Biomedical subjects
L Simon
Publications and source records attributed to L Simon.
Management of acute delirium in hospitalized elderly: a process improvement project.
This article will describe a systematic practical approach that was developed to evaluate and manage one of the most dangerous and costly geriatric emergencies in our nation-delirium in hospitalized frail elders. The article is about nurses and physicians who worked together in a continuous quality improvement process to find a collaborative method to reduce the occurrence, severity, duration, and devastating outcomes of acute delirium.
[Constrictive pericarditis in severe seronegative rheumatoid polyarthritis].
Constrictive pericarditis is a rare complication of rheumatoid arthritis, with 78 published cases. We report a new typical case where the pericardial disease was associated with a severe seronegative rheumatoid arthritis of 17 years duration. Constrictive pericarditis generally occurs in men (62.8% of all cases) aged 52.4 +/- 11.5 years. Its clinical features are identical with those of constrictive pericarditis due to other causes. Diagnosis rests on echocardiography and, chiefly, on right heart catheterization. The arthritis is seropositive in 85.7% of the cases, frequently nodular (75%) and advanced. There is no relation between its duration (mean: 9.6 +/- 7.4 years) and the occurrence of the pericardial pathology. The pericardial fluid has no specific abnormality. Histology shows fibrosis and a non-specific inflammatory cell infiltrate. Immunoglobulin and complement deposits in the walls of the pericardial vessels are detected by immunofluorescence. The only treatment is pericardiectomy; without it the disease is constantly lethal.
[Bone complications during the treatment of osteoporosis with fluor].
Fourteen osteoporotic women who had been under treatment with fluoride (23 mg/day of fluorine ions) for 12 months on average developed periarticular pain in the lower limbs or pelvis, corresponding to 21 fractures due to bone insufficiency. Six of these fractures were revealed only by radionuclide uptake in the painful areas, whereas the remaining 15 fractures, including 2 of the sacrum, were visible at radiography. Four patients had a past history of hyperthyroidism or were in a state of active hyperthyroidism detected by hormonal assays and iliac bone biopsy when the fractures were diagnosed. The decalcification associated with hyperthyroidism facilitates the occurrence of bone insufficiency fractures, as do treatments with high doses of fluoride, inadequate calcium supplement intake (observed in 5 cases) or the presence before treatment of renal impairment or disorders of bone mineralization, sometimes detected only by iliac bone biopsy. Repeated measurements of blood and urinary fluoride levels during treatment make it possible to adjust fluoride dosage, and lower doses (14 mg/day of fluorine ions) might reduce the incidence of the adverse effects of fluoride on bone.
Identification and control of dissolved oxygen in hybridoma cell culture in a shear sensitive environment.
The productivity of mammalian cells can be enhanced by facilitating adequate oxygen transfer into the cultivation medium. However, current methods of controlling dissolved oxygen (DO) fail to account for alterations in medium composition during the course of the fermentation. These changes, which directly affect gas solubility and overall mass transfer coefficient, may be significant and deteriorate controller's performance in the long run. In this paper, the applications of Generalized Predictive Controllers (GPC) to DO control were investigated in a shear sensitive environment and compared to PID and Model Predictive Controllers (MPC). Input and output data for system identification were initially generated by varying the composition of oxygen fed into the bioreactor from 0 to 0.21 mol % while keeping the total inlet gas flow rate at 8.75 vvm. The process was identified using an AutoRegressive model with eXogeneous inputs (ARX) model and tested on different data sets. The model parameters were then correlated with the overall mass transfer coefficients. In simulation tests, the output of the PID controller switched from minimum to maximum values while more continuous control signals were obtained with the MPC and GPC controllers. When tested in a cell-free medium, all three controllers were able to track setpoint changes with some chattering observed in the control signals. The GPC outperformed the MPC and PID controllers when applied to the cultivation of hybridoma cells.
Recombinant DNA: have recent experiments assessed all the risks?
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Surgical approach of an early mammalian embryo: the rabbit model.
We describe an experimental surgical model in early rabbit embryo (12.5 days of gestation). Twenty-one embryos were operated, of which 9 survived the first postoperative week and 5 had normal further growth until term. As far as we can ascertain, this is the first successful report of a surgical approach in early mammalian embryos. We think that this model may be useful for workers involved in the study of early congenital malformations.
[Cerebral blood flow in Paget's disease of the skull (author's transl)].
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[New face of the nursing profession in the world, psycho-medical assistance].
