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C Christides

Publications and source records attributed to C Christides.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Dysmorphic syndrome and vascular dysplasia: an atypical form of type IV Ehlers-Danlos syndrome].

A 29 year old woman was hospitalized for the successive onset of extremely serious vascular accidents: rupture of the gastro-duodenal artery, aneurysm of the posterior tibial artery, discovery of bilateral carotid and vertebral aneurysm with development of a carotid-cavernous fistula. The patient had a very unusual morphotype with dwarfism, white hair and alopecia. Histological investigations failed to reveal atheromatous lesions and by contrast showed involvement of the skin (dermal atrophy) and in the blood vessels fibro-dysplasia of the media. This picture was suggestive of a vascular form of Ehlers-Danlos disease (Sack's syndrome or type IV Ehlers-Danlos disease). This syndrome is characterized by minor skin or joint manifestations replaced by arterial accidents (arterial rupture or development of aneurysms). The etiology is faulty maturation of procollagen III and the diagnosis is based upon fibroblast culture.

Abnormalities, Multiple↗
PubMed1985

[Aortocaval fistulas. Apropos of 5 cases].

UNLABELLED: 5 cases of aorto-iliac aneurysms which fistulised into the inferior vena cava are described. They illustrate the problems encountered in this condition. - DIAGNOSIS: although a classical diagnosis, it is only recognised in 27 p. 100 of cases because the clinical presentation can be very variable. A pulsating, expansive, abdominal mass very suggestive of an aneurysm of the abdominal aorta should alert to the possibility of a fistula within the inferior vena cava when the patient has unexplained cardiac failure, shock, lower limb deep vein thrombosis, urinary or psychological problems. In the absence of a continuous abdominal murmur, the diagnosis may be confirmed by complementary investigations; the investigations of choice are non-invasive. Abdominal ultrasonography showing an aneurysm of the abdominal aorta associated with dilatation of the inferior vena cava is very suggestive of the diagnosis. - The only treatment is surgery. The operative risk depends on the presence of absence of associated retroperitoneal rupture of the aneurysm, the respective mortalities being 83 p. 100 and 15 p. 100. - The principal causes of death are pulmonary embolism and renal failure which necessitate special prophylactic measures (surgical and anaesthetic).

Aged↗
PubMed1985

[Trapped popliteal arteries. Incidence, epidemiology, therapeutic considerations].

The trapped popliteal artery syndrome is an extrinsic dynamic compression of the vascular structures in the popliteal fossa by the surrounding fibromuscular structures. The condition mainly affects the popliteal artery resulting in atypical intermittent claudication because it often occurs in young and active patients. The arterial lesions are initially purely extrinsic and dynamic; sometimes they progress to thrombosis, embolism or aneurysm due to jet lesions. The diagnosis is obtained by radiology in the uncomplicated forms by showing compression or complete occlusion of the artery during contraction of the gastrocnemius and quadriceps muscles. Doppler studies of the posterior tibial artery may also demonstrate the condition during these manoeuvres. The epidemiological study was performed in 199 medical students and 80 athletes. A positional abolition of the posterior tibial artery was demonstrated in 39 students (19%) and 12 athletes (15%). The entrapment was commoner in females (24%) than males (13%). It was observed more frequently in dancers, cyclists and basket ball players: 12 control digitised intravenous angiographies were performed; the diagnosis was confirmed in 11 cases. Several anatomical anomalies of the popliteal fossa may give rise to this condition. The commonest is a deviation of the artery within the internal head of the gastronemius muscle; compression by the soleus or fibro muscular bands arising from the semi-tendinous or semi-membranous have been described. The treatment is surgical in very symptomatic or complicated cases; uncrossing the artery associated with venous grafting in cases of thrombosis are the procedures of choice.

Constriction, Pathologic↗
PubMed1985

[Iatrogenic internal mammary arteriovenous fistula. Apropos of 2 cases].

Two fairly similar cases of internal mammary arterio-venous fistula were observed in two patients involved in serious road accidents, following which a catheter was inserted into the subclavian vein for the purposes of resuscitation. The clinical diagnosis was made in both cases on routine examination, which revealed a continuous right subclavian bruit with extensive radiation three years after the accident. There were no functional implications. Further investigations revealed a fistula located between the internal mammary artery and the right brachiocephalic venous trunk and demonstrated the haemodynamic consequences: normal intra-cardiac pressures, but a pulmonary blood flow which was twice that of the systemic blood flow. Both cases were treated by means of surgical cure via thoracotomy, which confirmed the nature of the arterio-venous fistula and which defined the relations with the phrenic nerve, which is the most exposed element. The results of this operation were excellent in both cases.

Adult↗
PubMed1985

[Pulsatile echography (ultrasonic cerebral tomosphygmography) in carotid and vertebral pathology. Surgical applications].

