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Biomedical subjects

A Brachet

Publications and source records attributed to A Brachet.

15 recordsLinked to original sources
PubMed1992

Treatment of malignant peritoneal effusion in digestive and ovarian cancer.

Intra Peritoneal Chemo Hyperthermia (IPCH) with Mitomycin C (MMC) or Cisplatinum (CP) was used to treat 32 patients with far advanced digestive or ovarian cancers and peritoneal carcinomatosis. Surgical resection of the primary tumor has been possible in 18 cases. After closure of the abdominal wall, a 90 minutes IPCH as performed under general anaesthesia and 32 degrees C general hypothermia, through 3 intraperitoneal drainages realizing a closed circuit, using 10 mg/l of MMC or 15 to 25 mg/l of CP in 6 l of peritoneal dialysate heated at the inflow temperature of 46 to 49 degrees C. The mortality rate was 3% and the morbidity rate was 3%. In 11 out of 12 patients with preoperative malignant ascites, no more ascites could be found after IPCH. For peritoneal carcinomatosis from digestive origin, median survival was 11.2 months and 1 year survival rate was 46.9%. These encouraging preliminary results show that IPCH is a safe and reliable treatment for peritoneal carcinomatosis in far advanced digestive or ovarian cancers.

Adenocarcinoma↗
PubMed1992

[Preoperative evaluation of respiratory function in thoracic surgery. Do reliable predictive criteria exist in that type of surgery?].

A cautions analysis of the respiratory preoperative study may decrease morbidity and mortality after pulmonary surgery. To search for predictive criteria of respiratory complications following this kind of surgery, 454 patients have been studied retrospectively. Morbidity was defined as the need for postoperative ventilation. Preoperative criteria were divided in clinical (age, obesity, history of pulmonary disease, dyspnea, score of Karnofsky), laboratory (blood gases, spirometry) and surgical (kind of procedure). Three criteria were significant for morbidity (15 ventilated patients) and mortality (27 deaths): age (> 65 years), obesity, hypocapnia (pCO2 < 4.1 kPa-31 mmHg). Analysed spirometric values were no significant.

Age Factors↗
PubMed1991

[Cavernous hemangioma of the liver associated with angiosarcoma: malignant transformation?].

Angiosarcoma of the liver is a rare tumor. Its treatment is usually regarded as unsuccessful and its prognosis extremely poor. The authors report the case of a solitary and encapsulated hepatic tumor characterized by the association of a cavernous hemangioma surrounded by an angiosarcoma. The hypothesis of an eventual malignant transformation of cavernous hemangiomas of the liver is raised.

Adult↗
PubMed1991

[Colonic angiodysplasia with chronic digestive hemorrhage cured after valvular replacement for aortic valve stenosis].

Aortic stenosis is found in 15 to 25% of patients with gastrointestinal angiodysplasia. The usual treatment for haemorrhagic angiodysplasia associated with aortic stenosis is the same as for other types of gastrointestinal angiodysplasias: segmental intestinal resection, electrocoagulation and laser photocoagulation. The authors report the case of a 73 year old woman with a long history of gastro-intestinal bleeding and chronic anaemia requiring a number of hospital admissions for blood transfusions. The cause of this bleeding remained obscure for many years, as it was initially thought to be due to portal hypertension complicating cyrrhosis and a surgical porto-caval shunt was performed. Later, angiodysplasia of the colon was recognised and a segmental colonic resection was performed. These two surgical procedures had no effect on the chronic bleeding and finally the patient was referred for a gram negative endocarditis complicating aortic stenosis, previously considered to be non-surgical. After controlling the infection, the patient was sent for surgery of the aortic valve disease with mitral regurgitation in view of progressive degradation of left ventricular function. A double valve replacement with bioprostheses was undertaken with no complication. Finally, three years now after valve replacement, no further bleeding has occurred and control colonoscopy is normal. In the light of this case and a review of the literature of about 30 similar cases, the physiopathology and management of these patients is discussed with respect to the choice of valve prosthesis and the attitude to anticoagulant therapy. These observations suggest that in the presence of valvular heart disease at a surgical stage associated to an angiodysplasia, it is preferable to propose valve surgery to start with. Gastro-intestinal surgery is only indicated if haemorrhage persists after a period of observation.

Aged↗
PubMed1990

[A "non-narrowing" patch using the superior thyroid artery in surgery of carotid arteries].

It seems to be generally agreed that a closing patch is necessary after carotid endarterectomy. The materials utilized (prostheses or veins) having their own morbidity, we prefer to use a piece taken from the superior thyroid artery; Satisfactory results were obtained in the first 26 cases. This autologous biological material has the advantage of being an arterial structure (therefore compatible with the sutured artery) which is obtained in situ and spares the venous system.

Arteries↗
PubMed1975

[Measurement of the blood levels of antiepileptic drugs. I. General principals].

The authors report some basic notions on the pharmacokinetics of antiepileptic drugs, and the informations given by serum level determinations of anticonvulsants. It is not conceivable to treat epileptics without taking into account these facts. But it is neither necessary nor desirable to measure blood levels of antiepileptic drugs in every patient.

Anticonvulsants↗
PubMed1975

Concentration of dipropylacetate in plasma.

Dipropylacetate is absorbed rapidly and attains a maximum concentration in serum 1 to 3 hr after ingestion. Since its half-life is on the order of 8 to 10 hr, it must be prescribed three times a day, every 8 hr. It reaches a stable concentration in blood within 48 hr after treatment is begun (by contrast with diphenylhydantoin and phenobarbital) and might therefore be useful when seizures must be controlled quickly. The serum concentration can be altered by some other anticonvulsant drugs, but these interactions should be studied in more detail. The serum concentration varies considerably in the course of a day and from one day to the next in the same subject, which makes it difficult to adjust the blood level. Depamide is rapidly transformed in vivo to dipropylacetate.

Administration, Oral↗
PubMed1975

[Serum phenobarbital levels in epileptics].

The results of serum level determination in 250 epileptics confirm previous papers. Phenobarbital: --Is a "safe" anticonvulsant: steady serum level during 24 hours periods in chronic treatment and rather stable relationship between ingested dose and serum level. It can therefore be given as in the past, without blood level control. --Must always be prescribed according to the patient's weight, because serum level and therefore cerebral concentration depends on the dose per kilogram and not on the absolute dose. --Must be given in relatively higher dosage to children on account of a faster catabolism. --Is interfered with in its kinetics by other anticonvulsants and this fact must be taken into consideration for drugs associations. --Has no predetermined blood level for the control of every epilepsy. Some patients no longer have seizures with a theoretically too low serum level, while others still have seizures in spite of very high serum levels.

Adolescent↗