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Biomedical subjects

J Francoeur

Publications and source records attributed to J Francoeur.

7 recordsLinked to original sources

CSF shunt infections: a fifteen-year experience with emphasis on management and outcome.

A retrospective study of patients with cerebrospinal fluid shunt infections was undertaken from 1975 to 1989 in a university hospital. The data were analyzed with emphasis on the choice of treatment and outcome. There were 44 infectious episodes in 38 patients for an overall rate of 2.6%, including 30 ventriculoperitoneal, 11 ventriculoatrial and 3 lumboperitoneal shunts. The most frequently isolated pathogens were staphylococci in 61% of the cases followed by gram-negative bacilli in 25%. Different modalities of treatment were used: support (2), intravenous antibiotics alone (6), intravenous antibiotics and shunt revision (3), intravenous antibiotics and shunt removal with or without prior externalization of the distal end (33: 13 + 20). The cure rate was 94% (31/33) with this last modality of treatment. Only 3 patients received intraventricular antibiotics. All deaths occurred in patients treated with support only (2) or with antibiotics alone (1). Four of the six recurrent episodes occurred in patients treated with antibiotics alone (2) or with a shunt revision (2). We conclude that carefully chosen intravenous antibiotics combined with shunt removal preceded or not by externalization of the distal end as an alternative therapy to repeated ventricular taps or insertion of an external ventricular drainage device is an appropriate therapy.

Adolescent↗

The effect of fleroxacin on hepatic drug metabolism in the rat.

Pretreatment of rats with repeated i.p. doses of fleroxacin had no effect on the hepatic O- and N-demethylation of p-nitroanisole (PN) and aminopyrine (A) respectively, on the p-hydroxylation of aniline or on the hepatic levels of cytochrome P-450 and protein content. Addition of fleroxacin directly to incubation mixtures reduced PN O-demethylase activity significantly but did not affect the other two oxidative reactions. The N-oxide metabolite increased PN O-demethylation by 16% whereas the N-demethylated metabolite decreased the N-demethylation of A by 10%. Concomitant administration or pretreatment with fleroxacin had no effect on antipyrine's elimination kinetic parameters.

Animals↗

[Early surgery of intracranial aneurysms].

In spite of scientific progress during the last two decades, microsurgery, neuroanesthesiology, and a better knowledge of the pathophysiology of cerebral vasospasm, the outcome of subarachnoid hemorrhage (S.A.H.) patients remains very poor. Each year, 28,000 North Americans are afflicted. Eighteen thousand of these patients will either die or become severely debilitated, a mortality morbidity of 64%. Only one patient out of five may return to the premorbid state. International cooperative studies report that the highest rate of rebleeding occurs during the first 24 hours post S.A.H. There is no rebound phenomenon during the 7th-8th day post S.A.H. Cerebral vasospasm begins during the 2d-4th day post S.A.H. and reaches its peak around the 8th day post bleed. Antifibrinolytics like AMICAR (aminocaproic acid) do not reduce significantly the rebleeding rate. In most of the cases the therapeutic level of these drugs is reached only on the third or fourth day of treatment. Hence antifibrinolytics are inactive during the first crucial seventy two hours. Antifibrinolytics increase the incidence of vasospasm, hydrocephalus, and thromboembolic phenomenon. At Infant Jesus Hospital, Quebec City, S.A.H. patients are operated on early since more than two years. Patients included in this study were admitted between January 1983 and December 1984. One hundred and thirty six patients were operated upon, 22 patients operated on acutely, less than 72 hours post S.A.H. Evaluation of these patients included the Glasgow Coma Scale (G.C.S.), the grade according to Botterell classification, a CT Scan, and angiography. A preoperative evaluation included Botterell classification and G.C.S., a post operative evaluation was performed during the first and seventh post operative days.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Intracranial dysgerminomas.

We have reported three cases of intracranial dysgerminoma. The origin of these tumors has been controversial for a long time. It is now accepted that they develop from germ cells. The diagnosis is often difficult to confirm because of the varity of signs. If their origin is now accepted, the best way to deal with these lesions is still controversial. They can be macroscopically removed if they are in the pineal region. Such treatment is not possible for suprasellar tumors. Since these tumors can metastasize, radiation should be administered as soon as a pathological diagnosis is obtained. It is our belief that it should be administered to the whole spinal axis.

Adolescent↗