PubMed Health⌕ Search

Biomedical subjects

H Charleux

Publications and source records attributed to H Charleux.

At least 19 recordsLinked to original sources
PubMed1991

[Causes for surgical interventions in HIV seropositive patients. 226 interventions].

Between January 1, 1983 and October 1, 1990, we performed 266 surgical operations in 255 patients with human immunodeficiency virus (HIV) infection. We report the reasons for these operations and compare them with those recorded in all patients operated upon in our department between January 1, 1988 and December 31, 1989 (4,960 operations in 4,498 patients). During the 1988-89 period, 2.4 percent of these patients had HIV infection, which suggests that the proportion of patients operated upon is the same in an HIV-infected population as in the general population. The proportion of HIV-infected patients who underwent surgery for diagnostic purposes or as adjuvant treatment was 42.7 percent as compared with 37.3 percent in the general population. Among laparotomies, 37.3 percent were exploratory in the HIV group versus 7.3 percent in the control group. The emergency surgery rate was the same in both groups. In gastrointestinal surgery, proctological operations were performed in 33.5 percent of the HIV group versus 7.4 percent of the control group. Among other types of surgery, only splenectomies were more frequent in HIV-infected patients than in the general population (6.3 versus 1.7 percent).

HIV Seropositivity↗
PubMed1991

[Appendicitis and acquired immunodeficiency syndrome. Apropos of 19 cases].

Appendectomy is the most current digestive surgical procedure in France. Ascending prevalence of infection by HIV, invites us to report 19 documented cases of appendicular syndroma in a population infected by HIV, within 13 cases who required criteria for AIDS. In 31.5% of cases, operation discovered infection by HIV or AIDS. 10 patients had an abscess or gangrenous appendicitis. Furthermore, a tumoral, inflammatory of infectious associated disease which required a treatment was found in 5 others patients. 2 patients died. In all cases, histologic, bacteriologic, virologic and parasitologic samps are warranted to discover current associated diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Implantable devices for permanent venous access. A single-center prospective study comparing an AIDS population with a control population (80 cases)].

Although the tolerance of indwelling catheters in AIDS patients has been evaluated, the complications of implanted devices in this population are unknown. This encouraged us to compare in a prospective unicenter trial, dealing with 80 consecutive implanted devices, the complications of this kind of system in 20 AIDS patients, versus a control population. The follow-up was 10,658 days. No patient was excluded or lost to follow-up. In the control population, the infection rate was 5% (0.036 per 100 catheter days). We observed 3 thromboses (5%). In the AIDS group, the infection rate was 25% (0.21 per 100 catheter days). We observed 1 thrombosis (5%). This trial shows that implanted devices are more frequently infected in AIDS patients (p less than 0.05) than in a control population; it suggests that the infection rate in AIDS patients is not superior to the indwelling catheter rate, as reported in the literature. The precision of bacteriological tests and use of antibiotic therapy adapted to the clinical context should help to determine, in the presence of suspected infection, whether the implanted device can be maintained or should be removed in this high risk population.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Emergency treatment of sigmoid volvulus. One-stage resection with mechanical staplers].

In sigmoid volvulus, most authors recommend an emergency detorsion with transrectal intubation and delayed resection. In 25% of cases, detorsion in unsuccessful, necessitating multi-stage laparotomy. However, this approach can be harmful in these patients who are often elderly or with multiple diseases. When detorsion is impossible, we now use a one-stage resection with staplers. Using a median laparotomy, detorsion is performed and viability of the colon is confirmed; a Faucher tube placed freely in the rectum, is pushed by the nurse into the dilated colon; the colon is then deflated by applying gentle suction. After removing the tube, we perform a side-to-side anastomosis at the lower ends of both limbs with mechanical staplers, after economic resection of the mesosigmoid. We have used this procedure in five patients with a median age of 82 years; the mean operating time was 92 minutes. There was no mortality, no fistulae, or stenosis with a median follow-up of 16 months. The patients stayed in hospital for 12 to 18 days. In volvulus cases which cannot be reduced immediately, this procedure obviates multi-stage operations, often the cause of mortality, morbidity or loss of autonomy in patients who are often elderly or with multiple disease.

Aged↗
PubMed1990

[110 consecutive laparotomies for hepatic metastasis].

From 1978 to 1988, we performed 110 laparotomies for hepatic metastases. With 41 resections for colorectal metastases, the survival was 34% at 3 years. The operative mortality was 7%. With 25 resections for non colorectal liver metastases, the survival was 42% at 1 year, 12% at 3 years. The results, compared with those of literature justify, in the absence of any other potential curative treatment, to remove colorectal liver metastases. For metastases from other tumours, results of resection for endocrine tumours and few sarcomas invite us to an aggressive approach.

