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Biomedical subjects

A Texier

Publications and source records attributed to A Texier.

9 recordsLinked to original sources
PubMed2006

[Health behaviours of students at the University Institute of Technology in Poitiers].

Better knowledge and understanding of students' health attitudes and behaviours are necessary to more effectively plan targeted prevention strategies. A survey conducted among 617 students at the University Institute of Technology in Poitiers showed that although some indicators affirm good health (relationships with friends and family, appropriate contact with care providers in the health system and regular visits to prevention centres, sexual life, and sports and physical fitness), other indicators reveal a certain amount of suffering among the student population. Students reported suicidal thoughts, symptoms of poor well-being (fatigue, sleeping disorders, concentration problems, sadness or depression) and poor eating habits and/or eating disorders. Consumption of both legal and illegal products seems to be a means utilised to facilitate the social integration process for some students. Therefore, this underlines a significant challenge for prevention campaigns to develop an alternative role model, which promotes the image and profile of a healthy student, with a strong sense of self-esteem, who is well-integrated with his peers without having to engage in substance abuse.

Adolescent↗
PubMed2002

[Ligamentoplasty of the anterior cruciate ligament after 40 years: a series of 41 patients].

PURPOSE OF THE STUDY: Ligamentoplasty for tears of the anterior cruciate ligament (ACL) is generally thought to be unreliable after the age of 40 years. The purpose of this retrospective analysis was to assess the five-year outcome after ACL plasty in patients aged over 40 at the time of surgery. MATERIAL AND METHODS: Between 1990 and 1997, 41 patients aged 44.5 +/- 4.5 years (28 men, 25 right side) underwent intra-articular reconstruction of the ACL. Clinical and radiological assessment using the IKDC criteria was obtained at a mean 62 months postoperatively using manual instrumental measurements with KT-1000. The indication for reconstruction was instability in daily life activities for 40 patients and difficulties encountered in sports activities in one; there were three cases of remodeling. Arthroscopy was used in all cases to perform a patellar tendon graft (bone-tendon-bone in 30 cases associated with extra-articular lateral reinforcement in eleven). RESULTS: There were no significant complications. Among 12 patients who initially participated in competition sports, seven were able to resume their activity at their former level. At last follow-up, global IKDC score was A for 12, B for 25, and C for three and D for one. All patients scored C or D had a poor IKDC symptom score, basically because of pain. Motion was not modified. The IKDC radiology score was A for 25, B for 15 and C for one, but the three cases of remodeling did not progress. Prognostic factors for overall IKDC result were: age of the patient at the time of reconstruction (under 45 years), and the delay to surgery for accident victims (less than one year). The following criteria had no effect at last follow-up: gender, sport practiced, type of initial laxity (anterior alone or global anterior), presence of meniscal damage, preservation of the medial and/or lateral meniscus, chondral injury observed peroperatively, and use of a lateral reinforcement. Radiographic remodeling observed in this group of 41 patients was related to delay from accident to surgery (p=0.0007) and preservation of the medial meniscus (p=0.03). Age, gender, type of activity before surgery, degree of initial and residual laxity had no statistically significant effect on remodeling. CONCLUSION: Age over 40 years is not a contraindication for arthroscopic free patellar tendon graft for the treatment of chronic anterior laxity. Using rigorous preoperative assessment criteria (delay from accident to surgery, absence of joint space narrowing on the AP and lateral view before intervention, symptomatic instability in daily life activities and motivated patient) this type of procedure can be performed safely and provides good functional outcome at five years. The current follow-up is insufficient to judge potential joint degradation. Age is not a contraindication if certain precautions are taken.

Adult↗
PubMed2001

Arthroscopic medial meniscectomy on stable knees.

We reviewed 74 partial medial meniscectomies in 57 patients with stable knees, to assess the long-term functional and radiological outcome. The International Knee Documentation Committee score and the residual laxity were assessed in both knees. At the time of surgery the mean age of the patients was 36 +/- 11 years and the mean follow-up was 12 +/- 1 years. All had a limited medial meniscectomy. The anterior cruciate ligament was intact in all cases. The meniscal tear was vertical in 95% and complex in 5%. The posterior part of the meniscus was removed in 99%. A peripheral rim was preserved in all cases. After 12 years 95% of the patients were satisfied or very satisfied with their knee(s). Objectively, 57% had grade A function and 43% were grade B. The outcome correlated only with the presence of anterior knee pain at final follow-up. In the 49 cases of arthroscopic meniscectomy for which there was a contralateral normal knee there was narrowing of the 'joint-space' in 16% of the operated knees. There was no correlation between this and other parameters such as age or different meniscal pathologies.

