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Biomedical subjects

R Lemaire

Publications and source records attributed to R Lemaire.

151 records · Page 9Linked to original sources
PubMedDate not supplied

[Treatment of osteoarticular lesions associated with traumatic vascular lesions].

A critical study is made of the management of fractures associated with major vascular injuries. The pros and cons of surgical and conservative management are analyzed; it is emphasized that internal fixation, although largely used in civilian practice, is by no means necessary for successful vascular repair. The latter must be given prevalence in every instance, and an aggressive approach to the skeletal lesion is justified only in selected cases where it will not jeopardize the results of vascular repair. The therapeutic approach is analyzed step by step: selection of external or internal fixation, chronological sequence of procedures, selection of a mode of internal fixation and of a surgical approach. The different techniques of internal fixation available for upper and lower limb fractures are considered. It is concluded that the method of management of fractures associated with vascular injuries remains controversial and must be selected in every instance by a team discussion taking into account the various parameters related to both skeletal and vascular problems.

Blood Vessels↗
PubMedDate not supplied

[Functional vascular investigation].

Having confirmed that functional vascular investigations arouse great interest, the author has tried to sketch the profile of the "functionalist". He, like the radiologist, is a specialist who should be thoroughly acquainted with: 1. Vascular anatomy and its anomalies. 2. Electronics, so that he can recognize the limits of the apparatus he uses. 3. Circulatory physiology, so that he is able to identify the parameters being explored. 4. Above all, he must be a clinician and fully aware of the problems caused by venous and arterial pathology. These conditions fulfilled, communication between the doctor and his patient will be fruitful.

Female↗
PubMedDate not supplied

[Return circulation in sportsmen].

Muscular exercise leads to increased arterial output and is accompanied by capillary vasodilatation. Under these conditions the return circulation must adapt in order to fulfill its role of drainage. Primarily this is brought about by changing the properties of the vein walls: at the level of the venule there is a reduction in smooth muscle tone while at the level of the collecting veins there is an increase in vein wall elasticity. Secondly there is co-ordination of the muscle pump effect such that it matches the exerted effort. A special mode of flow results: at the level of the deep veins the flow becomes pulsatile. If the degree of muscular activity is prolonged and intesnse this "arterialisation" may reach the superficial veins. These adaptations require a venous system which is in perfect condition with regard to its ability to respond properly to the demands placed upon it.

Arteries↗
PubMedDate not supplied

[The external saphenous vein and the Doppler effect].

After medium physical exertion, twelve athletes had their venous reflux measured using a Doppler fluxometer. A rise in the speed of the blood flow was recorded. This is due to the hyperactivity of the thoraco-abdominal and cardiac pumps, whose efficiency is boosted by arteriocapillary vasodilation. In some cases, this happens only in the deep system. But in others, this "arterialization" is apparent in the superficial system too, and especially in the region of the short saphenous vein. This occurs in such a way as to suggest that the deep course becomes saturated and so the reflux is redirected along the superficial course. This hypothesis is an argument in favour of the existence of vein to vein anastomosis.

Adolescent↗
PubMedDate not supplied

[Osteoarthrosis of the knee joint, a predictable consequence of meniscectomy in patients with angular deformity of the knee (author's transl)].

The load-bearing function of the menisci is now well established. Meniscectomy increases the load per unit area in the operated femorotibial compartment; this may result into accelerated wear and osteoarthrosis. This is even more likely to occur if meniscectomy is performed on a knee-joint which presents with a mechanical imbalance secondary to angular deformity in the frontal plane. Often, in such cases, the meniscus only displays secondary, degenerative changes, which do not justify meniscectomy. Through a better knowledge of the load-bearing function of the menisci and a more thorough clinical and roentgenological preoperative study in painful knees, undue meniscectomy could be avoided in a number of cases and the frequence of iatrogenic postmeniscectomy osteoarthrosis of the knee-joint could be reduced.

Adult↗
PubMedDate not supplied

[Role of climatic factors in the etiology of vascular diseases].

While there is no doubt about the role of genetic factors in the aetiology of vascular diseases, especially in the genesis of disorders of the venous system, a place should be reserved for climatic and social factors. By means of an investigation which we undertook in a tropical environment in senegal, we examined the morbidity due to atheromatous disease. This study extended over a period of 30 years, from 1945 to 1975. We found that arteriopathy of the lower limbs due to overload did not exist before 1960. Since 1966, a few cases of myocardial infarction have been noted, and since 1970, a few cases of arteriopathy. These cases are confined to an urban environment which, during the same period, has undergone profound social upheavals. It all seems to be as if there were competition between climatic factors protecting and social factors aggravating. In contrast to the rarity of vascular disorders in hot countries is their high incidence in cold countries. In Canada and Sweden a particular clinical aspect of the disorder has been found: arteriopaths in a subarctic environment suffer more than sensory disturbances than ischaemia. In conclusion, it seems that the environment, in the broad sense of the term, plays a role in the aetiology of atheromatous disease, which has been classified, not without reason, among the diseases of civilization.

Arteriosclerosis↗