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Biomedical subjects

P Balmes

Publications and source records attributed to P Balmes.

At least 37 records · Page 2Linked to original sources
PubMed1992

[A phase II trial of pirarubicin in untreated disseminated small cell lung cancer. A cooperative study of the French Pneumo-Cancerology Group].

The usual form of chemotherapy of metastatic small cell lung cancer gives a 50% objective response with a mean survival of 7-8 months. We have tested a new antimitotic drug using pirarubicin alone in 26 patients. After the second treatment we noticed a response level of 12% with moderate toxicity. Then, we undertook classical chemotherapy using cisplatin-V16. After 3 doses the response level was 50% with a median survival of 32 weeks. In our study the use of a single drug pirarubicin in metastatic small cell cancer did not appear to worsen the chance of survival in patients if polychemotherapy was carried out immediately in cases which failed on the single drug. Our monotherapy did not appear to induce resistance to affective polychemotherapy. This method applied carefully to patients with metastatic disease with a strict follow up may be utilised in the assessment of the efficacy of the newer antimitotic drugs.

Adult↗
PubMed1992

[Towards another diagnostic approach of peripheral pulmonary masses. Ultrasound-guided puncture].

In a series of 50 patients with lung lesions touching the thoracic wall, percutaneous ultrasonically guided needle aspiration yielded a pathological diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant lesion could be confirmed in 41 of these 44 patients. In this group of patients with neoplasia the diagnosis obtained by extemporaneous cytology was compared with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved to be higher than that of biopsy (86.36% and 65.90% respectively). Using the two methods concomitantly increased sensitivity up to 93.18%. A pathological diagnosis could be obtained in 3 out of the 6 patients in this series who had benign lesions.

Adult↗
PubMed1991

Comparative study of azithromycin and amoxicillin/clavulanic acid in the treatment of lower respiratory tract infections.

Forty-eight patients with acute bronchitis and four with pneumonia were randomly assigned to receive five doses (500 mg on day 1, plus 250 mg/day on days 2-5) of azithromycin; 54 patients with acute bronchitis and four with pneumonia were assigned 30 doses (625 mg every eight hours for ten days) of amoxicillin/clavulanic acid (CA). The two regimens were equally effective, with clinical improvement or cure in 92% and 87% of patients respectively, bacteriological cure in 89% and 86%, with 91% and 89% of pathogens eliminated. Minor side effects occurred in 6% and 12% of patients in the two groups, respectively. No major abnormalities in laboratory safety parameters were seen in either group.

Acute Disease↗
PubMed1991

[EC-cell pancreatic endocrine carcinoma responsible for chronic diarrhea].

Ec cell or carcinoid enterochromaffinomas are very rare among the endocrine tumors, and more specifically orthocrine tumors, of the pancreas. We report one case of primary malignant carcinoid tumor of the pancreas, with no apparent metastasis, discovered during exploration for chronic diarrhea associated with hypercalcemia, disorders of carbohydrate metabolism and a serotonin secretion. The treatment consisted in a left splenopancreatectomy associated with a left adrenectomy. The clinical and biological signs immediately disappeared and, after a time lapse of almost five years, the general condition of this patient is quite satisfactory.

Acidosis↗
PubMed1991

[Towards another diagnostic approach of peripheral pulmonary masses in pneumology: ultrasonically guided needle puncture].

In a series of 50 patients with lung lesions touching the thoracic wall, percutaneous ultrasonically guided needle aspiration yielded a pathological diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant lesion could be confirmed in 41 of these 44 patients. In this group of patients with neoplasia the diagnosis obtained by extemporaneous cytotology was compared with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved to be higher than that of biopsy (86.36% and 65.90% respectively). Using the two methods concomitantly increased sensitivity up to 93.18%. A pathological diagnosis could be obtained in 3 out of the 6 patients in this series who had benign lesions. No bleeding was observed, and there was only one complication: a partial pneumothorax not requiring drainage which was detected by ultrasonography and confirmed by radiography. Thus, ultrasonically guided needle aspiration of lesions adjacent to the thoracic wall appears to be an efficient and reliable diagnostic method. Lack of irradiation, real-time guidance, low cost, high sensitivity and easily available equipment are as many reasons to prefer this method to other interventional radiology methods in patients with peripheral lung masses detectable by ultrasounds.

Adult↗
PubMed1990

Pirarubicin phase II study in untreated metastatic small-cell lung carcinoma. A cooperative study of the Groupe Français de Pneumo-Cancérologie (GFPC).

Pirarubicin (THP) (Roger Bellon Laboratory, France) is a new anthracycline under clinical development. In order to assess the efficacy and toxicity of the drug in small-cell lung carcinoma (SCLC), we have undertaken this trial in front-line therapy in patients with metastatic disease, PS less than 3 and at least one evaluable lesion. Responses were assessed after two cycles of THP (60 mg/m2 i.v. bolus every 3-4 weeks) and a further cross over to VP16 + CDDP (three cycles) was systematic whatever the response to THP. This crossover was performed after only one cycle in case of obvious progression. From June 1988 to April 1990, 32 patients were enrolled: 6 were ineligible (4 non-SCLC, 2 M0), 26 patients were fully evaluable for THP and 18 patients for VP16-CDDP. The characteristics of the patients were as follows: mean age 57.4 years (38-71); T4: 54%; T3: 27%; T2: 19%; N3: 62%; N2: 35%; No: 4%. The efficacy was as follows 1 complete response and 2 partial responses (confirmed by endoscopy); 12 patients received only one cycle because of obvious progression; the overall response rate is 12% (95% confidence interval 0-24%). The patient who had complete response after pirarubicin remained in CR after VP16-CDDP, whereas the 2 patients who had partial response achieved CR for one and PR for the other; among the 15 who did not respond 1 CR and 7 PR were observed. The only significant toxicity of THP was granulopenia without infection. THP seems to be an effective anthracycline in SCLC, and the study is continuing. A response could be reached in 50% of the nonresponders with standard therapy and 10 of 24 patients (42%) finally responded. Therefore, this schedule for testing new drugs in metastatic SCLC appears ethically acceptable.

