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Biomedical subjects

J Alain

Publications and source records attributed to J Alain.

17 recordsLinked to original sources
PubMed2001

Prospective randomized comparison between a dynamic hip screw and a mini-invasive static nail in fractures of the trochanteric area: preliminary results.

OBJECTIVES: This study aimed at comparing the results obtained with a sliding screw plate and an experimental device including a small-diameter nail that can be placed with a mini-invasive approach and provides a stable fixation. DESIGN: Randomized prospective study. SETTING: University hospital. PATIENTS: The study included two groups with thirty fractures of the trochanteric area. INTERVENTIONS: In both groups, the surgical procedure was carried out on patients placed on a traction table in a supine position, under an x-ray amplifier. Sliding screw plates (THS) were set in place according to the usual open technique. Nails were placed through a twenty-millimeter supratrochanteric cutaneous incision. This experimental system comprised a locked intramedullary nail with two nonparallel seven-millimeter cervicocephalic screws. MAIN OUTCOME MEASURES: The comparison between the two groups was based on the surgical procedure (time, duration of x-ray irradiation, and total blood loss); the initial postoperative period (complications, duration of hospital stay, and the time before returning home); the time before full weight bearing became effective; the functional and social recovery; mortality; and the quality of immediate and final anatomic restitution and healing. RESULTS: Operating time (p < 0.001) and blood loss (p < 0.001) were lower in the nail group, and no blood transfusion was required. Postoperative pain (p < 0.01), time necessary to support full weight bearing (p < 0.02), and time before returning home (p < 0.05) were reduced in the nail group. All fractures healed in the same amount of time, with good anatomic results in the nail group, whereas ten impactions beyond ten millimeters occurred in the plate group. No difference was found between the two groups in walking ability and autonomy recovery, but hip function (p < 0.05) was better in the nail group. CONCLUSION: This preliminary clinical study has shown the advantages of this mini-invasive technique. It could not evaluate all the possible disadvantages inherent in the method. These points will be evaluated in a multicenter study justified by these preliminary results.

Aged↗
PubMed2000

Calciphylaxis: seven new cases.

BACKGROUND: Calciphylaxis is a rare condition occurring most frequently in patients with end-stage renal disease (ESRD). It is characterized by vascular calcifications with a large variety of skin lesions. Even though this entity was first reported almost 50 years ago, the pathogenesis is still not well understood. OBJECTIVE: Having retrieved seven new cases from a single tertiary care hospital, the disease occurs probably more frequently than reported until now. The potential mechanism of action in this disease is discussed, particularly the hypercoagulability state. We also review potential treatments described in the literature. METHODS: Seven patients with calciphylaxis that occurred at the Hôtel-Dieu hospital between 1992 and 1998 were identified and their case histories reviewed and analyzed. CONCLUSION: Although hyperparathyroidism and imbalance of calcium-phosphorus homeostasis are paramount for calciphylaxis to occur, other mechanisms must be involved because the disease manifests itself in only a minority of ESRD patients. As the majority were under anticoagulation therapy and as we found abnormalities of the coagulation pathway in one patient, we suggest emphasizing these phenomena in the future. Along with evaluation of putative risk factors (abnormalities of the calcium:phosphate axis, diabetes), a detailed evaluation of the coagulation system should be done in every patient with calciphylaxis until more data are available.

Adult↗
PubMed1998

Urethral cytology and diagnosis of the pregnancy term. About some observations on the use of this method in an hospital setting.

A retrospective study of routine urethrocytograms performed over a 10-year period in 3,478 pregnant women for the diagnosis of pregnancy term was carried out to determine the reliability of urethral cytology when two, three, or four successive urethral smears were performed at 2- or 3-day intervals, and to investigate the correlations between the cytological results and the neurological ages of newborns. Microscopical examination of the 3,478 routine smears demonstrated the existence of a before-term aspect, a near-term aspect, or an at-term aspect in 7.4%, 66.7%, and 22.1% of cases, respectively. The diagnosis of post-term was noted only in 1 smear. Repeated urethrocytograms (1, 2, or 3 smears after the firstone) in women with a previously diagnosed before-term aspect or a near-term aspect revealed the occurence of the at-term aspect over time. Concordant correlations between cytological results and the neurological ages of the newborns were noted in 98.1% of cases. Three developmental stages (beginning, middle, end) of the near-term aspect and three stages of the at-term aspect were described. Due to its interest, the urethral-smear method should be worth generalizing as the other laboratory examinations that are routinely used to determine the term of pregnancy.

Female↗
PubMed1994

[Maternal motivation for choice of feeding method].

We studied the different motivations mothers had for choosing a particular mode of nursing at the University Hospital in Limoges. An anonymous questionnaire was distributed to all mothers who hat delivered between January 1 and April 30, 1992. It was apparent that the medical team did little to promote breast-feeding or to counteract negative attitudes. The results of this study, together with a review of the literature were used to determine conditions for encouraging breast feeding.

Attitude of Health Personnel↗
PubMed1991

[Prevalence of antibodies to the hepatitis C virus in pregnant foreign residents in France].

