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Biomedical subjects

P N'Guyen

Publications and source records attributed to P N'Guyen.

6 recordsLinked to original sources
PubMed2005

[What kind of treatment are available in deep vein thrombosis prevention?].

In order to propose new recommendations concerning deep vein thrombosis prevention in surgery and obstetrics, we identified all the available tools. We performed a Medline search for ten years to review all the studies published in this field. This preliminary stage is mandatory in assessing guidelines able to work out strategies considering each patient in each particular surgical situation. There are no formal guidelines and we outlined a practical approach for the prevention of deep vein thrombosis. Data concerning all available treatment were not classified in an evidence-based strategy.

Fibrinolytic Agents↗
PubMed1998

The effects of capsaicin on the neurogenic hyperreflexic detrusor. A double blind placebo controlled study in patients with spinal cord disease. Preliminary results.

PURPOSE: Several recent open studies have provided encouraging results as to the efficacy of intravesical installations of capsaicin for neurogenic hyperreflectivity. The present trial was performed to verify these results under controlled conditions. Intravesical installation of capsaicin represents a new therapeutic hope for the treatment of the neurogenic hyperrelfexic bladder. METHOD: This randomized, double-blind study compared the results of the intravesical installation of 30 mg capsaicin in 100 ml of 30% alcohol (experimental group) with those of installing 100 ml 30% alcohol alone (control group). On day 0 and day 30, urodynamic and biopsic examinations were performed in all subjects of each group. PATIENTS: All the subjects included in the study had a functionally disabling form of neurogenic hyperreflexic bladder resistant to the usual therapies. Cystoscopy and retrograde cystography were performed to exclude any patient who presented with a tumor-like lesion or had vesicoureteral reflux. RESULTS: Twelve paraplegic of tetraplegic subjects, seven women and five men whose average age was 46, were included. Eight had multiple sclerosis, and four had sustained a traumatic spinal cord injury. The patients were randomly separated into two groups of six. Initially, there was no clinical or urodynamic differences in these groups. Installation immediately triggered side effects and during the first 7 days (suprapubic burning sensation, sensory urgency, hot flushes, autonomic hyperreflexia, hematuria) in five of the six subjects in both groups. Bladder biopsy revealed no significant deterioration. On day 30, there was improvement in all of the experimental-group of patients with significant regression of leakage (P = 0.002) and of sensory urgency (P = 0.01). Only one control subject had amelioration. Urodynamic examination showed a rise in bladder capacity from 172.5 to 312.3 ml in the experimental group, significantly greater (P = 0.03) than the rise from 129 to 175.3 ml observed in the control group. CONCLUSION: This trial fully confirms the efficacy of intravesical installations of capsaicin, an efficacy obtained at the cost of nonnegligible side effects. An intermediate-term follow-up of this treatment will be necessary before considering more widespread use of this agent.

Adult↗
PubMed1997

[Non-iatrogenic injuries of the ureter].

The increasing number of non-iatrogenic ureteric injuries can be explained by the increasing crime rate in certain large cities and by the performance of intensive car teams, both in civilian practice civil and in a context of war. The discovery of an ureteric injury during salvage laparotomy for vascular or visceral lesions is no longer exceptional. The initial diagnosis is missed in 10 to 20% of cases, due to the absence of any specific clinical signs, as radiological opacification of the urinary tract is rarely performed and the clinical situation is dominated by associated lesions. The treatment of ureteric injuries is guided by the severity and septic nature of associated lesions and the ballistic context. When the ureteric lesion is short and associated lesions are limited, urinary continuity can be restored, after debridement of the extremities, by end-to-end anastomosis for the upper 2/3 and by direct vesical reimplantation or into a psoas bladder for the lower 1/3. Drainage is ensured is by an externalised ureteric catheter or a double J stent and must be kept in place for at least 3 weeks. In the presence of a defect of the upper two-thirds of the ureter, mobilization of the kidney and the renal pedicle or transureteroureterostomy may be considered. In the case of unstable haemodynamic status, very septic associated lesions or in the presence of multiple fragments, urinary diversion by nephrostomy or in situ ureterostomy is indicated. Extensive contusion of the ureteric wall must be intubated to prevent fistula secondary to necrosis. Nephrectomy is inevitable in 10 to 20% of patients.

Anastomosis, Surgical↗
PubMed1996

[Fibrinogen: a risk factor].

More than 10 epidemiologic studies have established that a high fibrinogen level is a thrombotic risk factor. The role of fibrinogen in arterial occlusion is multiple : the atheroma plaque involvement in formation thrombus, erythrocyte aggregation, whole blood and plasma viscosity. Fibrinogen level is high during inflammation and increases with ageing and in tobacco addicts. In coronary disease, it is an independent risk factor of prognosis value. In arterial peripheral disease, it is a risk factor of postsurgical reocclusion. After a stroke, a high level of fibrinogen is a sign of severe disease. The dosage of fibrinogen is quite easy but requires a precise calibration. The determination of genetic polymorphism associated with high fibrinogen level is promising. Many circumstances can modify fibrinogen level and are targets for prophylaxis treatments. The influence of genetic factors is still discussed.

Arteries↗
PubMed1991

[Massive pulmonary embolism disclosing thrombocytopenia induced by low molecular weight heparin. Therapeutic success of prostacyclin].

The authors report a case of massive pulmonary embolism revealing thrombocytopenia induced by a low molecular weight heparin (LMWH) initially proposed for the treatment of superficial phlebitis. The diagnosis was confirmed by in vitro aggregation tests and a fall in the platelet count when the LMWH was reintroduced. The outcome was clinically, angiographically and hematologically satisfactory in response to in situ treatment with prostaglandin, subsequently replaced by Vitamin K antagonists.

Fibrinogen↗