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Biomedical subjects

D Alison

Publications and source records attributed to D Alison.

At least 55 records · Page 3Linked to original sources
PubMed1993

Spinal cord compression: the hospice perspective.

Spinal cord compression is an important complication of metastatic, malignant disease. It has not been extensively studied in the hospice setting. We conducted a retrospective study of the records of 34 patients with a history of cord compression. Clinical presentation, investigations, treatment, and functional outcome were recorded. Outcome was related to performance status before the development of spinal cord compression, and to motor function at the time of treatment. Patients with low scores were less likely than those with high scores to benefit from attempts to reverse the cord compression. These assessments may help the clinician decide which patients to refer for investigation and treatment. Overall median survival was found to be three months for those who were ambulatory after treatment, but only three weeks for those who were not. Patients who were not ambulatory following therapy suffered a wide range of related problems and required intensive palliative care.

Activities of Daily Living↗
PubMed1993

[CASTOR-Radiology: software of management in a Unit of Medical Imaging: use in the CHU of Tours].

Despite the large volume of information circulating in radiology departments, very few of them are currently computerised, although computer processing is developing rapidly in hospitals, encouraged by the installation of PMSI. This article illustrates the example of an imaging department management software: CASTOR-Radiologie, Computerisation of part of the Hospital Information System (HIS) must allow an improvement in the efficacy of the service rendered, must reliably reflect the department's activity and must be able to monitor the running costs. CASTOR-Radiologie was developed in conformity with standard national specifications defined by the Public Hospitals Department of the French Ministry of Health. The functions of this software are: unique patient identification, HIS base, management of examination requests, allowing a rapid reply to clinician's requests, "real-time" follow-up of patients in the department, saving time for secretaries and technicians, medical files and file analysis, allowing analysis of diagnostic strategies and quality control, edition of analytical tables of the department's activity compatible with the PMSI procedures catalogue, allowing optimisation of the use of limited resources, aid to the management of human, equipment and consumable resources. Links with other hospital computers raise organisational rather than technical problems, but have been planned for in the CASTOR-Radiologie software. This new tool was very well accepted by the personnel.

France↗
PubMed1993

[Antro-pyloro-bulbar contractibility in diabetics studied by cineradiography. Effect of erythromycin].

We studied antropyloroduodenal contractility in diabetics and the effect of erythromycin IV (100-500 mg) using the non invasive Boiron cineradiographic method analysis. Fourteen diabetics and 22 controls were examined. Four hours after a standard liquid-solid meal, patients drank 250 mL baryum solution. Fluorographic plates (10 x 10 cm) were taken every 2 s during 30 s. Semi-automatic data processing analysis allowed to measure motility parameters including antral (CA) and bulbar (CB) contractility indexes; pyloric opening index (OP), gastric (FG) and bulbar (FB) frequencies. Three types of pylorus behaviour patterns were define: A and B related to antropyloric and antropyloroduodenal coordination respectively and N without coordination. In diabetics, CA, OP and FG were decreased vs controls (P < 0.01) (CA: 65.5 +/- 6.8 vs 83.1 +/- 2.4%; OP: 60.9 +/- 8.7 vs 84.8 +/- 1.9%; FG: 2.42 +/- 0.14 vs 3.08 +/- 0.04 c/min) and antropylorbulbar coordination altered (N was predominant; no bulbar cycles at 3/min). Antral hypocontractility was correlated with autonomic neuropathy. After erythromycin, radiological parameters returned to normal values (CA = 83.0 +/- 2.4%; OP = 86.0 +/- 4.7%; FG = 3.0 +/- 0.16 c/min) and coordination improved type N disappeared and FB = 3 c/min (58%). Cineradiographic analysis is simple, able to show antropylorobulbar contractile abnormalities, to study pharmacological effects, and in diabetics is capable of studying improvement of motility parameters with erythromycin.

Adult↗
PubMed1990

Comparison of circadian blood pressure variations in hypertensive patients with renal artery stenosis and essential hypertension.

Ambulatory blood pressure measurements in 20 hypertensive patients with uni- or bilateral renal artery stenosis were compared with those in 20 essential hypertensive patients. Analysis of the 24 hour blood pressure curve of the renal artery stenosis group shows a tendency to equalization of blood pressure throughout the day. The nocturnal decrease of systolic or diastolic blood pressure was not significantly different between the two groups (9.2 vs. 15.3 mmHg). The blunted curve seems to be related more to the severity of hypertension than to its aetiology, but further studies are required to elucidate this point.

Adult↗
PubMed1988

Use of peak expiratory flow rate to identify patients with increased risk of contrast medium reaction. Results of preliminary study.

