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Biomedical subjects

J Lévy

Publications and source records attributed to J Lévy.

At least 19 recordsLinked to original sources
PubMed2006

[Implantable cardioverter defibrillators in pediatric patients: results in a series of 33 cases].

UNLABELLED: Implantable defibrillator is the recognized treatment of sudden cardiac death. Miniaturization of the devices allows implantation in children. METHODS: This multicentric retrospective study analyzed data of 33 children aged 18 years and less who were implanted from 1990 to 2005. RESULTS: Age of patients are 10 to 18 years, 20 patients were implanted after a resuscitation of sudden death, 10 after a syncope, 2 after a ventricular tachycardia and 1 in a prophylactic way. Tachycardias on primary electrical disease are most frequent (46%). Hypertrophic cardiomyopathy accounts for 22%, DAVD for 14%, congenital cardiopathies for 12%. Seventeen patients received appropriate shocks and 14 patients had inappropriate shocks. There were two unexplained deaths. Five leads fractures and two device infections were noted. CONCLUSION: Implantable defibrillator is an effective treatment for children high-risk of sudden death. Occurrence of inappropriate shocks due to sinusal tachycardia, infections and leads fractures are frequent.

Adolescent↗
PubMed2005

[Late stent-thrombosis-related myocardial infarction].

The objective of the study was to assess the frequency of late stent-thrombosis-related acute myocardial infarction in patients with LAD stents. A series of 930 PCI procedures involving LAD stenting were performed in 920 patients (mean age: 63 years, 667 men) from January 1999 to December 2001. Among those 14 patients had late (> 30 days), thrombosis-related acute myocardial infarction after a mean delay of 135 +/- 131 days. Three-year thrombosis-free survival was 97.6%. By univariate analysis, risk of late thrombosis was associated with LAD-diagonal bifurcation stenting, placement of a stent on the ostium of a diagonal branch and number of stents implanted on the LAD. Patients with these risk factors might be appropriate candidates for long-term combined antiplatelet therapy.

Aged↗
PubMed2004

[Hexavalent combined vaccination].

Since January 2004, hexavalent combined vaccines are available in Belgium. They protect children simultaneously against 6 diseases (poliomyelitis, diphtheria, tetanus, pertussis, invasive infections with Haemophilus influenzae type b and hepatitis B) and reduce the number of needed injections. Acellular pertussis vaccine is the corner-stone of the combination. Theoretically, only 5 visits and 6 injections are needed to complete the vaccination of the children. In addition to the reduction of injections and consequently a better comfort for the child, Hexavalent vaccination favours an increase of immunization coverage, alleviation of the burden of diseases evitable by vaccination, simplification of immunisation programme and diminution of their cost. However an increased surveillance of the incidence of the diseases, particularly for pertussis and invasive Haemophilus influenzae type b disease is needed. As always for a new product, pharmacovigilance has to be able to detect any severe adverse event. Parent's information must be strengthened to maintain confidence in the immunization programme. Medical practice will have to adapt to the new vaccine because it reduces individual flexibility and modifies the catch-up immunization schedule.

Child, Preschool↗
PubMed2004

[Pneumococcal conjugate vaccine in children].

Streptococcus pneumoniae is one of the major causes of severe invasive infections in young children. As purified polysaccharide are not immunogenic in infants, vaccines containing the bacterial polysaccharide conjugated to a carrier protein have been developed according to the model that has proved to be effective for Haemophilus influenzae b and group C meningococcus. A conjugate vaccine containing the 7 serotypes responsible for about 90% of the invasive infections occuring in children in the United States has been shown to have a 97% protective efficacy against infections caused by vaccine serotypes. Pneumococcal conjugate vaccines are also protective, although to a lesser extent, against otitis media caused by vaccine serotypes, but the global impact of these vaccines on the total number of otitis media remains limited. The large scale use of this vaccine has demonstrated its epidemiological impact on the burden of invasive pneumococcal disease in the age group targeted by vaccination as well as among the adult contacts of the vaccines. On the basis of these informations, the conjugate pneumococcal vaccine has been included in the recommended vaccination schedule in Belgium. However, repeated vaccine shortages as well as the high cost of the product make the implementation of this recommendation uncertain.

Child, Preschool↗
PubMed2004

[Pertussis vaccine in adolescents and adults].

Despite high immunisation rates in infancy, Bordetella pertussis is still circulating in industrialised countries, causing severe infections in infants too young to be vaccinated, as well as an important number of long lasting cough episodes in older children, adolescents and young adults. The limited duration of the protection resulting from vaccination in the 2 first years of life is probably responsible for the insufficient control of the disease. The development of acellular pertussis vaccines has allowed immunisation of school age children, and an adult formulation is now available. The indications of this vaccine will be discussed.

Adolescent↗
PubMed2001

Role of Tc-99m DMSA scintigraphy in the diagnosis of culture negative pyelonephritis.

The aim of this work was to evaluate prospectively the proportion of children with a clinical and biological presentation of acute pyelonephritis, abnormal Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy and negative or equivocal urine cultures. All patients aged 6 weeks to 15 years suspected of acute pyelonephritis (APN) were admitted to the Paediatric Department and underwent Tc-99m DMSA scintigraphy within 3 days after admission and at 6 months. Of 166 patients enrolled in the study, 15 (9%) had negative or equivocal urine culture despite clinical and scintigraphic evidence of APN. Of these 15 children, renal ultrasound was normal in 7 patients and vesicoureteric reflux was found in 9 patients. Control DMSA 6 months after acute episode showed the disappearance of cortical lesions in eight and partial improvement in four patients. In this prospective series, as many as 9% of patients with APN would have been missed on the basis of equivocal or negative urine cultures. It is suggested that Tc-99m DMSA scintigraphy should be performed in children with severe infection without clear aetiology, especially in those with abnormal urinalysis.

