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Biomedical subjects

Lucien Rumbach

Publications and source records attributed to Lucien Rumbach.

5 recordsLinked to original sources
PubMed2006

Limited impact of the summer heat wave in France (2003) on hospital admissions and relapses for multiple sclerosis.

Patients with multiple sclerosis (MS) often report worsening of symptoms with increased environmental temperature. The aim of this paper was to determine whether or not the heat wave of the summer of 2003 in France was responsible for an increase in hospital admissions and relapses in MS patients. MS patients who were hospitalized between January 1,2000 and December 31,2003 were identified, and we established which patients were suffering relapses. Hospitalization and relapse seasonality were examined and analyzed according to ambient temperature variations. We did not observe a greater number of hospital admissions and relapses during the summer of 2003 compared to the previous 3 years. Results showed that MS hospitalizations display a significant trough in the winter season, especially in December, but no significant peak season or month was observed. There was no statistically significant correlation between mean ambient temperature and the number of admissions and relapses. The adverse symptoms associated with high temperatures that are usually observed in MS patients may require rapid rises in ambient temperate or in internal body temperature.

France↗
PubMed2006

Side-effects of L-dopa on venous tone in Parkinson's disease: a leg-weighing assessment.

In the present study, the effects of L-dopa treatment on cardiovascular variables and peripheral venous tone were assessed in 13 patients with Parkinson's disease (PD) with Hoehn and Yahr stages 1-4. Patients were investigated once with their regular treatment and once after 12 h of interruption of L-dopa treatment. L-Dopa intake significantly reduced systolic and diastolic blood pressure, heart rate and plasma noradrenaline and adrenaline in both the supine and upright (60 degrees ) positions. A significant reduction in stroke volume and cardiac output was also seen with L-dopa. The vascular status of the legs was assessed through thigh compression during leg weighing, a new technique developed in our laboratory. Healthy subjects were used to demonstrate that this technique provided reproducible results, consistent with those provided by strain gauge plethysmography of the calf. When using this technique in patients with PD, L-dopa caused a significant lowering of vascular tone in the lower limbs as shown, in particular, by an increase in venous distensibility. Combined with the results of the orthostatic tilting, these findings support that the treatment-linked lowering of plasma noradrenaline in patients with PD was concomitant with a significant reduction in blood pressure, heart rate and vascular tone in the lower limbs. These pharmacological side-effects contributed to reduce venous return and arterial blood pressure which, together with a lowered heart rate, worsened the haemodynamic status.

Adult↗
PubMed2003

Automatic change detection in multimodal serial MRI: application to multiple sclerosis lesion evolution.

The automatic analysis of subtle changes between MRI scans is an important tool for assessing disease evolution over time. Manual labeling of evolutions in 3D data sets is tedious and error prone. Automatic change detection, however, remains a challenging image processing problem. A variety of MRI artifacts introduce a wide range of unrepresentative changes between images, making standard change detection methods unreliable. In this study we describe an automatic image processing system that addresses these issues. Registration errors and undesired anatomical deformations are compensated using a versatile multiresolution deformable image matching method that preserves significant changes at a given scale. A nonlinear intensity normalization method is associated with statistical hypothesis test methods to provide reliable change detection. Multimodal data is optionally exploited to reduce the false detection rate. The performance of the system was evaluated on a large database of 3D multimodal, MR images of patients suffering from relapsing remitting multiple sclerosis (MS). The method was assessed using receiver operating characteristics (ROC) analysis, and validated in a protocol involving two neurologists. The automatic system outperforms the human expert, detecting many lesion evolutions that are missed by the expert, including small, subtle changes.

Algorithms↗
PubMed2003

Impact of emergency room neurologists on patient management and outcome.

UNLABELLED: The frequency and impact of in-patient assessment by a neurologist in the emergency room (ER) setting remain largely underestimated. The objective of our study was to analyse the impact of neurologist in-patient management. METHODS: Over a period of 12 months, we prospectively recorded the demographics of patients requiring examination in the ER, the ER team's tentative neurological diagnosis, the neurology team's final diagnosis and patient outcomes. The time interval between admission, call for a neurologist and the assessment by the neurologist were recorded. RESULTS: Assessments by neurologists were performed in 14.7% (1,679/11,421) of all patients admitted to the ER. The mean time between admission and examination was 32 (+/- 36) min, irrespective of the day of the week, and dependent on the tentative diagnosis: shorter for stroke and status epilepticus (p < 0.05) and longer for confusion and vertigo (p < 0.05). The initial causes for examination were: stroke (33.1%), epilepsy (20%), loss of consciousness (9%), headaches (9%), confusion (5.4%), peripheral nervous system disorders (4.4%), vertigo (4.2%), cognitive dysfunctions (4%), gait disorders (3.2%) and miscellaneous (7.1%). Overall, false positive or negative diagnoses were produced by the ER in 37.3 and 36.6% of ER admissions, respectively. A complete change of diagnosis by the neurologist was found in 52.5% of patients. Of the patients undergoing a neurological examination, 18.4% were able to go home, 31.8% were admitted to the stroke unit, 32.4% to the general neurology unit and 17.4% to other departments. CONCLUSION: Our study stresses the need for a neurologist in the ER, both in quantitative terms and for the benefit of patient management.

Brain Diseases↗