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Biomedical subjects

A el Gariani

Publications and source records attributed to A el Gariani.

5 recordsLinked to original sources

Emergencies and somatization.

The article presents the clinical profile of 72 patients with somatization seen by a psychiatric team at the request of somaticians in a emergency service in St Luc hospital (Brussels-Belgium). These include 37.5% of mood disorders, 11% of psychotic disorders and 20% of serious anxiety disorders. The psychiatric antecedents of these patients are very poor. Only the combined intervention of the somatician and the psychiatrist can improve the compliance and the level of psychiatric care which is very low.

Adult↗

Twenty years' experience with the Model 6120 Starr-Edwards valve in the mitral position.

A total of 549 nonconsecutive patients underwent isolated mitral valve replacement with a Starr-Edwards valve prosthesis (Model 6120) at the University of Louvain (Belgium) from 1965 to 1985. Ninety-seven percent of the patients could be traced and only 17 patients were lost to follow-up. Cumulative follow-up totalled 3,130 patient-years. Actuarial and linearized statistical techniques were used to describe the survival and the incidence of valve-related complications (according to stringent criteria). Long-term overall survival rate including early deaths was 79% +/- 0.02% at 5 years, 65% +/- 0.03% at 10 years, and 54% +/- 0.04% at 19 years, with a linearized incidence of late deaths of 3.9% +/- 0.5% per patient-year. The incidence of late valve-related deaths was 1.25% per patient-year. Valve-related complications occurred at the following rates: thromboembolism 3.1% per patient-year, anticoagulant-related hemorrhage 1.08% per patient-year, endocarditis 0.26% per patient-year, reoperation and periprosthetic leak 0.45% per patient-year, and structural failure 0% per patient-year. All valve-related mortality and morbidity were calculated at 4.9% per patient-year and the rate of valve failure (deaths and reoperations) at 1.4% per patient-year. Among 376 survivors, 352 clinical functions could be obtained: 95% of patients belong to Class I or II of the New York Heart Association after operation versus 24% before operation. The study shows the structural durability of the Starr-Edwards mitral valve with a follow-up over 20 years. The Model 6120 valve may be considered a faithful standard.

Adolescent↗

Scintigraphy with Indium-labelled leukocytes in acute pancreatitis.

The authors assessed the clinical and prognostic value of abdominal (ASCI) and pulmonary (PSCI) scintiscans with 111Indium-labelled leukocytes in the early phase of acute pancreatitis. A grading scale was constructed for both ASCI (scored 0 to 3) and PSCI (scored 0 to 2) according to the intensity of isotope fixation versus adjacent structures. Results were compared in accordance to the presence or absence of a Ranson's score greater than or equal to 3, the presence or absence of respiratory failure and of late pancreatic complications. ASCI showed an important lack of specificity making its use uninteresting. PSCI revealed a very significant correlation with evaluation by Ranson's score and appears to have a high sensitivity and specificity to evaluate the patients who will develop ARDS or risk of ARDS. This demonstrates the pathophysiological role of leukocytes in the early phase of severe acute pancreatitis. The test might also be a reliable test for the assessment of therapeutic efficiency in acute pancreatitis.

Abdomen↗

[Pulmonary embolectomy. Clinical experience].

Between 1969 and 1984, twenty-three patients underwent an emergency pulmonary embolectomy under extracorporeal circulation in the Catholic University of Louvain (UCL), Department of Cardiovascular and Thoracic Surgery. The aim of this paper is to delineate the indications of this procedure. Patients were 23 to 70 years old. Diagnosis of Pulmonary Embolism was made according to clinical signs, ECG and Chest X Ray with Swan-Ganz catheter insertion into the pulmonary artery and the help of pulmonary angiogram if time permitted. The surgical technique is briefly described. Four patients died during the immediate postoperative period and three died later. The sixteen survivors all enjoy a normal life.

Adult↗

[Treatment of the first episode of pulmonary embolism in the hospital. Anticoagulants, anti-platelet aggregation drugs and thrombolysis stimulants].

The treatment of the first pulmonary embolic accident in Hospital consist in the administration of anticoagulants. Heparin will be first used intravenously or subcutaneously during 10 to 12 days and will be followed by oral anticoagulants (VKA) during 3 to 12 months. These treatments must be controlled following national or international standardized technics and can be associated with antiplatelet drugs or thrombolytic activators. The most important and frequent complications observed are haemorrhages. They are consecutive to a non conformed administration of the drugs or overdosage bound to a non correct control or drugs interferences or to a misappreciated counterindication. They will be corrected in most of the cases by a simple anticoagulant dosage reduction and exceptionally by the interruption of the therapy with administration of antidotes and plasma substitutes. Other complications are extremely rare and bound to the nature of the drugs used.

Anticoagulants↗