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Biomedical subjects

M Averous

Publications and source records attributed to M Averous.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Urinary calculi in children. Etiologic survey].

Thirty-three children with urinary calculi were studied. In 12, a metabolic cause of calculi was identified (4 hyperoxaluria, 6 hypercalciuria, 2 cystinuria). In 14 children, lithiasis was associated with a urinary tract infection. No identifiable cause could be found in 7 children. A protocol for metabolic evaluation is proposed.

Adolescent↗
PubMed1986

[Cancer of the prostate. Results and causes of failure after exclusive radiotherapy in 131 cases treated at in locoregional stage between 1972 and 1981].

A retrospective study was carried out to evaluate results of exclusively physical treatment by external radiotherapy of 131 cases of cancer of prostate treated between 1972 and 1981. Median follow up has been for 8 years in 19 cases (stage A), 61 cases (stage B) and 51 cases (stage C). Patients were treated exclusively by external irradiation after histopathologic diagnosis and assessment of possible extension of tumor. High energy photons were developed by a linear accelerator and irradiation carried out through four portals, two anteroposterior, two lateral, with precise guidance by rectal and bladder opacification. Irradiation delivered to a pelvic volume over 5 weeks was subsequently reduced to the prostate bed until a total dose of about 65 to 70 Gy has been given. Primary glandular chains received 60 to 65 Gy, and critical organs, bladder, rectum, small intestine a smaller dose of less than the tolerance levels for these organs. Clinical, biologic and scintiscan examinations were repeated every three months. Results are presented as actuarial survival, as survival without local recurrence and a detailed analysis of failure of treatment. The 8-year survival rate was 60% for stage A, 47% for stage B and 33% for stage C. Unsuccessful cases were evaluated in terms of isolated metastases, metastases associated with local recurrence and isolated local recurrence. The highest incidence of ineffectiveness of therapy was noted in patients with distant metastases (26%), the rate being higher (41%) in stage C cases than in stage B cases (19%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Nuclear magnetic resonance imaging in the urologic study of the male pelvis. Apropos of 60 examinations].

Theoretical concepts underlying the principle of nuclear magnetic resonance imaging are defined and the technical basis for its use in medical imaging described (sequences, accumulations, contrast media). Results are presented of a spectrometric study of 23 operative specimens from the bladder, prostate and seminal vesicles with analysis in vitro of relaxation time of the various tissues. Findings confirmed the value of NMR imaging for evaluation of macroscopic extension of tumors within the affected organs, as well as the interrelations of the organs, but the impossibility of identifying histologic structure of tumors and organs explored by this technique. Two groups of subjects were studied: a first group of 20 healthy volunteers to define NMR semeiology of male pelvis and a second group of 40 patients with mainly tumoral lesions of vesicles or prostate. Details are provided of the diagnostic value of NMR imaging with respect to the tumor, local and regional invasion and bone metastases. Excellent images of the tumor were obtained, with the possibility of determining its macroscopic stage, but its histologic nature could not be ascertained. Multiplane examination allowed better assessment of local and regional spread than by a CT scan, particularly for prostatic tumors (bladder, prostate bed or seminal vesicle extension). A negative feature of major importance exists, however, in that early glandular involvement is not detected by NMR imaging, which also fails to identify one case in two with bone metastases. Current research should allow progressive correction of present NMR imaging insufficiencies, notably in the field of tissue characterization.

Humans↗
PubMed1985

[Re-establishment of urinary continuity by uretero-ureterostomy in renal transplantation. Apropos of 135 cases].

Uretero-ureteral anastomosis was performed in 135 patients (40 women and 95 men) during kidney transplantation using either cadaver (120 cases) or living donor (15 cases) organs. The ureter of the retained kidney was linked proximal to the transplantation, whether or not there had been previous contemporary nephrectomy. Results were highly interesting: no mortality, no need to remove graft for urinary complications and no ureteral anastomotic stenosis. Urological complications were absent in 108 cases (80%) while 17 cases (12.6%) developed a urinary fistula, only 5 of which required surgical intervention Hematoma related to the nephrostomy occurred in 6 cases (4.4%) but operation was necessary in only 2 of these cases. Overall need for repeat surgery involved only 7 patients (5.2%) during the month following transplantation. One of 2 cases of hematoma operated upon required partial excision of the transplantation kidney due to the presence of an intraparenchymatous arteriovenous fistula. A curious finding was that of the 17 cases developing fistulae most of them had received live donor kidneys (5/15) whereas only 12 occurred in the 120 cadaver kidney transplants. Prevention of fistulae appears to be assisted by spatulation of the ureter rather than by its bevelled section, and the maintenance of a long ureteral loop to avoid traction. It is suggested that certain postoperative urine losses may be the result of a hyper-diuresis, without actual dehiscence of the anastomosis. In 4 patients with a urine output of more than 1.5 litres at the time of transplantation, the kidney proximal to the ureteral ligature became infected, and a second nephrectomy was necessary in 4 cases.

