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Biomedical subjects

J Leroy

Publications and source records attributed to J Leroy.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Macroglossia and speech in Beckwith-Wiedemann syndrome: a sample survey study.

In a sample survey study (questionnaires filled out by parents), all 40 patients with Beckwith-Wiedemann Syndrome (BWS) presented with macroglossia. Articulation problems were reported in 29 of them, which persisted in some following corrective tongue surgery. The impression emerges that the value of surgical treatment needs prospective assessment, that the parents are insufficiently informed, and that the adequacy of direct articulation therapy in BWS needs to be evaluated.

Adolescent↗
PubMedDate not supplied

Imaging studies in the diagnostic workup of neonatal nasal obstruction.

Twelve neonates presenting with nasal obstruction after birth were evaluated by imaging studies for diagnostic reasons. Four groups were recognized: Group I: choanal atresia (n = 5) and choanal stenosis (n = 1); Group II: congenital nasal pyriform aperture stenosis (CNPAS) (n = 3) and holoprosencephaly (n = 1); Group III: nasolacrimal duct mucocele (n = 1); Group IV: nasal hypoplasia (n = 1). Associated anomalies were found in eight patients. Four patients with choanal atresia showed manifestations of the CHARGE (coloboma, congenital heart defect, atretic choanae, retarded physical and neuromotor development associated with central nervous system anomalies, genital hypoplasia, and ear anomaly and/or deafness) association. In the fifth patient with choanal atresia, the diagnosis of amnion disruption sequence was made. One patient with CNPAS had a solitary maxillary central incisor (SMCI), a mild form of holoprosencephaly. Besides proboscis and synophthalmos, SMCI was also present in the holoprosencephaly case. The patient with severe nasal hypoplasia had warfarin embryopathy. This review emphasizes the need for performing imaging studies in the diagnostic workup of neonates born with nasal obstruction.

Abnormalities, Multiple↗
PubMedDate not supplied

Laparoscopic surgery for cancer: are we ready?

Following feasibility studies more and more large prospective reports even randomised trials document the treatment of digestive cancer using a laparoscopic approach. While the spectre of port-site recurrences, once so alarming has faded, it has become a challenge for laparoscopic surgeons to provide long-term follow-up. There is good class II and III evidence that staging laparoscopy (SL) has a value for oesophageal, gastric, pancreatic and hepatobiliary cancer as well as for intra-abdominal lymphomas since it adds to primary staging and often alters the clinical stage of the disease and hence the management of the individual patient. For minimally invasive oesophagectomy and gastric cancer surgery several series have demonstrated shorter perioperative morbidity and hospital stay however at present most studies report smaller numbers of selected patients and long term follow up is rare. The laparoscopic resection of pancreatic malignancies is not reported to be feasible, safe or potentially beneficial for the patient while the curative resection of suspected early gallbladder cancer is a poor indication. Nevertheless laparoscopy is documented to be safe and applicable for small malignant liver lesions and the Lacy trial was significantly in favour of laparoscopy-assisted colectomy, predominantly for stage III disease. Bearing in mind that in many fields of digestive cancer surgery, laparoscopy should still be conducted as part of a trial, it is safe to say that "we are ready" for this revolution to arise.

Abdominal Neoplasms↗
PubMedDate not supplied

[Malignant Neuroleptic Syndrome during tiapride treatment].

Tiapride, a benzamide compound, is a neuroleptic drug used in the treatment of some behavior troubles, especially in the alcohol withdrawal syndrome. We report a new case of malignant neuroleptic syndrome during a tiapride treatment in a 39 year-old alcoholic patient who had been admitted after a minor trauma. Symptoms were typical, with malignant hyperthermia in the absence of sepsis, coma, extrapyramidal syndrome, rhabdomyolysis, and severe metabolic acidosis. Dantrolene succeeded to reverse hyperthermia and rigidity; probably due to its delayed administration however, irreversible acidosis led to the patient's demise.

Adult↗
PubMedDate not supplied

[Acute nicardipine and nifedipine poisoning. Multicenter study. Cooperative study by the french poison control centers and the ARIT].

