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Biomedical subjects

J Jamart

Publications and source records attributed to J Jamart.

195 records · Page 11Linked to original sources
PubMedDate not supplied

Minor alterations in thyroid-function tests associated with diabetes mellitus and obesity in outpatients without known thyroid illness.

Thyroid function tests might be affected by diabetes and obesity. To evaluate the influence of these parameters in routine conditions, 72 diabetic and 53 non-diabetic outpatients without known thyroid diseases or severe chronic illness were recruited over a 7-month period. For each patient, dosages of thyrotropin (TSH), total and free thyroxine (TT4 and FT4, respectively), total and free triiodothyronine (TT3 and FT3) and T3 resin uptake (T3RU) were performed by radioimmunoassays. The simultaneous influence of various parameters known to affect thyroid-function tests was evaluated by multivariate linear regression. The studied variables included gender, age, glucosteroids, estrogens, tobacco habits, iodine contacts, body mass index (BMI) and diabetes mellitus. Tobacco habits and iodine contacts did not influence any tests. As expected, estrogens induced an increase in TT4 and TT3 values (p < 0.001 and 0.020, respectively) associated with a decrease in T3RU (p < 0.001). Consequently, females had lower T3RU than males (p < 0.0001). Corticotherapy was associated with decreased TSH values (p = 0.022). TT3 and FT3 decreased with age (p < 0.001), whereas T3RU and FT4 increased (p = 0.020 and 0.004, respectively). In contrast to an increase in TSH (p = 0.006), TT4 and FT4 decreased at higher BMI levels (p = 0.018 and 0.004, respectively), which is consistent with subclinical hypothyroidism. In diabetic patients, TSH was lower than in nondiabetic subjects (p = 0.039). Thus, the present study indicates that besides known parameters such as age and drugs, thyroid-function tests can also be altered by diabetes mellitus and obesity.

Adolescent↗
PubMedDate not supplied

The pediatric liver transplant program at the Université Catholique de Louvain, Cliniques Saint-Luc, Brussels: overall results in 444 children (1984-1997).

Between 1984 and 1997, a total of 444 children (< 15 years) received an orthotopic liver transplant (OLT) at Saint-Luc University Clinics. Biliary atresia constituted the indication for OLT in 304 cases (68%). Median age (range) at OLT was 2.1 years (0.3-14.5). 177 children (40%) received a whole liver graft, 184 (41%) a reduced-size graft, 26 (6%) a split liver graft, whereas a living-related donor graft was used in 57 children (13%). Most grafts were ABO-identical or -compatible, in 395 cases (89%) and 40 (9%), respectively. Overall actuarial patient survivals at one and five years were 85% and 81%. The overall retransplantation rate was 19%. The results of uni- and multivariate statistical analyses showed a significant impact of year of transplantation (learning curve effect), with a 15% improvement of patient survival between the 1984-7 and the 1995-7 periods (p < 0.002). Results differed according to the indications for OLT, the best survivals being recorded for familial cholestasis, the worst for liver tumor (p = 0.004). Five year patient survival was significantly better after elective OLT (82%), when compared to highly urgent OLT (63%) (p < 0.001). Patient survivals were comparable in the children receiving primary cyclosporin-A microemulsion or tacrolimus immunosuppression, which were significantly higher than in the historical group treated with cyclosporin-A. No impact of the age at OLT, type of graft and ischemic time could be reported. In conclusion, this series illustrates the progressive improvements introduced in our pediatric liver transplant program between 1984 and 1997, including the technical variants allowing pediatric OLT using adult donors as well as the introduction of new immunosuppressive strategies.

Actuarial Analysis↗
PubMedDate not supplied

Oesophageal self expanding metal stents. Preliminary report about covered and non-covered types.

OBJECTIVE: The aim of this study was to evaluate the effectiveness and complications rate of covered and non-covered self expanding metal stents in the palliative treatment of oesophageal dysphagia. DESIGN: In this retrospective non-randomized study, we evaluated 11 non-covered and 17 covered stents of different types. RESULTS: Grade of dysphagia and improvement after treatment were similar in both groups, all the seven fistulas were sealed by covered stents. Covered stents seem to be safer regarding the rate of life-threatening complications and reinterventions. In contrast to published studies, bleeding was our major complication with death related in half of these patients. Aorto-Oesophageal fistula was proved by autopsy in two of them. CONCLUSIONS: Covered stents lead to less drawbacks than non-covered ones and seem to be recommended in the palliation of oesophageal dysphagia even in the absence of fistula.

Aged↗
PubMedDate not supplied

Proximal femur density in type 1 and 2 diabetic patients.

