Search PubMed⌕ Search

Biomedical subjects

P Gehanno

Publications and source records attributed to P Gehanno.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Bacteriology of acute otitis, in current practice, in 1987. Therapeutic implications].

After presenting the methodology of their study and the structure of their chain of swabs, the authors report the bacteriological results and therapeutic consequences which they imply. In this study, which was conducted in children between the ages of 3 months and 3 years, Haemophilus influenzae was the bacterium most frequently isolated, regardless of the age-group. It was followed by Streptococcus pneumoniae and Staphylococcus aureus. Neither the recurrent nature of the otitis nor the child's life style influenced the predominance of Haemophilus influenzae. 23% of the strains were beta-lactamase producers. The production of beta-lactamase prevented the use of amoxicillin. The increasingly frequent resistance of Streptococcus pneumoniae and the poor sensitivity of Haemophilus influenzae discourage the use of macrolids; the combination of amoxicillin-clavulanic acid obtained a better score with an efficacy of 89%.

Acute Disease↗
PubMed1987

[Diffusion of ceftriaxone in bronchial secretions for 24 hours after a single injection].

The authors have determined the bronchi concentration 1 h, 3 h, 6 h and 24 h after a single muscular injection of ceftriaxone in a series a 13 patient with tracheostomy that received ceftriaxone for prophylaxis. In spite of a large inter-individual variability the result is a good mean ceftriaxone concentration during the first 24 h. Theses results confirms the value or a single daily injection in the treatment of pulmonary injection whose germ is sensitive to the drug.

Bronchi↗
PubMed1987

[Contribution of muscular and musculocutaneous flaps in the early postoperative period in total salvage laryngectomies and pharyngo-laryngectomies. Apropos of 35 cases].

From 1981 to 1985, 35 patients (34 male, 1 female), mean age, 56 years, underwent salvage total laryngectomy and pharyngo laryngectomy after full course radiotherapy. 13 cases have been closed primarily. 22 cases underwent reconstructive surgery using 15 musculo cutaneous and 7 muscular flaps. Complications occurred in 46% of the patients closed primarily and required further reconstruction by musculocutaneous flap. 90.7% of the cases where a flap was used initially had no post operative complications. This study confirms that the use of muscular and musculocutaneous flaps improve healing in salvage surgery.

Adult↗
PubMed1987

[Tonsillitis today. Epidemiologic review. Clinical correlates. Therapeutic impact].

A prospective study was conducted in 216 patients with ulceration of throat and 100 controls. Bacteriology showed, in the low percentage of case with positive results, the classical distribution of germs generally identified from throat swabs, with predominance of haemolytic streptococci AB and associated fusospirilla. Haemophilus influenzae was very rarely isolated (1%) and immunofluorescence tests for Chlamydia trachomatis in the pharyngeal exudate were always negative, in both patients and controls. These findings confirm utility of Penicillin V as single therapeutic agent in ulcerated throat. Correlations between clinical findings and between these and bacteriology results demonstrated that clinical examination failed to provide data contributive to the establishment of an aetiological diagnosis and therefore to treatment, which, in the absence of complementary examinations, must remain empirical.

Adolescent↗
PubMed1987

[Primary transmaxillary buccopharyngectomy and recovery transmaxillary buccopharyngectomy in giant cancers of the tonsilar region. Apropos of 120 cases].

Based on a series of 120 patients treated by trans-maxillary buccopharyngectomy for tumors (mainly T3, T4) of the tonsillar region, results are compared of primary and recovery surgery, the latter being instituted from 1981 because of the rapid strides made in new reconstructive procedures. This development markedly modified therapeutic indications, with substitution of radiotherapy as primary treatment. After primary surgery, the 3- and 5-year survival rates were globally 59 and 49% respectively. The usual prognostic factors emphasized, size of tumor and glandular involvement, were verified. Results of recovery surgery were less good, 39% survival at 3 years, for two main reasons: a higher level of lack of local control (34%) than that of primary surgery (14%) and a maintained elevated postoperative mortality. These findings indicate that the initial hope that the use of LMC would raise this surgery to the level of the performance of primary surgery has not been fully confirmed. Finally, analysis of all groups in this series demonstrates that prognosis is worse as the involvement of base of tongue increases.

Adult↗
PubMed1987

[Recovery surgery in cancer of the tongue. Apropos of 101 cases].

Results of 101 salvage glossectomies, after unsuccessful treatment of cancer of tongue by radiotherapy, showed a 3-year survival of 39% and a 5-year of 31%. Carcinologic failures represented 81% of causes of death: 17% due to distant metastases, 6% to a second focus and principally 32% to local recurrence. Local recurrence varied as a function of tumor size but also of site and type of surgical treatment. Tumors of the mobile tongue have a relatively good prognosis, even when the total organ is involved, with attachment to floor of mouth if an anterior transverse glossectomy is performed. Inversely, lateralized tumors spreading to base and to the mobile tongue treated by partial longitudinal glossectomy tend to have a high frequency of failure of local therapy, probably partly avoidable by wider excision. These same local failures of treatment are the cause of the worsening prognosis after total glossectomy in patients who had been poorly selected perhaps and presented extralingual spread not controlled by surgery. Finally, the authors emphasize the need for a collaboration of the patient in the choice of therapy, which involves surgery with functional sequelae that risk to be extremely heavy.

