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Biomedical subjects

S Lenoir

Publications and source records attributed to S Lenoir.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Motor deficiencies in children: for a nosologic clarification in epidemiological studies].

In order to clarify the epidemiological research on childhood motor deficiency in France there is a need to better differenciate the two terms used to define this pathology: the French term "infirmité motrice cérébrale" (IMC) and the English term "cerebral palsy" (CP). The distinction between IMC and CP is highlighted on the basis of clinical examples. IMC recovers motor deficiencies which are quite similar, however, it can be very difficult to control the variations in its use. CP has the advantage of a greater exhaustivity as well as a greater reproductibility for epidemiological records. Recently a study was conducted for measuring the prevalence of childhood deficiencies in France, and the results were expressed either as IMC or as CP. When using the CP definition the prevalence rate in France was found to be close to that of foreign studies (1.9 per thousand). In studies with etiological purposes involving several countries, a preliminary agreement on the definition of the clinical groups is absolutely necessary.

Adolescent↗
PubMed1996

Bronchiectasis: comparative assessment with thin-section CT and helical CT.

PURPOSE: To compare thin-section computed tomography (CT) and helical CT in the detection and assessment of the extent of bronchiectasis. MATERIALS AND METHODS: Both thin-section and helical CT scans were obtained in 50 consecutive patients with clinical symptoms suggestive of bronchiectasis. Thin-section CT was performed with 1.5-mm collimation and 10-mm intervals, and helical CT was performed with 3-mm collimation and a pitch of 1.6 during a 24-second breath hold. Three observers evaluated 593 segments on CT scans both independently and in consensus. Radiation dose was measured for both techniques. RESULTS: Bronchiectasis was noted in 77 segments (22 patients) on thin-section CT scans compared with 90 segments (26 patients) on helical CT scans. No findings were positive for bronchiectasis on only thin-section CT scans. Interobserver agreement was statistically significantly better (P < .05) in identification of segments that were positive for bronchiectasis on helical CT scans (kappa = 0.87) than on thin-section CT scans (kappa = 0.71). Total skin dose of radiation delivered with helical CT was 3.4 times greater than that delivered with thin-section CT. CONCLUSION: Helical scanning can improve CT depiction of bronchiectasis but with an increase in radiation exposure to the patient. It should be used in patients considered for surgery or for thin-section CT scans that are difficult to interpret.

Adult↗
PubMed1996

[Obstetrical management of triplets. A series of forty five cases].

OBJECTIVE: To evaluate management of triplet pregnancies. METHODS: A retrospective study of 45 triplet pregnancies which occurred spontaneously or after assisted reproductive technologies. All were managed by the same obstetrical and pediatric team. Obstetrical data were collected. RESULTS: Major etiologies were fertility drugs and in vitro methods (66%). Mean maternal age as 30 years, higher with assisted reproductive technologies (p < 0.05). Risks of chorioamniotitis, preeclampsia and anemia were respectively 4.4%, 13.3% and 70%. Triplets had a 100% prematurity rate and mean gestational age was 33.6 weeks; 22.2%, 51.1% and 64.4% delivered before respectively 32, 34 and 35 weeks of gestation. Triplet had a 91% cesarean section rate. CONCLUSION: Triplet pregnancies present a high risk of prematurity and infertility specialists have to be vigilant in the use of fertility drugs. Their management requires early reduced maternal physical activity.

Adult↗
PubMed1994

[Short and mid-term outcome of a cohort of 1157 newborn infants with respiratory distress syndrome].

BACKGROUND: Data concerning neonates with acute respiratory distress syndrome (RDS) are still scarce. The characteristics and follow-up of a French cohort which has participated in an international trial concerning the efficacy of artificial surfactant have been studied. POPULATION AND METHODS: One thousand one hundred and fifty-seven neonates admitted from October 1990 to December 1991 in 27 French intensive care units because of RDS due to hyaline membrane disease were included in the study, whatever their birthweight and gestational age (GA). RESULTS: Three hundred and sixteen neonates (27.3%) were born from twin or multiple pregnancies. Fourty-five (5.5%) of the mothers had been given corticosteroids for the week preceding delivery. 55.5% were delivered by cesarean section. Mean GA was 31.0 +/- 2.9 weeks and mean birth-weight was 1,603 +/- 625 g. Two hundred and sixty-six neonates (23%) were small for GA. Two hundred and twenty-three died after a mean survival of 4.2 days (63% before the end of the first week and 80% before the end of the third week). Fifty percent of these deaths were due to respiratory distress, 28% to severe brain disorders and 9% to infections. The bronchopulmonary dysplasia rate was 21.7%. Early ultrasound scan of the brain showed major injuries in 19.5% of cases; the second scan performed in 822 infants was normal in 84.3%. CONCLUSIONS: Taking into account GA, mortality and morbidity rates were similar to those of the other non-French participating centres.

Birth Weight↗
PubMed1994

[Fetal and neonatal effects of maternal treatment with angiotensin converting enzyme inhibitor].

