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Biomedical subjects

J Gruffaz

Publications and source records attributed to J Gruffaz.

At least 19 recordsLinked to original sources
PubMed1995

[Management by the angiologist of sequellae of radiosurgical treatment of breast cancer].

Often called in to give his opinion on lymphoedema of the upper limb after radiosurgical treatment for breast cancer, the angiologist should be familiar with the anatomic lesions induced by the treatment. The surgical procedure varies from simple tumourectomy to complete mammectomy. Complications include infection followed by fibrosis and occlusion of the collecting lymphatic vessels. Axillary venous thrombosis is exceptional. Dissection of the lymph nodes interrupts lymph drainage of the homolateral limb leading to lymphoedema which is worsened by fibrosis, venous stasis and damage to the plexus. Ionization therapy causes multiple organ damage to viscera (lungs, pleura), skeleton (ribs, clavicle), myocardium and coronary arteries, mediastinal brachial plexus, skin fibrosis, arterial obliteration and venous narrowing and thrombosis. Chemotherapy causes thrombosis of the superficial veins after perfusion. Deep vein thrombosis is rare. These lesions rarely occur alone. The clinical course of the associated lesions is part of a major psychological context which must be taken into account. The angiologist should perform a careful clinical examination, detect and document possible recurrence, explore the vascular axes with echo-Doppler or plethysmography when needed in order to detect the venous lesions which occur in 50% of the cases. Lymphatic involvement in lymphoedema is clinically obvious and may not require further explorations. Treatment is difficult in cases with associated venous involvement. Strapping with or without pressure, manual lymphatic drainage, active mobilisation and elastic sleave after reduction are used. When detected early venous thrombosis is managed as other deep vein thrombosis. Arterial damage may appear late (delay more than 3 years) in rare cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗
PubMed1985

[Manual lymphatic drainage].

Manual lymphatic drainage is non-invasive physiological method. Its real effectiveness still has to be demonstrated by means of a comparative quantitative experiment against other techniques. It is still difficult to apply for material reasons such as the small number of physiotherapists and the lack of inscription in the Social Security nomenclature. These two problems can only be resolved by a further development of the technique.

Drainage↗
PubMed1980

[Clinical aspects of acute inflammatory exacerbations lymphoedema (author's transl)].

An acute inflammatory exacerbation is the most frequent complication of lymphoedema. The provoking cause may be trauma. Favouring factors are obesity and heat. 1/3 of patients suffer from such acute inflammatory exacerbations. The onset is sudden, with fever, redness, pain and local heat. After repression of the acute, inflammatory episode, the oedema is often increased. Treatment involves antibiotics, corticosteroids, vaccinotherapy and bed rest. It is possible to prepare sequential treatment, drug prevention with general and dietary measures.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Edema of the lower extremities in the aged patient].

Oedema of the lower limbs in the elderly patient are sometimes easy to diagnose in cases of cardiac, renal or hepatic incompetence. But oedema can also be of venous origin: superficial (varicose) incompetence, or deep, with thrombosis (recent or previous] or compression. Certain oedema are of arterial origin when there is pain in the supine position, or after revascularization. Lymphostatic oedema are rarely primary, and most often indicate a pelvic tumour which has escaped diagnosis or has relapsed, sometimes following surgical or ionising treatment. A compressive treatment must take into account the arterial condition of the patient as well as any motor handicaps.

Aged↗
PubMedDate not supplied

[Venous component in lymphedema of the upper extremity after radio-surgical therapy of cancer of the breast].

The part played by the veins in lymphoedema--still controversial--can be investigated by means of venous functional exploration techniques. 58 patients had comparative venous Doppler and rheoplethysmography of the two upper limbs, in both the seated and prone positions. They had lymphoedema in the arm following radiosurgical treatment for breast cancer. 67% of these examinations were normal in the two positions. 20% of the patients had indications which vary according to their position and in 31% it was pathological in both positions. These disorders can be attributed to venous thromboses, fibrosis, static disorders, and disorders of the scapular girdle.

Adult↗
PubMedDate not supplied

[Compression technic of the upper limbs with adhesive bands to reduce edema].

Whatever the cause of an edema of the lower limbs, compression with temporary or permanent adhesive bands proves efficient. The wide range of bands proposed by manufacturers, makes it possible to find compressions that are well-suited to the case to be treated. The band should be rolled from the end to the root of the limbs, protect the skin beforehand with cotton and talcum. The deltoidian area is molded by cutting pieces of the band. The hand is also wrapped, with the fingers left free. The difficulty resides in the pressure to be applied: it is preferable to proceed in a gradual manner, beginning with a slight pressure. The bandage should be changed once or twice a week while the edema is being reduced, but may be left in place for six weeks.

Adhesives↗
PubMedDate not supplied

[Anatomy and physiology of the lymphatic system].

The lymphatic capillaries, elements of the micro-circulatory unit, are formed within the interstitial tissue to which they are fixed. The convergence of the interstitial capillaries creates collectors which become increasingly large and valved. Distributed along the main vascular tracts for the deep network and along the subcutaneous for the superficial, anastomoses exist between the deep and superficial networks and others form in certain pathological conditions. It is the liquid impregnation of the interstitial tissue which triggers off the filling of the lymphatic vessel. Lymph progresses thanks to: the presence of valvules on the collectors, the arterial pulse, the muscular contractions, the pressure of adjoining tissues, and to thoracic aspiration. Nervous and hormonal phenomena are responsible for the formation and progression of the lymph.

Arteries↗
PubMedDate not supplied

[A year's review of the treatment of lymphedema of the extremities with the Lymphapress (preliminary note)].

Lymphoedema of the limbs constitutes a chronic disorder. Its form may vary but its treatment is now well-established and medical and surgical therapies have been perfected. We have tried out the Lymphapress as a replacement of Van der Molen's treatment used successfully since 1968. After a brief anatomopathological resume based on Foldi's theory, we recall the various therapeutic indications and the observation of a patient with lymphoedema of the limbs following surgery and Cobalt for seminoma, which we treated using the Lymphapress. The results are analysed. 17 patients were treated between April and June 1979. The method of treatment is not detailed here. This technique does not dispense with secondary compression; it replaces the "piping" used by Van der Molen in major lymphoedema.

Adult↗