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Biomedical subjects

A Thibaut

Publications and source records attributed to A Thibaut.

At least 19 recordsLinked to original sources

Can Flemish women in semi-rural areas be motivated to attend organized breast cancer screening?

BACKGROUND: The implementation of organized breast cancer screening in Flanders was prepared by means of pilot projects within a multicenter study. In the semi-rural district of Kontich (Province of Antwerp, Flanders) a pilot project was performed using a mobile screening unit. Compared to international standards, the attendance rate for this pilot project (i.e. 34%) was low. Non-organized screening, which already exists in Flanders, at least partly explains this low attendance rate for the organized screening. The main purpose of our study was to investigate the experience of the pilot target group with respect to the organized breast cancer screening in the district of Kontich, in order to maximize the conditions for a high attendance rate in the organized breast cancer screening programme throughout Flanders. METHODS: With a random numbers procedure, performed by the computer, 500 women were selected among those who were invited to the first screening round of the breast cancer screening programme in the district of Kontich (n = 6,897). These 500 randomly selected women were asked to cooperate with a face-to-face interview. The questionnaire used dealt with the different aspects of the organized mammographic screening which were expected to influence the decision to attend. RESULTS: There were 348 women who responded to the questionnaire (69.6%): 138 of them were attenders and 210 were non-attenders at the organized breast cancer screening. Attenders and non-attenders at the organized breast cancer screening in the district of Kontich had different views about various aspects of the screening programme. The percentages of those who thought that an item was important or very important to them, were for the 138 attenders and the 210 non-attenders respectively: "to receive a personal invitation letter": 90.6 vs. 48.1% (p < 0.05); "a preliminary visit to the GP": 9.4 vs. 34.3% (p < 0.05); "possibility of examination outside business hours": 15.9 vs. 30.0% (p < 0.05). CONCLUSIONS: Although the putting into action of a mobile unit in the semi-rural area of the district of Kontich was productive, the attendance rate was still too low compared to international standards. To increase the attendance rate, the following interventions should be considered: devising the personal invitation letter in a more attractive way, activating and stimulating the important motivational role of the GP in persuading women to attend the organized screening programme and offering the invited population the possibility to have a mammographic examination performed outside business hours. Appropriate measures are being explored.

Aged↗

Second primary lung cancer in Flanders: frequency, clinical presentation, treatment and prognosis.

Patient and tumour characteristics of 23 patients presenting with a second primary lung cancer were analysed and compared with 534 patients with radically resected stage 1 non-small cell lung cancer (NSCLC). None of these characteristics is associated with a higher occurrence rate for second primary lung cancer. Prognosis in the latter patients is significantly worse than after resection of a 'solitary' NSCLC: the median survival time (MST) after resection of the first tumour is 50 months; after diagnosis of the second tumour only 14 months. Surgically retreated patients have a prognosis that is similar to that after resection of a 'solitary' NSCLC. No separate independent prognostic factors responsible for this survival difference could be isolated. Squamous histology and central location are associated with a longer recurrence free survival time. We conclude that the occurrence of a second primary lung cancer can not be predicted based on patient or tumour characteristics and that only surgical retreatment offers a chance of long survival in these patients.

Adult↗

[Hyperaldosteronism suppressible by glucocorticoids. An unusual cause of familial hypertension].

The glucocorticoid suppressible hyperaldosteronism (GSH) is a rare form of systemic hypertension. We report a family--a father and his two children--with this disease. GSH represents a peculiar form of primary hyperaldosteronism, with usually an absence of increase of aldosterone in response to upright posture, a sustained responsiveness of aldosterone to prolonged ACTH stimulation and high levels of two steroids, the 18-hydroxy- and the 18-oxocortisol. But the two main features of GSH which distinguish it from other causes of hyperaldosteronism are the prompt reversal of the features of mineralocorticoids excess by glucocorticoid therapy and the autosomal dominant mode of inheritance. Recent studies demonstrate that this disorder is caused by an abnormal structure of the aldosterone synthase gene. Treatment by glucocorticoid (usually 0.30 to 0.75 mg dexamethasone daily) can reverse hypertension and hypokaliemia.

Adult↗

Preparation of poly (D,L) lactide microspheres by emulsion-solvent evaporation, and their clinical applications as a convenient embolic material.

The aim of preoperative embolization is to facilitate surgical removal by reducing tumor volume and vascularity, thereby decreasing blood loss during surgery. In a search for a better embolic material, compared to heterogeneous commercial products, we describe here in detail the preparation of poly (D,L) lactide microspheres by an emulsion-solvent evaporation process. The size distribution of the microparticles and their aggregation state--critical parameters in view of such application--have been investigated. Their effectiveness, as an embolic material, has been evaluated by some preliminary experiments undertaken on humans. The results were assessed on clinical and histological grounds.

