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Biomedical subjects

J S Bedoucha

Publications and source records attributed to J S Bedoucha.

11 recordsLinked to original sources
PubMed1996

Epidermoid carcinoma complicating chronic osteomyelitis of the femur.

A case of epidermoid carcinoma of the femur that arose in an area affected with chronic osteomyelitis for over 40 years is reported. The incidence of this rare complication has been estimated at 0.23% to 1.6% of all cases of chronic osteomyelitis. Although cases of sarcoma, adenosarcoma, plasmocytoma, and malignant fibrous histiocytoma have been reported, epidermoid carcinoma is the most common cancer type. This tumor develops after 20 to 40 years of chronic infection with a discharging fistula. Epithelialization of the fistulous tract has been demonstrated. The cancer arises in the metaplastic epithelium and can secondarily spread to the bone. Despite the low grade of malignancy of many of these epidermoid carcinomas, pulmonary metastases are not rare. Amputation meeting criteria for oncologic surgery is the only means of ensuring a good prognosis.

Aged↗
PubMed1977

[Synovectomy in the treatment of acute arthritis caused by Micrococcus pyogenes].

In addition to antibiotic therapy associated with immobilization in a plaster cast, effective in the majority of cases of acute arthritis caused by St. pyogenes and resection-arthrodesis which is necessary in the stage of osteoarthritis, synovectomy occupies an intermediate position. During a period--possibly not a short one--when the lesions are still purely synovial and do not regress under medical treatment, their ablation permits recovery from the infection with restoration of the functional activity of the joint. The experience is based on 26 observations (19 knees, 3 hips, 2 shoulders, 1 thumb, 1 metacarpo-phalangeal lesion). In 2/3 of cases these arthritides were iatrogenic (13 after cortisone infiltration, 4 postoperative, 1 haematogenic from i.v. catheterization). Synovectomy should be complete; haemostasis must be rigorous; an aspiration drain is left in place for 5 or 6 days; additional immobilization in plaster is not obligatory; antibiotic treatment is continued until the BSR has returned to normal. As regards control of the infection, this was obtained in 19 of 26 operations. As regards function, in 10 of these cases the results were very good, in 7 good (slight persistent restriction of movement), in only 2 cases the results were unsatisfactory. The factors that appear to affect the results are on the one hand rigorous technique and on the other sufficiently early operation before the lesions have become too fully established. However, a study of arthritides after cortisone infiltration of previously affected joints has shown that even relatively late operation can lead to satisfactory results (9 of 13).

Acute Disease↗
PubMed1977

[Treatment of fractures of the cervical spine and of the dorso lumbar spine with neurological complications (author's transl)].

Our surgical therapeutic attitude in neurological complications of fractures of the spine seems to us justified by the results which we have obtained. It never caused any aggravation and permitted better relief of the complications of bed rest during the early stages. It always permitted satisfactory vertebral position. It is of course difficult to say definitely whether it was responsible for the neurological recovery often observed. It is nevertheless probable in a certain number of cases and in any case, this recovery will occur under better conditions more favourable for later rehabilitation. But one should emphasise if one wishes to improve further the results, that this reduction should be performed very rapidly.

Adult↗
PubMed1975

[Treatment of idiopathic femur head necrosis with an appropriate cup with cylindrical support].

The objective of treatment of necrosis of the femoral head by means of an appropriate cup is to protect the sequestrum and to avoid secondary arthrosis. Hemispherical cups have a tendency to be easily deformed; cups with cylindrical support should be used in preference as they are mechanically stable and make it possible to cover the femoral head in cases of relatively extensive necrosis. Good results are obtained quickly and are often spectacular : in 90 percent of the cases operated on, pain disappeared or was reduced and normal socio-professional activity was again possible. A clinical and radiological study of 30 hips treated at least 2 years previously, established that the result was stable in the majority of cases : there was one real clinical and radiological deterioration, two cases of pinching of the interspace. This operation is thus worth while in all cases of necrosis, at the stage when the sequestrum is clearly delimited and when there is clear deformation of the contour of the femoral head. It also seems to be worth while at the "eggshell" stage, when the lesions detected at the time of an operation are aften considerable and appear non-reversible : the quality of the results obtained mean that the criteria of tolerance should be much more severe.

Adolescent↗