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P Oberlin

Publications and source records attributed to P Oberlin.

At least 19 recordsLinked to original sources
PubMed2005

[French modalities of myocardial revascularisation in 2001].

UNLABELLED: French modalities of myocardial revascularization were unknown, whereas beneficial effect on outcome was controversial. The study describes current practices in 2001 and analyzes those data according to regional coronary heart disease incidence and mortality. METHODS: Data are obtained from the French hospital national database (PMSI). Mortality is obtained from French mortality registry, and myocardial infarction incidence is estimated with French registries of MONICA project. RESULTS: Myocardial revascularization utilization fluctuate from 25% of patients hospitalized for coronary disease in Limousin to more than 40% of patients in Provence-Alpes-Côte d'Azur (PACA), Languedoc-Roussillon and Ile-de-France. Standardized rate per 100,000 individuals is 109 in Pays de la Loire and 309 in Corse. Medical care offers seem to influence the practice. In the six regions where the rates are the lower, the density of interventional unit and on-pump center are below the national average, and the cardiologist density is very low. Consequences on regional clinical outcome of coronary heart disease are discussed based on mortality rate and levels of evidenced based medicine in myocardial revascularization. CONCLUSION: For the first time, we describe a wide variation of regional practices for myocardial revascularization in France. A part of those variations can be attributed to regional differences in medical care offers. Finally, the impact on clinical outcome appears clearly but seems limited. Cardiovascular prevention strategy remains of first line importance and emphasizes this main mission of cardiologists.

Age Distribution↗
PubMed1998

A collaborative approach to building a terminology for medical procedures using a Web-based application: from specifications to daily use.

The MAOUSSC (Model for Assistance in the Orientation of a User within Coding Systems) Web server supports a collaborative work on the description of medical procedures. The specifications for the MAOUSSC application are conceptual modeling, definition of semantically fully described procedures, re-use of an existing vocabulary, the UMLS, and sharability. This paper reports on some difficulties in applying those principles in a networked building and updating of the terminology. The users are physicians who have to represent procedure terms in the MAOUSSC formalism. They must apply the constraints of the underlying model, and re-use the representation of the UMLS knowledge base. In our experience, we found that the implementation of syntactic and semantic constraints was not sufficient. Guidelines for pragmatical aspects in representation are required to make a collaborative approach in terminology building more operational.

Humans↗
PubMed1996

[Prolonged clinical remission of cholangitis in early human immunodeficiency virus infection after surgical biliary derivation].

During the acquired immunodeficiency syndrome, most cases of cholangitis develop at an advanced stage of disease. We report a case of cholangitis in a 47-year-old homosexual man, stage IIa according to Center of Disease Control classification. An isolated jaundice was the first manifestation of the disease. The number of CD4 was 380/microL. Ultrasonography and endoscopic retrograde cholangiography showed a 7 cm stenosis of the common bile duct, and cystic duct stenosis, with associated intra-hepatic biliary duct dilatation. No infectious agent was found. Cholecystectomy and hepaticojejunostomy were performed. Pathological examination of liver biopsy and a sample of the resected common bile duct was consistent with sclerosing cholangitis. The postoperative course was uneventful. During a three year follow-up period, the patient was disease free but he suddenly died of uncontrolled bleeding from duodenal ulcer. In HIV-infected patients, surgical treatment can be performed in case of symptomatic long stenosis of the common bile duct.

Biliary Tract Surgical Procedures↗
PubMed1996

[Clinical and radiological aspects of tuberculous splenic abscesses. Presentation of 3 cases].

Tuberculous splenic abscess is an exceptional disease with silent presentation in disseminated tuberculosis infection. Imaging procedures allow to suspect this diagnosis in case of multilocular nodules of the spleen, or unilocular pseudotumoral macronodule. We report three cases of tuberculous splenic abscesses in two patients with acquired immunodeficiency syndromes and one with polycythemia vera. Under antituberculous treatment, clinical evolution was good with regression of the radiological features.

Abscess↗
PubMed1995

[Neurogenic pain].

Explore the source record for details and available documents.

Afferent Pathways↗
PubMed1993

Indications for right hemicolectomy in carcinoid tumors of the appendix. The French Associations for Surgical Research.

The records of 181 patients with carcinoid tumor of the appendix, seen during a ten year period (1977 to 1987), were analyzed retrospectively to determine the indications for right colectomy and the signification of intermediate histopathologic forms. Appendectomy was the only treatment in 146 patients; while right hemicolectomy was performed upon 35 patients--in seven patients with one postoperative death initially and in 28 patients without any death or morbidity, secondarily. Colectomy was indicated initially in seven patients for bulky tumors of the base of the appendix invading the cecum or for associated carcinoma of the right colon. The 28 secondary colectomies were indicated for tumors that were statistically larger and more invasive than those treated by simple appendectomy or for intermediate forms, or both, in five instances. There were five instances of residual tumor on secondary hemicolectomy specimens. In 11 of the 181 carcinoid tumors (6 percent), the intermediate type tumor was associated with mucinous production--seven adenocarcinoids and four carcinoids with mucocele. Of the seven instances of adenocarcinoid, there was one death at two years and one patient is alive with metastases. Other than size greater than 2 centimeters and base localization, the results of the current study suggest that the presence of mucinous production cells is a further indication for secondary right hemicolectomy.

Adolescent↗
PubMed1992

Splenic salvage using an absorbable mesh: feasibility, reliability and safety.

Forty-nine adults underwent surgery for splenic injury: 17 (group 1) had salvage with a splenic mesh, seven (group 2) underwent other preservation techniques, and 25 (group 3) underwent splenectomy. There were six, zero and 11 hilar lesions in groups 1, 2 and 3, respectively. Seven of 15 associated lesions involved the digestive tract. There was no significant difference in transfusion requirements, length of operation or postoperative complications. One patient died in each of groups 1 and 2, and eight in group 3. Secondary splenectomy was performed once in groups 1 and 2. The duration of hospital stay was shorter in the preservation groups (1 and 2) than in group 3. Splenic preservation was feasible in 24 of 49 adults with splenic injury requiring surgery. The splenic mesh wrap is safe and reliable, and allows splenic salvage even with hilar injury.

Adolescent↗
PubMed1991

[Metacarpal bone chondrosarcoma. Apropos of a case].

On the basis of a personal case of non-symptomatic chondrosarcoma of the metacarpal bone and a review of the literature, the authors advise the biopsy of any lesion which resembles a chondroma of the hand. Only histological examination can provide evidence for diagnosis and guide effective treatment.

Bone Neoplasms↗
PubMed1991

[Benign mucus-secreting tumors of the appendix. Six cases].

The authors report six cases of mucus-secreting tumor of the vermicular appendix, in four women and two men (mean age 59 years). All were benign. Pain in the right lower quadrant was the initial sign in 4 cases, while the mucus-secreting tumor was an incidental finding in the other two cases. A mass was palpated in the right lower quadrant in one case. A barium enema was performed in four cases and showed an extrinsic compression of the caecal base in one case, and of the right colon in another case. Four appendectomies, one associated with removal of the adjacent caecal tissues and two right colectomies were performed. Analysis of these six cases and a review of the literature allow us to recall the histologic classification of these tumors, which determines the prognosis and to emphasize the sonographic and CT scan findings which might lead to earlier preoperative diagnosis in the future. Management depends upon the circumstances under which the tumor is discovered, the local anatomy, and the type of tumor. Appendectomy is the treatment most often performed. Faced with a tumor of the appendix, without histologic proof or when the local anatomic conditions increase the risk of opening an abscess, right colectomy is recommended.

Aged↗