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Biomedical subjects

P Barnaud

Publications and source records attributed to P Barnaud.

At least 19 recordsLinked to original sources
PubMed1991

[Inguinal lymphatic metastasis of cancer of the testis: staging and therapeutic approach].

Inguinal lymph node metastases from testicular tumors are reported in 2% of cases. Between 1980 and 1990, two patients in a series of 54 testicular tumors, presented with inguinal node metastases. In there two cases and in the cases in the literature, it is well known, that testicular tumors in patients who have had the lymphatics disrupted by prior scrotal or inguinal surgery, or tumor-contaminated scrotum, can metastasize primarily to the ipsilateral inguinal nodes. Even in the absence of other retroperitoneal metastases, these testicular tumors must be considered to be stage IIA. Owing to the efficacy of primary or secondary chemotherapy, ipsilateral inguinal node dissection is not necessary in nonseminomatous testicular tumors. For testicular seminoma, an additional inguinoscrotal radiotherapy is necessary. Survival rate for testicular tumors with isolated metastatic inguinal nodes, particularly in tumor-contaminated scrotum, is not significantly different, compared to a group of patient without inguinal nodes.

Adult↗
PubMed1989

[Extra-corporeal lithotripsy (EDAP LT 01) in urinary lithiasis].

Five hundred and twenty six extracorporeal lithotripsies have been performed for renal and ureteric stones. Using low frequencies (1.25 to 2.5 cycles per second), extracorporeal lithotripsy was performed without anaesthesia and without premedication in 85% of cases. 91.9% of patients treated were followed and reviewed after one and three months: 292 (55%) were successes, 124 (22.5%) obtained partial results, 122 (22.5%) were failures. The best results were obtained in stones less than 20 mm in diameter. The results could only be improved by a second session of extracorporeal lithotripsy. Scintigraphic scars observed after high frequency lithotripsy and not observed after low frequency lithotripsy were again seen after renewal of the firing head.

Evaluation Studies as Topic↗
PubMed1988

[Extracorporeal lithotripsy in urinary calculi using the LT 01 EDAP].

Three hundred and sixty nine extracorporeal lithotripsies for renal stones have been performed using the EDAP apparatus (ultrasound detection, piezoelectric destruction). In 7.1% of cases, the stone could not be located. By using low frequencies (1.25 to 5 cycles per second), extracorporeal lithotripsy was able to be performed in 82% of cases without anaesthesia and without premedication. 96.5% of patients treated have been followed and reviewed at one and three months: 169 (61%) cases were successful, 59 (21.3%) were partial results and 49 (17.7%) were failures. The best results were obtained in stones less than 20 mm in diameter. A poor result can only be improved by a second session of extracorporeal lithotripsy. The scintigraphic scars observed after high frequency extracorporeal lithotripsy were not observed when low frequencies were used. This new outpatient extracorporeal lithotripsy procedure without anaesthesia currently represents 79% of our primary indications in renal stones.

Adult↗
PubMedDate not supplied

[Urinary tract infection and surgical disorders of the lower urinary tract].

Infection is a constant concern during perioperative period. Bacteremia occur during intervention and immediate postoperative period. They are the risk of acute complications, mainly septic shock with a high mortality rate. Escherichia coli is the germ most often found, then Enterococcus and other gram-negative germs. Diagnosis of an urinary infection is made difficult because the presence of a vesical catheter; so, 10(3) bacteria per ml. have to be considered as pathological. Two therapeutic behaviours can be considered in practice: suitable antibiotherapy in obvious infections, but sterilization of urines must not delay surgical intervention, short-time peri-operative prophylaxis cephalosporins of the 2nd or 3rd generation are most often utilized. Overseas, trimethoprim associated with sulfamides can be administrated per os every 2 hours before surgical intervention, at the time of anesthesia for example.

Anti-Infective Agents, Urinary↗
PubMedDate not supplied

[The role of surgery in acute epididymitis].

