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D Brousse

Publications and source records attributed to D Brousse.

11 recordsLinked to original sources

Effects of PEEP on oxygenation and respiratory mechanics during one-lung ventilation.

BACKGROUND: One-lung ventilation-related hypoxaemia (OLV-RH) can occur in patients with healthy lungs. In this case, PEEP frequently improves oxygenation. The aim of this study was to determine, in a healthy lung model of OLV, whether the increase in PEEP improved oxygenation and whether the mechanisms involved include both inspiratory lung recruitment and an end-expiratory lung volume increase. Since inhaled nitric oxide (iNO) may have a synergistic effect on oxygenation in the case of PEEP-induced recruitment, their association was also tested. METHODS: Twenty pigs were studied during open-chest, left OLV. Arterial blood gases and haemodynamic variables were measured at different levels of PEEP (0, 5, 10 and 15 cm H(2)O) applied in random order with or without iNO 4 p.p.m. Pressure-volume curves were measured at each level of PEEP. RESULTS: PEEP(5) and PEEP(10) improved Pa(O(2))/FI(O(2)) ratio (P<0.005) and shunt (P<0.005) regardless of the presence of iNO. PEEP(15) improved oxygenation and shunt only when it was associated with iNO (P<0.001). Whereas PEEP(5), PEEP(10) and PEEP(15) were associated with a significant increase in end-expiratory volume (P<0.001), only PEEP(5) and PEEP(10) were associated with continuous lung volume recruitment (P<0.01). Moreover, PEEP(15) induced a significant decrease in linear compliance (P<0.001). CONCLUSIONS: In a healthy porcine lung model of OLV-RH, moderate PEEP can improve oxygenation. This effect implies both expiratory and inspiratory pulmonary recruitment. Co-administration of 4 p.p.m. iNO was ineffective.

Animals↗

[Cysticercosis in Guadeloupe].

We report two cases of cysticercosis proved by histology, one in the brain, the other in the orbit. The first case was observed in a traveller, heavy smoker, serologically negative to cysticercosis in whom an isolated cerebral tumoral metastasis was suspected and resected. The lesion was centered by a typical cysticercus of Taenia solium. The second was a periorbital intramuscular nodule observed in a child who had never left our island. The fibroinflammatory nodule was centered by a cysticercus with a scolex without rostellum and without suckers. Its histological aspect led us to the diagnosis of cysticercosis. Three species of Taenia are discussed : T. solium, T. crassiceps and T. bovis. This case shows that the human transmission of the disease may exist in Guadeloupe.

Animals↗

[Fuchs' uveitic syndrome in a patient with ocular toxoplasmosis].

We report a case of Fuchs' uveitic syndrome associated with toxoplasmic chorioretinis scars, and a positive Desmonts' coefficient. This allows us to emphasize ocular toxoplasmosis as a main association to be searched for clinically. In the cases in which this association is found, it would be warranted, if a high level of specific antitoxoplasmic antibodies is demonstrated in aqueous humor, to consider toxoplasmosis as one of the potential etiopathogenic factors of the Fuchs' uveitic syndrome.

Adult↗

[Acute open-angle glaucoma in a woman with AS hemoglobinopathy].

A 64-year-old black woman presented unilateral acute ocular hypertension. Gonioscopy showed a blood clot obstructing Schlemm's canal. Intraocular pressure returned to normal values after resorption of the blood clot. Hemoglobin electrophoresis found a sickle-cell trait, raising the hypothesis that the obstruction of outflow was probably due to the mechanism of sickling.

Acute Disease↗

[Floppy eyelid syndrome. Apropos of 4 cases and review of the literature].

Often unrecognized, Floppy eyelid syndrome is an impairment of the eyelid statics with marked conjunctival signs. Over-weight middle aged men are principally concerned. Excessive eyelid laxity in the Floppy eyelid syndrome is responsible for a night ectropion of the upper lid, creating the clinical manifestations. We report four cases of Floppy eyelid syndrome to illustrate our work and discuss the clinical and therapeutic aspects.

Aged↗

[Corneal ulcer and Behçet disease. Apropos of a case].

We report a case of a peripheral corneal ulcer that occurred to a 33 years old female with a Behçet's disease. This patient had a previous history of viral keratoconjunctivitis with subepithelial nodules one year ago. The type, aspect and localization of the ulcer suggested an immunologic origin. The evolution was favourable after systemic and local steroid therapy. The other aetiologies of such ulcer are discussed by the authors.

Adult↗

[Pleural lipoma].

Reviewing the clinic cases of two patients bearing with asymptomatic pleural lipoma, whose general course and treatment of their disease were very different, it seemed useful to us to focus on such a benign uncommon tumor. We therefore analysed this tumour's features, especially its scanographic characteristics, its spontaneous evolution, and its potential complications, in order to avoid diagnostic thoracotomy as far as possible.

Aged↗

[Complication of keratoprosthesis of posterior fixation: retroprosthetic membranes. Apropos of 4 cases].

Keratoprosthesis represents the last solution for patients with bilateral corneal blindness or for monophthalm patients who cannot benefit from corneal grafts. Complications related to this technique are recalled together with an in-depth analysis of the problem of retroprosthesis membranes. The frequency of retroprosthesis membranes varies depending on the series reported, although it appears to be a more agreement on treatment and causes. Among 8 patients who underwent a KPF operation using the E. Lacombes technique, 50% of the cases had retroprosthesis membranes with an unusual thickness, vascularization and recurrent character. Emphasis was placed on early and intense intraocular inflammation.

Adult↗

[Pleural fibroma: a case of a patient exposed to tungsten carbide and asbestos].

We report here a case of localized fibrous pleural mesothelioma diagnosed in a sixty-year old patient, who had been exposed to tungsten carbide and asbestos dust for almost twenty years. He first consulted because of enduring lateral chest pains combined with progressive and increasing dyspnea on exertion. The initial diagnosis, after both pulmonary radiograph and computerised tomography, was confirmed by a histology which revealed fusiform cells of fibroblastic origin. After simple and total excision of the tumor, symptoms improved.

Asbestos↗

Refractive results of radial keratotomy after 10 years.

BACKGROUND: We analyzed retrospectively the refractive and visual results of a cohort of patients who underwent radial keratotomy for myopia 10 years ago. METHODS: Radial keratotomies using centripetal incisions were performed by the same surgeon in 1986 and 1987 to correct myopia of -0.75 to -10.00 diopters (D). Refractive and visual results were evaluated at 1 month and on average 10 years after surgery. RESULTS: Thirty-nine patients (71 eyes) underwent radial keratotomy. Mean spherical equivalent refraction before surgery was -3.90 D and after surgery was -0.50 D at 1 month and +0.13 D at 10 years after surgery. At last examination, 41 eyes (43.7%) had a spherical equivalent refractive error within +/- 1.00 D of emmetropia (24 eyes [34%] +/- 0.50 D) and 32.4% of eyes were overcorrected by more than 1.00 D. Between 1 month and 10 years after surgery, a hyperopic shift greater than 1.00 D occurred in 34.1% of eves with a single procedure. Ten years after surgery, 59 eyes (83%) had uncorrected distance visual acuity of 20/40 or better (22 eyes [31%] with uncorrected visual acuity of 20/20 or better). CONCLUSION: This retrospective evaluation confirms that radial keratotomy is an effective procedure to correct myopic error, but the hyperopic shift produces an unstable, less predictable refraction in one-third of eyes at 10 years.

Adult↗