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Biomedical subjects

P Bierling

Publications and source records attributed to P Bierling.

103 records · Page 6Linked to original sources
PubMed1983

[Multiple myeloma with high tumoral mass. Treatment combining melphalan, cyclophosphamide, vincristine, CCNU and prednisone. 35 cases].

The results of a combination chemotherapy trial (melphalan, CCNU, vincristine, cyclophosphamide) involving 28 patients with stage III (n = 21) or stage II (n = 7) multiple myeloma suggest a high response rate, with a mean 71% malignant cell destruction in 78.5% of the patients. A longer survival in responsive stage III patients as compared with patients treated with alkylating agents seems likely, but this can only be established by a randomized trial. Despite haematological side-effects, this combination therapy may be used in high risk patients, especially those resistant to a single alkylating agent and in whom the frequency, intensity and duration of responses appears to be the same as in previously untreated patients. In contrast, only one of the 7 patients treated for relapse after previous response to a single alkylating agent responded to the combination chemotherapy.

Adult↗
PubMed1979

[An atypical form of Waldenstrom's macroglobulinaemia with complete remission lasting for more than two years after multiple chemotherapy (author's transl)].

An authentic case of Waldenstrom's macroglobulinaemia without a tumoural syndrome is reported, with initial signs of peripheral pancytopenia. Complete and persistent remission appears to have followed multiple sequential chemotherapy. This very satisfactory and, according to data in the published literature, very rare result suggests that this type of treatment should be prescribed for all patients with macroglobulinaemia with poor prognostic clinical and histological characteristics.

Adult↗
PubMedDate not supplied

[Persistence of accessory spleen after splenectomy for auto-immune thrombocytopenic purpura: apropos of 2 cases].

Two cases of accessory spleen persisting after splenectomy for autoimmune thrombocytopenic purpura are reported. The diagnosis of accessory spleen must be considered whenever post-splenectomy blood smears fail to show pitted erythrocytes or Jolly's bodies in red cells. Isotopic methods, now completed by computerized tomography, will then confirm the persistence of splenic tissue. As illustrated by one of our patients, only large accessory spleens would produce a relapse of autoimmune thrombocytopenic purpura. In case of major thrombocytopenia a second splenectomy is worth attempting, although its benefits are inconstant and unpredictable.

Adult↗
PubMedDate not supplied

A UMLS-based knowledge acquisition tool for rule-based clinical decision support system development.

Decision support systems in the medical field have to be easily modified by medical experts themselves. The authors have designed a knowledge acquisition tool to facilitate the creation and maintenance of a knowledge base by the domain expert and its sharing and reuse by other institutions. The Unified Medical Language System (UMLS) contains the domain entities and constitutes the relations repository from which the expert builds, through a specific browser, the explicit domain ontology. The expert is then guided in creating the knowledge base according to the pre-established domain ontology and condition-action rule templates that are well adapted to several clinical decision-making processes. Corresponding medical logic modules are eventually generated. The application of this knowledge acquisition tool to the construction of a decision support system in blood transfusion demonstrates the value of such a pragmatic methodology for the design of rule-based clinical systems that rely on the highly progressive knowledge embedded in hospital information systems.

Artificial Intelligence↗