Search PubMed⌕ Search

Biomedical subjects

R Montagnac

Publications and source records attributed to R Montagnac.

At least 37 records · Page 2Linked to original sources
PubMed1997

Indwelling silicone femoral catheters: experience of three haemodialysis centres.

The aim of this study is to describe the experience of three haemodialysis centres using indwelling femoral silicone catheter (model SSL 1220M, Medcomp, USA) in 55 patients, three with acute renal failure, one requiring plasmapheresis, and 51 with chronic renal failure but no other available vascular access. Sixty-four catheters were in place for a mean duration of 41.5 +/- 30 days. The rate of catheter-related complications, including mechanical problems, thromboses, and infections was low and they were never life-threatening. The results of the study suggest that femoral cannulation with modern flexible devices can be considered as a reliable temporary access, even for extended periods, with advantages exceeding those for subclavian and jugular routes.

Acute Kidney Injury↗
PubMed1997

[Recombinant human erythropoietin (epoetin) and autologous blood transfusion in chronic hemodialysis. Apropos of 2 cases].

Recombinant human erythropoietin (epoetin) is sometimes used in order to enhance autologous blood predonation before scheduled hemorrhagic surgery. This procedure reduces and some times better avoids homologous blood transfusions with their disadvantages. In certain circumstances, it will be of particular importance and, despite of its cost, has to be discussed for several surgical operations in some patients. Among them, pre-dialysis and dialysis patients can benefit of autologous blood transfusion if their anemic state and the response to epoetin and iron supplementation allow a sufficient and well-tolerated preoperative collection. As such observations are rare, we report two successful cases of autologous transfusion strategy with epoetin therapy in chronic hemodialyzed patients undergoing orthopedic surgery.

Aged↗
PubMed1997

[Bilateral nephrectomy before renal transplantation in autosomal dominant polycystic renal disease].

Patients with autosomal dominant polycystic kidney disease are good candidates for renal transplantation, despite the fact that they are older at initiation of dialysis treatment. After grafting, the native polycystic kidneys are, however, at risk of infectious and hemorrhagic complications, in addition to patient's discomfort and technical difficulties with graft placement. We report on 10 successful cases of pretransplant binephrectomy performed in one time and analyse the risk factors of such a surgery. Nowadays, it appears that the disadvantages of an anephric state can be balanced by substitutive therapy. In conclusion, after this short series, we think that bilateral nephrectomy has to be considered in patients with autosomal polycystic kidney disease, especially when they have a prior history of renal infections and/or repeated hematurias.

Adult↗
PubMed1996

[Auto-dialysis: an 11-year experience of a hemodialysis center in France].

OBJECTIVES: Report 11 years of experience with self-managed hemodialysis in patients medically apt for extra-hospital dialysis and living close enough to small outpatient hemodialysis units to become totally self-sufficient. RESULTS: Among the 276 patients with chronic renal failure managed at the hemodialysis center at the Troyes hospital during the 11-year study period from 1984 through 1994, self-managed hemodialysis at small outpatient units was initiated in 127 (46%). None of these 127 patients required medical assistance or specific care during dialysis sessions. At initial hospital admission, only 60/127 (47%) were totally self-sufficient: 52 (41%) were later graft recipients; and 21 (16.5%) had to return to the hospital for a medical or surgical condition incompatible with extra-hospital care but all of these 21 patients remained self-sufficient. CONCLUSION: Extra-hospital hemodialysis in units close to the patients residence offers patients a better quality of life, even when medical assistance is required. All patients who require hemodialysis can thus be treated at lower cost without compromising quality of treatment. Perfect self-sufficiency may not be a goal in itself, but self-managed hemodialysis can be a very useful technique for patients without major medical problems. Continuing contact with the organizing hemodialysis center guarantees the safety of the system.

Adolescent↗
PubMed1996

Chronic renal failure and its treatment in tuberous sclerosis.

BACKGROUND: Chronic renal failure is rare in tuberous sclerosis, but its precise frequency is not known and treatment modalities have not been evaluated. METHODS: A questionnaire was addressed to the 260 French dialysis centres and the characteristics of 65 patients with tuberous sclerosis and chronic renal failure were analysed. RESULTS: In France the approximate prevalence of tuberous sclerosis with end-stage renal failure is 0.7 cases per million and that of end-stage renal failure in tuberous sclerosis 1 per 100. Tuberous sclerosis with chronic renal failure was more frequent in females (63.1%) and was diagnosed at a mean age of 29 years. Renal impairment was the first manifestation of tuberous sclerosis in about half the cases. Renal tumours were frequent, with angiomyolipomas in 15 cases (23.1%), cysts in 12 cases (18.5%), and both in 35 cases (53.8%). Malignancies were associated in nine cases (13.8%). Nephrectomy was done before dialysis in 21 cases (32.3%), and after the start of dialysis in six cases (9.2%). All but one of the 48 patients with end-stage renal failure were treated by dialysis; 20 were transplanted, with good results. CONCLUSIONS: Tuberous sclerosis with end-stage renal failure is rare. These patients require dialysis and renal transplantation, but we recommend binephrectomy after starting dialysis and before transplantation, given the risk of cancer and bleeding related to angiomyolipomas.