Adult↗
PubMed1986

[Treatment of cerebrospinal fluid otorrhea. A closure procedure using a pretragal flap].

Based on a series of 12 cases of osteo-dura mater breaches (including 11 cases admitted to hospital for meningitis), the authors review the various techniques for closure and propose simple closure by aponeurosis and tissucol in the treatment of breaches of the tegmen and the use of a pretragal flap to exclude the middle ear, in ballistic disruptions or resection cavities.

Adolescent↗
PubMed1985

[ORL localizations of Abrikosov's tumors. Apropos of 5 cases. A tumor which is not always benign].

Abrikossoff's tumor is a benign lesion affecting the oropharynx in more than half the cases. Five cases are reported and symptoms and signs reviewed. Treatment was by wide excision, although a less extensive operation is possible to avoid major damage to surrounding structures. This attitude can be adapted because the course of the affection is by slow progression, with the possibility of no further growth, and the fact that surgery can be repeated.

Adult↗
PubMed1985

[Postoperative infection in ORL oncologic surgery. The choice of preventive antibiotherapy. Experience of the ORL Department of Hôpital Claude Bernard].

The incidence of infection after cervicofacial surgery for ENT cancer varied between 38 and 60% as a function of the type of operation, and prophylactic antibiotic therapy administered, in a series of 133 cases. Contamination was greatest after operations of longest duration and with the largest exposure of tissue. Previous cobalt therapy was an aggravating factor. The highest risk of infections complications resulted therefore from combined salvage operations and the use of a musculocutaneous flap. Among these infections, a purulent bronchorrhea was a frequent and potentially serious complication sometimes the cause of septicemia. A review of 4 different antibiotic therapy regimens showed the pre-operative administration failed to alter the outcome. Combined penicillin-5 imidazole treatment, effective in preventing local and regional anaerobic infection, resulted in secondary infection developing in about 56% of cases. It was not able, in fact, to cover under certain circumstances during prolonged surgery, the postoperative risk of inhalation of gram-negative anaerobic and aerobic bacteria form the buccal cavity. Short-term antibiotic therapy was totally ineffective. It is suggested that combined penicillin-5 imidazole be reserved for operations provoking little contamination of the tracheobronchial region, such as total laryngectomy and total pharyngo-laryngectomy, and that prophylactic therapy using an antibiotic with a wide spectrum against gram negative germs be administered prior to major buccopharyngeal operations with tracheotomy.

Anti-Bacterial Agents↗
PubMed1985

[Surgery of pericannular recurrence and extensive tumors of the trachea].

Treatment proposed for pericannular recurrence and previously irradiated vast, extensive, subglottotracheal tumors involves the performance of a manubriectomy with reconstruction using a musculocutaneous flap. The former solves the problem of the route of approach and local carcinologic safety and the latter provides a solution to the problem of congruence of trachea and presternal teguments as well as postoperative complications by protecting the brachiocephalic arterial trunk.

Humans↗
PubMed1985

[Velopharyngeal rehabilitation after transmaxillary buccopharyngectomy extending to the soft palate].

Two types of velopharyngeal rehabilitation are proposed after transmaxillary buccopharyngectomy extending to the soft palate region. The first method is by velopharyngoplasty, when exeresis has not involved a half or a quarter of the soft palate and at least half of the posterior pharyngeal wall. The second procedure is for use after exeresis involving all or almost all of the soft palate and a half of the posterior pharyngeal wall, and makes use of velum palatinum reconstruction. The method of choice is velopharyngoplasty, excellent functional results being obtained for both phonation and feeding.

Humans↗
PubMed1985

[Purulent meningitis after minor nasosinus surgery. Apropos of 10 cases].

Purulent meningitis developed during the immediate or late postoperative period in 10 patients undergoing minor surgical procedures for nasosinusal affections. An important point is that the meningeal infection may be a very late onset complication, the osteodural gap sometimes giving rise to several attacks of meningitis at unexpected times. Treatment should be based on the presence or absence of clinical cerebrospinal fluid rhinorrhea, of a fracture of the anterior shelf of base of cranium on tomography, and results of isotopic scanning which are valid only if positive. Surgery to close the gap is justified when rhinorrhea persists after recovery from meningitis or when recurrent bouts are reported. Even after surgery, however, there is still the risk of further attacks of meningitis. An interesting adjuvant to treatment is by antipneumococcal vaccination.

Adult↗
PubMed1985

[Total glossectomy with preservation of the larynx and immediate reconstruction. Apropos of 27 cases].

Total glossectomy with preservation of larynx was performed in 27 patients with lesions affecting the whole tongue and developing from the base, the tonsilloglottal recess, of the junction zone and of the posterior wall, or from the mobile tongue. Results in patients followed up for more than one year (27 cases) showed: 11 survivors only, with 12 deaths from local, regional or metastatic recurrence. Among the 11 survivors, 7 presented very satisfactory functional rehabilitation--they no longer required tracheotomies, were free from pain and fed themselves without problem with mixed types of food. Phonation could be understood and they were reasonably autonomous. When tumoral excision is possible in patients with extension not evident as palpable glands, this operation appears quite justified for patients who are psychologically motivated and very insistent on some therapy, the modalities and risks of which have been exposed.

Adult↗