This study reports on the proximal femur mineral content in 36 Type 1 and 60 Type 2 diabetic patients. Bone mass measurements were performed in the neck, Ward's triangle and in the trochanteric area of the femur, using dual-photon absorptiometry with 153Gd. Bone mineral density (BMD) was significantly decreased in Type 1 diabetic men and women as well in Type 2 men, when compared with a non diabetic matched population. In Type 1 men, neck and Ward's triangle densities were reduced from 0.94 +/- 0.05 to 0.86 +/- 0.11 (p = 0.007) and from 0.87 +/- 0.10 to 0.74 +/- 0.14 g.cm-2 (p = 0.011), respectively. In Type 1 women, BMD was reduced from 0.97 +/- 0.10 to 0.90 +/- 0.10 g.cm-2 (p = 0.023) in the femoral neck. In Type 2 men, BMD in Ward's triangle was also significantly lower than in controls: 0.69 +/- 0.14 vs 0.76 +/- 0.19 g.cm-2, respectively (p = 0.001). In contrast, no bone loss was observed in a group of Type 2 overweight diabetic women. No statistical correlation was observed between bone loss and age, duration of diabetes, body mass index, C-peptide levels, daily insulin doses, HbA1 and the presence of diabetic complications. In conclusion, long-standing Type 1 diabetic men and women and Type 2 diabetic men have a decrease in the proximal femur bone mass. Type 2 diabetic women appear to be protected from diabetic osteopenia.

Adult↗
PubMedDate not supplied

[The surgical treatment of obstructive cancers of the left colon. Apropos of a series of 66 cases].

From 1977 to 1989, 66 patients were operated on in emergency, without any bowel preparation, for acutely obstructing left-sided colon cancer. Two synchronous cancers were diagnosed and the 68 tumours were located as follows: 13 on the left transverse colon or at the splenic flexure, 7 on the descending colon, 37 on the sigmoid, and 11 at the rectosigmoid junction or below. According to Astler-Coller staging, 15 patients were classified as B, 17 as C and 25 as D. Initial treatment was a colostomy in 58 patients (88%), or a resection with or without anastomosis in 2 and 6 cases respectively. Most patients underwent a two- or more rarely a three-stage resection and 44 patients left the hospital without either tumour or stomy. Cumulative operative mortality was 12%. Five-year survival rates were 21% for the patients with a minimal potential follow-up of 5 years, and 39% for curative resections (disease-free survival of 33%). From these results, we think that two-staged resection, with close proximal colostomy followed by resection and anastomosis, remains an appropriate approach for most obstructing left-sided colon cancers; more tempting procedures such as resection with primary anastomosis or subtotal colectomy are probably indicated in selected patients.

Adult↗
PubMedDate not supplied

[Stomach cancer: surgical experience in the clinics of the Louvain University (UCL) 1969-1986].

Gastric carcinoma: surgical experience at the University of Louvain Clinics from 1969 to 1986. From january 1969 to june 1986, 201 gastrectomies were performed for gastric adenocarcinoma (curative resection in 81%, palliative resection in 19% of the patients). Hospital postoperative mortality was 6.9%. Five and ten year actuarial survival rates were, +/- 4% and 34 +/- 7%, respectively. In this series, there was a rather high percentage of early gastric carcinoma (23% of the patients), with, as expected, a high actuarial 5 year survival rate: 90 +/- 6%.

Actuarial Analysis↗
PubMedDate not supplied

Transcatheter arterial chemotherapy using doxorubicin, iodized oil and Gelfoam embolization in hepatocellular carcinoma.

Computed tomography (CT) was performed in 54 patients with hepatocellular carcinoma three weeks after transcatheter arterial chemotherapy using iodized oil and doxorubicin with or without gelfoam embolization. Patients with iodized oil retention in the tumor greater than 50 per cent of tumor size survived longer than patients with retention of less than 50 per cent. Differences were also found within Okuda stages I and II, but they were significant only in Okuda stage I (p less than 0.0001). These results suggest a possible relationship between iodized oil retention and survival. In addition to Okuda stage, several factors affected iodized oil retention: tumor vascularity, tumor size, portal thrombosis and Gelfoam embolization. These factors may thus influence the prognosis after transcatheter arterial chemotherapy.

Adult↗
PubMedDate not supplied

[Esophageal intramural bronchogenic cysts (author's transl)].

The authors report two cases of bronchogenic cysts of the esophagus. The first description of an intramural double bronchogenic cyst of this organ is published. These cysts are uncommon and result from an aberrant cleavage of the primitive gut. They are characterized by the presence of a ciliated cylindric epithelium of the respiratory type, bordering the intern side of the tumor. The symptomatology is not specific. The diagnosis of benign tumor is based on the roentgenologic picture. The thoracotomy is necessary and the best treatment is enucleation of the tumor.

Adolescent↗
PubMedDate not supplied

[Paraduodenal hernia: 3 cases and revue of the literature (author's transl)].

Three cases of surgically treated para-duodenal hernia are presented. The literature is reviewed. Several modalities of this entity are described as well as the embryological hypotheses to explain their genesis. The diagnosis is usually made at the time of a laparotomy for bowel obstruction. The surgical manipulations to reduce the hernia content (one or several loops of small bowel) are discussed.

Adult↗