plate after removing the cement without problem. Actually she is in good health, 78 years old.

Aged↗
PubMed1990

[Frequency of infections in intensive care units: an incidence survey].

During a nine months period, 568 patients entered the Polyvalent Intensive Care Unit and were prospectively studied: 153 became infected and 289 infections were diagnosed. Urinary tract infections (31%) in patients with indwelling catheter, lower respiratory tract infections (22%) in tracheally intubated and ventilated patients and bacteremias (19%) totalized 75% of all I.C.U. acquired infections. Post operative and trauma patients were more frequently infected than medical patients. E. coli (19%), S. aureus (14%), Enterococcus (13%) and P. aeruginosa (12%) were isolated and resistance to antibiotics was not always important. The prescribed treatment was an association of antibiotics in 55% of cases. The group whose patients were infected had a longer stay in I.C.U. and a higher mortality rate than group of uninfected patients.

Cross Infection↗
PubMed1990

[Chronic subdural hematoma in the elderly and computerized tomography. Study of 80 cases].

The pathogenesis of chronic subdural hematoma, especially the reason why it becomes chronic is still under discussion. A series of 80 patients older than 60 years (47% older than 75 years) were studied clinically and by CT. As compared with angiography, CT allows the subdural hematoma to be detected earlier. In some cases the subdural hematoma might have been missed without CT. The indication for surgery remains unchanged and surgical techniques too. In 80% of the patients good results from the clinical point of view could be achieved. There was no correlation between clinical signs and the findings obtained by CT. Postoperatively it usually took 60 to 70 days for CT findings to disappear. The prognosis of subdural hematoma in the elderly remains guarded. The mortality rate in our series was 11% possibly as a consequence of age.

Aged↗
PubMed1989

Disseminated Geotrichum capitatum infection in a patient with acute myeloid leukemia.

A case of invasive Geotrichum capitatum infection is reported; a young patient had an acute leukemia for which he received a chemotherapy, and presented sepsis with blood cultures for Geotrichum capitatum, namely Dipodascus spicifer; this pathogen only described in cactus rot, is responsible for the first case of a human disseminated infection reported in literature. Then he developed a splenic and epididymic infection, with positive cultures for Geotrichum capitatum after splenectomy and castration. Treatment with amphotericin B and itraconazole was started with low minimal inhibitory concentration (0.1 microgram/ml). The patient died of massive hemoptisis. Autopsy findings demonstrated a lung, brain and kidneys seeding.

Adult↗
PubMed1989

[Rupture of neoplastic intracranial aneurysm caused by metastatic uterine choriocarcinoma].

Authors report a case of 18 years old woman with intracranial neoplastic aneurysm. Its rupture occurred one month after delivery, and the diagnosis of metastatic aneurysm from choriocarcinoma was made by pathologist. The craniotomy has allowed to remove the hematoma and the aneurysm with good immediate follow-up. In spite of X-ray-therapy and chemotherapy, the patient died one year after the outset from choriocarcinoma dissemination, in a comatose state. The review of the literature shows that this form of aneurysm is very exceptional. It is resulting from the invasion of the arterial wall by metastatic cells, by a neighbouring metastatic tumor or by another type of brain-tumor. In some cases, the aneurysmal rupture was the first symptom, before any gynecologic manifestation of the choriocarcinoma. The prognosis has been bad in such cases in spite of a commonly good response after chemotherapy.

Adolescent↗
PubMed1989

[Interventional computed tomography in thoracic oncology. Apropos of 170 cases].