One third of the acute épididymitis (A.E.) admitted in the Military Hospital in Marseilles have been operated, i.e. 33 cases; out of them the last 12 cases have been systematically monitored by ultrasonography. Twice out of three times, clinical picture suggested a possible twisting that led to an emergency surgical exploration. Interest of ultrasonography of the scrotum is underlined as far as diagnosis is concerned but also in monitoring A.E. Indeed, despite medical treatment (antibiotics + anti-inflammatory drugs), it is possible that some A.E. are evolving either to abscess or to their "vascular" form; The ultimate form of the acute epididymo-orchitis is necrosis of the testis. This is due to, or amplified by, vascular compression linked up with edema. Surgical intervention has therefore to investigate by inguinal path the entire spermatic cord and the épididymis-testis system, and to apply the "decompression technique" requested.

Acute Disease↗
PubMedDate not supplied

[A case of ureteral bilharziasis followed for 22 years].

The authors report on one case of urinary schistosomiasis monitored for 22 years. It illustrated the problems posed by the "bilharzial uretero-hydronephrosis". They analyse the different therapy problems which have to have been successively solved: Low double ureteral stenosis. The difficulty to be certain of such a stenosis is recalled. The possibility of a reflux or an ureteral atony must be eliminated. True stenosis must be operated without delay; Kidney cancer revealed 20 years later through chronic renal failure by vesico-ureteric reflux caused by the first surgical intervention (latero-lateral vesico-ureteric anastomosis); Iatrogenic vesico-ureteral reflux, treated by uretero-vesical implantation on "psoic" bladder with anti-reflux submucous path. The future of such a chronic renal failure is linked to the capability of the remaining ureter to ensure an acceptable passage of urine, and to the rehabilitation possibility of the kidney. Finally, the authors recalled the difficult therapeutic indications in case of ureteral attack due to bilharziosis.

Follow-Up Studies↗
PubMedDate not supplied

[Ureteral war injuries. Apropos of 3 African cases].

The war ureteral gunshot wounds (W.U.G.W.) are, in practice, scarce but not an exception. They are to be suspected in every war abdominal injury. Urethral catheterization, microscopic hematuria research, simple X-Ray and I.V.P. have to be undertaken; but it's never easy in wartime circumstances. Investigation must be carried out during intervention: ureteral exploration in case of retroperitoneal hematoma or wound. Three observations illustrate these main difficulties. Unfortunately diagnosis is often done in post-operative time when a complication arises. The treatment is now well known: adequate debridement, anastomosis or reimplantation and drainage.

Adult↗
PubMedDate not supplied

[Management of sexually-transmitted diseases diagnosed in women in tropical Africa].

Taking into account their own experience and very numerous recent publications, the authors proposed an easy protocol towards diagnosed S.T.D., in African woman. Diseases are classified according to symptomatology: clear infection in case of cervico-vaginitis, ulcerations (painful or not), tumural formations, and also during salpingitis or infertility. They particularly emphasize cervico-vaginitis manifestations which represent one visit out of three in Gynecology Departments. For each infection, they recall its symptomatology, diagnosis and efficient treatment. They strongly recommend to keep in mind, in Africa, multi-microbial associations.

Adult↗
PubMedDate not supplied

[Urethral stricture in Africa. Urologic complication of sexually transmitted diseases in the male in Africa].

Urethral stricture is a very frequent and severe complication of sexually transmitted diseases in African male. It is very often largely sclerous and inflammatory as the patients come to consultation very late. Urethral repair techniques are analysed, so the principles of surgical procedure. When urethral stricture is brief and "catheterisable", and in case of recurrence, endoscopic dilatation or endoscopic internal urethrotomy must be performed in the first place. In the others cases, in order, we advise: free skin graft urethroplasty (Devine), pedicled vaginal urethroplasty (Kishev), scrotal flap urethroplasty (Blandy), and the two-stage urethroplasty. In fact this choice depends on the urethral and peri-urethral lesions and on the operator's practice.

Adult↗