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Biomedical subjects

P Monnier

Publications and source records attributed to P Monnier.

At least 127 records · Page 7Linked to original sources
PubMed1988

What energy level is required to avoid nutrient depletion after surgery in oropharyngeal cancer?

The rate of energy expenditure was repeatedly measured by indirect calorimetry both in the basal state (BMR) and in the resting fed state (RMR) in 8 middle-aged male patients operated for oropharyngeal cancer. In the postsurgical phase, two sequential energy levels were administered by nasogastric tube: (1) a 'maintenance' level (days 3-5) at 1.4 X measured presurgery BMR; (2) a 'supramaintenance' level (days 6-9) at 1.7 X measured BMR on day 6. Before surgery the patients had a BMR averaging (23.7 +/- 1.0 kcal/kg.day). After surgery BMR increased to 27.6 +/- 2.7 kcal/kg.day (day 6), then it decreased to 24.4 +/- 1.4 kcal/kg.day (day 10). The difference between RMR and BMR yielded a nutrient-induced thermogenesis averaging 5 +/- 1 and 8.5 +/- 2% (p less than 0.05) on levels 1 and 2, respectively. It is concluded that an energy level corresponding to 1.4 X presurgery BMR is sufficient to maintain energy and substrate equilibrium in nondepleted patients, whereas 1.7 X BMR induces positive protein and fat balances concomitant to a decrease efficiency of energy utilization.

Adult↗
PubMed1987

Percutaneous transtracheal ventilation for laser endoscopic procedures in infants and small children with laryngeal obstruction: report of two cases.

The case reports of two children with obstructive lesions of the larynx are presented to illustrate the advantages of transtracheal ventilation for paediatric endoscopic laser surgery. The first patient was a four-month-old infant with inspiratory stridor due to a subglottic haemangioma obstructing 80 per cent of the lumen. The second patient was a five-year-old child with posterior synechiae of the larynx. The anaesthetic and ventilation techniques were the same for both cases. A transtracheal catheter was introduced percutaneously into the trachea under endoscopic control and connected to a high frequency jet ventilator. The advantages of this technique during laser surgery are: clear vision of the operative field, good gas exchange, elimination of airway trauma from intubation, reduction of the hazard of airway fires, and decreased risk of aspiration of blood and debris. In addition, this method of providing oxygen and/or mechanical ventilation may be extended into the postoperative period. In certain situations, this technique can be an attractive alternative to a tracheostomy with its potentially dangerous and incapacitating complications in infants and small children.

Airway Obstruction↗
PubMed1987

Anisoylated plasminogen streptokinase activator complex versus streptokinase in acute myocardial infarction. Preliminary results of a randomised study.

25 patients with acute myocardial infarction pain lasting more than 20 minutes which was not relieved by nitrates, whose ECGs showed ST segment elevations of 1 mm or more in 2 or more ECG leads, and who presented less than 3 hours after onset of their symptoms were randomly assigned to one of 2 thrombolytic treatment groups: a single intravenous bolus of anisoylated plasminogen streptokinase activator complex (APSAC) 30U in 5 minutes or an intravenous infusion of streptokinase 1,500,000U over 60 minutes. 3 to 4 hours after the administration of the thrombolytic agent, all patients received intravenous heparin at full dosage for 24 hours. The patency of the infarct-related coronary vessels was assessed by angiography 1 to 4 hours after administration of the thrombolytic agent. Clinical signs, ECGs, pulse, blood pressure and temperature were monitored regularly for 24 hours after treatment or as clinically appropriate. APSAC seemed to be at least as effective as streptokinase in terms of patency of the infarct-related vessel (92% vs 63%, respectively). The adverse events were similar and none was life-threatening. APSAC and streptokinase caused similar falls in blood fibrinogen levels. APSAC, given as a bolus injection over 5 minutes, was easier to administer than streptokinase, which was given as an infusion during 60 minutes.

Adult↗
PubMed1987

[Precancerous conditions of the digestive system: true risk or a paper tiger? The esophagus].

The incidence of the squamous cell carcinoma of the esophagus shows geographical variations. As a rule it is found in heavy smokers and alcoholics. Multicentricity (mouth, hypopharynx, esophagus) is very frequent and accompanied by large dysplasias of different stages. The adenocarcinoma develops on the metaplastic cylindric epithelium of the Barrett esophagus. Positive dysplasias are highly suspicious of the development of a carcinoma and demand the reconfirmation of the finding by a second pathologist. In this case the resection of the esophagus has to be done. The abdominal-cervical method should be preferred.

Adenocarcinoma↗
PubMed1986

[Epidermoid cancer of the upper respiratory and digestive tracts].

Early diagnosis of cancer of the upper aerodigestive tract is possible provided that high risk patients are recognized and their symptoms correctly interpreted, screening endoscopy of the whole squamous cell oropharyngo-oesophageal mucosa and of the tracheo-bronchial tree is performed in every high risk patient presenting the slightest symptoms related to the upper aerodigestive tract, the general practitioner is aware of the limits and pitfalls of the various possible investigation methods (barium swallow, CAT, fine needle biopsy of lymph-nodes, and endoscopy).

Biopsy, Needle↗
PubMed1981

Intraepithelial carcinoma of the oesophagus: endoscopic morphology.

The endoscopic detection of 18 "early" hypopharyngo-oesophageal carcinomas, has allowed us to perform a detailed study of the morphological correlation between endoscopy and histology (in 10 cases). We have thus defined 4 different endoscopic types of intraepithelial carcinomas; their morphology, mapping and evolution are greatly variable. In high risk groups (heavy smoking and alcohol consumption, ENt-cancer) the multicentricity of intraepithelial carcinomas (80%) entails a thorough endoscopic screening of the upper digestive tract (mouth, pharynx, oesophagus) and of the lower respiratory tract (larynx, trachea and bronchi).

Carcinoma in Situ↗
PubMed1981

[Gastroesophageal reflux: importance of endoscopy in surgical indications and postoperative control].

Endoscopy constitutes an important investigation in the presence of a gastro-oesophageal reflux. The primary intention is to exclude the possibility of an organic pathology, for example cancer, which has not been demonstrated by other investigative procedures. Accordingly it must provide a detailed exploration of the whole superior digestive tract, from the mouth to the duodenum. Secondly, endoscopy must establish the consequence of the reflux on the mucosa of the lower oesophagus both by a macroscopic and a detailed microscopic description. Peptic lesions are classified according to 4 degrees of severity. The difficulty in evaluating the very early lesions (1st degree) and the advanced stages (4th degree) necessitates systematic biopsies of the lesions. The erythroplasic type of carcinoma in situ can present the same endoscopic changes as a 1st degree peptic lesion, whereas the exclusion of an adenocarcinoma constitutes the major preoccupation at the time of endoscopy of a 4th degree oesophagitis.

Adenocarcinoma↗
PubMed1979

[The place of total aerodigestive upper endoscopy in oncology].

The epidemiology of upper digestive and bronchogenic carcinoma shows a large overlap between the high risk groups. Thus, a candidate for bronchogenic carcinoma is also a possible candidate for upper digestive cancer. Furthermore, the high frequency of multiple carcinoma in the upper aero-digestive tract, the esophagus and the tracheo-bronchial tree warrants a pan-endoscopic (buccal-pharyngo-esophagoscopy and laryngo-tracheo-bronchoscopy) approach to the problem. Using this type of endoscopy, 16 multiple carcinomas have so far been simultaneously discovered among 200 pan-endoscopies.

Carcinoma, Bronchogenic↗