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Biomedical subjects

J F Marichal

Publications and source records attributed to J F Marichal.

At least 19 recordsLinked to original sources
PubMed1995

["The Dialybre card". The minimum portable dialysis medical record. Results of the development phase].

Dialybre is the research study on portable minimum medical records related to patients treated by hemodialysis. It uses the chip card, a new technology which makes relationships between health practitioners and patients easier. Since 1992, it is broadcasted in 15 hemodialysis centers. Evaluation of the development phase shows that despite its advantages, the chip card is not much used for the following reasons: usage not yet fully understood, lack of coherence in the computerized hospital information system, not enough card readers which are very costly, and a cultural lack of trust in any new technology. There is, more over, extra work involved for entering data in "Logidial" (computerized medical records) from where "Dialybre" is automatically updated.

Evaluation Studies as Topic↗
PubMed1994

Laparoscopy: an alternative to surgery in patients treated with continuous ambulatory peritoneal dialysis.

Fifteen laparoscopic abdominal operations were performed in 14 patients treated by continuous ambulatory peritoneal dialysis for chronic renal failure. Celioscopic exploration of the abdomen and subsequent operation displayed several advantages specific to the method: identification of the etiology of scrotal dialysate outflow was achieved in 4 cases, peritoneal dialysis catheter salvage during laparoscopic cholecystectomy in 1 case, abdominal exploration during occurrence of peritonitis in 3 cases, and catheter dysfunction or abdominal examination before catheter implantation in 7 cases. The laparoscopic procedure allows early resumption of peritoneal dialysis after surgery, hence avoiding the need for transient hemodialysis. Nevertheless, it seemed unable to offer a salvage capability of infected catheters through extensive abdominal washing. Laparoscopy has been reported to decrease postoperative pain and disorders of ventilation, allowing for rapid recovery of social and professional activities following this minimal invasive surgical technique. Laparoscopy is a novel technique which enables precise diagnosis and surgical operations in patients treated by continuous ambulatory peritoneal dialysis.

Abdomen↗
PubMed1993

Ambulatory monitoring of blood pressure in normal pregnancy.

The definition of hypertensive disorders in pregnancy is plagued by many difficulties, in part related to the limits of intermittent clinic readings of blood pressure. In order to better define the evolution of arterial blood pressure in normal subjects during normal pregnancy, casual and ambulatory (Spacelabs 90207, n = 22 or Diasys 200, n = 26) measurements of blood pressure were performed at gestational months 3, 6, and 9, in 48 normal women aged 18 to 39, both nulliparas (n = 19) and multiparas (n = 29). Ambulatory blood pressure levels were lowest in the first gestational trimester (24-hour mean: 104 +/- 8/63 +/- 6 mm Hg) and rose by a small increment during the last trimester (109 +/- 8/67 +/- 7 mm Hg at 8 months). Mean daytime ambulatory pressure was almost superimposable to clinic measurements at the three time points. A day-night variation in blood pressure level was detectable in all subjects at each recording. It is concluded that during normal pregnancy, ambulatory blood pressure levels were highest in the day and lowest at night at all gestational ages and increased only minimally before the ninth month. Reference values, as defined by the percentile distribution of daytime and nighttime systolic and diastolic blood pressure, may help define more precisely an alteration in the level and/or the circadian variation of arterial blood pressure during abnormal pregnancies.

Adult↗
PubMed1993

[Laparoscopic surgery: a new alternative to abdominal surgery in renal insufficiency treated by CAPD].

Six laparoscopic abdominal operations were performed in five patients with chronic renal failure with continuous ambulatory peritoneal dialysis. Coelioscopic exploration and operation disclosed several advantages including peritoneal dialysis catheter salvage, abdominal exploration in peritonitis or before catheter implantation, early dialysis after surgery, hence avoiding the need for transient hemodialysis. Furthermore, laparoscopy was reported to decrease postoperative pain and ventilatory disorders. This minimal invasive surgical technique allows rapid recovery of social and professional activities.

Abdomen↗
PubMed1991

[Treatment of chronic renal insufficiency: hemodialysis at a center or continuous ambulatory peritoneal dialysis? Comparative retrospective study of the success of both methods].

In a retrospective study, the authors analyse the dialysis-technique success rate in 276 chronic renal patients. 137 patients have been treated with in-center Hemodialysis (CHD) since 1972, 139 patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) since 1978. The 6-year technic success rate reaches 28% in CAPD and 31% in CHD (not statistically significant). The risk factors influence the technic-success rate of both methods in the same way. The results suggest that in the analysed patients CAPD is at least as effective as CHD at maintenance in the technic.

Adolescent↗
PubMed1990

Continuous ambulatory peritoneal dialysis (CAPD) or center hemodialysis? Retrospective evaluation of the success of both methods.

In a retrospective study, the authors analysed the dialysis-technique success rate in 276 chronic renal patients. Of these, 137 patients have been treated with in center hemodialysis (CHD) from 1972 to 1989 and 139 with continuous ambulatory peritoneal dialysis (CAPD) from 1978 to 1989. The six-year technique success rate was 28% in CAPD and 31% in CHD (statistically not significantly different). Various risk factors influence the technique-success rate of both methods in the same way. The results suggest that in our center CAPD is as effective as CHD in the treatment of patients with end-stage renal failure.

Adolescent↗
PubMed1990

[Daily hemodialysis of ultra-short duration with non-traumatic vascular access. Two cases].

The authors report their experience on treating two patients, suffering end-stage renal disease, by daily hemodialysis of ultra-short duration with a non-traumatic vascular access. 90 minutes dialysis are realized 6 days a week. Clinical tolerance is excellent and patients' adhesion is satisfactory. However, despite reutilization of the dialyzer, the method remains costly.

