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Biomedical subjects

C Garde

Publications and source records attributed to C Garde.

At least 19 recordsLinked to original sources
PubMed2006

Gastroesophageal reflux: prevalence of psychopathological disorders and quality of life implications.

There is evidence in the literature that psychosocial aspects affect the symptoms and results of surgery for gastroesophageal reflux. The purpose of this study was to estimate the prevalence of psychopathological disorders measured using the General Health Questionnaire (GHQ-28) in a sample of patients with gastroesophageal reflux, and to assess the influence of such disorders on their quality of life. A prospective study was conducted in 74 consecutive patients before gastroesophageal reflux surgery; patients answered the GHQ-28, the health questionnaire SF-36, and the Gastrointestinal Quality of Life Index (GIQLI). The convergent validity of the GHQ-28 questionnaire as compared to the other two questionnaires and preoperative quality of life was tested. A pathological result of the GHQ-28 questionnaire was found in 38.3% of patients. A correlation was seen between the results of the GHQ-28 questionnaire and all categories of the SF-36 and GIQLI questionnaires. Patients with pathological results in the GHQ-28 questionnaire had poorer results in all dimensions of the SF-36 and GIQLI quality of life questionnaires as compared to patients with a normal result in the GHQ-28 questionnaire. In conclusion, 38.3% of patients with gastroesophageal reflux showed psychopathological disorders when administered the GHQ-28 questionnaire. These patients also had poorer results in quality of life studies.

Adult↗
PubMed1995

Ambulatory phlebectomy.

BACKGROUND: Ambulatory phlebectomy (AP) is a gratifying technique that allows one to solve problems otherwise requiring traditional surgery. However, when AP is practiced indiscriminately, results may be disappointing and can tarnish the technique, although there is always a solution to restore the situation. OBJECTIVE: To evaluate the defects of AP, their frequency, and to propose solutions for treatment and prevention. METHODS: This study was based on a review of 900 patients who underwent AP with no less than 6 months follow-up. Complications were grouped into three categories: cosmetic, functional, and efficacious (recurrence rates). RESULTS: Cosmetic problems included pigmentation, tattooing, telengiectatic matting, and appearance of new varicose veins. Functional problems included paresthesia and edema. Hematomas disappeared within 3 weeks but sometimes led to pigmentation. CONCLUSIONS: After having analyzed all the reasons for complications, we can formulate logical solutions. Risks may be greatly reduced by strict adherence to proper technique, patient selection, and pretreatment venous mapping. For all complications we found a solution. Sclerotherapy is used in all cases because AP, like all surgical techniques, leads to recurrence when performed alone. In this study, all the described side effects were treated by sclerotherapy, which remains the only solution that gives good results in all cases.

Ambulatory Surgical Procedures↗
PubMed1994

Cryosurgery of varicose veins.

BACKGROUND: It is impossible to treat all varicose veins employing the same method. Cryosurgery offers a new modality for the detraction of the long and short saphenous vein deletion. OBJECTIVE: To describe the technique, its indications, potential complications, and cosmetic results. METHODS: We followed 800 patients over 6 years. The study allows evaluation of the results of and the best indications for this method. With a follow up of five years, we have analyzed: 1) the immediate complications, and 2) middle-term results. RESULTS: The results of cryosurgery of varicose veins were generally comparable to those obtained using classical surgery (stripping). CONCLUSION: Cryosurgery of varicose veins is a fast and safe method for selected varicose disorders, exhibiting good cosmetic results.

Cryosurgery↗
PubMed1994

[Clindamycin-primaquine in the treatment of Pneumocystis carinii pneumonia].