BACKGROUND. Exposure of pregnant women to angiotensin converting enzyme inhibitor may have side effects on the fetus or newborn, mainly oligoamnios and impaired renal function. CASE REPORT N zero 1. A 34 year-old woman was given enalapril from the onset of her pregnancy because of hypertension from the age of 18 years. Oligoamnios was diagnosed in the fetus on gestational week 28; enalapril was then replaced by nifedipine but this drug was badly tolerated so that the woman was again given enalapril 8 days later. The baby (1700 g) was born by cesarean section at gestational week 34 because of acute distress syndrome; he developed hypotension, anuria, generalized oedema and was placed in intensive care. Treatment included ventilation, sympathomimetic agents, and diuretics. An exchange-transfusion followed by peritoneal dialysis was performed a few hours later. Renal function returned to normal between the 3rd and 5th day. Unilateral kidney hypoplasia was diagnosed at the age of 2 years. CASE N zero 2. A 24 year-old woman was given enalapril at the third trimester of a twin pregnancy. Delivery was full term at 37 weeks. The first baby, a boy weighing 2610 g, suffered from hypoglycemia and vomiting followed by hypotension and oliguria that required exchange-transfusion and repeated peritoneal dialysis. This boy has developed moderate chronic renal failure and hypertension. The second baby, a girl weighing 2,165 g, suffered from respiratory distress syndrome followed by hypotension and oliguria, but her renal function returned to normal within a few days. CONCLUSIONS. The use of angiotension converting enzyme inhibitor by pregnant women places the fetus at severe risk: treatment with this type of drug should be stopped as soon as pregnancy is confirmed.

Acute Kidney Injury↗
PubMed1994

[Angiotensin-converting enzyme inhibitors and pregnancy. Apropos of 2 cases].

Angiotensin converting enzyme inhibitors do not have any teratogenic effect in man but their use during pregnancy has led to cases of hypotension and subsequent severe renal failure in the newborn. The authors report two cases, one involving a twin pregnancy which illustrate the variability of the foetal involvement. It is emphasized that the side effects of angiotensin converting enzyme inhibitors are not only reversible but also are not constantly found.

Adult↗
PubMed1993

High-resolution CT for specific diagnosis of diffuse chronic infiltrative lung disease.

High-resolution CT is highly contributive for correctly diagnosing chronic infiltrative lung disease, as it enables better interobserver agreement, it reveals more discriminant findings, and it provides complementary information. High-resolution CT should be considered an excellent extension to chest radiography and should be included in the routine investigation strategy of chronic infiltrative lung disease.

Humans↗
PubMed1992

Pulmonary sarcoidosis: CT assessment of lesion reversibility.

By comparing serial computed tomographic (CT) scans obtained when sarcoidosis was clinically active and after the onset of remission, an attempt was made to differentiate inflammatory from fibrotic lesions in the lungs of patients with sarcoidosis. Twenty patients with pulmonary infiltration seen on their chest radiographs were studied. For each patient, lesions found on the first CT scan were assessed by two observers as being decreased or increased on the second CT scan. Nodules (n = 8), irregularly marginated nodules (n = 5), and alveolar or pseudoalveolar consolidation (n = 5) always disappeared or clearly decreased. Septal lines (n = 10), nonseptal lines (n = 9), and lung distortion (n = 7) remained unchanged or increased. Some findings varied among patients: Micronodules (n = 9) and subpleural thickening (n = 5) disappeared or decreased in sarcoidosis of recent origin. Many findings of pulmonary infiltration seen on the first CT scan can be considered expressions of either inflammatory (reversible CT findings) or fibrotic (irreversible CT findings) lesions.

Adolescent↗
PubMed1991

[Contribution of imaging in the diagnosis of interstitial fibrosing lung diseases].

Standard radiography of the chest shows pulmonary infiltration and is determinant for the diagnosis of chronic diffuse infiltrative lung diseases. Since lung biopsy is an invasive exploratory technique, using computed tomography (CT) in the diagnostic approach is perfectly justified as a direct prolongation of plain radiography. CT identifies patients who, in spite of normal chest X-ray films, do have pulmonary infiltration. It is superior to radiography in suggesting the correct aetiological diagnosis, as it provides signs that are more discriminant than the radiographic signs. It also gives a better approach to the localization of lesions, thereby helping in guiding lung biopsies. Finally, once the diagnosis has been made CT remains useful in evaluating the effects of treatment of pulmonary lesions and in detecting possible complications.

Humans↗
PubMed1991

Chronic diffuse interstitial lung disease: diagnostic value of chest radiography and high-resolution CT.