Aged↗
PubMed1990

[Influence of experience on the success of the treatment of chronic kidney failure by continuous ambulatory peritoneal dialysis compared with hemodialysis at a center].

Experience influence on treatment success of renal chronic failure by continuous ambulatory peritoneal dialysis comparatively to hemodialysis in center is estimated by the probability variation of still being in dialysis techniques. The retrospective study was realized in 276 dialysed patients who were taken over from 1972 to April 1989. In this population, there isn't any significant difference between the probability to stay in ambulatory peritoneal dialysis or in hemodialysis in center. But, if the study is realizing from the 4 years which followed the technique introduction in the center, the success probability at 30 months, remains the same for hemodialysis in center whether the technique has began in 1972 or 1976, whereas for continuous ambulatory peritoneal dialysis, this probability raises from 52% to 72% if it begins after 1982. Ambulatory peritoneal dialysis treated patients would be maintained more longer in their system than hemodialysis patients. Those results are explaining by prevention of the peritonitis thanks to technological progress and the early prevention of possible complications.

Adolescent↗
PubMed1990

[Continuous ambulatory peritoneal dialysis: the perfect dialysis?].

Among the dialysis method, Continuous Ambulatory Peritoneal Dialysis (CAPD) is considered as simple, efficient, economical and giving autonomy to the patient. After more than ten year using Continuous Ambulatory Peritoneal Dialysis, results are evaluated. The method remains simple, but the obvious simplicity demands a strict medical control. It is efficient, but the hope in anemia and osteodystrophy correction is not confirmed. It offers more freedom but with a lot of restraints: the dietary restriction must be followed and there is only relative moving autonomia. It is economical, but the costs with the use of disconnectable systems which reduce morbidity, bring it near to the home hemodialysis.

Anemia↗
PubMed1989

[Local immunologic reactions induced by CAPD].

During CAPD, the peritoneal cavity is submitted to situations such as the accidental bacterial contaminations and the continuous presence of dialysate, which stimulate immunological factors. The antibacterial defenses include opsonins and cells. Only IgG and fibronectin are present in the peritoneal effluent but they are diluted by the dialysate. Macrophages represent 70 to 80% of the peritoneal cells. Beside good phagocytic capacity, some may have a defective bactericidal activity. The continuous presence of dialysate leads to a chronic local inflammation. Macrophages and lymphocytes will synthesize IL-1, PGE2 and IFN-Y. These substances generate movement, attachment and proliferation of fibroblasts in the peritoneal submesothelial tissue, resulting in progressive fibrosis. This fibrosis, generally asymptomatic, may be responsible for loss of Ultrafiltration (UF) and Sclerosing Encapsulating Peritonitis (SEP).

Bacterial Infections↗
PubMed1988

[Experience of decentralized informatics at a nephrology unit of a general hospital].

The computerized medical specialized records covering the follow-up of hypertension (ARTEMIS), diabetes (MELLITEE), chronic renal failure and the minimum medical record of Nephrology (THESEE) using the temporal database management system LIED, have been developed in several units of University Hospitals. The authors show that these computerized records are usable in a Nephrology Unit in a General Hospital.

Diabetes Mellitus↗
PubMed1987

[Evaluation of the control quality of arterial hypertension over a 10-year period at a hemodialysis center].

Using the "Diaphane" computed medical record system enables multicentric statistical studies to be conducted. With this system, the quality of arterial hypertension control (supine systolic and diastolic arterial pressure before and after dialysis) was evaluated over a 10-year period in chronic haemodialysis patients in comparison with a multicentric population. A continuous statistical study of the results showed a regular voluntary decrease in arterial pressure. The evaluation of the quality of medical care represented by this comparison contributes to a therapeutic improvement.

Adult↗
PubMed1987

Progressive calcifying peritonitis: a new complication of CAPD? Report of two cases.

The authors report the history of two patients treated with CAPD who developed a progressive calcifying peritonitis (PCP). The symptoms include abdominal pain, impairment of bowel movements, sterile effluent dialysate and progressive development of peritoneal calcifications. The etiology of the PCP remains elusive, but dialysate with acetate, high peritonitis incidence and continuous lavage as treatment for peritonitis are suspected to play a role in its evolution.

Acetates↗
PubMed1987

[Decentralization of the ARTEMIS system in a nephrology service in a general hospital].

"ARTEMIS" is a standardized and computerized medical file which is intended for improving the follow-up of hypertensive patients, the efficacy of treatment and for realising national-wide surveys. The software "LIED" of data base for "ARTEMIS" is nowadays transposable on mini-computer. In Nephrology Unit of General Hospital from Colmar, the system has been working since September 1985 with MICRO-MEGA E 32 (Thomson). The administrative and medical data are directly acquired by the doctors and secretaries of the Unit on a conversational mode from six terminals. There is no writing collecting of data. An evaluation of the system was realized with the 113 first hypertensive patients. The results were compared to those obtained from patients of Paris area.

Follow-Up Studies↗
PubMed1987

[Continuous ambulatory peritoneal dialysis: results after more than 3 years].

The authors report the result obtained with CAPD in 20 chronic renal patients treated during 4.6 years in average. The dialysis possibilities have maintained at middle term. Nevertheless, the awaited advantages concerning anemia, calcium and phosphorus disorders, neuropathy, are transient and incomplete. The water and sodium intakes need strongly to be controlled in order to achieve normal blood pressure. Finally the use of "Y" disconnect systems dramatically reduces the peritonitis rate.

Adult↗