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C Herisson

Publications and source records attributed to C Herisson.

15 recordsLinked to original sources
PubMed2005

[C-reactive protein, leukocyte count and D-dimer monitoring after orthopedic surgery: early diagnosis of infectious or thromboembolic complications. Part two: does d-dimer measurement contribute to the diagnosis of postoperative venous thromboembolism?].

OBJECTIVES: To determine the modification in postoperative D-dimer level as a function of the surgical act and to assess the relevance of this measure for diagnosing thromboembolism. METHOD: A cohort of 179 patients was followed: group 1 comprised 128 patients undergoing lower limb arthroplasty, group 2 comprised 29 patients undergoing lower limb surgery without implant, and group 3 comprised 22 patients undergoing spinal or upper limb surgery. D-dimer level was systematically measured on admission and then once a week for 4 weeks. Doppler ultrasonography was performed on clinical suspicion of deep vein thrombosis. D-dimer levels were compared between patients with and without deep vein thrombosis. RESULTS: D-dimer levels were constantly elevated postsurgery (2- to 6-fold above normal) and returned to normal by week 4 in groups 2 and 3 but remained elevated in group 1 (3-fold above normal). Deep vein thrombosis was suspected in 45 cases and confirmed by Doppler ultrasonography in 10 cases. D-dimer level was not significantly different between patients with deep vein thrombosis and those without. DISCUSSION AND CONCLUSIONS: In the postoperative period, measurement of D-dimer level does not aid in diagnosing thromboembolism since its constant high level obviates any negative predictive value.

Adult↗
PubMed2005

[C-reactive protein, leukocyte count and D-dimer monitoring after orthopedic surgery: early diagnosis of infectious or thromboembolic complications. Part one: C-reactive protein and leukocyte count as an aid in diagnosing postoperative infection].

OBJECTIVES: To evaluate the usefulness of monitoring C-reactive protein (CRP) level and leukocyte count for early diagnosis of infection following orthopedic surgery. METHOD: A cohort of 179 patients was followed: group 1 comprised 128 patients undergoing lower limb arthroplasty, group 2 comprised 29 patients undergoing lower limb surgery without implant, and group 3 comprised 22 patients undergoing spinal or upper limb surgery. CRP level and leukocyte count were systematically measured on admission and then once a week for 4 weeks. Wound infections, other infections, wound disconnection without infection and hematoma were noted. CRP level and leukocyte count were monitored postoperatively in patients with and without complications. RESULTS: CRP level was 4- to 8-fold above the normal range at the first postoperative measurement but normalized within the next 3 weeks (reaching normal levels by the 30th postoperative day, on average). In the 7 cases of wound infection (WI), the CRP level rose to 28-fold above normal and was significantly different from that in without infection or with intercurrent infection (P<0.01). A receiver operating characteristic (ROC) curve was established for CRP level, and for a value of 60 (12-fold above the normal range) the sensitivity was 100%, the specificity 83.6% and the negative predictive value 100%. The variation in leukocyte count was minor, with a significant difference noted between only patients not infected or those with WI (P<0.05). DISCUSSION AND CONCLUSIONS: Measurement of CRP level can be used for early diagnosis of wound infection. In the case of strong clinical suspicion or in the presence of high risk factors, when the level is at 12-fold or more above the normal range, the diagnosis of infection is highly probable.

Adult↗
PubMed2005

[Isokinetic strength measurement and training of the shoulder: methodology and results].