BACKGROUND: The efficacy of clindamycin-primaquine as treatment of Pneumocystis carinii pneumonia (PCP) is similar to that of trimethoprim-sulfamethoxazol and endovenous pentamidine. The untoward effects of this combination are scarce and of mild degree. METHODS: Patients presenting with microbiologically confirmed PCP (bronchoalveolar lavage or induced sputum) were treated with clindamycin-primaquine. Patients presenting PO2 of less than 60 mmHg were excluded, being therefore treated with conventional therapy. RESULTS: Sixteen patients received treatment with clindamycin-primaquine. All demonstrated clinical improvement after the fifth day of treatment. Treatment was discontinued in three patients due to cutaneous adverse reactions. One patient voluntarily discontinued treatment, being readmitted with acute respiratory failure, and died. Clinical cure was achieved in 13 patients who completed the treatment with clindamycin-primaquine. CONCLUSIONS: The combination of clindamycin-primaquine was effective as the treatment of Pneumocystis carinii pneumonia in the patients here reported. The percentage of patients who presented secondary effects was not greater than expected with other therapeutic options. The severity of the adverse events was mild and easy to control.

Adult↗
PubMed1992

[Rhodococcus equi in HIV infected patients: 2 new cases].

We reported two HIV infected patients with bacteremia and pneumonia due to Rhodococcus equi. None of them had suffer any opportunistic infection before this episode. Clinical presentation includes respiratory tract symptoms of subacute onset and fever. The X-ray examination in both cases revealed pneumonia and lung abscess in upper lobes as well as lung infiltrates in other lobes. The microorganism was isolated in lung fine needle aspiration, bronchoalveolar lavage and blood cultures in both cases. One patient died and the other was under antibiotic treatment 5 months after discharge. The therapeutic options in this infection must include the use of at least two different antibiotics to which the microorganism is sensitive, and for a prolonged period of time. Surgical treatment should be considered if the evolution is poor.

Actinomycetales Infections↗
PubMed1991

[Invasive aspergillosis in patients infected by the human immunodeficiency virus].

Invasive aspergillosis is a disease that affects immunosuppressed patients, in close relationship with the presence and duration of neutropenia. Although formerly included among the AIDS definition criteria, it was thereafter dropped out because of its very low prevalence. We describe here four cases of invasive aspergillosis in HIV infected patients, diagnosed at our institution. Three patients presented with invasive pulmonary aspergillosis, including one patient with chronic ulcerative pulmonary aspergillosis. The fourth patient developed aspergillosis of the brain. Taking into account the difficulties in establishing a diagnosis of this infection before death (most of published cases were from autopsy reports) and because of the paramount importance of early diagnosis for improving survival, we support the use of invasive pulmonary aspergillosis diagnostic criteria in a similar way as used in patients suffering lymphoproliferative disorders. Although classic treatment of this infection is based on the use of amphotericin B (with or without 5 fluorocytosine), the potential usefulness of itraconazole (a new imidazole drug) has to be considered. In spite of the low number of published cases, we believe that invasive aspergillosis among HIV infected patients has to be included as a likely diagnosis, specially in view of the prolonged survival and widespread use of cancer chemotherapy in this population.

Adult↗
PubMed1990

[Good response to azidothymidine in 3 patients with vacuolar myelopathy].

We report 3 drug abusers with human immunodeficiency virus (HIV) infection who had presented with myelopathic symptoms. A diagnosis of vacuolar myelopathy associated with HIV was made. The patients had a favorable response to azidothymidine. They were followed up as outpatients, and they showed a significant clinical improvement within 1-3 months of therapy. They remained stable 11 months afterwards. The patients with this type of disease may benefit from azidothymidine therapy.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Evaluation of the results of the curative treatment of varices using 3 scoring systems: clinical, Doppler and echographic].

There have been many studies reporting results of curative treatment of varicose veins. Four methodological errors are nevertheless often committed: groups of varicose vein patients not comparable with regard to the degree of venous dilatation; insufficient objective parameters; population inadequately followed up; retrospective studies. It was felt necessary to develop systems for the quantification of varicose disease. These systems provide three grades: a clinical grade, a Doppler grade and an ultrasonographic grade. Clinical grade essentially involves the maximum diameter of varicose veins found by palpation and expressed in millimetres. The Doppler grade takes into account the maximum duration of the reflux wave in compression-decompression manoeuvres. The ultrasonographic grade also involves the maximum diameter of the varicose system. These grades enable the numerical assessment of the results of curative treatment of varicose veins, as well as forming the basis for statistically satisfactory epidemiological surveys.

Combined Modality Therapy↗