Adolescent↗
PubMed1985

[The bladder immaturity syndrome. Apropos of 1097 cases].

Acquisition of control of micturition in children involves several stages, the most critical being the bladder immaturity phase. Although the passage from bladder automatism of the neonate to coordinated conscious bladder-sphincter activity in adults is usually a problem-free period, it is nevertheless a critical and sometimes dangerous phase in certain subjects. Purely functional disorders may induce, above a certain physiological limit, a true pathologic state considered up to the present as being organic in nature and requiring urodynamic exploration to confirm their individuality. This bladder immaturity syndrome has the common denominator of diurnal or nocturnal urine leaking, sometimes with an associated lower urinary tract infection in young girls. The first part of this review discusses a clinical trial conducted in 1 097 children (840 girls, 257 boys) age 4 to 15 years, with the "urine-leaking" symptom, divided into 2 groups as a function of its diurnal or nocturnal prevalence: Group I: diurnal incontinence alone: 285 children Group II: diurnal and nocturnal incontinence: 812 children Investigations included: a clinical examination including a full past history to determine possible infectious origin, the primary or secondary nature of the disorder, possible family history and particularly any associated diurnal micturitional disorders such as pollakiuria and urgency; cytobacteriology of urine; an I.V.U. reduced to a minimum of images; cystography and micturitional study; cystometry. Results in each group were expressed analytically, and showed assimilation of the 2 groups, having in common the incontinence-urine leaking symptom, whether it occurred during the day or night, with the diurnal manifestations of pollakiuria and urgency. This clinical feature derived from simple questioning was accompanied in 9 out of 10 cases by cystographic anomalies (notched bladder outline, modified proximal urethra in young girls, sometimes vesico-renal reflux) and cystometric changes (vesical hyperactivity and hypersensitivity). These findings provide better understanding of the significance of these clinical manifestations and their place within the framework of the urinary bladder immaturity syndrome. After a summary of the physiology of the bladder-sphincter apparatus and the stages of acquisition of micturitional control, with definition successively of the automatic, immature and adult bladder, the second part of the report discusses the urinary bladder immaturity syndrome itself. Symptoms are dependent on the urodynamic factors involved.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1982

[Course of primary nonoperated vesicorenal reflux in children. Apropos of 44 cases].

From a series of 600 cases of reflux seen over 12 years, the authors chose a group of 44 children aged between 3 and 11 who had not been operated for their reflux. The period of follow-up ranged from 1 to 10 years. Treatment consisted of massive antibiotic therapy for the severe episodes of infection and maintenance treatments for more than six months in a great many cases. For this group of 44 children with 60 refluxing ureters, the results were: --a disappearance of infection in 82% of cases, --a disappearance of the reflux in 70% of cases, even including type III reflux. 4 children were lost to follow-up, and 5 had to be operated secondarily. The authors reserve this trial of medical treatment to reflux in the small child, intermittent reflux, reflux with no or only minor involvement of the upper urinary tract on I.V.P. and finally, reflux which causes infections particularly sensitive to medical treatment in the presence of a cooperative family. With the aim of reducing the irradiation to a minimum, the authors performed follow-up urography with a single 15 min film every two years and annual isotope cystography. The authors discuss the possibilities of extending this medical approach for the future.

Anti-Infective Agents, Urinary↗
PubMed1981

[Urethral stenosis in the young girl, myth or reality? Comparison of clinical, radiological, instrumental and urodynamic data (author's transl)].

In 240 girls aged between three and fifteen years with mictional problems or urological infectious complications, 58 had radiological appearances of urethral stenosis. A complete clinical, urographic, urodynamic, endoscopic and instrumental study was performed in these 58 children. The majority of these young girls suffered from frequency with urgency, enuresis, pyuria and radiological and endoscopic appearances of trabeculated bladder. Thirteen showed signs of vesico-ureteric reflux. A basic fact: only two of the children had meatal stenosis. All the others had a urethral calibre larger than normal. Almost all the children had an unstable bladder, but with the exception of the two girls with a tight meatal stenosis, none had urodynamic data compatible with poor stream or vesico-sphincter dysinergism. The author concluded in the existence and the exceptional nature of true stenosis of the terminal urethra in the young girl. Most often, in the absence of true stenosis, there is nevertheless a functional stenosis related to contraction of the striate sphincter intended to overcome contraction of the unstable bladder. Such non-inhibited bladders are the site of marked disinhibition contractions without any element of outlet obstruction no increase in urethral resistance and no increase in micturation pressures. Disturbances of day and night continence are essential. Vesical trabeculations are a logical consequence, easy to understand, but the episodes of recurrent infection and the development of vesico-ureteric reflux (present in 13 of the girls) are rather more complicated to explain. This pathological state is most often reversible as the bladder matures. Nevertheless, bladder education, pharmacological treatment, dilatations and urethrotomy may help such children. Such treatment has given favourable results in 50% of cases.

Adolescent↗