A study, that was realized by the French Association of Poison Control Centers, tried to estimate the toxicity of Dihydropyridine derivatives towards human beings, in comparison with other calcium antagonists, said to be more toxic. Though, the toxicity of the Dihydropyridine derivatives happens to be far less important considering the rarity or absence of their cardiac effects, it must not however be underestimated in the case of a mass ingestion, or if they are taken simultaneously with psychotropic or cardiotropic drugs.

Acute Disease↗
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[Splenic infarction in Plasmodium falciparum malarial attack].

Splenic infarct during P. falciparum malaria is rare but well known. We report one case where ultrasonography and computed tomography suggested the diagnostic, showing respectively in splenic parenchyma a peripheral hypoechoic lesion and a low attenuation lesion. Diagnostic was confirmed by spontaneous regression during following days. We shall encounter more frequently than nowadays this rare entity due to expanding tourism and P. falciparum resistance.

Adult↗
PubMedDate not supplied

Autosomal recessive inheritance of polymicrogyria and dermatomyositis with paracrystalline inclusions.

A 7-year-old mentally retarded girl died following subacute dermatomyositis. Muscle biopsies supported the clinical diagnosis and revealed paracrystalline inclusions on EM. The brain autopsy showed cerebral and cerebellar polymicrogyria. The clinico-pathological findings in this child are related to similar previously reported data in her older sister. The possibility of a new autosomal recessive syndrome involving both fetal brain development and childhood immunological function is discussed.

Atrophy↗
PubMedDate not supplied

[Infections and bone marrow autograft carried out for leukemias in children. Apropos of 47 cases].

This study included 44 children undergoing autologous marrow transplantation for leukemia between August 1979 and June 1987. Three of them received a second transplant. In the phase of neutropenia, 38 children presented with fever. Nineteen septicemia occurred (13 Gram positive cocci, 6 Gram negative bacteria), and 2 interstitial pneumonitis were observed. All children with documented infection or a fever of unknown origin recovered after treatment, except 3, who died from infection. The latest antimicrobial therapy used was a combination of an aminoglycoside and a third generation cephalosporin. When necessary, vancomycin or amphotericin B were added. After engraftment (granulocyte count greater than 0.5 X 10(9)/l) 14 septicemia (which recovered) and 10 herpes zoster infections were observed. Only one patient died of infection (herpes zoster with encephalitis).

Adolescent↗
PubMedDate not supplied

The white clot syndrome or heparin associated thrombocytopenia and thrombosis (WCS or HATT) (26 cases).

The Authors report a new iatrogenic complication of preventive or curative standard heparinotherapy. This so called "white clot syndrome" or "Heparin associated thrombocytopenia and thrombosis" is an anatomico-clinical entity characterized by severe, multiple, recurrent, arterial and/or venous thromboembolic accidents which are sometimes fatal. They appear, paradoxically, under heparin treatment and are concomitant with thrombocytopenia (generally less than 100 10(9)/l). Antiplatelet immunoallergic phenomena, via type IgG antibodies, induced by heparin, are the most commonly admitted in physiopathology; however they remain controversial. Treatment of "WCS" includes urgent suppression of standard heparin, administration of antivitamin K, or the new generation of low molecular weight heparin. This series presents 26 cases of HATT treated by LMWH (CY 216 CHOAY). Severe complications must be surgically cured. Prevention of WCS or HATT is mandatory by the systematic survey of platelet count during heparinotherapy.

Aged↗
PubMedDate not supplied

[Possible role of committees concerned with the fight against tuberculosis and respiratory diseases in home ventilatory assistance of severe chronic respiratory insufficient patients (author's transl)].

It appeared that the departmental committees involved in the fight against tuberculosis and respiratory diseases were qualified to bring assistance to severe chronic respiratory insufficient (C.R.I.) patients. This modified course of action replaces their previous struggle against tuberculosis due to its recession. In Seine-Maritime the committee has signed an agreement with the principal Social Security organizations. This agreement defines the modalities and cost of home care for severe C.R.I. patients who have been tracheostomized permanently and whose condition justifies the continuation of assisted ventilation. Contingent on certain medical and socio-family conditions, the return home of such patients is possible. Thus in 15 years we have been able to benefit 72 patients with assisted endo-tracheal ventilation at home. Thirty-two of them are actually still living.

France↗