[Physiopathology, classification and symptoms of pulmonary arterial hypertension in adults].
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Adult↗
Biomedical subjects
H Lacroix
Publications and source records attributed to H Lacroix.
[Modified Bristow procedure in recurrent anterior shoulder dislocation caused by trauma].
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Adolescent↗
[Right ventricular fibroma. Value of different methods of invasive and noninvasive exploration].
The authors report the case of a 20 year old man with a primary cardiac tumour. The relative usefulness of invasive (catheterisation and angiography), and non-invasive investigations (echocardiography, computerised axial tomography, myocardial scintigraphy and digitalised angiography) in determining operability and the benign or malignant nature of the tumour was evaluated. The patient was admitted to hospital for severe incapacitating effort dyspnoea. Cardiac auscultation was suggestive of pulmonary stenosis associated with tricuspid regurgitation. M mode and 2D echocardiography demonstrated a large mass within the right ventricular cavity and also its size shape, mobility and its relationship to the interventricular septum, tricuspid valve and the main pulmonary artery. Echo contrast studies confirmed tricuspid regurgitation and also demonstrated a patent foramen ovale. The cardiac CAT scan confirmed the preceding data. Myocardial scintigraphy demonstrated the vascular character of the tumour. Digitalised angiography showed the presence of a tumour in the right ventricle and the rest of the morphological information was identical to that obtained by conventional angiography. Cardiac catheterisation demonstrated an obstruction to right ventricular ejection and abnormal filling of both ventricles. It was the association of 2D echocardiography and Technetium 99 myocardial scintigraphy which provided the most information. The results of the other investigations were not essential in deciding the operative indications. A 230 g tumour was excised at surgery and the tricuspid valve replaced by a Hancock n 33 bioprosthesis. Anatomopathological examination showed the tumour to be a fibroma. The finding of a tricuspid diastolic rumble led to control catheter and angiographic studies 13 days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Multifocal hematogenous osteomyelitis in an adult treated with corticosteroids.
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Female↗
[Rare hemoglobins in Guadeloupe and in the Lesser Antilles (author's transl)].
Screening of abnormal hemoglobins on 25 136 samples allowed us to detect from 1974-1979 rare or uncommon hemoglobins as N Baltimore, Korle Bu, Lepore, K Woolwich, J Broussais and J Baltimore. Hemoglobins N Baltimore, J Broussais, and J Baltimore are detected for the first time in Guadedoupe. The identification of these asymptomatic hemoglobins in this part of the Carribbean region provides information concerning the exact origin of the black population of these islands; e.g., hemoglobin K Woolwich and N Baltimore are found only in specific regions of West Africa.
Fetal Hemoglobin↗
[Hemoglobin N Baltimore: 28 cases in one Guadeloupe family (author's transl)].
The detection of hemoglobin AN Baltimore in a young man, 28 years old in June 1978, led us make a family study. This family study was very interesting because our proband had 16 brothers and sisters, many of whom also had many children. Research on abnormal hemoglobins was done on 46 family members: 28 were carriers of hemoglobin AN Baltimore and three children, carriers of heterozygote SN Baltimore.
Adolescent↗
Iatrogenic pseudoaneurysm in the upper arm: treatment by transcatheter embolization.
A 32-year-old woman presented with a pulsatile, painful mass in her left upper arm, originating several days after removal of an Ilizarov external fixation. The diagnosis of a pseudoaneurysm was made by medical history and by physical and ultrasonographic examination of the mass. Angiography confirmed the presence of the pseudoaneurysm, originating from a branch of the arteria profunda brachii, and definitive treatment was performed by transcatheter embolization. Clinical follow-up showed absence of pulsation and pain in the upper arm and a gradual volume decrease of the mass lesion.
Adult↗
Oral anticoagulant therapy: a precipitating factor in the pathogenesis of cholesterol embolization?
The authors describe three patients who developed a blue toe syndrome after initiation of oral anticoagulant therapy. Based on these observations and data in the literature, they discuss a possible relationship. They conclude that the vascular surgeon should be aware of this possibility and that oral anticoagulants should be used very carefully in the "medical" management of cholesterol embolization.
Aged↗
[Clinical hematological and biochemical pattern of three SN Baltimore hemoglobin carriers (author's transl)].
The clinical, hematologic and biochemical study of three children, carriers of the double heterozygotous SN Baltimore hemoglobin from Guadeloupe, have not allowed to detect any typical anomaly and specially no sign of anemia or hemolysis. An iron deficiency of parasitologic origin has only been detected. This absence of pathological symptoms is related to the fact that SN red cells tend to sickle less rapidly than those from persons with sickle cell trait AS.
