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Biomedical subjects

R Petit

Publications and source records attributed to R Petit.

At least 19 recordsLinked to original sources
PubMed2006

Lipoprotein (a) and risk of ischemic stroke in young adults.

UNLABELLED: Lipoprotein (a) [Lp(a)] is a LDL-particle linked to apoprotein (a) [apo(a)]. High Lp(a) plasma level is a risk factor for coronary heart disease and, in older men, for ischemic stroke. The role of Lp(a) as a risk factor for ischemic stroke in young adults is uncertain. METHODS: Lp(a) concentration was prospectively measured in 100 consecutive patients with acute ischemic stroke (58 men and 42 women) aged 18-55 years, and in 100 controls matched for age and gender. RESULTS: The distribution of Lp(a) concentration was skewed toward the highest and median tertiles in male patients. In multivariate logistic regression analyses adjusting on classical risk factors for ischemic stroke and lipid variables, Lp(a) concentration in the highest and medium tertiles compared with the lowest tertile was significantly associated with ischemic stroke in men (OR 3.55, 95% CI 1.33-9.48, p = 0.012), but was not in women (OR 0.42, 95% CI 0.14-1.26, p = 0.12). Although large vessel atherosclerosis was more common in men than in women, there were no differences in Lp(a) concentration according to the cause of ischemic stroke. CONCLUSION: Among subjects aged 18-55 years, a slightly elevated Lp(a) concentration was strongly and independently associated with ischemic stroke in men, but not in women. Further studies are required to elucidate the mechanisms underlying this gender-specific association.

Adolescent↗
PubMed2005

[Partial replacement of obsolete prosthetic implants].

Thanks to better technique for cemented prostheses or to better osteointegration of porous coated implants, a long term survival can be expected for joint prostheses. Wear of the bearing surfaces resulting in osteolysis, metallosis and even rupture has become the main threat after several years. In such cases, revising all the parts of a stable and well fixed implant may cause fractures, loss of bone and thus need an extensive reconstruction. Revising only the worn out parts might be preferable, provided that they still are available. Data collected by the SFHG (French Hip and Knee Society) and AVIO group show that 45% of hip revisions and 16% of knee revisions are partial ones. The need for a total exchange instead of a partial one appeared in 6.4% of knee revisions and 2.8% of hip revisions, because parts were no longer available. These problems linked to a longer life expertancy of the patients and the increasing number of hip and knee arthroplasties will be met more and more often by orthopedic surgeons. When parts identical to the worn out ones are still on the market, there is no problem. When their production has been given up, but the company has kept their references and accepts to make a single element it may be possible to obtain the missing unit. The increased cost of such a fabrication, however is not nowadays supported by an appropriate price. But in a few remaining cases without enough industrial references, a custom-made part had to be done to allow partial replacement, with the benefit of an adapted price. Care must be taken to observe the regulations. The surgeon endorses full responsibility not only for the surgical procedure but also for the choice of the implanted device. For custom-made products he is responsible for the technical data given to the company. The patient must be thoroughly informed, and his opinion taken into account in the operative decision. As a revision arthroplasty aims at restoring a good function, the procedure should suit best the patient's health condition and try and avoid any hazard. Rejecting the option of partial replacement just because of parts unavailability is not acceptable when it seems the safest way to get the best result. Help can come from orthopedic surgeons themselves, if they give to their patient precise reports on the primary arthroplasty. The technical references of all the devices devoted to joint arthroplasty should not only be collected by public health services (AFSSAPS) but they should also be available to orthopedic surgeons. The real production cost of prosthetic elements should be taken into account in order to encourage the companies to deliver parts that are not on the market anymore.

Arthroplasty, Replacement, Hip↗
PubMed1997

[Urinary stress incontinence and celioscopy: 20-month-experience of an original technique of colposuspension via extraperitoneal endoscopy. "Pantalon technique"].

The authors describe an original extraperitoneal endoscopic colpo-suspension procedure for the treatment of stress urinary incontinence in women, by the use of a Y-shaped non-absorbable mesh (polypropylene). The short Y arms are sutured to the front-lateral walls of the vagina, the Y basis is grasped through a short suprapubic incision involving the skin and subcutaneous fat with a pair of forceps to perforate the muscle aponeurosis. This technique allows an adequate and firm tension on the mesh under endoscopic control. The basis of the mesh is then sutured at the pubic bone insertion of the rectus abdomini. So far, we have performed 28 operations--between April 1995 and December 1996. The objective cure rate is 88.5%. Two laparotomy had to be performed.

Adult↗
PubMed1996

[Endoscopic extraperitoneal colposuspension].