Although the intravenous injection of iodinated contrast media is usually well tolerated by patients, it does cause a significant number of side effects. The current study was designed to determine whether the measurement of peak-expiratory-flow rate before injection of contrast medium can be taken as a predictor of reactions to contrast media. The study covers a population of 100 patients who underwent excretory urography; those with a history of allergy or atopic hypersensitivity were given premedication before contrast injection. Peak-expiratory-flow measurements were made 10 minutes before, and immediately before injection, and at 1 and 15 minutes postinjection by a Wright flow meter. They revealed a subclinical bronchospasm after the intravenous injection of iodinated contrast medium that was more severe for subjects demonstrating an untoward reaction to contrast media. A single measurement of peak expiratory flow 10 minutes before contrast injection is, in itself, a good indicator of increased risk. A patient with a peak expiratory flow of less than 400 L/min 10 minutes before the injection, runs a 3.8 times higher risk of developing an adverse reaction to intravascular radiodiagnostic compounds in this study.

Bronchial Spasm↗
PubMed1988

[Rupture of the rotator cuff. Quantification of indirect signs in standard radiology and the Leclercq maneuver].

The roentgenograms and the "Leclercq's manoeuvre" of 105 patients who had a shoulder arthrography were reviewed. We differentiated two groups: One with a rotator cuff tear. The other without a rotator cuff tear. The space between the acromion and the head of the humerus was measured on rotation zero degree and external rotational roentgenograms. When the acromio-humeral space was less than 8 mm, it was always correlated with a rotator cuff tear (specificity = 1). If at least tow of the following signs were present, there was in most cases a rotator cuff tear (specificity = 0.96): Sclerosed acromion. Spur of the acromion. Cystic changes around the greater tuberosity. Rounded tuberosities. Inferior gleno-humeral spur. The "Leclercq's manoeuvre" was considered positive either when there was an acromio-humeral space narrowing compared with the other side, or when there was an upward subluxation of the head of the humerus. When positive there was always a rotator cuff tear (sensibility = 0.7; specificity = 1).

Arthrography↗
PubMed1988

[Control of the patency of coronary-internal mammary artery bypasses by non-selective angiography].

98 successive coronary bypasses using the internal mammary artery were controlled systematically, at an early stage, about the 17th postoperative day, by non selective brachial angiography using a retrograde injection. This control method, simple, quick, reliable and non-aggressive, enables to visualize the internal mammary artery and the bypassed coronary vessel, over its entire length. There were no failure in the control, nor any local or general complication during this examination. The overall patency of such bypasses, evaluated with this method, is 98 p. cent in our series, with however, 12 p. cent of angiographic aspects of a poorly functional bypass. These aspects are related to a slow flow in the by-pass (spindly internal mammary artery, anastomotic stenosis or thin distal bed of the bypassed coronary artery), or to a competitive flow (non significant coronary stenosis). The perfusion of the bypassed coronary, which is not so well studied in the literature, is important to analyze and difficult to evaluate with our technique because of the static views that are used. A similar non-selective angiographic method using a dynamic recording (radio-cinema with dual incidence) is currently being evaluated.

Adult↗
PubMed1987

[Comparative study of 2 dosages of low molecular weight heparin, PK 10169, in the prevention of thromboembolic incidents during treatment of 103 femur neck fractures].

Results of this study in the elderly with fractures of femoral neck, in whom their exists an enhanced thrombogenic risk, showed that the dose of 40 mg per 24 hours as one or two divided injections of enoxaparine was as effective as adapted subcutaneous doses of calcium heparinate. It was also less iatrogenic and easier to manage (biological assays were of little use apart from platelet counts). Clinical evidence of pulmonary embolism, or mortality, were not observed in this series of 103 patients.

Aged↗
PubMed1987

[Partial interruption of the inferior vena cava using the 2612 filter. Apropos of 35 patients].

Partial interruption of inferior vena cava (I.C.V.) forms an integral part of treatment of thromboembolic disease. The most frequently used filter worldwide is currently that of Greenfield, but although its effectiveness and permeability are remarkable it can be the subject of transfixions, sliding movements and migrations. A new model of the authors' own conception is presented which eliminates these faults. The "2612" filter is based on the same concepts, but has added to it 6 lateral flanges soldered to the base of the arms, these applying pressure to the I.V.C. and ensuring its perfect positioning, and 12 hooks (6 turned downwards and 6 upwards) ensuring perfect stability. Results of a multicentre trial in 35 patients, after insertion of the "2612" filter and follow up assessment after 3 months (28 cases) by cavography and in some patients by a scan, showed permeability of 93% and total efficacy. No side effects were reported. This filter appears to represent true progress in the means of interrupting I.V.C., and further studies are contemplated.

Female↗
PubMed1987

Use of lymphscintigraphy in traumatic chylous ascites.

This report describes the use of lymphscintigraphy in a patient with traumatic chylous ascites. Radioactivity "leakage" near the origin of the thoracic duct and accumulation into the peritoneal cavity were delineated.

Adult↗
PubMed1986

[Peroperative endoluminal dilatation or recanalization (DELPO or RCPO) in arteriopathies of the lower extremities. A new therapeutic weapon for the vascular surgeon. Apropos of 42 cases].

