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Biomedical subjects

D Dupont

Publications and source records attributed to D Dupont.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Long-term development of Permacath Quinton catheters used as a vascular access route for extra-renal detoxification].

Between July 1984 and July 1991, we have inserted surgically 147 Permcath Quinton catheters in 126 uremic patients for the following reasons: group I: necessity of hemodialysis without vascular access for acute (group Ia: 44 patients) or chronic renal failure (group Ib: 11 patients); group II: difficulty of creation or loss of vascular access (group II: 45 patients); group III: hemodialysis for patients with short life expectation or contraindications for vascular access on their limbs (group III: 26 patients). The duration of use (+/- SD and range) were respectively for each group: 1.6 +/- 2 (0-10); 3.4 +/- 2.8 (1-11); 7.4 +/- 11 (0-50); 6.7 +/- 8.7 (0.1-34.5) months. Seventeen patients (group IV) coming from groups Ib and II preferred to go on with the use of their catheter for 10.5 +/- 13.5 (0.1-50) months rather than to use their arteriovenous fistula. The complications observed on whole population were: 11 septicemia responsible of 2 deaths, 9 cutaneous local infections, 28 total obstructions of the catheter, 17 partial obstructions with insufficient flow; 10 destructions of the catheter. In conclusion the Permcath Quinton catheter is an adequate long term vascular access for hemodialysis. It is well tolerated since it is preferred to the usual arteriovenous fistula by many patients who have both. The incidence of infection is low. However, obstruction (partial ou total) is frequent (29%), necessitating local fibrinolytic treatment.

Actuarial Analysis↗
PubMed1993

[Blood donation intended for the transfusion of anemic premature infants].

Between July 3rd 1990 and January 4th 1993, directed blood transfusion was authorized in neonatology in France. In 1991 and 1992, anemia of prematurity was treated at Lenval hospital by directed blood transfusion. 60 preterm infants with non immune mediated anemia received 85 transfusions, 24.7% of them being provided from parental blood. 26.7% of these 60 infants were transfused only with familial blood. Although authors and parents found these preliminary results very encouraging, directed blood transfusion has been forbidden in France since January 4th 1993. It is believed that such a transfusion does not solve many problems (ie: methodological, material, moral, ethical), and the risk of transmitted infections diseases seems not to be decreased. Therefore traditional transfusion using anonymous donors is recommended.

Anemia↗
PubMed1992

[Postoperative intestinal intussusception in children].

Two cases of postoperative intussusception (POI) are reported. Both children, 13 and 6 months old, had long and difficult surgery for abdominal neuroblastoma after four courses of chemotherapy. Obstruction of the small intestine occurred on the fifth postoperative day, after feeding had been started again, in the first child, and on the third day in the second one. Surgery revealed a loose ileo-ileal invagination of 10 and 15 cm respectively, which was easily reduced. The postoperative course was uneventful in both cases. Although POI is a classical complication of abdominal surgery, it is often forgotten. In the cases described, the first surgical procedure combined most causative factors for POI: young age, preoperative chemotherapy, prolonged general anaesthesia, extensive retroperitoneal dissection close to components of the neurovegetative system. The use of opioids for postoperative analgesia may be an additional risk factor, as they alter intestinal motility. Epidural analgesia with local anaesthetics should be preferred in such cases.

Abdominal Neoplasms↗
PubMed1992

Tardive dyskinesia in elderly psychiatric patients: a 5-year study.

OBJECTIVE: The authors investigated the prevalence of tardive dyskinesia among elderly psychiatric patients who had never received neuroleptic medication before their first hospitalization. METHOD: The study was performed in the geriatric psychiatry unit of a university-affiliated hospital in Canada and involved all first-admission patients admitted from September 1984 through August 1989 who had never taken neuroleptic drugs. In September and October 1989, the patients who were available for follow-up were examined and given ratings on the Abnormal Involuntary Movement Scale to establish the presence or absence of tardive dyskinesia. The patients' records were reviewed for information on age, diagnosis, duration of hospitalization, neuroleptic treatment received after admission, anticholinergic drugs received, and drug-free periods. RESULTS: Of the 162 patients who were available and whose data were analyzed, a total of 99 had been treated with neuroleptics, and 35 (35.4%) of these were found to have tardive dyskinesia. Two of the 35 also had tardive dystonia. Significantly more patients with major depression than patients with primary degenerative dementia or delusional psychosis had tardive dyskinesia. CONCLUSIONS: This study confirms the higher vulnerability of elderly psychiatric patients treated with neuroleptics to the development of tardive dyskinesia. The authors stress that caution is especially necessary when neuroleptics are prescribed for older patients with major affective disorders.