The authors report their experience with follow-up cytohistological examination of subclinical thoracic lesions in oncology by transparietal puncture with CAT-scanning localization in 170 patients. They detail a few special points concerning the material used and their techniques, in view of reducing the most common incidents and of managing the most severe complications. They analyze their results in two groups of patients, one investigated in a context of known malignancy and the other, with no history of malignancy in whom bronchoscopy, bronchial lavage and brushing were negative. They found an overall sensitivity and specificity of 86% and 100%, respectively, in the diagnosis of malignant disease. The method showed an efficacy of 83.5%. For the two populations, sensitivity was 84% and 87% respectively, and efficacy was 82 and 85% respectively. Thus, the results were better in the patients who had never received anticancer therapy. They also observed significant differences depending on whether the targets were mediastinal, pleuropulmonary or parietal. While the rapid diagnostic information appears invaluable in both groups of patients, in contrast, the small volume of the specimens, which may be hemorrhagic, necrotic, with more or less extensive fibrosis of the stroma, and the immaturity of certain tumors, sometimes make it impossible for the pathologist to give a precise diagnosis of the tumor other than the benign or malignant structural character of the lesion. This represents a significant obstacle in hematology for affections which, although non surgical, nevertheless require precise identification of the lesion for effective therapy. The elaboration of more effective sampling material, repeated punctures and immunohistoenzymatic analysis techniques would probably further improve the results of the method.

Adolescent↗
PubMed1988

[Hand-Schüller-Christian disease with tumor localization in the posterior fossa].

A 19-year-old girl had been suffering since the age of 4 from Hand-Schüller-Christian disease. The condition was diagnosed by biopsy of a cranial bone lacuna. Later on, she developed diabetes insipidus and bilateral exophthalmos, both being typical signs of Hand-Schüller-Christian disease. At the age of 14, an intracranial tumour in the posterior cerebral fossa was discovered by computerized tomography, but in view of her parent's refusal of surgery, she was operated upon only 4 years later for obstructive hydrocephalus with intracranial hypertension. Two years after this operation, she presented with neurological signs of compression of the medulla oblongata, including tetraparesis and respiratory disorders, and the tumour was resected. Following a brief improvement she died of major hydroelectrolytic disorders due to her irreducible unstable diabetes insipidus. A review of the literature on Hand-Schüller-Christian disease and its rare association with intracranial tumours is analysed. The occurrence of such tumours raise important therapeutic problems and make the prognosis considerably worse.

Brain Neoplasms↗
PubMed1988

Hypereosinophilic syndrome with multiple organ dysfunction treated by allogeneic bone marrow transplantation.

A 26-year-old man with hypereosinophilic syndrome who had initial neurologic, cardiac, and pulmonary dysfunction, high eosinophil count, thrombocytopenia, and bone marrow fibrosis had only a transient response to conventional treatment with corticosteroids and hydroxyurea. He therefore received human lymphocyte antigen-identical allogeneic bone marrow transplantation (BMT) after conditioning with cytoxan and fractionated total body irradiation. Hematologic recovery was prompt, with normalization of blood counts and bone marrow. The patient died less than 3 months after transplantation from diffuse cytomegalovirus infection. Potential interest of BMT in patients with resistant hypereosinophilic syndrome and features of poor prognosis is discussed.

Adult↗
PubMed1987

[Erythromycin and latamoxef in the initial treatment of diffuse peritonitis with visceral failure].

In a thirty months prospective study, 61 patients treated in an Intensive Care Unit received erythromycin (E) (3 g/24 h) and latamoxef (L) (2 g/24 h) as soon as acute peritonitis was surgically confirmed. Five days later, E + L were stopped and nitro-imidazol (NI) was prescribed while searching for a possible infection. The severity of the illness was assessed by clinical study of organ failures and by use of the Simplified Acute Physiology Score (SAPS). 21 patients died (34%): among them 8 of the 19 with postoperative peritonitis. Average SAPS was 17.8 (+/- 4.1) while it was 13 in 631 ICU treated patients (mortality: 22%). Every patient needed mechanical ventilation; pré or per-operative shock has been noted in 41 (67%) and 27 had developed acute renal failure (44%). During E + L, 6 patients died because of an irreversible shock and twice the treatment was not efficient on the isolated bacteria (Pseudomonas aeruginosa, Staphylococcus). No more shock developed post-operatively. During NI, 11 secondary infections (20%) were diagnosed (bacteremia = 6, urinary tractus infection = 4, reactivated arthritis = 1). The bacteria were Streptococcus (n = 6) with Enterococcus (n = 5), Staphylococcus (n = 3) and Pseudomonas aeruginosa (n = 2): they were still respectively sensitive to ampicillin, methicillin and ticarcillin. The association E + L was clinically and biologically well tolerated.

Acute Disease↗