Actuarial Analysis↗
PubMed1989

[Experimental models in studying gastric secretion in dogs: innervated pouch, denervated pouch, cervical esophagostomy. Execution, monitoring, use].

Different surgical models are used in the dog for studying gastric secretion: gastric fistula, denervated Heidenhain pouch, innervated Amdrup pouch and cervical esophagostomy. The surgical procedures are described as well as the care and the monitoring allowing long-term survival of the animals. The association of gastric fistula - Heidenhain pouch has been assessed 30 times and 8 times with cervical esophagostomy. The death-rate was been 7% and the morbidity 24%. Three dogs were provided with an Amdrup pouch. Calibration of the animals allowed the acid and pepsin secreting dose-response to be platted and translation according to lineweaver-Burk or Dowd and Riggs is used to calculate the efficient dose (ED 50) and the maximal response (maxR). Pharmacological or physiological effects might be analyzed in regard to the modification of these parameters in response to a pharmacological agonist or antagonist substance. Some physiological studies could be made using sham-feeding on dogs fitted with a cervical esophagostomy.

Animals↗
PubMed1989

[Splenectomy in hematologic diseases. Indications, technics and early results. A retrospective study of 1095 cases].

Since July 1st, 1958, we have operated 1095 patients with some hematological disease. We review the chief currently accepted surgical indications for splenectomy (Hodgkin's disease no longer being one of them, or seldom so), and we communicate our results pertaining to the immediate postsurgical period. Mortality and morbidity have been 1.36% and 3.28%, respectively. In over 95% of cases, there have been no complications. The low incidence (1.36%) of infection-related complications was partly due to the important number of splenic drains placed. High quality results can only be achieved when tight collaboration exists between hematologists, radiologists and surgeons.

Drainage↗
PubMed1987

[Surgical treatment of locoregional recurrence of colorectal cancer treated by an anal sphincter-conserving procedure].

Between 1980 and 1985, the authors have treated 26 recurrences of a colon or rectal cancer in patients in whom the sphincter apparatus was preserved. In 9 cases only a curative repetitive excision was possible with 3 patients currently alive, without recurrences (8 months, 12 months, 50 months). 11 patients underwent another excision, which was only a palliative one. When no surgical procedure is feasible, the evolution is rapidly fatal. According to the literature, the capabilities of "curative" excision vary between 16 and 47% with often disappointing results. Prevention of these recurrences does not depend probably on the extension of the first excision but on a much earlier screening process. The treatment is surgical and only complete excision may let hope for an adequate survival. The surgical approach depends on the site of the recurrence in relation to the upper pelvic strait and the invasion of peritumoral structures.

Aged↗
PubMed1986

[The glucagonoma syndrome. Review of the literature. Apropos of a case].

A patient with typical clinical and biochemical features of a glucagonoma also presented obvious signs of hypokalemia, indicating combined secretion of renin by the tumor. The latter was voluminous, was located in the tail of the pancreas and was of a malignant nature as shown by the development of secondary hepatic metastases. Syndromes associated with glucagonoma and mixed or combined insular tumors are reviewed in detail.

Adenoma, Islet Cell↗
PubMed1986

[Massive digestive hemorrhage caused by aorto-esophageal fistula].

A very rare diagnosis before a terminal hemorrhagic accident, aorto-esophageal fistula (FAO) is almost always fatal. Three cases of this exceptional lesion are reported. The first patient died within a few minutes of admission from a cataclysmic hematemesis. This 52 year old man had a recurring adenocarcinoma of the cardia that had been treated by laser. A "premonitory hematemesis" of bright red blood had occurred eight hours before admission. In the two other cases the problem arose with an "open abdomen" in exsanguinated patients operated upon as emergencies for massive hematemesis. In both cases, an intra-esophageal balloon catheter and controlled hypotension allowed performance of a left thoracotomy and aortic clamping. One patient had a cancer of middle third of esophagus that had perforated into the descending aorta. A resection-graft of the aortic isthmus and a retrosternal gastric esophagoplasty was successfully carried out at the time of exploration. The other patient had an FAO in the aortic isthmus region probably due to a foreign body. Operation involved an esophagectomy with cervical esophagotomy and gastrotomy combined with a resection-graft of aortic isthmus using a Dacron prosthesis. This patient died on the 21st postoperative day from rupture of the brachiocephalic trunk over a tracheotomy tube. In both of these patients a "premonitory hematemesis" with dysphagia had preceded the severe hemorrhagic accident. Successful treatment is rarely obtained with such lesions, since difficulties in ensuring rapid hemostasis in exsanguinated patients operated upon usually without diagnosis and for massive hemorrhage only, are associated with the risks of aortic repair surgery in a hemorrhagic field and with a mediastinum infected from the esophageal wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