Anemia, Sickle Cell↗
Transperitoneal versus extraperitoneal approach for routine vascular reconstruction of the abdominal aorta.
In this non-randomised retrospective study we have compared 79 cases with transperitoneal approach and 90 cases with extended postero-lateral extraperitoneal approach for elective reconstruction of the infrarenal aorta. In the extraperitoneal group more patients were diabetic (7.8% vs 1.3%, p < 0.05) or had a serum creatinine of more than 1.5 mg % (10.1% vs 2.5%, p < 0.05). The study shows that in spite of a higher proportion of risk factors, a longer preparation (61' vs 44', p < 0.001), dissection (55' vs 46', p < 0.05) and total procedure time (193' vs 173', p < 0.05), the need for more blood transfusion (2.8 U vs 2.3 U, p < 0.05) and colloid perfusion (2.1 L vs 1.8 L, p < 0.05) in the extraperitoneal group, the incidence of complications is not higher compared to the transperitoneal group (29% vs 24%, NS). On the contrary, problems of intestinal transit were found exclusively in the transperitoneal group (7.6%, p < 0.01). Therefore it seems that, as far as the peri- and postoperative period is concerned the extraperitoneal approach might be the technique of choice for the simple elective infrarenal aorta reconstructions.
Aged↗
The value of carotid stump pressure and EEG monitoring in predicting carotid cross-clamping intolerance.
The authors analyse their experience with carotid stump pressure (CSP) and electro-encephalogram (EEG) monitoring in relation to the incidence of peroperative stroke during internal carotid artery reconstruction. A series of 215 patients is presented, among whom six (2.8%) developed a peroperative stroke. The stroke rate in patients with a CSP below 50 mm Hg (n = 92) was 7% (2/27) without a shunt and 3% (2/62) with the use of a shunt. The respective numbers for patients with a CSP equal to or above 50 mmHg were 1.7% (2/123) and 0% (0/10). The EEG remained normal after cross clamping in 180 cases (84%): the incidence of stroke was 1.5% (2/138) without and 5% (2/42) with a shunt. A shunt was used in 33 of the 35 patients with EEG changes after cross clamping. None of them sustained a stroke in contrast to both patients where despite EEG changes no shunt was used (respective stroke rates 0% and 100%). It is concluded that regarding cerebral function, EEG monitoring provides more accurate information than CSP.
Adult↗
The venous thrombectomy: obsolete or forgotten?
This report describes the surgical management of three patients with an extended ilio-femoral deep venous thrombosis. In the first patient a residual occlusion of the common iliac vein was treated conservatively and this patient developed severe chronic venous insufficiency. In the second patient a residual (sub)occlusion of the common iliac vein was treated with a stent and this patient remained asymptomatic with two years follow-up. In the third patient no residual or underlying anatomical abnormality was found with a good result at one year. Venous thrombectomy still has a place in the treatment of deep venous thrombosis and the long term results may be improved by application of endovascular techniques.
Adult↗
Classic versus endoscopic perforating vein surgery: a retrospective study.
PURPOSE AND METHODS: In this retrospective non-randomized study the results of the FELDER technique (n = 29) were compared to two endoscopic techniques for ligation of incompetent perforating veins: using a mediastinoscope (n = 19) and laparoscopic instruments (n = 57). The indication was a venous ulcer in nine, five and thirteen patients respectively, lipodermatosclerosis in thirteen, five and twenty-four, and simple varicose veins in the remaining patients (NS). RESULTS: The mean number of interrupted perforating veins was 4.2, 2.4 and 3.8 (p < 0.05). The mean hospital stay was 3.5, 1.9 and 1.6 days (p < 0.0001). The mean period of convalescence was 8.7, 4.1 and 3.7 weeks (NS). The number of complications was 9 (suralis lesion 4, pain/swelling 4, wound problem 1), 6 (saphenous lesion 3, pain/swelling 3) and 15 (pain/swelling 14, deep venous thrombosis 1) (NS). Ten patients were lost to follow-up (five, two and three). Respectively 19, 12 and 45 patients were satisfied with the end-result. The condition had worsened in one, two and three patients (NS). During the short follow-up period all ulcers healed and there was no recurrence. CONCLUSIONS: The endoscopic techniques produce results comparable to the FELDER procedure, with smaller scars and a tendency towards a faster recovery.
Adult↗