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O Haillot

Publications and source records attributed to O Haillot.

47 records · Page 3Linked to original sources
PubMed1990

[Imaging and the court of law: useful images and useless images].

The expert who review a medical record in a liability suit is required to determine whether the tests performed were necessary and, above all, whether they were adequate. In France, physicians are legally required to use adequate diagnostic and therapeutic means, especially in complicated cases. When this obligation is not fulfilled, the urologist is often held responsible since he or she is in charge of interpreting the tests and drawing final conclusions. Urologists are rarely criticized for performing too many investigations. The urologist is not considered liable for complications that occur during the performance of a necessary test: in this case, the physician who performed the test is legally responsible.

Diagnosis, Differential↗
PubMed1989

High dose chemotherapy including vepeside, cyclophosphamide and carboplatin with autologous bone marrow transplantation in one case of chemoresistant testicular cancer.

Non seminomatous germ cell testicular tumors (NSGCTT) is a very chemosensitive cancer; vepeside, cyclophosphamide or ifosfamide and cisplatin are the most effective drugs. Carboplatin is also active with a lack of nephrotoxicity, but there is probably a cross-resistance to cisplatin. High dose chemotherapy with autologous bone marrow transplantation is able to cure poor prognosis testicular cancers in first partial remission or in sensitive relapse. We report one case of non seminomatous testicular cancer which was progressive after chemotherapy with cisplatin and vepeside or teniposide, and which is in prolonged complete remission after conventional chemotherapy (vepeside, ifosfamide, carboplatin) and high dose chemotherapy (carboplatin, vepeside, cyclophosphamide) with autologous bone marrow transplantation.

Adult↗
PubMed1989

[Prostatic type papillary tumor of the urethra with endocrine cells. Immunohistochemical study].

A peculiar variety of prostatic neoplasm harbouring a constellation of endocrine cells is reported. The tumor had a papillary growth projecting into the lumen of the prostatic urethra. The histological appearances were somewhat unusual. One fragment showed a typical feature of a prostatic-type polyp. However, much of the tissue were covered by a dysplastic epithelium. Adenomatous transformation of prostate-type polyp or "endometrial" adenocarcinoma could be considered.

APUD Cells↗
PubMed1989

[Urologic surgery and risks of complaints in medical responsibility].

The card-index study of specialized insurance companies allowed the analysis of 82 cases concerning urological surgical procedures. Forty-two cases went to the Civil Court, 10 to the Penal Court and 5 to the Administrative Tribunal, while 5 cases were simply declared to insurance companies without judiciary consequences. Sixty-two cases concerned private plaintiffs surgeons and 34 cases concerned non specialist urologic surgeons. Sixteen plaintiffs were compensated, 9 after a conciliatory agreement and 7 after trial. There were no penal condemnations (one case on the waiting list). Impotence was the most frequent cause for complaint which was compensated. Next, came incontinence generally secondary to endoscopic resection. Retrospectively, 19 cases seemed to be unwarranted due to the dishonesty of patients (3 patients were prosecuted for unwarranted procedures). On the other hand, 32 cases seemed to be due to a lack of information given to the patients themselves or to their families, either before of after the incriminated act. The risk of prosecution is relatively low in urology. It could be decreased by careful management of the medical chart, by rapid analysis of complications and by a constant effort to inform the patient and his family.

France↗
PubMed1989

[Urology facing the courts. The basis of professional responsibility].

The liability of the urologist can be involved according to 3 procedures: The civil procedure is that of the Tribunal de Grande Instance (High Court) then the Cour d'Appel (Court of Appeal). Financial compensations are claimed from the surgeon for not respecting the medical contact. This contract is tacit, oral and carries obligations for the surgeon. The administrative procedure is that of the Tribunal Administratif (Administrative Court) then the Conseil d'Etat (Council of State). This only concerns the salaried surgeon in his salaried activities. The penal procedure is that of the Tribunal Correctionnel (Criminal Court) then the Cour d'Appel (Court of Appeal). The surgeon is then charged with a crime, usually unintensional injuries or through negligence. Although the harlm is easy to prove, the reality of the fault of the surgeon and the relation between fault and damage are far less so. It is the plaintiff (Civil Course, Administrative Cours) or the State Prosecutor (Penal Course) who must prove the fault and causality by the help of an expert's report. So, the responsibility of the surgeon can be committed. However, the development of the insurance system has allowed more widespread compensation without any fault found on the surgeon's part and increasingly frequent conciliatory procedures.

France↗
PubMed1989

[Epidemiology of tumors of the testis in Indre-et-Loire from 1978 to 1987].

All the testicular tumors found among the inhabitants of the Indre-et-Loire department between 1978 and 1987 were reviewed. There was a total of 122 tumors, i.e. a direct standardised incidence rate of 4.55/100,000. The incidence increased over the years 1978-1982, with an abrupt decrease at 50% in 1983 and the increase since then has been minimal. There was an excessive morbidity rate of 22% for patients living in an urban environment. There was no preferential side for the tumor. The histological types of the tumors permit to distinguish three types of populations: non seminiferous germ cell tumors (51.3%) at the age of 30 years; seminoma (41.3%) at the age of 40 years and lymphoma (7.4%) at the age of 74 years. An indirect standardisation revealed an excessive rate of 22% for the socioprofessional category of employers and a rate of 28% for artisan, business men and company directors. The study confirms the known notions about the age and the histologic distribution of testicular tumors. The highest incidence rate of all the French departments, the drop in the rate of this growth curve in 1983 and the over representation of the employee category appear to be the most specific notions in the Indre-et-Loire department.

