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Biomedical subjects

G P Laroche

Publications and source records attributed to G P Laroche.

16 recordsLinked to original sources
PubMed1990

Steroid anabolic drugs and arterial complications in an athlete--a case history.

Serious side effects and complications have been attributed to anabolic and androgenic steroids when used for medical reasons or when taken in sports in hopes of increasing strength and, hence, performance. The author presents a case of an athlete who experienced two metachronous arterial complications after taking these drugs: a cerebrovascular accident caused by a carotid artery thrombus that partially embolized to the brain and, later, a severe ischemic episode in a lower limb caused by a diffused distal arterial thrombosis. This patient represents the first reported case of vascular events in an otherwise healthy athlete taking androgens to increase his skeletal muscle mass.

Adult↗
PubMed1987

[Validity of plethysmography and the digital temperature recovery test in the diagnosis of primary and occupational Raynaud's phenomenon].

Of 405 patients with Raynaud's phenomenon seen for clinical investigation, including 210 with vibration-induced white fingers, 365 were evaluated with sequential determination of digital temperature recovery time after cold exposure, and plethysmography after cold provocation. The results of this objective testing were compared with the results of the clinical evaluation in an attempt to check the former's usefulness as a tool to prove the diagnosis of the vasospastic condition and to assess its degree of impairment. The sensitivity of digital recovery time and plethysmography was, respectively, 56.5% and 80.5% in the primary Raynaud's phenomenon, 48.7% and 67.8% in the secondary Raynaud's phenomenon, and 49.1% and 69.7% in the vibration syndromes. The specificity of these tests was 79.6% and 67.7% for the secondary Raynaud's phenomenon, and 71.4% and 36.8% for the vibration syndrome. When digital recovery time and plethysmography are used together, the sensitivity is increased to 78.8% for the vibration-induced white fingers and 85.5% for the primary Raynaud's phenomenon. Objective evidence of Raynaud's phenomenon can be obtained by provocative digital recovery time and plethysmography, especially if the two tests are considered together, but their response was too unpredictable to assess accurately the degree of severity and the degree of impairment caused by the vasospastic disease. Nevertheless, they remain a useful and necessary adjunct to the clinical evaluation, particularly when dealing with occupational Raynaud's phenomenon.

Adult↗
PubMed1982

Associated laryngeal and lung carcinoma.

Synchronous or metachronous carcinoma of the larynx and of the lung were seen in seven patients between 1971 and 1977 at the Hôtel-Dieu de Québec. The pulmonary lesion was either missed completely or misdiagnosed. Laryngeal tumours were curable but only two of the pulmonary tumours were treated successfully. The primary nature of the pulmonary lesion may be established by careful examination of the bronchial mucosa. Hemoptysis must always be regarded as a sign of pulmonary cancer unless proven otherwise; hoarseness must not be bluntly attributed to invasion of the laryngeal nerve by lung cancer because a small primary lesion of the vocal cords may exist. Possible pulmonary metastases from any respiratory tract cancer must be carefully diagnosed since curative resection of primary lung lesions is possible.

Aged↗
PubMed1980

Renal revascularization as treatment for malignant hypertension.

Twelve patients critically ill with accelerated or malignant hypertension caused by atheromatous renal artery disease were treated by renal revascularization because an intensive program of medical treatment had failed. Seven patients had unilateral stenosis, five patients had bilateral lesions. This aggressive approach was beneficial to all the patients; there was no operative mortality and morbidity was minimal. Blood pressure was adequately controlled in all 12 patients. After a mean follow-up of 42 months, renal function was improved or stable in 10 patients but had deteriorated slightly in 2. Interestingly, one patient who had a higher renin activity in his contralateral nonstenotic kidney was much improved by correction of only the stenosis. The authors recommend early surgical intervention in severe renal artery lesions in cases of accelerated or malignant hypertension refractory to vigorous medical treatment or with rapidly progressive renal failure. An occluded renal artery can be revascularized if the kidney has no gross evidence of infarction, has viable glomeruli and if distal arteries and their intrarenal branches are intact. Reduction of blood pressure and stabilization or restoration of renal function can be expected.

Adult↗
PubMed1976

Traumatic vasospastic disease in chain-saw operators.

Raynaud's phenomenon is commonly induced in chain-saw operators by vibration; the hand guiding the tool is the more severely affected. The condition tends to persist after use of the chain-saw is stopped but compensation is rarely sought. Among 17 cases of Raynaud's phenomenon in lumberjacks the condition was found to be related to use of the chain-saw in 14, 10 of whom had to give up their work in colder weather because the disease was so disabling. Two criteria essential to establish the condition as vibration-induced Raynaud's phenomenon are the presence of symptoms for at least 2 years and a history of at least 1 year's constant use of the chain-saw. Careful physical examination and simple tests of vascular function will provide objective evidence of permanent damage by which the patients may be classified and compensated.

Adult↗
PubMed1976

Chronic arterial insufficiency of the upper extremity.

When claudication or distal ischemia is significant, the treatment of choice for intrinsic arterial insufficiency of the upper extremity caused by atherosclerotic occlusive disease of the subclavian, axillary, or brachial artery with patent distal circulation is direct arterial surgery. Both endarterectomy and bypass procedures are utilized. In the 20 years from 1947 to 1967, 15 patients were operated on for such lesions and adequate circulation was restored in 12 patients treated by the direct method. Nine patients available for 1-year follow-up were cured of their symptoms; of the remaining three patients, one had amputation of an arm and two had sympathectomy with improvement. No hospital death occurred and morbidity was minimal. Although the diagnosis can be established on clinical grounds, arteriography is essential to ascertain the surgical procedure needed. Peripheral diseases involving the small arteries are clinically a more common cause of arterial insufficiency in the upper extremity; progress is slow and complications are infrequent. When ischemic complications exist, direct arterial surgery is not feasible and cervicodorsal sympathectomy is the usual form of treatment. Of 76 patients operated on for such disease, 74 underwent sympathetic neurectomy. The results were excellent, good, or satisfactory in 50 (78%) of the 64 traced patients. The remaining 14 patients had persistent or recurrent symptoms after operation. Removal of the stellate ganglion in addition to the second ganglion yielded better results and is indicated in recurrent or more cases.

Adult↗