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Biomedical subjects

V Vidal

Publications and source records attributed to V Vidal.

72 records · Page 4Linked to original sources
PubMed1988

Angiographic and surgical aspects of compressive muscular bridges and intramyocardial paths of the anterior interventricular artery (based on 12 cases).

The authors report 12 cases of myocardial bridges over the anterior interventricular artery discovered surgically. In 5 the compressive myocardial bridges were limited; in 7 the intramyocardial course of the anterior ventricular artery was discovered at operation. Comparison of the operative appearances with the angiographic findings affords a basis for anatomico-radiologic correlation. The authors stress the difference in frequency and significance between the compressive myocardial bridge (an indication for surgery) and the intramyocardial anterior interventricular artery discovered by chance during a procedure for coronary revascularization indicated for stenosing atherosclerotic lesions.

Adult↗
PubMed1988

Primary megaureter in the neonate with prenatal or postnatal diagnosis.

Twenty-nine cases of primary megaureter diagnosed before the age of 3 months are grouped in this diagnostic and therapeutic study. Seventy-five per cent were discovered by antenatal sonography due to the presence of pelvicalyceal dilatation without localising precisely the position of obstruction, twenty-five per cent were detected by the occurrence of early urinary tract infection. Four patients were operated during the first few months. 2 diversions and 2 reimplantations. Fifteen including the 2 with early diversion were submitted to later reimplantation at the average age of 15 months. 12 patients were treated conservatively by antibiotics and regular supervision. The respective results of the operated and non-operated patients were evaluated comparing the initial dilatation and the last IVU using the classification of Beurton. Regardless of the marked initial dilatation, significant spontaneous regression or complete resolution were often seen during the first year of follow-up. Thus surgery should be deferred initially even for the severely dilated forms, except in a few critical cases where a diversion is indicated. Reimplantation should be deferred for some months unless deterioration is noted, or performed only after one year or 18 months if regression is insufficient, thus optimising operative conditions.

Child, Preschool↗
PubMed1988

[Primary obstructive megaureter in infants: medical or surgical treatment? Apropos of 24 cases].

The authors analyse 24 cases of primary obstructive megaureter diagnosed before the age of 3 months. 18 were discovered by antenatal echography between 28 and 39 weeks, whereas 6 were detected by the occurrence of early urinary tract infection. Initial investigations included echography, intravenous urography and micturating cystouretrogram. Primary megaureter was bilateral in 14 cases, unilateral in 12. According to the urographic classification of Beurton, there were 12 ureters stage III, 12 stage II, 10 stage I. 15 patients were operated, 4 of them during the first months (2 reimplantations, 2 urinary diversions). 12 were submitted to later reimplantation at the mean age of 15 months, one had a non functioning kidney removed. 9 were non operated and treated conservatively by antibacterials and regular supervision. Results analysis evaluated according to radiological stage and treatment showed that in more cases, surgery should be differed initially. Complete clinical and radiological resolution is possible even in severe obstructions. Antibacterial treatment beginning at birth favorises regression of dilated ureter. Thus reimplantation should be deferred undercover of regular biological and radiological survey. The age of 12 to 18 months is the most technically favorable time to ureteric reimplantation.

Female↗
PubMed1988

[Renal hemangiopericytoma. Review of the literature apropos of a case].

Regard to a new case of renal hemangiopericytoma, the authors have reviewed the literature, in order to specify the main features of this uncommon entity. Because of the lack of correlation between the clinical behavior and the histologic pattern, hemangiopericytomas should be treated as potential low grade malignancies and followed carefully. Surgery seems to be actually the only form of treatment to propose.

Adult↗
PubMed1986

[Mural thrombosis of the abdominal aorta. A sometimes unrecognized cause of recurrent embolisms].

A 23 year old patient with an infrarenal abdominal aorta mural thrombosis developed recurrent peripheral emboli. This case underlines the etiologic investigation necessary in cases of peripheral emboli unexplained by the conventional cardiac examinations. Filling of total aorta with contrast is essential (assisted if necessary by oblique projections) to detect possible mural thrombi carrying the risk of recurrent emboli.

Adult↗
PubMedDate not supplied

Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients.

