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Biomedical subjects

P Dollfus

Publications and source records attributed to P Dollfus.

At least 19 recordsLinked to original sources
PubMed1999

Workshop on spinal cord injuries (SCI) management: the Chiang Mai experience.

OBJECTIVES: To give an opportunity to health workers in South Asia (SEA) to improve their knowledge in the comprehensive management of SCI. SETTING: Chiang Mai, Thailand; 5-7 November 1997. PARTICIPANTS: Sixteen faculty members (from Europe, Australia and Thailand) and 160 participants (94 Thais, 66 from SEA, China, India and Bangledesh). METHODS: Two days of lectures and 1 day of workshops and discussion. Evaluation was performed by questionnaires. Suggestions and comments are reported. RESULTS: Ninety-two per cent of participants said the workshop was really useful. Eighty-eight per cent were very satisfied with the quality of the programmes and 92% with the workshops and discussion on the last day. CONCLUSIONS: A follow-up study should be conducted by the Educational Committee of IMSOP. This will help to plan more efficacious training programmes for the future.

Asia↗
PubMed1998

The 'Dejerines': an historical review and homage to two pioneers in the field of neurology and their contribution to the understanding of spinal cord pathology.

Our purpose, in this number of Spinal Cord devoted to the French speaking Society of Paraplegia (AFIGAP), is to render homage to two very distinguished doctors, who by their work at the end of the XIXth and the beginning of our century contributed greatly to our knowledge of the nervous system and in particular the spinal cord (SC). This was at the time a field of considerable interest in France and abroad. Professor Jules Dejerine was from 1911-1917 the holder of the Chair for Nervous System Diseases created for Charcot. Dejerine and his American born wife, Augusta Klumpke, and had very limited means for investigation compared to actual technological advances. They relied mainly on their superb clinical observations and neuropathological examinations. Dejerine was also a pioneer in the growing field of neuroanatomy. In 1895 he published a treatise on the anatomy of the nervous system, which is still considered worldwide to be a masterpiece. Augusta Dejerine-Klumpke, the first woman Intern in Paris Hospitals, was not only a fine clinician, neuroanatomist and pathologist, but also contributed greatly to her husband's work. Amongst other things she is known for the 'Klumpke palsy'. She was also a pioneer in France, during the First World War and subsequent following years, in the treatment and rehabilitation (medical and vocational) of the large number of soldiers afflicted by wounds of the nervous system and especially of the SC. During the same period, many authors contributed to SC pathology, but only a few to the treatment and rehabilitation of these patients. This was brought to our attention, in the sixties, by Professor Pierre Houssa, pioneer in Belgium in the field of comprehensive care of those who have SC lesions. Augusta Dejerine-Klumpke also contributed to our present knowledge of heterotopic ossification following a SC injury, including its pathogenesis. Most of their clinical and pathological findings and discussions are recorded in Dejerine's famous monograph which was published in 1914: La séméiologie des Affections du Système Nerveux (The Semiology of the Diseases of the Nervous System).

History, 20th Century↗
PubMed1997

Neurological issues.

The case histories of two patients who had had a spinal cord injury (SCI) were selected by the senior author and sent to four experts in the field of SCI. Based on the 1992 American Spinal Injury Association (ASIA) and International Medical Society of Paraplegia (IMSOP) standards, the four participants plus the senior author recorded the motor and sensory scores, the ASIA impairment scale (AIS), the neurological level (NL) and the zone of partial preservation (ZPP). Several minor scoring errors occurred among the participants, especially with motor scores when key muscles could not be tested due to pain, or external immobilization devices. Difficulties with interpretation occurred with the motor levels and the ZPP for the patient with a complete injury. This exercise points to the need for all examiners of SCI patients to thoroughly familiarize themselves with the standards and to use the motor and sensory scores to arrive at a NL and ZPP. They also indicate a need to revise the standards to clarify the determination of sensory levels and how to score muscles whose strength is inhibited by pain.

Adult↗
PubMed1993

Rehabilitation following injury to the spinal cord.

There are several key aspects in the rehabilitation of patients with traumatic spinal cord injury, including the delivery of lifelong resources and services. Rehabilitation must commence as early as possible after the injury and encompass secondary and tertiary prevention efforts in order to minimize the personal and social consequences associated with neurotrauma. Recent advances in molecular neurobiology and new information gained from randomized clinical trials may help reduce the consequences of this type of injury. These advances need to be extended and research must be encouraged.

Activities of Daily Living↗
PubMed1991

[Neurophysiopathology of spinal lesions, evaluation of the 80s. Post-injury assessment and treatment of the neurogenic bladder in the acute period].