Forty-two DELPO or RCPO were performed using coaxial balloon catheters through surgical vascular approach for 35 cases of advanced lower limb arterial disease (stages: pronounced II: 6, III: 13, IV: 12, subacute ischemic: 4). The DELPO involved the following arteries: iliac: 12, deep femoral: 3, superficial femoral: 12, popliteal: 5, leg artery: 8, stenosis of popliteal anastomosis: 2, and was combined with a reconstructive arterial operation in 26 cases (proximal: 11 times, distal: 14 times or intersegmental: twice in relation to the surgical procedure). The DELPO was conducted alone in 9 cases and the RCPO alone in 6 cases, the surgical approach being preferred to the percutaneous route. Early results were rated as good in 89%, with clinical failures requiring amputation in 4% and failure of the method in 7%. The DELPO allows two objectives to be reached. First, when combined with a surgical procedure it reduces the extent and therefore the degree of surgical aggression while creating improved hemodynamic conditions for vascular reconstruction (improved proximal or distal beds or both). Second, when performed alone DELPO or RCPO enable safe, reliable treatment of lesions usually approached by a percutaneous endoluminal dilatation procedure.

Aged↗
PubMed1986

[Arteriovenous fistula disclosing a renal cancer. Apropos of a case].

The authors report the case of a 49 year old woman who presented with congestive cardiac failure and hypertension. Clinical examination revealed a high output state and an abdominal mass with a continuous murmur which angiography showed to be a very vascular right renal tumour with a large and early venous return. Catheter studies confirmed the increased cardiac output (cardiac index 5.37 l/mn/m2), an increase in right heart and mean pulmonary capillary pressures (28 mmHg), decreased peripheral arterial resistances and a left-to-right shunt effect at the level of the suprarenal inferior vena cava (+ 3.8 volumes of oxygen per 100 ml). After radical right nephrectomy, the cardiac failure and hypertension regressed and the haemodynamic parameters returned to normal.

Arteriovenous Fistula↗
PubMed1985

Budd-Chiari syndrome: US evaluation.

Twelve patients with proved Budd-Chiari syndrome (eight acute and four chronic cases) were examined, using real-time ultrasonography (US). In all acute cases, US study showed at least one hepatic vein with findings suggestive of the syndrome, such as stenosis, dilatation, thick wall echoes, thrombosis, abnormal course, or extrahepatic anastomosis. In chronic cases, hepatic veins were usually not visible. Modifications of liver morphology were present in all patients except those with recent onset of the disease. Caudate lobe hypertrophy was present in only six cases. US study is therefore the procedure of choice for initial diagnosis of acute Budd-Chiari syndrome. Pitfalls were the failure to detect two caval thromboses and one hepatic vein web. Cavography should still be performed systematically, but hepatic phlebography is useful in selected cases only.

Adult↗
PubMed1984

Place of intravenous arteriography with non-numerized processing in vascular pathology and surgery. Results of 424 investigations.

424 intra-venous arteriographies with non-numerized photographic subtraction have been carried out in 304 patients. Exploration concerned supra-aortic trunks in 204 cases, abdominal aorta in 107 cases, arteries of the lower limbs in 89 cases, thoracic aorta in 19 cases and arteries of the upper limbs in 5 cases. Technique is described, indications, results, complications and limits of the method are discussed for each explored area. This method is an interesting contribution as a morphological, slightly invasive evaluation of arterial lesions when computerized systems are not available.

Adolescent↗
PubMed1984

[Evaluation of the degree of carotid stenosis by spectral analysis of the Doppler signal. Comparison of the results of spectral analysis, angiography and anatomo-pathology].

With the single Doppler spectrum analysis, one can appreciate the degree of the carotid stenosis according to the importance of the haemodynamic disturbances induced by the stenosis. The purpose of our study is to show the possibilities and the limitations of this method. Spectrum disturbances were classified in 5 grades, each of them being related to the importance of the stenosis. The degree of stenosis has been evaluated by the C.W. Doppler spectrum analysis, the angiographies and the anatomical study of the endarteriectomies. We considered that we had a perfect concordance between the results of the different methods when the degree of stenosis measured on the angiographies or on the endarteriectomies was compatible with the spectrum analysis classification: grade I: stenosis inferior to 40% (in area), 23% (in diameter); grade II: stenosis ranging between 40 and 60% in area (23 and 40 in diameter); grade III: stenosis of 60 to 75% in area (40 to 50% in diameter) and of particular shape (extended plaque); grade IV: stenosis ranging between 60 and 90% in area (40 to 70% in diameter); grade V: stenosis higher than 90% in area (70% in diameter). The confrontation of spectrum analysis and angiographic date concerns 58 bifurcations. We got a perfect correlation in 93% of the cases. The confrontation of the spectrum analysis method and the anatomical study of the endarteriectomies concerns 38 bifurcations. We got a perfect correlation in 92% of the cases. The appreciation of the carotid stenosis degree is now performed in routine at the Hospital. For some patients, the endarteriectomy has been decided from the clinical and the spectrum analysis data, and an electro-encephalogram with compression. However these date are generally completed with an angiography with venous punction.

Carotid Arteries↗