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Biomedical subjects

R Dumas

Publications and source records attributed to R Dumas.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

[Cholangiography by magnetic resonance for detection of cholelithiasis: comparison with endoscopic retrograde cholangiography, operative cholangiography and percutaneous cholangiography].

UNLABELLED: To evaluate the diagnostic efficiency of the magnetic resonance cholangiography (MRC) in the detection of main bile duct stones in a set of 102 patients. METHODOLOGY: Criteria of inclusion were: Clinic and biological suspicion of biliary stones obstruction with exams of first intention no contributive. We used the "turbo spin echo" sequences with thick slices in single shot mode and fine slides with reconstruction in 3D by a computer. Exams of reference were the endoscopic retrograde cholangiography (76.47%), an intraoperative cholangiography (20.59%) and a per-cutaneous cholangiography (2.94%). RESULTS: Stones of the main bile duct have been diagnosed at thirty-five patient (35.7%); we had 3 positive forgeries and 6 negative forgeries of the MRC. The sensitivity was 82,9%, the specificity of 95,5%, the positive predictive value and the negative predictive value were, respectively, of 90,6% and 91,4%. The observant variance test was excellent (kappa = 0.83). Mistakes of diagnosis of the MRC were bound to: stones less than 3 mms with a bile duct no dilated, malignant stenosis, structural details as the presence of a duodenal diverticula's or severe duodenitis and a certain difficulty to see the sphincter complex. CONCLUSION: Performances of the CIRM was good, and only in very particular cases, it was the origin of confusions.

Adult↗
PubMedDate not supplied

[Erythema multiforme induced by the combination of phenytoin and cerebral irradiation].

The authors report the case of erythema multiforme characterized by its cephalic onset and its rise after association phenytoin and cranial irradiation, for glioblastoma with epileptic fits. Eight similar cases are observed in literature with the same timing. Benign outcome is not always the rule because 2 patients died. This type of reaction being not forseeing, and outcome very varying, we suggest to avoid phenytoin in patients having a cerebral tumor revealed by epilepsy and needing a cranial irradiation.

Brain↗
PubMedDate not supplied

[Follow-up of elderly patients after emergency hospitalization for severe drug reactions].

Forty-one observations concerning persons aged over sixty-five hospitalized for adverse drug reactions in the Emergency Service of Clermont-Ferrand University Hospital were collected and analysed by the Adverse Drug Reaction Monitoring Centre. The symptoms were predominantly haemorrhage, particularly digestive, connected with the use of oral anticoagulants, salicylates and anti-inflammatories. The follow-up of the thirty-one most severe cases (hospitalization over 48 h and/or initial resuscitation) was undertaken in hospital and other care centres. In seventeen cases, complications occurred linked to the hospitalization (especially infections and neuropsychic complications) or to the adverse reaction itself through the measures taken to correct it (particularly cardiovascular complications). The hospitalization revealed hitherto undetected conditions in twelve patients, thereby allowing the prognosis to be improved. This positive side hardly outweighs the detrimental effects of adverse drug reactions in elderly subjects (six deaths and four irreversible incapacitations). Thus vital and social prognosis of elderly appears greatly damaged by adverse drug reactions.

Aged↗
PubMedDate not supplied

[Acute intestinal occlusion and calcium antagonists].

A 41 years old male patient suffering from angina pectoris was treated with diltiazem (Tildiem). He was administered with nifedipine (Adalate) 3 times in succession and each time either complete or partial intestinal occlusion occurred. A laparotomy was carried out after the first occlusion, but no organic lesions were found. The search for an alternate non-drug related explanation proved negative. The most likely hypothesis is that of a direct relaxant activity on intestinal smooth muscle, which would explain the functional nature of the occlusion. Therefore it must be considered that the two drugs acted synergistically.

Adult↗
PubMedDate not supplied

[Epilepsy and endocrine modifications].

From a few personal works and from a review of the literature, the authors discuss the current date of the endocrinological involvement of epileptic seizures, epileptic diseases, and anticonvulsants. Generalized epileptic seizures are followed by a constant, specific and significant rise of ACTH and Prolactin during the hour after the fit. That is a very good biological marker of the epileptic cause of a loss of consciousness. The duration and the repetition of the seizures involve the pituitary-gonadotropic+ axis that explains the anovulatory cycles and hypofertility in women, and the decrease of libido in men. Then, the anticonvulsants involve the hormonal balance, either by a direct action upon the hypothalamo-pituitary axis (ACTH, Prolactin) or by a direct action upon peripheral hormones (Testosterone, Thyroxine). These problems must be known for the follow-up of the epileptic patients, and for the interpretation of the hormonal dosage of these patients.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Biological and bone histomorphometric studies in hypophosphatemic vitamin-resistant rickets treated with 1,25-(OH)2D and phosphorus].

Five children aged 6 to 15 years were studied. They presented all the biological signs of hypophosphatemic vitamin resistant rickets: normal calcemia, hypophosphatemia, decrease in phosphorus Tm and normal PTH plasma level. Two children had never been given vitamin D treatment previously. The 1.25 (OH)2D has been given in 4 doses a day, to a total of 1 microgram/day, for one year. Phosphate was administered for the same time, doses varying from 40 to 150 mg/kg/day. Bone biopsies were performed at the onset and the end of treatment. Normal growth concerning bone age was observed in 3 cases. In the two others, growth remained disturbed. Radiological recovery was observed in all cases. Treatment induced and increase in serum phosphate. Tm PO4/FG remained lower than normal and even decreased during treatment. After one year of treatment, the osteoid volumes and surfaces decreased in all cases but did not always return to normal. The thickness index of osteoid and the speed of calcification were improved in 4 cases and worsened in the 5th. In two previously untreated patients an increase in plasma PTH and in the osteoclastic surface of resorption were observed on the bone biopsy during treatment.

Adolescent↗
PubMedDate not supplied

The cluster concept in nursing research.

Innovative strategies are needed to promote research development in schools of nursing. At the University of Michigan School of Nursing, using a visiting professor to direct a research cluster project enhanced scholarly productivity among new faculty investigators and graduate students.

Administrative Personnel↗
PubMedDate not supplied

[Interhemispheric disconnection syndrome in glioma of the posterior part of the corpus callosum].

The syndrome of interhemispheric disconnexion has been systematically researched in 10 cases of medial and posterior callosal tumours. The cases have been documented with CT Scann and two of them were anatomically verified. Two had a complete disconnexion syndrome; another, whose lesion was situated on the forceps major, had no sign of disconnexion. In the others, the semiology was proportional to the extent of the tumour, sometimes minimal and in this case, only corresponding to an extinction of the left ear in the dichotic test, which therefore appeared in our series as the most constant sign of a transfer-trouble. Among the other signs, left tactile anomia was found in two patients, left ideomotor apraxia in three, left visual anomia in five. Seven patients had a right constructional apraxia, which was bilateral in five of them. Left agraphia was noted in five patients, among which three had also a right hand dysgraphia, whose physiopathology is discussed. Tactile alexia was noted in three patients, two had a trouble of somesthesic information's transfer, one had a pure alexia (left occipital lesion plus splenium). Signs of hemispheric independence were uncommon: one patient presented a "foreign-hand sign".

Agraphia↗