Ultrasonographic cerebral tomosphygmography (U.C.T.S.) is a method for determining cerebral pulsatility by centimeter-thick sections. The prototype uses a 2 MHz ultrasound wave emitted in the direction of cerebral structures. The reflected wave is captured by centimeter-thick sections, the mean determined and a pulsatile index defined. This index varies according to the regions studied (cortico-subcortical, superficial sylvian, deep sylvian and vertebrobasilar). Physiologic pulsatility was determined from a series of 150 healthy subjects. This technique was used to evaluate effects of carotid and vertebral circulation revascularization in 21 patients. Findings showed lack of relation between anatomic lesion and cerebral pulsatility, absence of significant modification of the index after release of carotid occlusion except when postoperative thrombosis occurred, and heterogeneous individual behavior after revascularization distinguishing subgroups of indifferent (40%), improved (27%), hyperpulsatile (27%) and worsened (13%) subjects. Two patients presented worsening on the contralateral side compatible with a steal syndrome. Results suggest that U.C.T.S. is a promising method of preoperative investigation and postoperative surveillance of carotid artery stenosis.

Aged↗
PubMed1984

[Hemasite: a means of vascular access for chronic hemodialysis].

Hemasite is a prosthetic device made of titanium and destined to be inserted in an arterialized circuit, thus constituting an elegant and comfortable means of performing chronic haemodialysis. It would be wrong to reject it because its price is still high, but it should not be used as first-choice device. Three patients in our centre have been equipped with hemasite for periods of 18, 5 and 2 months respectively.

Arm↗
PubMed1984

[Results of singular valve replacement with a mechanical prosthesis or bioprosthesis in valve diseases with advanced myocardial failure].

Surgery may prolong survival in some patients in advanced cardiac failure due to valvular heart disease refractory to digitalo-diuretic and vasodilator therapy. The operative risk is high and myocardial dysfunction after surgery is also a problem. However, in some cases, surprising improvement is observed. An analysis of the principal publications in the literature on the natural history of valvular heart disease and the results of surgery in the last ten years show that: In chronic aortic valve disease complicated by congestive heart failure, the natural prognosis does not exceed 2 to 3 years in either aortic stenosis or regurgitation. On the other hand, prosthetic valve replacement is associated with a 57% 4 years survival in aortic regurgitation, and a 70% 5 years survival in aortic stenosis, but with an operative mortality of 20 to 27%. Surgery is even more valuable in acute aortic regurgitation due to endocarditis, leading to a 60% 2 years survival compared to only 6% with medical therapy alone. In chronic mitral valve disease with advanced cardiac failure, the natural prognosis does not exceed 4.5 years in mitral regurgitation, 8 years in mitral stenosis and an intermediate period in mixed mitral valve disease. On the other hand, prosthetic valve replacement with an operative risk of 21 to 26% is associated with a life expectancy of 56 to 60% at 5 years, and 46% at 10 years, operative mortality included. The surgical results depend on good myocardial protection and intensive pre-, per- and post-operative care using positive inotropic agents, vasodilators and, when necessary, intra aortic balloon pumping.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1984

[Chronology of vascular access in hemodialysis. Apropos of 244 accesses in 150 hemodialysis patients].

Out of an experience of 244 vascular access in 150 patients the authors try do find the best chronology of the angioaccess procedures. 68% of the patients see their need in vascular access definitely resolved by the first classical forearm internal arterio-venous fistula and everything must be done in the dialysis population to avoid the failure of the fistula. This would lead to internal shunt procedures using graft materials of which we know the limited potency, leading to periodic operations. Emergency situations are approached by use of the femoral vein catheterization for hemodialysis. Only the impossibility of femoral or jugular catheterization would lead to the use of the external A.V. Shunt which would be placed on the leg to preserve the vessels of the arms. For some patients the repeated failure of the successive A.V. fistula and shunts have drived us towards either peritoneal dialysis or "hemasite" vascular access system.

Acute Kidney Injury↗
PubMed1984

[Septicemia on endocavitary sounds for cardiac stimulation].

Two cases of septicaemia on endocavitary cardiac pacemaker probes lead the authors to discuss the aetiological and therapeutic aspects of this type of infection. In both cases, the pacemaker had been in situ for a long time and had been replaced on several occasions, there was infection in the site of implantation and an attempt at removal of all of the pacemaker material failed, leaving a probe incarcerated in the right ventricle by one of its extremities with the other extremity floating free. The endocarditis associated with this septicaemia can, theoretically, be due to two mechanisms: metastatic implantation of infection form a distant site which must be detected or infection developing in contact with the pacemaker and propagated along the probe. The treatment of this type of septicaemia consists of appropriate antibiotics, which are only rarely sufficient to sterilize the infection. In most cases, all of the pacemaker material must be removed, which is easily achieved in the majority of cases. After cleansing of the site, the pacemaker has been successfully replaced. Sometimes, the probe is buried in the myocardium: surgical removal by cardiotomy, with or without extracorporeal circulation, seems to be preferable to the techniques of continuous traction which carry certain risks (tricuspid and myocardial lesions). Persistent floating probes must be removed surgically.