Age Factors↗
PubMed1992

[Parents' view on the care of their children at pediatric emergency department in 1991].

A survey carried out by questionnaire was performed among parents accompanying their children to the emergency department of the Lenval's children hospital in order to determine their opinion on the quality of the reception and care. The questionnaire was distributed to 2,382 parents. A total of 719 questionnaires (30.2%) were returned. A large majority of the parents (99%) expressed their satisfaction with the care and reception in the emergency department. The necessary improvements following this survey concern the duration of waiting prior to the consultation and the quality of the reception in the radiological and admittance departments; it is hoped that the radiological and admittance areas will be included within the emergency department, in the future.

Adult↗
PubMed1992

[Activity of pediatric emergency departments in 1991].

The authors report the results of a prospective survey concerning the children examined in the pediatric emergency ward of the Lenval's hospital in Nice. The study was conducted over a period of 124 days, one month of each season, and included 3,611 children. There was a majority of boys (60.8%) and children older than 7 years (56.8%). The representation of foreign children was 11.2%. Most of the consultations were decided by the parents (86%); 6.2% were sent by a general practitioner and 1.1% by a pediatrician; 6.5% were conveyed through a professional public health service transport. Traumatology was the main surgical etiology and supplied the large majority of benign cases and 23% of the emergencies. Upper respiratory and bronchopulmonary tract infections and gastroenteritis represented 70% of medical etiologies. A complementary investigation, essentially a radiological examination, was carried out in 53.6% of cases. A wound suture was performed in 13% and a plaster immobilization in 9.2% of cases. The hospitalisation's rate was 22%. Emergencies represented 1.8% of cases. A surgical intervention with general anesthesia was performed in 4.4% of cases within 12 hours following the admission. A recent law (ministerial circular: 14.05, 1991) defines the organisation and working principles of the public emergency departments in France as requiring an uninterrupted activity, a continuous medical presence and an area for very short hospitalization. This should improve the quality of the pediatric emergency wards, providing that the financial means will be available.

Child↗
PubMed1991

[Severe life-threatening in an infant due to deficiency rickets].

The authors report on a case of cardiocirculatory arrest in a 4-month old infant, related to severe vitamin D deficiency rickets with hypocalcemia. Despite medical follow-up, this infant, who was breast-fed during the first 3 weeks of life, did not receive any vitamin D prophylaxis. This observation shows the potential severity of vitamin D deficiency rickets. Thus, systematic prophylaxis should be applied as soon as the infant is born, even in breast-fed children.

Heart Arrest↗
PubMed1991

[Palatal groove in premature newborns].

Prolonged intubation for very low birth weight neonates induces the formation of a palatal groove. Intraoral appliances are used to prevent this complication. However, it still exists inhalation and ingestion risks when an impression is taken. Irritation of the skin of the upper lip when using a surgical tape to secure the tube is usual. This article deals with modifications brought to avoid such disadvantages.

Dental Impression Technique↗
PubMed1990

Spontaneous hematoma of the kidney simulating a nephroblastoma. Report of two cases.

The International Society of Pediatric Oncology (SIOP) 6 clinical trial for Wilms' tumor (WT) includes preoperative chemotherapy for all nonmetastatic patients. Approximately 50% of patients treated in this manner can be classed stage 1 after surgery. This strategy requires a positive diagnosis in the absence of histologic data. Diagnostic errors are very rare: Only 1.5% of the first 856 cases entered in the SIOP 6 trial were found to be benign. This article reports two very similar cases of spontaneous hematoma of the kidney that were initially misdiagnosed as hemorrhagic WT. Unusual severe acute anemia was a feature of both cases. Even the most modern state-of-the-art imaging techniques were unable to rule out the possibility of a tumor subjacent to a voluminous renal hematoma. The patients' courses during preoperative chemotherapy were of no formal diagnostic value, and the correct diagnosis was not made until surgery.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Epikeratoplasty without sutures using collagen IV lens in monkeys: description of the surgical technic].