Adult↗
PubMed2001

[Arthroscopy-assisted revision in failed reconstruction of anterior cruciate ligament: 32 cases].

PURPOSE OF THE STUDY: The aim of this retrospective study was to analyze mid-term outcome after anterior cruciate ligament (ACL) revision performed arthroscopically with a patellar tendon graft. MATERIAL AND METHOD: The series included 32 revision arthroscopies for ligamentoplasties of the ACL performed after primary intraarticular plasty. Outcome was assessed using the IKDC score at least 2 years after revision surgery. A free patellar autograft was used in all cases in association with an anterolateral plasty in 9 cases using the Marshal-MacIntosh technique. There were 25 men, mean age 28.5 years. Mean follow-up was 4 years. The initial plasty was done with a synthetic ligament in 15 cases and an autograft in 17, including 12 patellar tendons. In 3 cases, the revision was needed for synovitis involving the synthetic ligament. In all the other cases, revision was indicated for instability, most of the failures resulting from a defective femoral position (particularly for autografts) or renewed trauma. RESULTS: Among the 23 patients who were initially competition-level athletes, 18 recovered their sports activity, 8 at an equivalent level. At last follow-up, the IKDC global scores were: A 5 patients (15.6%), B 16 patients (50%), C 8 patients (25%), D 3 patients (9.4%). Certain residual laxity was present in 3 cases (C and D laxity score for 2 of them). A tibiofemoral narrowing was present in the medial compartment in one patient alone. Factors of poor prognosis for the IKDC score were: long delay from accident to initial treatment (p=0.04), associated medial meniscectomy (p=0.02). Presence of an initial femoral tunnel had no effect on revision due to its very anterior situation. DISCUSSION: The technical difficulty of revision of an intra-articular ligamentoplasty of the ACL is to position the new transplant so it will satisfy the same requirements as the initial plasty. This position depends particularly on the femoral component due to the importance of the position of the initial femoral tunnel and the degree of bone loss (osetolysis, ablation of an interfering screw.). The homolateral patellar tendon was used for the graft in all cases except one and iterative use of the patellar tendon for grafting did not cause supplementary morbidity. The patellar tendon remains the transplant of choice for ligament reconstruction. Meniscectomy had a deleterious effect on the final outcome. As for first intention plasty, the therapeutic strategy should preserve as much meniscal stock as possible, depending on the type and degree of damage. CONCLUSION: Revision ACL plasty can provide good anatomic results although functional outcome is less satisfactory than after primary intention ligamentoplasty. A precise clinical and radiographic analysis of the cause of failure of the primary plasty must be obtained in order to establish a surgical strategy allowing the most clinically effective plasty with well positioned bone tunnels.

Adult↗
PubMed1977

[Campimetric changes in optic radiation lesions].

Visual field defects may be congruous or not in lesions affecting the optic radiation. This fact, and the macular sparing found in some cases, can be explained if the optic radiation is envisaged as formed by three layers, the superficial corresponding to homolateral peripheral vision, the intermediate to contralateral peripheral vision, and the deepest to central vision from both hemimaculae. The fibers of all these layers fan out sequentially, first the more superficial, then the deeper, around the posterior part of the lateral ventricles, following a longitudinal plane of divergence in their way to area 17. The progressive displacement, upwards and downwards, of the thick fibers transmitting peripheral vision, leave out finally the thin fibers for central vision as the sole constituents of the central and terminal part of the optic radiation. As supporting evidence of this conception we have the fact that if the optic radiation is encroached on from its outer side (as it generally happens for reasons stated in the full text) visual field defects tend to be larger in the homolateral field. This holds true for temporal and parietal lesions, and to a lesser degree for occipital lesions. Deep lesions (for instance intraventricular tumours) tend to affect first the deeper strata of the optic radiation (macular vision and/or contralateral quadrants of peripheral vision). The schematic drawings presented allow us to understand how a temporal lesion may produce: a) no visual field defect, b) an upper homonimous quadrantopsia, c) a lower homonimous quandrantopsia, d) a homonimous hemianopsia; and that these field defects can be either congruent or uncongruous. Deep parietal lesions will produce visual field defects in the lower quadrants, which may be congrous or not. As the visual fibers for macular vision are deeply located in the optic radiation, forming a thin but wide layer in the vertical plane, they cannot be affected to a significative extent without the more superficial fibers for peripheral vision being also affected to an even greater extent. Due to the width and depth of this macular layer even in extensive lesions of the optic radiation some of its fibers can escape injury. This can explain macular sparing in some cases without resorting to hypothetical bilateral macular representation which is deemed unacceptable. Anatomical data and clinical examples are given which lend support to all these contentions.

Epilepsy↗