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Biomedical subjects

E Picard

Publications and source records attributed to E Picard.

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

Mediastinitis in heart transplant recipients: successful treatment by closed local irrigation.

Following cardiac transplantation bacterial mediastinitis is a severe early complication. Between March 1986 and September 1993, cardiac transplant operations were performed in 101 patients, of whom six developed purulent mediastinitis. Treatment consisted of surgical débridement, closed local irrigation, drainage and systemic antibiotics. No patient died as a result of bacterial mediastinitis. Low cardiac output and requirements for resternotomy for bleeding and prolonged artificial ventilation were significantly higher in the group with sternal infection. In contrast, since January 1991 the dose of corticosteroid was decreased from 5 mg/kg per day to 1.5 mg/kg per day beginning on the first day after operation. A total of 51 heart transplant operations have been subsequently performed without sign of mediastinal infection.

Adult↗
PubMed1992

Abdominal pain with free peritoneal fluid detected by ultrasonography as a presenting manifestation of acute rheumatic fever.

The clinical and laboratory data for an 8 year old girl with abdominal pain as a presenting manifestation of acute rheumatic fever are reported. An abdominal investigation with ultrasonography carried out at the same time showed free peritoneal fluid. These findings support the proposal that the abdominal pain classically described in acute rheumatic fever is one of the manifestations of the inflammatory process. It is suggested that in patients with abdominal pain, fever, and increased erythrocyte sedimentation rate in whom the diagnosis is not clear, an abdominal investigation with ultrasonography could be helpful in establishing the correct diagnosis.

Abdominal Pain↗
PubMed1992

[Sterno-mediastinitis after heart transplantation. An easy treatment: irrigation-lavage].

After cardiac transplantation bacterial mediastinitis is a severe early complication. Between 1986 and 1990, we performed 49 cardiac transplantations. Six patients developed purulent mediastinitis. Treatment consisted in surgical debridement, local irrigation, drainage and systemic antibiotics. No patient died of this bacterial mediastinitis. Low cardiac output, re-sternotomy for bleeding, prolonged artificial ventilation were significantly higher in the group with sternal infection. Closed tube irrigation is a simple and efficient treatment of mediastinitis.

Adult↗
PubMed1991

Femorofemoral crossover bypass for noninfective complications of aortoiliac surgery.

Between 1973 and 1989, 39 femorofemoral crossover bypasses were performed to treat unilateral noninfective complications of aortoiliac surgery. The initial revascularization procedure, performed an average of 79.5 months previously, was an aortobifemoral bypass in 29 cases, an aorto- or iliofemoral bypass in six cases, an inlay graft for abdominal aortic aneurysm and aortoiliac endarterectomy in two cases each. The indications for femorofemoral crossover bypass included prosthetic occlusion in 35 cases, thrombosed false aneurysm in two, and further degradation after endarterectomy (iliac stenosis and occlusion in one case each). There was no operative mortality. One patient with acute ischemia upon admission and another with distal gangrene required below-knee and forefoot amputations, respectively. No amputations were required during the rest of the follow-up period. Three repeat aortobifemoral bypasses were performed because of occurrence of aortic or inflow vessel lesions. Primary and secondary actuarial five year patency rates for femorofemoral crossover bypasses were 59.7% and 78.4%, respectively. Femorofemoral crossover bypass can extend the benefits derived from direct aortoiliac surgery with low mortality and morbidity in the absence of associated aortic pathology (false aneurysm at the aortic implantation site or severe obstructive lesions).

Aged↗
PubMed1991

Factors associated with neonatal problems in twin gestations.

We examined the neonatal outcome of 644 twins weighing 500 g or more and 656 singletons, born in the years 1984-1986 in the Soroka Medical Center, Beer-Sheva, Israel. There was nearly a four-fold risk of antepartum death in twins vs singletons, which disappeared when birth weight was controlled for. The risks for intrapartum and early neonatal mortality were not raised in this population. A statistically significant relative risk for congenital heart malformations in twins vs singletons remained (RR = 5.0, 95% CI = 1.5-16.3), after controlling for maternal age. Significantly higher rates of hyalin membrane disease, hypoglycemia, hyperbilirubinemia, anemia and septicemia were found in twins. Controlling for the confounding of the association between twinning and mortality or morbidity caused by differences in distributions of mode of delivery or gestational age between twins and singletons, was not as efficient as the controlling for birth weight. Thus, adjustment for birth weight removed all the excess risks detected except in hypoglycemia. Our findings suggest that the lower birth weight of twins, which is so intimately associated with multiple gestations, is probably the single most important factor associated with neonatal problems found in twin births.

Adult↗
PubMed1991

Ethnicity and sex ratio in twin births.

The patterns of sex ratio in Israeli twins by maternal age and parity are described in two ethnic subpopulation. Jews and Bedouins differ one from the other in genetic, environmental, lifestyle, and reproductive factors. In the Jewish subpopulation, the proportion of males was significantly lower in twin than in singleton births; parity increased the odds of male twin births while maternal age had the inverse effect. In the Bedouin subpopulation, the sex ratio did not differ significantly from that of singletons, and no consistent patterns were found by maternal age and parity. The data suggest that several factors may influence the sex ratio in twin births. In Jewish twin births, the findings are consistent with the literature and can be largely explained in terms of high level of maternal gonadotropins. In the Bedouin subpopulation, paternal influence which could be related to lifestyle may be present, and as yet undefined genetic factors may also be involved. It would be of great interest, therefore, to continue monitoring of the effects of changes in lifestyle on the Bedouin population in order to tease out the relative importance of the varying factors on the sex ratio of twin births.

Adult↗
PubMed1991

[Late cardiac tamponade by localized compression of the left cavities after heart valve surgery. Apropos of 2 cases].

The authors report two cases of left cardiac failure occurring three and ten months after aortic valve replacement. Echocardiography established the diagnosis of localized compression of left heart chambers by hemopericardium. Surgical drainage dramatically improved patients with a follow-up of 4 years and 18 months. The authors emphasize the interest of left thoracotomy for drainage and discuss the etiology.

Aortic Valve↗
PubMed1989

'Sabbath' electric plate burn: a ritual hazard.

This report describes the burns caused by an electric hot plate which is used by orthodox Jews for keeping food and liquids warm during the Sabbath (Saturday). An illustrative case is presented and the preventable aspects of this particular burn are discussed.

Accidents, Home↗
PubMed1986

Auditory arousal thresholds of normal and near-miss SIDS infants.

The sleep characteristics and auditory arousal thresholds of 20 near-miss sudden infant death syndrome (SIDS) infants and 97 age- and sex-matched normal infants were studied. It was observed that spontaneous arousals occurred significantly less frequently in the near-miss SIDS infants. In both groups, induced arousals occurred at comparable stimulation intensities, and arousal thresholds decreased significantly from the 44th to the 52nd postconceptional week. This supports the notion that both groups present a similar maturational process within the auditory pathways and brainstem, and that arousal is not related to differences in behavioural response to ambient noise during sleep.

Acoustic Stimulation↗
PubMedDate not supplied

Dissection of the abdominal aorta in blunt trauma: management by percutaneous stent placement.

We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients were treated with Wallstents, one with a Palmaz stent. The occlusion of the false channel was obtained in all patients without any significant residual stenosis. No early or late complication was noted in any of the patients. The longest follow-up was 2 years. We conclude that stent placement is an efficient method for the treatment of noniatrogenic inframesenteric aortic dissections.

Adult↗