The authors describe their original epikeratoplasty technic without sutures which is compatible with the use of collagen IV lens. They describe the first four observations of primates operated on using this technic. At first the epithelium is removed at the cornea center and a trepanation is made of 4 mm diameter and 0.1 mm depth. The bottom of the trepanation is then cut horizontally, and the periphery of the lens is put in the cornea stroma. Later the epithelium will recover the collagen lens. The lens is perfectly set in the cornea. We don't use any suture and so we avoid astigmatism and neovascularisation. The follow-up consisted of biomicroscopic examination photography, specular microscopy, pachymetry, photokeratoscopy (Nidek System) tonometry and histology. Clinical observance showed a perfect lens tolerance. The cornea is immediately transparent and within a week epithelial cells recovered the lens of three animals out of four. The photokeratoscopy study proved the important cornea refraction modification. This technic is reversible and the lens can be exchanged. A study of histology has begun and already shows a pluristratified epithelium. Further studies will test the biomaterial stability and ultra structural relations between the collagen IV lens and epithelial cells.

Animals↗
PubMed1989

[Nutritional copper deficiency. Apropos of a case].

Copper deficiency developed in a five-month-old prematurely born infant with an abdominal wall closure defect and a small bowel fistula under long-term parenteral nutrition. The first manifestations were typical bone changes including diffuse osteoporosis, delayed bone age, widened cupped metaphyses with beaks and a fracture, subperiosteal hematomas and ossifications in the shafts of long bones, and a diaphyseal fracture. Other findings that confirmed the diagnosis included edema of the limbs with pseudoparalysis, neurologic abnormalities, anemia, leukoneutropenia, and very low serum levels of copper and ceruloplasmin. Following initiation of copper supplementation, clinical, hematological and biological disorders resolved within a few days and roentgenologic bone abnormalities within four months. Copper deficiency develops only in the presence of specific risk factors, that are often combined in a single patient: inadequate stores due to prematurity, excessive loss due to chronic diarrhea, exudative enteropathy, a proximal stoma, or a biliodigestive fistula; and inadequate intake due to malabsorption or long-term exclusive parenteral nutrition (EPN). Appropriate copper supplementation is needed in all these high risk situations. Early, continuous copper supplementation is required for young children under EPN. Serum copper assays should be included among the periodically monitored biochemical parameters.

Copper↗
PubMed1989

Biocompatibility of human collagen type IV intracorneal implants.

A new biomaterial made from human placental collagen type IV has been developed in corneal inlays for refractive keratoplasty. Eight dogs received intracorneal lenses to investigate biocompatibility. Postoperative follow-up observation of 2 years revealed that the eyes remained clear and without inflammatory reaction. Endothelial cells were unaltered. Histological and ultrastructural studies showed no signs of inflammation, ulceration, or encapsulation. No fibroblastic activity was evident at the lens stroma interface.

Animals↗
PubMed1988

[A trial use of lenses of human placental collagen in epikeratoplasty procedures].

Epikeratoplasty is a refractive surgery procedure described by Werblin and Kaufman which is simple, effective and reversible. However its development is hampered by the need of human corneas. We evaluated this procedure in rabbits and monkeys using lenticules of human collagen. The collagen is obtained from frozen human placentas, washed and subjected to pepsin digestion; it is contained in the supernatant of centrifugation and can be isolated by a physico-chemical treatment. 15 days after surgery the lenses of 14 rabbits were completely covered with a layer of epithelial cells. 6 months after surgery, the eyes of 14 monkeys were quiet and the lenses were covered with an epithelium made up of 2 to 5 layers of cells. The lens exhibited no inflammatory infiltration and there was no inflammatory reaction around the lens. These studies are still preliminary and longer term tests are necessary. These initial results are very encouraging, prompting us to develop the use of this type of material in refractive surgery.

Animals↗