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[Improving potentially painful nursing care].
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The first histological demonstration of pancreatic oxidative stress in human acute pancreatitis.
Necrotizing acute pancreatitis is associated with an inflammatory explosion involving numerous pro-inflammatory mediator cascades and oxidative stress. Acinar oxygen free radical production aggravates pancreatic tissue damage, and promotes cellular adhesion molecule upregulation resulting in leukocyte adherence and activation. The cerium capture oxygen free radical histochemistry combined with reflectance confocal laser scanning microscopy allows the "in situ" histological demonstration of oxygen free radical formation in live tissues. Here we present a case report, where oxidative stress is demonstrated on a histological level for the first time in human acute pancreatitis. A 44-year-old male patient suffering from acute exacerbation of his chronic pancreatitis developed a pancreato-pleural fistula with amylase-rich left pleural exudate causing respiratory compromise. Subsequent to an urgent thoracic decompression a distal pancreatectomy and splenectomy was performed with the closure of abdomino-thoracic fistula. The postoperative course was uneventful, except for a transient pancreatico-cutaneous fistula, which healed after conservative treatment. To carry out cerium capture oxygen free radical histochemistry the resected pancreas specimen was readily perfused with cerium-chloride solution through the arteries on the resection surface. Frozen sections were cut, E-, P-selectin, ICAM and VCAM were labeled by immunofluorescence. The tumor-free margin of an identically treated pancreas carcinoma specimen served as a control. Intrapancreatic oxidative stress and cellular adhesion molecule expression were detected by confocal laser scanning microscopy. Numerous pancreatic acini and neighboring capillaries showed oxygen free radical-derived cerium-perhy-droxide depositions corresponding to strong local oxidative stress. Acinar cytoplasmic reflectance signals suggested xanthine-oxidase as a source of oxygen free radicals. These areas presented considerably increased endothelial P-selectin expression with adherent, oxygen free radical-producing polymorphonuclear leukocytes displaying pericellular cerium-reflectance. Modest ICAM upregulation was noted, E-selectin and VCAM expression was negligible. The control pancreas specimen showed minimal oxidative stress with weak, focal P-selectin expression. The development of deleterious pancreatic oxidative stress was based on indirect evidence in human acute pancreatitis. To the best of our knowledge this is the first report demonstrating persistent intrapancreatic oxidative stress histologically in human acute pancreatitis. We have noted P-selectin overexpression with a preponderance in the areas of acinar oxidative stress.
Research into the origins and characteristics of unicorns: mental illness as the unicorn.
Basic research, particularly into the psychological and neurological underpinnings of schizophrenia and other "mental illnesses," is flawed because of its adherence to the ideology that unwanted, hard-to-understand behavior constitutes true medical illness. It is argued here that psychiatric diagnostic terms represent moral judgments rather than medical entities. By reducing experimental subjects to a moral label, and assuming that neurological differences associated with unwanted behavior are brain diseases, researchers fail to take into account the conscious experience, organization of self and self-image, patterns of motivation, history and social contexts of their patients. The failure to consider the psychology of their subjects renders the results of these studies ambiguous and irrelevant for any uses except bolstering the biomedical model of psychiatry.
[Talalgia caused by fluorine during the treatment of osteoporosis].
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[An unusual compartment syndrome].
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[Clinical study of benorilate. Co-ordinated multi-centre test (author's transl)].
During a co-ordinated test realized by four centres of rheumatology, 91 patients had been treated by benorilate,giving so the possibility to appreciate its efficiency and its tolerance as well in the articulary fits of degeneration as in the inflammatory rheumatisms. The observations had been collected during ambulatory treatments and consequently in the conditions of daily practice. The efficiency of benorilate has been estimated by the two big disadvantages of the rheumatic person: importance of pains and capacity to do principal movements of daily life. The almost totality of patients having been preliminarily treated by another anti-inflammatory and/or antalgesic, the judgement aimed at the amelioration given by the benorilate : 41% of patients affected by arthropathy of degeneration feeled better or much better after taking benorilate. The amelioration reaches 61% for cases of rheumatoid polyarthritis. About the four criterions which could have been numerically quoted, the amelioration that had been observed is statistically significant. No anomaly had been pointed out as for the biological tolerance. The suspension form is well accepted by the rheumatic persons.
[The Achilles reflexogram. Importance of standards established in relation to body measurements in children under 3 years of age].
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[Cervical intraspinal study using gas myelography].
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[Bone metastasis of nevocarcinoma].
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