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Biomedical subjects

A Rance

Publications and source records attributed to A Rance.

11 recordsLinked to original sources
PubMed2000

The role of B-mode ultrasonography and electron beam computed tomography in evaluation of Takayasu's arteritis: a study of 43 patients.

OBJECTIVES: To evaluate the capacity of B-Mode ultrasonography (B-Mode US) and electron-beam computed tomography (EBCT) to detect arterial changes in Takayasu's arteritis. METHODS: EBCT angiography of the thoracoabdominal aorta and pulmonary artery, and B-mode US of large superficial arteries (common carotid, subclavian, and common femoral arteries) were performed prospectively in 43 consecutive patients with established Takayasu's arteritis. The arterial wall thickness was measured, and lumen changes (stenosis, aneurysm) were noted. RESULTS: The combined results of B-Mode US and EBCT examinations showed that every patient had at least one abnormality at the studied sites. The median score of abnormal sites was 7. The most frequent lesion was a characteristic long, homogeneous, circumferential thickening, visualized in 52% of examined sites and in all patients but one (98%). Stenosis was detected by US and by EBCT, respectively, in 44% and 32% of patients, and aneurysm in 0.4% and 68%. CONCLUSIONS: In Takayasu's arteritis, B-Mode US and EBCT was able to visualize the classical caliber abnormalities (stenosis, aneurysm) and, in contrast to angiography, to depict vessel wall thickening, a major pathologic feature of the disease. Both these safe techniques seem more useful than angiography to characterize and map the vascular lesions of Takayasu's arteritis.

Adolescent↗
PubMed1998

Brain involvement in scleroderma: two autopsy cases.

BACKGROUND: Neuropathological data are very scarce in systemic sclerosis and fail to demonstrate primary changes in the brains of such patients. CASE DESCRIPTIONS: A 41-year-old woman with CREST syndrome developed signs of dementia after an episode of severe dehydration and died two months later of septic shock. A 63-year-old woman with CREST syndrome and a history of two unexplained transient ischemic attacks had had balance disorders since age 62. She died of severe pulmonary hypertension. In both cases, the autopsy showed extensive wall calcification of small arteries and arterioles in the brain, primarily in the basal ganglia, and also in the frontal lobes and the cerebellar area in the second case. No known cause of cerebrovascular calcification was found in either patient. CONCLUSION: The neuropathological findings in these two patients suggest that systemic sclerosis may induce primary vascular changes in the brain, of which calcification may be a marker.

Adult↗
PubMed1997

[Evaluation of a test for rapid detection of D-dimers for the exclusion of the diagnosis of venous thrombosis].

OBJECTIVES: The SimpliRED whole blood D-dimer assay for exclusion of deep venous thrombosis in symptomatic outpatient appears to be a simple and rapid method; we wanted to confirm its reliability. METHODS: Fifty consecutive outpatients (mean age 57, range 20 to 89) referred to our department between September and December 1996, for clinically suspected deep venous thrombosis (DVT) were included. Hospitalized patients were excluded as well as patients under anticoagulant and pregnant women. DVT was diagnosed with our usual strategy of compression ultrasonography at the levels of the common femoral, the superficial femoral and the popliteal veins including the exploration of sural and saphenous veins. The D-dimer assay was performed, according to the manufacturer recommendation, blindly by a physician unaware of the results of ultrasonography within one hour. RESULTS: Eight of nineteen patients with DVT had a normal D-dimer test result Four had a sural DVT, but four had a proximal DVT. Furthermore four patients with normal D-dimers had superficial venous thrombosis. CONCLUSIONS: Our series does not confirm the high sensitivity and negative predictive value reported previously. To date it is premature to propose this assay as a first line test in the therapeutic management of patients with suspected DVT.

Adult↗
PubMed1997

[Venous thromboembolic disease and occult cancers: what investigations should be done? Apropos of 204 patients].

There is no consensus about the investigations which should be performed to detect occult malignancy after an episode of venous thromboembolism. The authors studied 204 patients (167 in-patients and 37 day hospital patients) with deep venous thrombosis or pulmonary embolism to determine the incidence of cancers detected during or after the thrombosis and the diagnostic value of abdomino-pelvic ultrasonography. Of the 167 in-patients, 18 (10.7%) had a known malignancy. After the initial investigations, 7 tumours were detected (4.6%). In all cases, clinical history and examination or chest X-ray were suggestive of neoplasia. Abdomino-pelvic ultrasonography did not detect any cases of occult malignancy. Of the 37 patients seen in the day hospital, only one had known malignant disease and no other cases were detected. After exclusion of the 26 patients with known malignancies or tumours discovered after the initial investigations, the remaining 178 patients were followed up for an average of 27 months. Four cancers (2.5%) were detected in this period. The authors conclude that the occurrence of deep venous thrombosis should lead to investigation for malignant disease: clinical examination, chest X-ray and laboratory tests are sufficient to orientate this investigation. Systematic abdominopelvic ultrasonography does not seem to be worthwhile in this indication.

Abdomen↗
PubMed1995

Bridging the theory--practice gap in the ITU with in-service education.

The use of an education programme within a busy intensive therapy unit has proved to be highly successful in providing a framework for learning for those taking up an appointment in the unit with no previous experience of intensive therapy. The creation of a supportive learning environment was vital for it to work, promoted by enthusiastic and motivated staff and led by a full-time education coordinator. New course members were allocated to teams and provided with a 4-week supernumerary status to work alongside the education coordinator or mentors who acted as role models. This provided an opportunity for junior nurses to build confidence in newly acquired skills and knowledge. Resources for learning included a room designated for teaching equipped with visual teaching and learning aids. It has been shown that a large percentage of the nurses who have completed the education programme have gone on to undertake the English National Board Course 100 or other related courses. The education programme has been effective in bridging the theory-practice gap and ultimately achieving excellence in patient care.

Critical Care↗
PubMed1992

Characterisation of ovine mast cells derived from in vitro culture of haemopoietic tissue.

Ovine mast cells generated in vitro from bone marrow (BMMC) were compared with mucosal mast cells (MMC) isolated from parasitised abomasum. Ultrastructurally, the granules of BMMC were partially developed and immature. Both cells types contained beta-hexosaminidase, arylsulfatase, histamine, dopamine and sheep mast cell proteinase (SMCP). Greater amounts of beta-hexosaminidase, but less SMCP, histamine and arylsulfatase were present in BMMC. Stimulation with calcium ionophore A23187 caused the secretion of granule constituents and generation of leukotriene C4 by BMMC in a dose-dependent manner. An additional [3H]diisopropylfluorophosphate-binding 31,500 mol. wt. serine esterase, antigenically related to SMCP (27,000 mol. wt.) was present in cultures of BMMC but was not detected in isolated MMC. Both enzymes were detected in BMMC by Day 7 of culture and were secreted concomitantly following stimulation of BMMC with ionophore.

Abomasum↗