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Biomedical subjects

P Michaud

Publications and source records attributed to P Michaud.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Congenital aortic valve stenosis. Long-term results after valvulotomy].

The cases of 73 patients undergoing valvulotomy for congenital valvular aortic stenosis between 1957 and 1982 were reviewed. Data was updated after recalling patients to the outpatient clinic and/or analysis of the results of a questionnaire sent to the patient's family doctor or cardiologist. Babies less than 12 months old at the time of surgery were excluded from the study. Operation consisted of valvulotomy under direct control with few associated procedures as the valvular lesion was isolated in 89 p. 100 of cases. 5 patients died in the first 30 postoperative days, an operative mortality of 5,4 p. 100. The follow-up period ranged from 1 to 25 years, with 15 patients having been followed up for over 10 years. 6 patients were reoperated with no operative mortality. 2 of whom have since undergone a second reoperation. Of the 59 patients not re-operated, 54 were class I and 5 class II of the NYHA. Of the latter group, 4 are candidates for aortic valve replacement for significant aortic regurgitation. The actuarial survival graph shows a 92.82 p. 100 probability of survival at 5 years, and 86.83 p. 100 at 10 years. Aortic valvulotomy remains a palliative operation which does not protect the patient from subsequent sudden death.

Adolescent↗
PubMed1984

[Association of an interauricular communication of the sinus venosus type with obstructive myocardiopathy. Surgical treatment].

The authors report the case of a 46 year old man in congestive cardiac failure for 4 years due to the association of a sinus venosus atrial septal defect and hypertrophic obstructive cardiomyopathy. Surgery was attempted because of the poor response to medical therapy. The operation consisted in a trans aortic left ventricular myotomy with mitral valve replacement, enlargement of the atrial septum by a patch and correction of the sinus venosus also by a patch. The result was excellent, with regression of the clinical signs of cardiac failure, maintained after 6 months' follow-up. This is certainly a very rare pathological association of which we were unable to find any previous reported case in the literature. Two cases of ostium secundum atrial septal defect with hypertrophic obstructive cardiomyopathy have been operated on previously, one successfully and the other one without success. A rational surgical approach is suggested, based on the analysis of the physiopathological consequences of this rare association.

Cardiomyopathy, Hypertrophic↗
PubMed1983

Effect of the combination of dexamethasone and sodium ipodate on serum thyroid hormones in Graves' disease.

To investigate the effect of the combination of dexamethasone (Dex) and sodium ipodate (SI) on hyperthyroidism, we studied 24 patients with typical Graves' disease, divided into four groups of six persons each. Three groups (Study I) were studied acutely (24 h) to determine the effects of Dex (5 mg every 12 h intramuscularly), SI (one oral dose of 3 g) and both drugs at the same doses, upon T4, T3, and rT3 at 0900 h before therapy was started and 24 h later. The group on Dex and that on SI had a similar T3 decrement of 25.9 +/- 4.0% and 35.8 +/- 5.0%, respectively, (P less than 0.05), whereas the effect of both drugs combined was greater (64.2 +/- 3.6%; P less than 0.01, Dex, and P less than 0.01, SI, respectively). The increment of rT3 was markedly greater in those patients on SI than in those on Dex (561.3 +/- 149.2% and 58.9 +/- 11%, respectively, P less than 0.025). A fourth group (Study II) was studied for seven days while receiving both Dex (1 mg orally three times per day) and SI (500 mg orally three times per day). Both T4 (from 18.8 +/- 1.1 to 13.1 +/- 1.1 micrograms/dl, P less than 0.02) and T3 (from 593 +/- 41 to 136.3 +/- 12.7 ng/dl, P less than 0.001) decreased at day 8. The initial brisk increment of rT3 at 24 h (808 +/- 149%, P less than 0.005) then diminished concomitantly with the fall of its precursor, T4.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

[Use of valved tubes in the treatment of ventriculo-pulmonary discontinuity. Long-term results].

Forty five patients, 2 months to 42 years of age, had valved tubes implanted for ventriculo-pulmonary discontinuity. The underlying malformations were: certain forms of Fallot's tetralogy (16 cases), transposition of the great arteries with ventricular septal defect and pulmonary stenosis (8 cases), truncus arteriosus (9 cases), double outlet right ventricle (6 cases), other malformations (4 cases). Hospital mortality (at 30 days) was 31% (14 cases). This was mainly due to technical difficulties related to the large number of palliative procedures and to irreversible pulmonary hypertension, present in 43% of cases with fatal outcomes. Thirty one patients were followed up for 6 months to 7 years (mean 3 +/- 1,6 years). There were 3 late deaths, one during reoperation for a residual shunt. All survivors underwent clinical assessment with hemodynamic control in 17 cases (15 routine control catheterisations). To date it has only been necessary to change one valved tube: a good result was obtained.

Adolescent↗
PubMed1981

[Prognostic histopathological features of cutaneous malignant melanomas. New statistical approach (author's transl)].

The records of 203 Cutaneous Malignant Melanomas treated at the Centre René Huguenin in Saint-Cloud from october, 1959 to december, 1978 were reviewed. The histologic data were reexamined and 155 cases were retained. Previously classified according to the histologic type and the invasion level of Clark, they were evaluated according to the thickness of the tumor by the ocular micrometer in 100 ths of a millimeter, as was done by Breslow. Other histologic data were collected for each case. Clinical and therapeutic informations and carcinologic events were gathered together. From this research, 155 cases were proved significant in accordance with Multifactorial Statistic Analysis. This study pointed out significant facts: 1) The thickness of the tumor is the utmost important factor, i.e. correlative with survival rate, recurrence and metastasis. 2) Starting with a short number of histologic and clinical variables it seems possible to draw a profile of a patient with cutaneous malignant melanoma and to obtain a precise prognosis and so prepare complementary treatment.

Humans↗