Adolescent↗
PubMed1999

[Angioplasty or surgery in the patient with multivessel disease].

The aims of myocardial revascularisation are to treat angina, reduce ischaemia and improve life expectancy. Patients with multivessel disease have a poor prognosis, especially when the lesions are proximal, when the preseptal left anterior descending artery is involved and when left ventricular dysfunction is present. In this particular group of patients, coronary bypass surgery has been shown to improve 10 year survival. Coronary angioplasty has been compared with surgical treatment in many clinical trials. The medium-term survival is the same in both groups, but with a higher number of repeat procedures except in diabetic patients in whom mortality is higher after angioplasty. The use of coronary stents should reduce the number of post-angioplasty procedures. Constant technical improvements, the introduction of surgery without cardiopulmonary bypass, combined revascularisation procedures, new antiplatelet drugs, the absence of long-term comparative results, all this results in a personalized choice of revascularisation procedure based on the overall clinical and angiography features of each particular case.

Angioplasty, Balloon, Coronary↗
PubMed1998

[Contraceptive behavior of young Latin-American adults living in Montreal].

Recent research on the contraceptive practices of Hispanics adolescents living in Latin America and the United-States indicates that their practices are inadequate. However, contraceptive practices can vary according to levels of traditionalism and acculturation. In order to verify these hypotheses, the contraceptive behaviors of a group of 114 young adults from both genders of Hispanic origin were evaluated. Results indicate that half of the participants did not use any contraceptive method during the first intercourse and that condoms were the most common method. Contrary to American results, acculturation levels were not significant in contraceptive use. Degree of traditionalism in sexual roles was more significant.

Adult↗
PubMed1997

[Complications of silastic implants used in orbital repair].

Several questions concerning the material to be used for surgical repair of fractures of the orbit are still under debate. Surgeons may choose between autologous or heterologous grafts or different biomaterials. We conducted a retrospective analysis of 137 patients treated in our unit for fractures of the floor of the orbit over the last 20 years who received a silastic implant. After 20 years, the rate of complications requiring removal of the implant was 13.8%. Complications observed were dacryocystitis, implant migration to the skin and the maxillary sinus, skin fistula, persistent diplopia, communication between the orbit and the sinus, periorbit cellulitis.

Biocompatible Materials↗
PubMed1994

Comparison of the effects of calcipotriol, prednicarbate and clobetasol 17-propionate on normal skin assessed by ultrasound measurement of skin thickness.

In this study, we investigated the effect of calcipotriol, prednicarbate and clobetasol 17-propionate on skin thickness over a treatment period of 6 weeks. The study was conducted as a controlled, randomized, double-blind comparison. The influence of these drugs on normal skin under occlusive conditions was assessed visually and by measuring skin thickness using 20 MHz B mode ultrasound. Both topically applied glucocorticosteroids lead to a significant decrease in skin thickness. In contrast to the glucocorticosteroid-induced atrophy, calcipotriol application on normal skin leads to an increase in skin thickness in all volunteers. The effect remains constant for the duration of treatment. The cause of this increase seems to be an irritative reaction of the skin which was histologically investigated in one volunteer. The histological features of this reaction are characteristic for a subacute dermatitis. The implications of these findings for the therapeutic mechanism of calcipotriol are discussed.

Administration, Topical↗
PubMed1984

[Short-term obstetrical anesthesia. Study of the tiapride-ketamine combination].

Minor surgical procedures do not always require hospitalisation for several days. The use of short-acting anaesthetic agents should make such procedures possible on an ambulatory basis. A study was undertaken of the combination of tiapride and ketamine in 97 women seen in the department of obstetrics for therapeutic abortion or biopsy-curettage. The drug combination was satisfactory in the great majority of cases. It is sufficiently analgesic for surgery of this type. The minimal level of narcosis ensures rapid recovery without any subsequent falling asleep again. The psychomotor agitation caused by ketamine is counteracted by the doses of tiapride used. Only vomiting may be felt to be too frequent. Nevertheless, this occurred in women who were fully awake and had no major consequences.

Abortion, Induced↗
PubMed1982

Microencapsulation III: Preparation of invertase microcapsules.

Invertase was incorporated into polyamide microcapsules. The following parameters were studied: pH of the aqueous phase during interfacial polymerization; duration of the polymerization; surfactant concentration; stirring rate; improvements in the isolation procedure; effect of lyophilization. The inactivation of the encapsulated enzyme by pepsin was shown to be related to the acidic incubation medium and prompted incorporation of protective proteins in the microcapsules. This process allowed relative protection of the enzyme. In a second set of experiments, an emulsification-reticulation method was developed, which encapsulated invertase in a cross-linked protein. Various proteins and bifunctional acylating agents were tested. Microcapsules of immobilized invertase were prepared through cross-linking of the enzyme protein itself.

Capsules↗
PubMed1982

Microencapsulation IV: Cross-linked hemoglobin microcapsules.

Hemoglobin microcapsules were prepared through cross-linking of hemoglobin itself with various acyldichlorides. Variations in the reticulation conditions were preformed in order to ameliorate the oxygen dissociation curve, the mean diameter, and the possibility for the microcapsules to be lyophilized. With terephthaloylchloride, as the cross-linking agent, incorporation of inositol hexaphosphate and glucose, followed by stabilization through glutaraldehyde and using high stirring speed, allowed preparation of stable hemoglobin microcapsules, 5 micrometers in diameter, which suffered rapid lysis by proteases. They were able to ensure oxygen transfer: the dissociation curve was sigmoidal with a p50 = 13 mm Hg. They retained these properties after lyophilization followed by rehydration.

Capsules↗