Adult↗
PubMed1990

[Echography of pneumothorax].

Ultrasound of 28 radiologically confirmed cases of pneumothorax were compared to 100 controls. Specific ultrasonographic signs were shown in all cases and could be categorised into four groups: isolated pneumothorax (n = 16), hydro-pneumothorax (n = 9), subcutaneous emphysema (n = 1) and post aspiration pneumothorax (n = 2). The isolated pneumothorax was characterised by the disappearance of the lung deflection signal. The effusion of the hydropneumothorax allows in addition a curtain sign which depicts the movement of the air/fluid level, the detachment of the lung being calculated across the liquid window whose echo-structure is analysed. Pneumothoraces appearing during an echo guided thoracic puncture are confirmed by the disappearance of the pathological image. Thus echography appears to be a new method in the diagnosis of pneumothoraces and is complimentary to standard radiology. It should be confirmed as particularly useful during the process of thoracic puncture or juxta-diaphragmatic puncture when following the process of a pneumothorax, for emergency situations and/or those in which no radiological equipment is available.

Aged↗
PubMed1990

[Juvenile aponeurotic fibroma (Keasbey tumor) with metastatic course. Apropos of a case].

Juvenile aponeurotic fibroma, isolated in 1953 by Louisa Keasbey is a rare tumour which is characterized by its recurrence and infiltration, but which has no tendency to metastasis. The case we report differs in its long-term outcome. The tumour diagnosed in a seven-year-old child has recurred locally for seven years, necessitated hand amputation, and finally developed a fibroblastic process extending to lung and pleura which caused the child's death. This new finding in Keasbey's disease led us to reconsider the nosological situation in juvenile fibromatoses and its reputation for benignity.

Child, Preschool↗
PubMed1989

[Juvenile aponeurotic fibroma (Keasbey's tumor) with metastatic progression. Apropos of a case].

The juvenile aponeurotic fibroma, isolated in 1953 by Louisa Keasbey is a rare tumour which is characterized by its recurrence and infiltration, but which has no tendency to metastasis. The case we report differs in its long-term outcome. The tumour diagnosed in a seven-year-old child has recurred locally for seven years, necessitated hand amputation, and finally developed a fibroblastic process extending to lung and pleura which caused the child's death. After this new finding in Keasbey's disease, we are led to reconsider the nosological situation in juvenile fibromatoses and its character of benign disease.

Adolescent↗
PubMed1988

[Pancreatic insulinoma. Peroperative topographical diagnosis].

Difficult problems may arise and place the surgeon in an uncomfortable position in cases where neither pre-operative investigations nor palpation of the pancreas have enabled pancreatic insulinomas to be localized. However, 3 examinations performed during the operation should help solve these problems, as shown by the case presented here. These examinations are insulin assays in the peripancreatic venous blood, blood glucose measurements under constant rate glucose infusion, and intra-operative ultrasonography. Pre-operative radioimmunological assays of insulin have been used for about 10 years, but owing to technical advances and shortening of the incubation time these assays can now be performed during surgery and, above all, with immediate results. Blood glucose measurements are good pointers, and this method has long been used in this type of surgery. Intra-operative ultrasonography has recently been introduced; it is very effective in diagnosing endocrine tumours of the pancreas, since the images it provides are quite characteristic. These 3 examinations combined should be used to localize pancreatic insulinomas; they may replace most of the pre-operative examinations that are still carried out.

Adenoma, Islet Cell↗
PubMed1988

Juvenile fibromatosis resembling aponeurotic fibroma and congenital multiple fibromatosis. One case with pleuropulmonary involvement.

This article deals with a young school boy born in 1971 with a tumor in the palm of his right hand. We have considered this a juvenile aponeurotic fibroma. This tumor has recurred several times, leading to unavoidable amputation of the right wrist and hand. Seven years after the initial diagnosis, the axillary area became involved, then the pleura and lung. Such an unusual process leads to reconsidering the diagnosis and to regard this case as an intermediate form between Keasbey's juvenile aponeurotic fibroma and generalized fibromatosis.

Child↗
PubMed1988

[Giant diverticulum of the transverse colon].

A complication of colonic diverticulosis, giant diverticula are seen above all in the sigmoid region. On the basis of a case involving the transverse colon, the authors stress the clinical and ultrasonographic pseudo-tumoural symptomatology as well as the degree of superinfection of the contents. Anatomical arguments would be in favour of pathogenesis by progressive increase in size of an ordinary diverticulum rather than by perforation with secondary encystment. Excision of the diverticulum required segmental colectomy.

Colectomy↗
PubMed1981

[Carcinoma of the pancreas with amyloid stroma and calcitonin secretion : ultrastructural study (author's transl)].

The authors report a case of anaplastic carcinoma with amyloid stroma, accompanied by the secretion of calcitonin, detected in a cervical lymph node and initially interpreted as being a metastasis from a medullary carcinoma of the thyroid. The actual pancreatic origin of the malignant tumour was proved only during the advanced stages. Ultrastructural study confirmed the endocrine nature of the tumour (neurosecretory granules). Despite its exceptional character, the existence of such a tumour is not surprising, if one accepts the concept of a diffuse endocrine system.

Calcitonin↗