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Biomedical subjects

P Pere

Publications and source records attributed to P Pere.

At least 55 records · Page 3Linked to original sources

[Joint complications in patients with chronic renal failure hemodialyzed for over 10 years. 40 cases].

A retrospective study of 40 patients with chronic renal failure who underwent haemodialysis for more than 10 years (mean: 153 months) showed that 18 patients (45 p. 100) had arthralgia in the shoulders, hands, wrists and knees, 13 (32 p. 100) had carpal tunnel syndrome requiring surgery, and 20 (50 p. 100) were found to have bone cavities in the humeral head, external supra-acetabular region, carpus and patella. Aluminium overload was present in 47 p. 100 of the patients, and amyloid deposits were found in 10 of the 12 patient operated upon for carpal tunnel syndrome. This study confirms the frequency in patients under long-term haemodialysis of an articular pathological entity consisting of arthralgia, carpal tunnel syndrome, juxta-articular bone cavities and amyloid deposits which are now known to be made of beta 2-microglobulin. The initial lesion seems to affect the synovial membrane; it appears to be facilitated by age and is often associated with aluminium overload. The mechanism(s) responsible for amyloid deposits remain (s) to be elucidated.

Adolescent↗

Insufficiency fractures of the pelvis.

There are two kinds of stress fracture. One is fatigue fracture of a healthy bone during unusual mechanical overloading. This kind is seen particularly in young persons, such as soldiers and athletes, and most often affects the metatarsals, calcaneum, tibia, and fibula. The second kind is insufficiency fracture, in which the bone has become fragile because of age, metabolic disorder, static disorder of a leg, or prior orthopedic surgery, and cannot withstand even moderate stress. This type of fracture particularly affects the elderly, and is by far most frequent in the pelvis. Bone imaging is very helpful in early diagnosis of stress fractures, because as soon as there are clinical signs it reveals some degree of very localized uptake.

Aged↗

[X-ray computed tomography and synovial chondrometaplasia].

Scanography allows diagnosis of radiotransparent intra-articular foreign bodies and establishment of their synovial origin, sometimes even in the absence of joint opacification. It provides an overall assessment of the joint that can be improved by arthrography. Clinical and standard radiologic pictures of primary synovial chondrometaplasia (synovial osteochondromatosis) and intra-articular foreign bodies can cause confusion if the latter are modified by secondary chondrometaplasia. Scanographic analysis of islets of chondrometaplasia suggests their primary nature in the presence of plaques of calcification of a small size, of low density and diffused throughout the image while peripheral, lamellar, dense calcifications are suggestive of secondary lesions.

Adult↗

Changes in heart rate variability in elderly patients undergoing major noncardiac surgery under spinal or general anesthesia.

BACKGROUND AND OBJECTIVES: Heart rate variability (HRV), widely used as an indicator of activity of the autonomic nervous system, has been reported to decrease during and after both spinal and general anesthesia in patients without cardiovascular disease. We evaluated the changes in HRV bands in 40 patients with a high risk of ischemic heart disease. METHODS: The patients were randomly assigned to receive either spinal (SA) or general anesthesia (GA) for elective total hip arthroplasty or peripheral vascular surgery. Anesthetic techniques and perioperative fluid administration were standardized. Holter monitoring was started preoperatively and continued until the third postoperative day. Three HRV frequency bands were analyzed. RESULTS: A significant decrease was seen in very low frequency (VLF) and low frequency (LF) bands during GA but not during SA. Also the LF/high frequency (HF) ratio decreased during GA but not during SA. A decrease in all HRV frequency bands was seen after both types of anesthesia. None of the frequency bands returned back to the preoperative level during the 3-day trial. Postoperatively circadian variation was found only in the VLF band after SA. CONCLUSIONS: The sympathovagal balance (LF/HF) is more stable during SA than during GA in patients with a high risk of ischemic heart disease. The postoperative decrease in HRV bands, however, is independent of the anesthetic technique.

Aged↗