Aged↗
PubMed1983

[Must acute carotid thrombosis be surgically treated? 1962-1973: long-term results].

A study of long-term results (mean follow-up: 10.6 years) in 22 patients operated on for acute carotid thrombosis between 1962 and 1973 is reported. In most instances, surgery was performed at the acute phase of a massive cerebrovascular occlusion, usually more than 8 hours after onset (10 cases). Five of these patients (22%) died in the postoperative period. Eight (35%) recovered without residual disease. In six, the condition improved, while it remained unchanged or worsened in three (14%). There were ten delayed deaths, including two from a recurrent cerebrovascular episode and four from cardiac disease. The actuarial survival curve does not differ from that of patients treated conservatively, with rates being 60% at five years, 36% at ten years and 28% at thirteen years. The quality of certain postoperative results suggests that surgical indications at the acute stage of carotid occlusion be reviewed. The study of thirty series from the literature (1 046 cases) shows a 17% mortality rate, while 50% of patients recover or improve. This mortality is significantly lower in recent statistics, under 10%: this improvement may be ascribable to more rigid surgical indications (delay under 6 hours, operation in variable neurologic deficiencies, early diagnosis by the Doppler procedure, better postoperative management). The authors conclude that surgical management of acute carotid thrombosis should no longer be systematically dismissed.

Acute Disease↗
PubMed1983

[Latent adrenal cortical tumor. Plea for a better designation of adrenal cortical tumor. Apropos of 3 cases].

The authors isolate the characteristics of "nonhormonal" adrenocortical carcinomas from three clinical reports and a review of the literature. The absence of any clinical endocrine syndrome at the outset, and the tardy appearance of the tumoral syndrome explain the latency of these tumors. The investigations aim at circumscribing the tumor itself and any extensions - especially invasion of the vena cava, which is a determining point in the choice of therapy. Management is mainly surgical even though, in some cases, the operation can do no more than confirm the diagnosis. The prognosis seems to be greatly improved by medical treatment, especially with OP'DDD.

Adrenal Cortex Neoplasms↗
PubMed1983

[Was it necessary to treat acute carotid thromboses surgically? 1962-1973: long-term results].

A 13 years study of 22 patients with surgical treatment of acute occlusion of the internal carotid artery is reported. Mortality rate was 22% (5 patients). 35% had a complete recovery of the stroke without any sequelae. 6 were better after intervention, 3 worsened. Long term mortality is 10 patients with 2 strokes and 4 myocardial infarction. No significant difference can be observed on life table of the survivors with reference to recent medical series, 60% at five years, 36% at ten years, 28% 13 at years. A review of 30 studies of the literature (1,046 cases of acute stroke or transient ischemic attacks) shows a 17% global mortality, with 50% of good results. Mortality of surgical treatment of acute carotid occlusion is lower in recent papers (inferior 10%). This progression seems to be related to the selection of the indications of surgery in stroke (shorter delay, early diagnosis with non-invasive procedures, post-operative management). The conclusion is that a surgical therapy of acute thrombosis of the internal carotid artery cannot be systemically rejected.

Acute Disease↗
PubMed1981

[Exploration of major veins by Doppler ultrasonography. Indications and limits (author's transl)].

Doppler ultrasonography is a first-choice, non-invasive, inexpensive and repeatable procedure for exploring major veins and for detecting venous thrombosis, venous insufficiency and arterio-venous fistulae. It also provides invaluable information on post-operative haemodynamics in cases of thrombectomy, venous shunt and vena cava clip, and helps in evaluating the effectiveness of thrombolytic agents. Its sensitivity is satisfactory: in 110 patients with suspected phlebitis, there was an 86,5% agreement between the results of doppler ultrasonography and those of phlebography. False negative results are encountered with distal thromboses and, unfortunately, floating clots (there were 3 cases of undetected iliac vein floating clots in this series). It seems rational to use Doppler ultrasonography in patients with high risk venous diseases. The method will not replace phlebography, but when applied on correct indications, it may substantially reduce the number of negative or unassessable results.

Doppler Effect↗
PubMed1981

[Compared results of flail chests treatments : standard internal pneumatic stabilization, new technics of assisted ventilation, osteosynthesis (author's transl)].

The analysis of 170 cases of flail chests, divide into three groups according to the type of treatment, proves the efficiency of the new technics of assisted ventilation and of the osteosynthesis by Judet clasps. The most significant advantages of those two complementary methods are a lowered mortality rate and a reduced frequency of refractory hypoxy and infectious complications.

Adult↗