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Biomedical subjects

C Giraud

Publications and source records attributed to C Giraud.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Indications and results of combined urokinase-lys plasminogen in acute ischemic pathology of the legs].

Low dose urokinase-lys plasminogen was used to treat 10 patients with acute ischemia of lower limbs. Preliminary results are reported and indications defined, the combination producing effective relief and being very well tolerated biologically and clinically. All patients presented clear signs of ischemia provoking a short term risk for the limb. Direct femoral puncture arteriography of the ischemic limb was an essential pretreatment investigation. A thin catheter left in contact with the thrombus allowed localized fibrinolysis to be performed. Follow up arteriography examinations assessed clinicopathologic results, while biologic surveillance of principal coagulation parameters showed a lack of significant alterations during treatment. Ischemic signs were totally relieved in 7 cases, with arterial repermeabilization allowing recuperation of one (3 cases) or both (2 cases) distal pulses. Persistence of a popliteal thrombus in one case required a fogarty after a direct approach and the limb was saved. Two patients had to be amputated because of delayed treatment. These encouraging results suggest that this procedure of local thrombolysis be reserved for popliteal or infra-popliteal occlusions accompanied by sensory-motor signs and of recent (less than 72 hours) onset. Follow up for 8 months is insufficient but has shown the absence of deterioration, but this is obviously a function of the natural course of the underlying atheromatous disease.

Acute Disease↗
PubMed1984

[Cockett's syndrome. Treatment by venous envelopment in a ringed prosthesis].

The surgical treatment of Cockett's synechiae is now well established, with only minor variations. Various techniques have been suggested to solve the problem of arterial compression, but none of these is fully satisfactory. The authors favour the use of new externally supported grafts, notably the ringed polytetrafluoroethylene (PTFE) prosthesis, to protect the left iliac vein, these grafts being effective and easy to apply.

Blood Vessel Prosthesis↗
PubMed1984

[Role of thrombolytic treatment in thrombosis of valvular prostheses. Apropos of 2 cases and review of the world literature].

The authors report 2 cases of thrombolytic therapy by Urokinase at the dose of 4 500 U/kg/hour, for 24 hours, in patients with thrombosis of a Bjork aortic and Lillehei mitral valve prostheses, and assess the efficacy with a review of the world literature. The first case was a 65 year old woman who received a Bjork No 25 aortic valve prosthesis for aortic regurgitation. Two years later oral anti-vitamin K anticoagulants were replaced by an association of Aspirin-Persantine. She developed acute pulmonary oedema secondary to thrombosis of her valve during the fifth postoperative year. Treatment with Urokinase was successful (4 500 U/kg/hour for 24 hours). The second cases was a 33 year old woman who received a Lillehei No 27 mitral valve prosthesis for mitral regurgitation due to infective endocarditis. Six years later, during a period of apparently ineffective oral anticoagulation, she developed subacute pulmonary oedema due to thrombosis of her prosthesis. Urokinase therapy was successful after 4 hours, but the valve surface area on cardiac catheterisation was decreased and elective reoperation to change the prosthesis was decided upon. Prosthetic valve thrombosis is a serious complication with an operative mortality of 68.6% (35 deaths out of 51 reoperations in the worl literature) whilst the efficacy of thrombolytic therapy would appear to be about 80%. When thrombosis is progressive, the valve has to be changed surgically, but when it is secondary, thrombolytic therapy at least helps the patient survive the acute phase.

Adult↗
PubMed1984

[Malignant degeneration in testicular feminization. Apropos of a case].

The authors describe the main therapeutic features found in a case of testicular feminisation that became malignant. Bilateral gonadal ablation should be carried out after puberty for fear of malignancy. When cancer occurs treatment is best decided on the grounds of extension to the lymph nodes and the histological findings in the tumour. Where there is no extension to the lymph nodes, surgery should be carried out on the gonads with radiotherapy to the lymph nodes. If the tumour is not clearly a seminoma the lymph nodes should be removed before radiotherapy is started.

Adult↗
PubMed1983

[Rupture of the left diaphragmatic cupola with pericardiac rupture complicated by heart luxation. Apropos of 2 new cases].

Pericardiac rupture associated with a rupture of the left diaphragmatic cupola is a seldom possibility. This possibility is principally observed during important thoracic and abdominal traumatism. Heart luxation through the pericardiac break is a complication which can involve brutal death, stay unknown or be an operative discovery. Two new cases of left diaphragmatic cupola rupture are related. The authors analyse ways of this pericardiac luxation, definite diagnostic components and the therapeutic methods. Prognosis stays serious because of the importance of the associated lesions.

Adult↗