The authors point out the advantages and the inconveniences of the different surgical procedures (conventional surgery, transperitoneal celioscopy and extraperitoneal endoscopy) performed in order to treat urinary stress incontinence. An original extraperitoneal endoscopic procedure, using a non resorbable mesh (polypropylene), is proposed. The technique is based on the principle of the open approach described by Burch. The short branches of an Y shaped mesh are sutured at the antero-lateral walls of the vagina. The basis of the Y is pulled out of the extraperitoneal space by using a grasper introduced through a short incision of the skin and the subcutaneous tissues, and perforating the aponeurosis of the rectus muscle. This technique provides the surgeon with an effective and strong tension on the mesh under endoscopic view control. The basis of the mesh is then fixed at the insertion of the rectus muscle on the pubic bone.

Colposcopy↗
PubMed1995

Antral motility in patients with cirrhosis with or without gastric antral vascular ectasia.

Gastric motility has not been extensively studied in patients with cirrhosis and gastric antral vascular ectasia (GAVE) may be associated with antropyloric dysfunction. This study therefore looked at antral motility using ultrasound in patients with alcoholic cirrhosis with or without GAVE. Twenty six patients were included: 10 patients with cirrhosis without GAVE, eight patients with cirrhosis and GAVE, and eight controls without liver disease. Measurement of antral area and antral contractions (amplitude and frequency) was performed for three hours after ingestion of a standardised solid-liquid meal. Antral area half time (mean (SD)) was not significantly increased in patients with cirrhosis without GAVE (84 (42) min), but increased by 120% (123 (43) min; p < 0.01) in patients with GAVE compared with controls (56 (26) min). GAVE patients exhibited the same frequency and amplitude of antral contractions at each time point as controls and had the same tendency to increase these values over time although this was attenuated in the late postprandial phase. In contrast, cirrhotic patients without GAVE exhibited a significantly higher frequency and amplitude of antral contractions during the initial postprandial phase but showed no change in either frequency or amplitude over time. In conclusion, in cirrhosis there is an abnormal antral motor response to a meal, which has a different pattern over time in patients with or without GAVE.

Aged↗
PubMed1995

Operative experience in hypospadias surgery.

The authors report their experience of the last 50 hypospadias corrections. 30% of the cases were glandular hypospadias. The correction was made by the MAGPI procedure. Thirty per cent of the cases were coronal hypospadias. The Mathieu procedure (meatal-based flap) is compared with the meatallateral flap technique. Twenty-five per cent of the cases were several hypospadias with chordee. The procedures of the tubed-transversal-preputial flap, versus onlay-transversal-preputial flap, are compared.

Adult↗
PubMed1986

Developmental changes in gonadotrophins and testicular gonadotrophin receptors in the pig, from neonatal to adult life.

Changes in the concentrations of LH and FSH testicular receptors have been studied in the pig, from neonatal to adult life, and correlated with blood LH, FSH and testosterone concentrations. Quantification of gonadotrophin receptors was performed in equilibrium binding studies, using homologous systems. The presence of high-affinity binding sites for LH and FSH (association constant (Ka): LH approximately 20 litres/nmol; FSH approximately 10 litres/nmol) was demonstrated in the testes of all animals studied. The apparent affinity of LH and FSH receptors did not change significantly with age. During the first weeks of life, there was a transient rise in LH receptor content, reaching a maximum of 8.7 +/- 2.2 (mean +/- S.E.M.) pmol/g testis at 24 days of age. This was correlated with a peak in testosterone secretion and reflects the second wave of interstitial cell proliferation in the pig. A second increase in the number of LH receptors occurred after 12 weeks of age and corresponds to pubertal maturation and final differentiation of adult Leydig cells. During this period, circulating concentrations of testosterone markedly increased without any significant variation in LH blood levels, suggesting a change in testicular sensitivity to LH in the maturing pig. A continuous increase in FSH receptor content was observed from the neonatal to the adult pig. This increase occurred in two phases. During the first 2 months of life, the increase in the number of FSH receptors exceeded that of testis growth rate and resulted in an increase in FSH receptor concentrations which reached a peak at 12.1 +/- 1.8 pmol/g testis, at week 9.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Enuresis and urethral instability.

31 patients with refractory enuresis underwent simultaneous urethrocystometry. Pure urethral instability was encountered in 14, urethral and bladder instability in 11 and isolated uninhibited bladder in 3. This allows us to discuss the functional relationship between the urethra and the bladder. We consider urethral instability as being a trigger mechanism for detrusor contraction, and the explanation for the paradox of stable bladder enuresis. Phenylpropanolamine (Ornade), 25-50 mg at bedtime, stabilizes the vesicosphincteric unit and stopped bedwetting in 11 of 16 patients.

Adolescent↗