OBJECTIVE: To evaluate the contribution of isokinetic methods of shoulder strength measurement and training. METHOD: A Medline search of English and French publications, including referenced articles, allowed us to analyse non-indexed publications. Eighty-seven articles were retained for analysis. RESULTS: The isokinetic evaluation of the shoulder is valid. Although reproducibility of shoulder evaluation is inferior to that of the knee, it is nevertheless satisfactory when a rigorous test method is used. Normal values for the rotators, abductors-adductors, and extensors-flexors depend on diverse parameters such as age, gender, fat mass, and the type and intensity of physical activity. The agonist to antagonist ratio is particularly informative in pathological conditions. The ratio is modified in cases of impingement syndrome and shoulder instability, and this modification appears to be a cause rather than a consequence of pathologic features. The ratio generally remains modified post-surgery, and normalization must be a major focus of post-surgery rehabilitation. CONCLUSION: Isokinetic measurement, particularly disturbances in the agonist-antagonist balance, is a reference method for evaluating shoulder muscle strength and detecting deficits in specific muscle groups seen in certain shoulder abnormalities. Such measurement is a valuable tool for orienting rehabilitation towards the deficient muscle groups, complements classical techniques of muscle strengthening, and is an accurate means for following the rehabilitation progress.

Humans↗
PubMed1990

[Diabetic cheiroarthropathy. Microcirculatory aspects].

Diabetic cheiroarthropathy (DCA) or pseudosclerodermatous hand of the diabetic is characterized by nonpainful limited extension of the proximal metacarpophalangeal and/or interphalangeal joints with spontaneous flexum of the fingers. The mechanism of lesion formation is poorly known but apparently associates neurogenic, vascular and cutaneous phenomena. Fifteen patients with DCA (9 men, 6 women; range 20-74 years) were studied by capillaroscopy, photoplethysmography and skin biopsy. Eleven had type 1 diabetes and 4 type 2 over periods ranging from 1 to 42 years (mean 19.9 years). Diabetic retinopathy was noted 10/15 times, nephropathy 5/15 times and neuropathy of the lower limbs 13/15 times. All patients had at least one of these abnormalities. In capillaroscopy, "Shoal of fish" features of diabetic microangiopathy were found only 4 times, but minor dystrophy was noted in 12 cases. In digital photoplethysmography, a drop in digital systolic pressure or an increase in pulse time was noted in 5 cases. The Hillestad test was less than or equal to 2 in 8 patients. Histological study showed constant dermal collagenous fibrosis in diseased skin, which was also found in normal skin in 6/13 patients. PAS staining showed a thickening of vascular basal membrane 14/15 times in diseased skin and 11/13 times in normal skin. The relation between DCA and microangiopathy is discussed in terms of collagen metabolism abnormalities observed during diabetes.

Adult↗
PubMed1990

[Biphotonic absorptiometry of the foot: methodology and application to algodystrophy].

A simple methodology for the evaluation of the bone mineral content of the foot by biphotonic absorptiometry is described. From the study of a test population, a pathological demineralization threshold of 10%, given that the measurement is expressed in g, has been defined at the level of the forepart of the tarsus. This threshold enables the significant distinction between the test population and a population with algodystrophy. Biphotonic absorptiometry seems to provide a quantitative diagnostic argument to complement the radiographical and scintigraphical examinations.

Absorptiometry, Photon↗
PubMed1988

[Insufficiency fractures of the sacrum. 5 cases].

Five cases of insufficiency fracture of the sacrum in women aged over 60 are reported. The elements of diagnosis and causative factors are reviewed. In all cases the diagnosis was confirmed by technetium bone scintigraphy and computerized tomography of the sacrum. Bone tissue evaluation in search of a bone-wasting disease, the principal cause of this type of fracture, was conducted in all 5 patients, using photon absorptiometry and/or double energy computerized tomography and histomorphometry. These examinations provided detailed information on disorders of mineralization in the genesis of these insufficiency fractures.

Aged↗
PubMed1988

[Musculo-cutaneous nerve syndrome in the foot. Apropos of 10 cases].

In 10 cases, the authors describe the musculo-cutaneous nerve syndrome in the foot. It involves pain and paresthesias located on the dorsal aspect of the foot, occurring after local trauma or repeated microtraumas (ill fitted shoes), promoted by a static disorder (anterior hollow foot, calcaneal valgus). The diagnosis is essentially clinical, based on the presence of a Tinel sign on the dorsum of the foot and on the infiltration test. The treatment consists in the combination of local measures and steroid infiltration. Neurolysis is only indicated in case of failure of the medical treatment (4 cases). Then, it always proves to be effective.

Adult↗