This introductory presentation deals with the recent pathophysiological aspects of the post-traumatic spinal cord lesion and the population concerned. The neurophysiology of the bladder and its sphincters is summarized so as to try and explain some disturbances occurring during the acute phase following a spinal cord injury; their clinical and urological aspects and the methods of bladder drainage.

Acute Disease↗
PubMed1990

The locked-in syndrome: a review and presentation of two chronic cases.

The locked-in syndrome (LIS) is a state of an upper motor neurone quadriplegia involving the cranial nerve pairs with usually a lateral gaze palsy, paralytic mutism, full consciousness and awareness by the patient of his environment. A historical presentation of the LIS is given as well as a short description of the clinicoanatomic lesion causing LIS. The usual cause is vascular and corresponds to a pontine infarction due to an obstruction of the basilar artery but other lesions in the brainstem can also be the cause. Non-vascular aetiologies, especially traumatic, are reviewed. The use of electroencephalography (EEG), brain auditory evoked potentials (BAEP) and somesthesic evoked potentials (SEP) are discussed as well as the use in the acute stage of computed tomography (CT), angiography, and magnetic resonance imagery (MRI). The last method may show well delineated ischaemic lesions some time after the event. The communication disability is probably the most difficult to overcome. Two cases of LIS are presented.

Adult↗
PubMed1987

Surgical treatment of the static perineal modifications in spinal cord or cauda equina lesions.

Severe dysuria, due to insufficiency of the perineal floor associated during micturition with a posterior tilting of the prostate-bladder block in lower or in associated upper and lower motor neuron lesions, can be treated surgically by a prostato cytso pexy. Since 1971, eight patients with post-traumatic conus and/or cauda equina lesions have been treated by this intervention. On the follow-up the satisfactory results appear to remain stable. An alternative surgical technique using the abdominal pyramidalis muscle is described so as to fix the prostate, associated with a bladder-pexy. The recurrence of dysuria, after the intervention, has always been caused by an additional lower urinary tract pathology. The comfort of the patients has been greatly improved.

Abdominal Muscles↗
PubMed1984

Technical note: preliminary communication a tridigital dynamic orthosis for tetraplegic patients.

A new orthosis using the same principles as the tridigital pinch for forearm amputees is presented. The forward movement of the shoulders activates a cable which allows the two first fingers to grasp an object firmly against the thumb which is maintained in half opposition. This device can be particularly useful for low cervical lesions with no or weak finger flexors.

Biomechanical Phenomena↗
PubMed1982

Clinical and anatomical observation of a patient with a complete lesion at C1 with maintenance of a normal blood pressure during 40 minutes after the accident.

The authors report on their clinical observations concerning a patient with a complete spinal cord injury at the level of C1, followed by a cardiac hypoxic arrest, due to immediate respiratory paralysis after the accident. Normal cardiac activity was obtained as a result of rapid resuscitation measures, using only intubation and external cardiac massage without any drug administration. The blood pressure was maintained without any drugs at a level of 130 Torr during 40 minutes before it fell to a permanent level of 50--40 Torr on ventilation alone. The diagnosis during the first hours was believed to be that of an irreversible coma with no evidence of vertebral injury. The patient started to recover consciousness after a few days but died on the 15th day. The case is discussed in the light of the literature and of the recent physiological experiments concerning the rapid changes of blood pressure after spinal cord section in animals.

Adolescent↗
PubMed1982

An unusual injury of the cervical spine caused by a fork lift.

A case of very unusual aetiology is reported. A severe traumatic injury of the cervical spine was associated with a suspended bilateral phrenic nerve paralysis, with limited sensory involvement, and weakness of the muscles of the right upper limb. The neurological status was otherwise normal, apart from slight weakness of the left upper limb. Artificial ventilation was necessary. Respiratory recovery was slow. The neural aetiology is discussed in relation to spinal cord and/or root involvement.

Accidents, Occupational↗
PubMed1980

The value of the thromboelastogram as means of monitoring the sub-cutaneous preventive action of calcium heparinate.

The index of the thrombodynamic potential (I.T.P.) as one of the biological means of controlling the prophylactic effect of sub-cutaneous injections of Calcium Heparinate has been studied in 34 spinal cord injuries during the acute phase. Individual tolerance variations, some of them important, have been noted as well as the necessity of adjusting the doses, according to the time after injury. A biological hypercoagulability has been noted within the first and third month after injury. The interest and the cost of such a method are discussed and further comparative biological investigations, using other methods, have started.

Female↗