The diagnostic value of chest radiography and high-resolution computed tomography (CT) in chronic diffuse interstitial lung disease (CDILD) was assessed in 140 consecutive patients with diffuse infiltration of the lung visible at radiography. Radiographs and CT scans were separately read by three independent observers without knowledge of clinical and pathologic data. The observers listed the three most likely diagnoses and recorded the degree of confidence they had in their choice on a 0%-100% probability scale. Findings at radiography and high-resolution CT were recorded by each observer and were used for a stepwise discriminant analysis between diagnoses. First-choice diagnoses of all three observers that were made with a high level of confidence (probability, greater than or equal to 75%) were more accurate with CT than with radiography (P less than .001). The superiority of high-resolution CT over radiography was most obvious for histiocytosis X and sarcoidosis; in cases of pulmonary fibrosis, CT was not significantly different from radiography. The interobserver agreement for the proposed diagnosis was significantly better with high-resolution CT (P less than .001). Twenty-one of 26 radiographic findings and 21 of 25 CT findings were discriminant. Stepwise discriminant analysis revealed the superiority of CT over radiography, since the ranking of all findings showed that the four most discriminant findings, and eight of the first 12 findings, were revealed with CT.

Adolescent↗
PubMed1991

[Prenatal diagnosis of neuroblastoma].

One of the prognostic factors for neuroblastoma is age at the time of diagnosis: neuroblastoma detected prenatally or in the first year of live have a more favorable outcome. Antenatal diagnosis is essential early management. Knowledge of local tumor extent is invaluable in determining the appropriate treatment, and MR imaging has proved to be the most useful procedure in this regard.

Female↗
PubMed1990

Pulmonary lymphangiomyomatosis and tuberous sclerosis: comparison of radiographic and thin-section CT findings.

Chest radiographs, thin-section computed tomographic (CT) scans, and results of pulmonary function tests in nine women with pulmonary lymphangiomyomatosis and two women with pulmonary tuberous sclerosis were retrospectively evaluated. In all patients, CT demonstrated thin-walled cysts less than 20 mm in diameter scattered at random in all parts of the lungs. In eight patients, cysts larger than 20 mm in diameter were also present. Lung tissue between cysts appeared normal in all 11 patients, except one with septal lines and dependent alveolar areas of attenuation. CT showed cysts in three patients whose radiographs were normal, and it demonstrated that many lesions that appeared reticular on plain radiographs were actually cysts. CT findings correlated better with the diffusion capacity of the lungs for carbon monoxide than did the plain radiographic findings. CT was more sensitive and more precise than radiography at showing the presence and morphology of lung abnormalities.

Adult↗
PubMed1989

Pulmonary histiocytosis X: evaluation with high-resolution CT.

Eighteen patients with pulmonary lesions of histiocytosis X were studied with high-resolution computed tomography (CT). Thin-walled cysts were found in all but one patient. The other abnormalities included nodules (n = 14), cavitated nodules (n = 3), thick-walled cysts (n = 7), reticulation (n = 4), ground-glass opacities (n = 4), and irregular interfaces (n = 4). The lesions were most often diffuse (n = 16), with a topographic predominance in the upper or middle lung zones in nine patients. Comparison of CT scans and chest radiographs shows that small and large cysts and micronodules are better detected with CT. Comparison of abnormalities found in patients in the early and late stages of the disease, as well as the evolution observed in one case, suggests that CT patterns progress from nodules to cavitated nodules and thick-walled cysts to cysts to confluent cysts.

Adult↗
PubMed1989

Pulmonary sarcoidosis: evaluation with high-resolution CT.

Forty-four patients with histologically confirmed sarcoidosis were prospectively studied with high-resolution computed tomography (CT). Nodules were seen in all cases. They were isolated in 19 cases and associated with other lesions in 25 cases. Other abnormalities were irregular interfaces (n = 18, 41%), linear network (n = 14, 32%), thickening of the pleural surface (n = 9, 20%), ground-glass opacities (n = 7, 16%), lung distortion (n = 11, 25%), traction bronchiectasis (n = 3, 7%), and network of air-filled cavities (n = 3, 7%). Predominant sites of lesions were the upper and middle zones (n = 30, 68%) and posterior zones (n = 13, 30%). Nodular abnormalities were noted at CT in six cases in which the pulmonary parenchyma appeared normal on radiographs. Lung distortion was noted at CT in eight cases without visible fibrosis on chest radiographs. The majority of patients with lung distortion (nine of 11, 82%) had disease of greater than a years duration. CT improved sensitivity for the detection of all types of lesions, mainly lung distortion. Low but significant correlations were found between visual score at CT and total lung capacity, vital capacity, forced expiratory volume in 1 second, and diffusing capacity.

Adult↗
PubMed1989

[Nosocomial infection at a neonatal care unit].

The incidence of nosocomial infections in a neonatal intensive care unit was evaluated to be 11.5% over a 2 year-survey period (1984-1985) in 451 artificially ventilated newborns. Staphylococcus, Enterobacter and Pseudomonas were the most frequently identified germs. Low birth weight, gestational age, mode of delivery and type of the initial pathology were not found to be responsible for the superinfection. The duration of hospitalization was 3 times longer and the cost per infant largely increased in cases with infection. Antibiotic treatment at admittance seemed to delay the onset of nosocomial infection by 8 to 12 days in this population.

Anti-Bacterial Agents↗