Adult↗
PubMed1996

[Femoral indwelling silicone catheter: experience of three hemodialysis centers].

The use of femoral vein for temporary access in hemodialysis patients is still considered as a slightly desirable route. However recent technical improvements have made this approach more reliable because the new femoral catheters can be left in place for a long time and used for ambulatory treatment. We describe the experience of three hemodialysis centres with temporary indwelling femoral catheter made of silicone (SSL 1220 M, Medcomp) in 55 patients: 3 patients with acute renal failure, 1 requiring plasmapheresis and 51 with chronic renal failure but no other available vascular access. Sixty four catheters were implanted and left in place for a mean of 41.5 +/- 30 days. Complications (mechanical, thrombotic and infectious) were infrequent and never life-threatening. These results suggest that the femoral route can be used reliably for temporary access, and provides advantages over subclavian and jugular routes in certain circumstances.

Acute Kidney Injury↗
PubMed1995

[Repeated studies of the prevalence of Staphylococcus aureus in the nasal cavity in hemodialysed patients].

OBJECTIVES: In order to better establish a prevention strategy based on mupirocin, we evaluated nasal carriage of Staphylococcus aureus in haemodialysis patients over a 15 month period. METHODS: Search for Staphylococcus aureus in the nasal cavities was made every 2 months in 92 chronic dialysis patients. These patients were divided into 3 groups according to the nature of the carriage: non-permanent, intermittent or permanent. RESULTS: Among the 80 patients retained for analysis, there were 27.5% with intermittent carriage and 11.25% with permanent carriage. Factors which appeared to protect against carriage were rural residence and home self-dialysis. CONCLUSION: Repeated long-term search for nasal carriage of Staphylococcus aureus has provided reliable data for each patient and gave information on the effects of epidemiological conditions and health care structures.

Aged↗
PubMed1994

[Renal transplantation in Bourneville tuberous sclerosis].

A 37 year-old patient with tuberous sclerosis and renal failure had renal transplantation performed, after 21 months of hemodialysis treatment and cerebral glioma removal, with good results 7 years later. In order to assess renal transplantation as a treatment for end-stage renal failure of tuberous sclerosis, we have reviewed the literature. 14 observations could be analysed: the patients were young with a mean age of 29.2 years, women in majority, with minor neurologic involvement. Because of the risks of neoplastic transformation and angiomyolipoma bleeding, bilateral nephrectomy is cautious, before or during the renal transplantation. Otherwise a close monitoring of the native kidneys by CT-scan is necessary. So the patients with tuberous sclerosis are good candidates for renal transplantation, with the same results as other patients of the same age, with no aggravation of the neurologic disorders, even when a cerebral tumor has been removed, as in our case.

Adult↗
PubMed1994

[Central venous stenosis in hemodialysis: comparative angiographic study of subclavian and internal jugular access].

From January 1986 to December 1990, we studied angiographically the subclavian-brachiocephalic vein of 100 patients dialysed on subclavian catheter for 50 (first group) and on internal jugular catheter for the 50 others (second group). These 2 groups are not statistically different for age: 61.6 +/- 11.3 years in the first and 61 +/- 11.1 in the second, for sex: respectively 48% and 56% of women, for time-length of catheter insertion: respectively 31 +/- 21.8 days and 31.7 +/- 16, and for number of dialysis sessions: respectively 13.5 +/- 9.1 and 13.6 +/- 7.1. The type of catheters, the frequency of removal for poor flow (16% in both groups) or for infections (6% in both groups) and the local nursing are similar in the 2 groups. Only the side of cannulation differs: the right side is used in 58% of cases in the first group and 78% in the second one. The angiographic study reveals a stenosis of the vein in 42% of the subclavian group and in 10% of the internal jugular group. The left side presents more risks of stenosis than the right, what can be explained by anatomical features. The strictures, whose severity is variable, are mainly located at and slightly above the junction of jugular and subclavian veins. This significative difference in favour of the internal jugular route asserts its superiority on subclavian route in respect of venous access of dialysed patients.

Aged↗