Adolescent↗
PubMed1988

[Chorionic gonadotrophic hormone and transitional cell carcinoma of the bladder. Immunohistochemical characterization of HCG and its alpha and beta subunits].

Investigation of cellular localization of hCG and alpha- and beta- subunits in 17 transitional cell carcinomas of urinary bladder was performed using immunohistochemical techniques. Serial sections were tested with monoclonal antibodies to hCG, free beta hCG and free alpha hCG. Transitional cell carcinomas producing hCG and/or beta hCG are easily found (6/17 cases). None of these tumors correspond morphologically to a choriocarcinoma. However, it must be mentioned that neoplastic areas exhibit some features reminiscent of a choriocarcinomatous structure. Notably, positive cells can be disposed at the periphery of neoplastic nests, mimicking the arrangement of syncytiotrophoblast. Positive neoplastic cells express hCG and/or beta hCG; alpha hCG immuno-reactivity is quite rare. The relative distribution of hCG/beta hCG is excessively variable from case to case. In contrast, normal transitional epithelium contains endocrine cells which only express the alpha-subunit of hCG.

Carcinoma, Transitional Cell↗
PubMedDate not supplied

Eutectic mixture of local anesthetics in adult urology patients: an observational trial.

BACKGROUND AND OBJECTIVES: The effectiveness of EMLA eutectic mixture of local anesthetics, (ASTRA Co, France) cream in minor surgery on the penis and its acceptability in unpremedicated outpatients were assessed. METHODS: EMLA cream was applied 1 hour before surgery (fremulum plasty, circumcision or dorsal section for phimosis, and condyloma accuminatum) in addition to a subcutaneous infiltration of lidocaine 1%, just before incision in cases of circumcision. Verbal Rating Scale (VSR) was assessed during the surgery and the acceptance 15 days later by a questionnaire. RESULTS: Thirty-two patients included. In all of the cases, the application of EMLA cream was sufficient, with the exception of one (fremulum plasty). General anesthesia was used for this patient unable to tolerate the proprioceptive sensations (VRS = 0). In cases of circumcision, the subcutaneous infiltration was not experienced as painful. Eighty-eight percent of patients who answered the questionnaire confirmed that if they had to be reoperated on, they would opt for this technique of anesthesia. CONCLUSION: EMLA cream is effective in minor penile surgery in adult patients, and it is associated with subcutaneous infiltration of local anesthetic in the case of circumcision.

Adult↗
PubMedDate not supplied

[Adverse effects of glycolic irrigation solutions].

The aim of this study was to evaluate the frequency and the gravity of Trans Urethral Resection of the Prostate Syndrome or 'TURP Syndrome,' which occurs when irrigating fluids containing 1.5 per cent glycocolle are used. All the adverse effects that occurred with 5 products containing 1.5 per cent glycocolle which were notified to the pharmacovigilance structures in France were reviewed. The adverse effects notified comprised 24 cases of TURP Syndrome and 5 of renal failure. TURP Syndrome consisted of neurological signs (92 per cent); cardiovascular signs (54 per cent); visual disturbance (42 per cent) and digestive signs (25 per cent). Hyponatraemia occurred in all patients (mean 113 +/- 6 mmol.l-1) and 25 per cent of patients died. In 27 per cent of cases TURP Syndrome occurred when glycocolle was in contravention of AMM guidelines. The Drugs Agency has requested that modification be included in the Vidal pharmacopoeia (warnings and adverse reactions) and on glycocolle bags and that surgeons and anaesthetists be informed.

Adult↗
PubMedDate not supplied

[Carcinoma in situ of the testis].

Carcinoma in situ (C.I.S.) of the testis is the only known precancerous lesion of germ cell tumours. The prevalence and the incidence of C.I.S. are both unknown, although predisposing factors have been identified: history of germ cell tumour of the contralateral testis, cryptorchidism or history of ectopic testis, decreased fertility or sterility. The incidence is higher in the presence of a combination of several of these factors. No complementary investigations have been demonstrated to be of any value in the detection of C.I.S. which can only be diagnosed, at the present time, by means of surgical biopsy. Once C.I.C. has developed, it never resolves spontaneously. In one half of cases the C.I.S. evolves into an invasive tumour over a period of 5 years. There is no consensus concerning the population in which testicular biopsy should be proposed looking for C.I.S. A large scale C.I.S. screening and detection programme has been proposed in Denmark. However, it is not clear that there is any major gain in testicular cancer morbidity and mortality in comparison with a surveillance programme of patients at risk. Apart from conservative follow-up, two types of treatment can be proposed: orchidectomy or external beam radiotherapy which appears to eradicate the C.I.S. while preserving endocrine function.

Carcinoma in Situ↗