Embolization, Therapeutic↗

(D, L) polylactide microspheres as embolic agent. A preliminary study.

Owing to their shape, accurately calibrated microspheres appear to be very suitable material for distal embolization. Moreover, the biocompatible (D, L) polyactide (PLA) microspheres possess two other valuable advantages: easy adjustment of their biodegradation rate, and incorporation of chemotherapeutic agents during their production. The authors describe the preparation of these (D, L) PLA microspheres and their clinical applications as a preliminary step to arterial chemoembolization.

Aged↗

[Application of the Talairach stereotaxic system for the purpose of establishing a common reference plane for brain imaging technics (CAT scan, NMRI, PET scan)].

Confrontation of data obtained from several modern imaging techniques (CAT Scan, NMR Scan, PET Scan) is a fundamental problem in actual neurological practice and must be correlated with histology. For that purpose, we use the referential plane of the stereotactic Talairach frame. Using teflon intraosseous buttons, the referential plane and a common zero reference point can be objectivated by CAT, NMR and/or PET Scans. A computer program gives the exact coordinates of the chosen target. These coordinates are immediately usable in the operating room for stereotactic serial biopsies.

Brain↗

Adipsic hypernatremia in a patient with pseudotumor cerebri and the primary empty sella syndrome.

Adipsic hypernatremia, a rare disorder, usually secondary to a hypothalamic lesion, is caused by the combination of partial central diabetes insipidus with hypo- or adipsia. We studied a patient who presented with a global hypothalamic dysfunction including adipsic hypernatremia. An extensive work-up disclosed the presence of pseudotumor cerebri and an empty sella turcica. Although endocrine abnormalities including true diabetes insipidus have been reported in conjunction with pseudotumor cerebri or an empty sella, no patient described presented such a global hypothalamic dysfunction or adipsic hypernatremia. The increased intracranial pressure is postulated to be the responsible mechanism for both the empty sella and the hypothalamic dysfunction.

Adult↗

Paradoxical release of LH under TRH dynamic test in patients suffering from "psychogenic" erective sexual impotency: lack of neuroradiological signs for hypophyseal lesions.

More than two thirds of the patients suffering from "psychogenic" erective sexual impotency display a paradoxical LH response to the injection of 200 micrograms of TRH. As it is known that similar responses exist in patients with gonadotropic cell adenomas, we undertook a tomographic examination of the sella turcica in 8 such patients. In none of the patients did the results favour the existence of a microadenoma. Though the hypothesis of an infra-radiological microadenoma cannot be excluded, it is highly plausible that the origin of the paradoxical response observed is a functional impairment of the hypothalamo-hypophyso-gonadal regulation.

Adenoma↗

Invading meningiomas of the sphenoid ridge.

The authors report a series of 34 meningiomas of the sphenoid ridge. Eight tumors were totally removed uneventfully: two from the middle sphenoid ridge and six from the pterion or Sylvian point. Five tumors were not operated on because of their extensions or the patient's age. Twenty-one tumors raised serious surgical problems, resulting in a classification into three groups: deep or clinoidal, invading beyond the sphenoid wings, and a combination of both. Histological study of the hyperostotic bone showed meningiomatous cells in the bone in 12 of 13 cases so examined. Surgical limitations included invasion of the cavernous sinus (15 cases), of the dura mater of the sella turcica (seven cases), of the lateral part of the sphenoid body at the insertion point of the ala magna (seven cases), and of the common tendinous annulus of Zinn in the orbit (five cases), and basilar extracranial extension, particularly in the pterygomaxillary fossa (three cases). Following extensive removal, there were no early recurrences and three late recurrences (9 years and more). In 13 cases with a follow-up period of 1 to 8 years, there were no clinical recurrences. In only two cases was the meningioma totally removed. There were three postoperative deaths, two cases of hemiparesis with aphasia and epilepsy, one case with a frontal lobe syndrome, and nine with slight oculomotor, visual, or esthetic sequelae.

Adult↗

Embolization and surgical removal of nasopharyngeal angiofibroma.

The usefulness of embolization of one or several feeding arteries before surgical removal of nasopharyngeal angiofibroma has been proven. However, there are two questions which remain: (a) At what point should the embolization stop? (B) What is the optimal delay between embolization and operation? These questions are discussed but not resolved.

Adolescent↗

CT scan and gas encephalography in diagnosis of arachnoid cyst and epidermoid cyst of Galen's cistern.

The CAT scan is insufficient to make the differential diagnosis between an arachnoid cyst and an epidermoid cyst in the cistern of Galen. Gas encephalography is necessary. This procedure reveals arachnoid cysts of the commmunicating type, but is insufficient in distinguishing between an epidermoid cyst and a non-communicating arachnoid cyst. In this situation, histograms of the absorption values in each section of the lesion may be helpful for the diagnosis.

Arachnoid↗