Blood transfusion and intravenous drug use are the two main modes of transmission of the hepatitis C virus (HCV). Sexual intercourse seems to play a less significant part in transmission of the HCV and data are still lacking on vertical mother-to-offspring transmission. HCV seroprevalence was determined in 1,084 pregnant foreign residents of France living in a single city (Limoges). Antibodies to the HCV were detected in sera using both the first and second generation Abbott ELISA kits. Sera yielding reproducible positive results with either kit were retested with a blocking test (HCV EIA Neutralization, Abbott) and a second generation RIBA (Ortho) for confirmation. For screening, use of tests detecting both nonstructural and structural antibodies improved results noticeably (5 of 16 sera). Use of confirmation tests was found to be indispensable. Overall seroprevalence was 1.47%. However, results varied across geographic regions or origin, ranging from 0% for Europe, 1.9% for North Africa and 1.78% for South-East Asia, to 4.76% for black Africa. These findings demonstrated the potential for mother-to-offspring transmission among women from high prevalence areas. A prospective study in African an Asian women is being considered to evaluate ineffectiveness and transmission using serial serologic tests and viral genome detection by polymerase chain reaction studies (PCR).

Adult↗
PubMed1990

[Prevalence of hepatitis B (Hbs Ag, Hbe Ag, DNA) and delta virus markers, in about 10,000 pregnant women in Limoges (France)].

The risk of perinatal B virus transmission is well known, but is estimated in France on results obtained from blood donors or from urban populations. In the present study, the screening of HBs Ag was carried out during five years (1984-1988), within a sample population of pregnant women (french women: 8,364, immigrant women: 1,206) seen in the university hospital of Limoges. Positive sera for HBs Ag were also tested for the other markers of B virus including specific DNA, and markers of the delta virus. The total seroprevalence of HBs Ag among these women was 0.54%, and was significantly higher in the immigrant women group (2.57%) when compared to that of french women (0.25%). During the same period (1984-1988), the seroprevalence among females blood donor was 0.03%. Among the HBs Ag chronic carrier pregnant women (n = 52), 27% were HBe Ag positive and four of them (31%) had viral DNA in their serum. Viral DNA was found in three women who were HBe Ag negative. Thirteen per cent of the HBs Ag positive pregnant women were infected by the delta virus.

Adolescent↗
PubMed1989

[Pregnancy and delivery after the age of 40].

When pregnancy occurs in a woman who is more than 40 years of age there are certain risks, ranging from the risks of chromosome abnormalities to those associated with grand multiparity and the syndrome of "the precious baby", when it is a first pregnancy. We have looked at the case notes of 52 patients who delivered after the age of 40. This was a total of 59 pregnancies which occurred in our service between the 1st January 1981 and the 31st December 1986. Of these patients 6 were primiparous, which was 1.17% of all those women delivered in the service. 83% delivered vaginally, with or without the help of forceps. In this group hypertension as well as vein troubles and fatness are more common. Prematurity was of a low order (3.4%), as was perinatal mortality as compared with other series in the literature. We only had one case of trisomy and this was very upsetting for us because we could not get across to our patients the importance of antenatal screening in more than one third of all cases.

Adult↗
PubMed1988

[Metabolic and cardiovascular effects of beta-blockers taken by the mother in newborn infants].

The effects of beta-blockers administered to mothers with arterial hypertension were investigated in 38 neonates of varying gestational age and weight. During the first 48 hours of extra-uterine life, heart rate was continuously monitored and blood pressure and glycaemia were measured every 3 hours. Left ventricular function was studied by echocardiography on the first day post-partum, once again between the 5th and 10th days. Hypoglycaemia was observed in 42% of the neonates; 47% had one or several episodes of bradycardia and 2 had arterial hypotension. Most important, a significant improvement of left ventricular function was observed between the first and the 5th-10th days. This time-related change was not found in a control group. The cardiac dysfunction was more pronounced in neonates who had an episode of bradycardia, and although it is usually asymptomatic, it probably accounts for the fortunately rare cardiovascular collapses observed in some newborn babies.

Adrenergic beta-Antagonists↗
PubMed1984

Adaptation of the Syva EMIT-cad digoxin enzyme immunoassay technique on the Instrumentation Laboratory Multistat-III microcentrifugal analyzer.

The Syva EMIT-cad digoxin assay, a three-step manual enzyme immunoassay (EIA) technique, was adapted to be run on the Multistat-III microcentrifugal analyzer. This adaptation permits semiautomation of the procedure along with a sizable reduction in sample and reagent volumes. A 5-min pretreatment of a 100-microliters sample with 0.5 N NaOH is followed by a 15-min incubation with 625 microliters of the anti-digoxin antibody and enzyme substrate reagent. A 198 microliters aliquot of this mixture and 65 microliters of the second digoxin enzyme conjugate reagent are loaded separately onto the rotor by the loader module in two successive loading cycles. The final 30-min incubation is initiated by rotation in the analyzer module. Intraassay performance [coefficient of variation (CV)] using patient samples (n = 10) is 10.5% at 0.6 ng/ml, 10.2% at 1.4 ng/ml, and 10.5% at 2.9 ng/ml. Interassay performance (CV) using the Hyland Omega II (1.4 ng/ml) and Omega III (2.8 ng/ml) ligand quality control sera (n = 13) is 12.3% and 9.7%, respectively. Assay linearity is excellent up to 5.0 ng/ml. Correlation of the results with a radioimmunoassay (RIA) method is EMIT = 0.98 RIA + 0.02, r2 = 0.92, standard error of estimate = 0.23 (52 patient samples). The time required for a normal run (10 patients) or a single urgent analysis is approximately 75 min.

Autoanalysis↗
PubMedDate not supplied

[Beckwith Wiedemann syndrom (author's transl)].

In connection with four new observations and a revue of 82 cases published the mains features of Beckwith-Wiedeman syndrom are described insisting on the neonatal troubles of the glycoregulation upon the structural development of the childrens and on the pathologics associations.

Abnormalities, Multiple↗