PURPOSE: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the control of bleeding from ectopic varices. METHODS: From 1995 to 2004, 24 cirrhotic patients, bleeding from ectopic varices, mean age 54.5 years (range 15-76 years), were treated by TIPS. The etiology of cirrhosis was alcoholic in 13 patients and nonalcoholic in 11 patients. The location of the varices was duodenal (n = 5), stomal (n = 8), ileocolic (n = 6), anorectal (n = 3), umbilical (n = 1), and peritoneal (n = 1). RESULTS: TIPS controlled the bleeding in all patients and induced a decrease in the portacaval gradient from 19.7 +/- 5.4 to 6.4 +/- 3.1 mmHg. Postoperative complications included self-limited intra-abdominal bleeding (n = 2), self-limited hemobilia (n = 1), acute thrombosis of the shunt (n = 1), and bile leak treated by a covered stent (n = 1). Median follow-up was 592 days (range 28-2482 days). Rebleeding occurred in 6 patients. In 2 cases rebleeding was observed despite a post-TIPS portacaval gradient lower than 12 mmHg and was controlled by variceal embolization; 1 patient underwent surgical portacaval shunt and never rebled; in 3 patients rebleeding was related to TIPS stenosis and treated with shunt dilatation with addition of a new stent. The cumulative rate of rebleeding was 23% and 31% at 1 and 2 years, respectively. One- and 2-year survival rates were 80% and 76%, respectively. CONCLUSION: The present series demonstrates that bleeding from ectopic varices, a challenging clinical problem, can be managed safely by TIPS placement with low rebleeding and good survival rates.

Adolescent↗
PubMedDate not supplied

[Radio-anatomy of the paranasal sinuses].

UNLABELLED: The imaging anatomy of the paranasal sinuses presents some complexity. The paranasal sinuses develop within facial and cranial bones. They communicate with one another and with the nasal cavity. Knowledge of normal anatomy is mandatory for accurate diagnosis of sinonasal pathology. The most frequent anatomical variants should be identified to decrease surgical risks. CT is the main imaging modality for the evaluation of sinonasal pathology. LEARNING OBJECTIVES: to review the normal sinonasal anatomy and its frequent anatomical variants at CT imaging.

Facial Bones↗
PubMedDate not supplied

[Radiologic imaging of chronic sinusitis in the adult].

The diagnosis of chronic sinusitis is based on clinical presentation, nasal endoscopy and CT scan. As a matter of fact, the CT scan of the paranasal sinuses is absolutely necessary to characterise the lesions, to visualise anatomic variations which are risk factors for the endoscopic surgery and to follow up treated and/or operated patients with recurrent symptoms. Nowadays, plain films of paranasal sinuses do not have any indication. MR Imaging may be indicated in selected cases of complicated sinusitis and of pseudotumors associated to sinusitis.

Adult↗
PubMedDate not supplied

[Heart transplantation. Clinical study and results apropos of a consecutive series of 100 first grafts].

OBJECTIVES: Global results of entire series of heart transplantations are essential to better evaluate survival rates. We therefore report the results of our first 100 transplantations. METHODS: Orthotopic heart transplantation was performed in 82 men and 18 women (age 50.5 +/- 11.4; range 9-65). Sixteen were over 60. Primitive cardiomyopathies (n = 51) and coronary artery disease (n = 44) were the most frequent underlying diseases. Secondary morbidity was evaluated according to the international classification on the basis of pathological examination of endomyocardial biopsies. RESULTS: Immediate post-operative survival rate was 89 percent: there was 1 peroperative death, 7 deaths due to persistent pulmonary hypertension and 4 due to irreversible left ventricular failure. Eight deaths occurred during the 2nd and 3rd postoperative months for an overall early survival rate of 81 percent. After a mean follow-up of 2.4 years (maximum 6.16 yr), the actuarial survival rate at 5 years was 58 percent. Among the 470 biopsies performed, rejection was classified weak or null in 326, moderate in 125 and severe in 19. Pulmonary artery resistance, immunosuppression and, later, the risk of coronary artery disease and intrinsic graft changes were the three major problems encountered in this series. CONCLUSIONS: Despite its limits, heart transplantation remains an effective therapeutic option, particularly for young patients in good general health.

Adolescent↗