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Biomedical subjects

M Di Schino

Publications and source records attributed to M Di Schino.

At least 19 recordsLinked to original sources
PubMed2006

[A prosthetic joint infection caused by Streptococcus pneumoniae: a case report and review of the literature].

We report a case of hematogenous streptococcus pneumoniae infection of a total knee arthroplasty observed in an 82-year-old woman who initially presented a lung infection. The therapeutic approach was largely dictated by the patient's precarious general status. Arthroscopic washings were associated with adapted antibiotics followed by removal of the prosthesis and replacement with a spacer. The patient declined further intervention so the prosthesis was not reimplanted. Hematogenous infections of joint prostheses are rarely caused by such streptococcal species. Since this is a well known germ, it would be logical to apply the usual rules for treatment of infected prostheses caused by sensitive germs. However, the analysis of the present case and a review of the literature shows that various therapeutic approaches have been used. These infections appear to be more common in seriously ill patients which could explain this variability. Mortality is high. The number of reported cases is too small to propose a specific treatment.

Aged, 80 and over↗
PubMed1995

[One-year follow-up of 466 nerve decompressions in 123 lepers during multidrug therapy in Madagascar].

Surgical decompression of nerves in patients with leprosy is a simple procedure that can be used in developing countries. At the leprosy center of Ambatoabo on the east coast of Madagascar, 466 nerve decompressions were performed on 123 subjects and results were evaluated by the same examiner 15 months later. All subjects were undergoing multidrug therapy at the time of the procedure. The decision to perform surgery was based on recent onset of sensory and motor neurologic signs and on progression or persistence of symptoms despite administration of prednisolone. Decompression led to pain relief in 100% of cases and regression of sensory disturbances in 97%. Sensory recovery in the plantar ulcers of the foot was obtained in 80% of cases and motor performance improved in 61%. These favorable results confirm the value of surgical decompression to prevent sequels of leprosy and the feasibility of this procedure in remote areas.

Adolescent↗
PubMed1994

[Results of 466 nerve decompressions in 123 leprosy patients during polychemotherapy with a minimum follow-up of one year. Value of preventive surgery in a leprosy control program].

The clinical expression of leprosy is primarily cutaneous but its serious neurologic manifestations are maiming. Mutilations mainly of limb ends are due to peripheric nerves compression and may appear before or during the clinical treatment of the illness. Their appearance which is not automatically related to multiple Hansen's bacilli, may be prevented surgically by nervous decompression. The authors report their experiences of 466 nervous decompressions of 123 patients (89 men and 34 women), among them, 14 were pauci-bacillary and 109 multi-bacillary. They conclude that very good results (complete recovery or improvement of sensitivity, disappearing of pain) have been obtained through simple and easy-to-learn surgeries.

Adolescent↗
PubMed1991

[Post-traumatic osteolysis of the distal end of the clavicle. Contribution of MRI].

The authors describe a case of post-traumatic osteolysis of the clavicle. The clinical and roentgenographic aspects are well known. But regarding the lytic X ray aspect, another diagnosis, particularly a tumor may be evoked. Scintigraphy and computed tomograms can take a part in the diagnosis. But scanograms are uneasy to do in this region. The MRI allows to delimit the lesion, and the hypointense signal in T1 and T2 weighted sequences directs to a fibrosis in the area between the end of the clavicle and the acromion. In this case report, the relation between the MRI findings and the pathological aspects was good.

Adult↗
PubMed1991

[Fractures of the capitellum humeri with late discovery].

Four patients with an old fracture of the capitellum humeri were treated by simple excision of the fragment. The results were good in two patients and fair in the two others. The event of a painless period in two cases raised the problem of the limits with the osteochondritis dissecans.

Adult↗
PubMedDate not supplied

[Extra-abdominal desmoid fibroma and pulmonary metastases. (New Caledonia)].

A 22 years old Melanesian patient had a tumor in the anterior and external side of the left leg. Three times, this tumor had a surgical treatment, by resection, then an amputation of the leg. Always, its histological aspect was agreeing with a desmoid fibroma. After an evolution of 23 months time, metastases appeared in the lungs. Most of the authors don't agree the existence of metastases in these tumors. Four observations were reported in the literature, including one in 1989. They emphasize the difficulties of the histological diagnosis of these tumors. The metastases seems to be an argument in the evolution, which incites to modify the initial diagnosis as a fibrosarcoma in spite of the lack of obvious histological malignancy.

Adult↗
PubMedDate not supplied

[Resection of the distal part of the humerus in neglected elbow dislocations. Apropos of 23 case reports].

The authors describe the results obtained in 23 resections of the lower extremity of the humerus in neglected elbow dislocation examined after periods of between 7 years to 4 months. Results on elbow mobility are satisfactory in more than 70% of the cases, taking into consideration initial disability. But the cost of such intervention to be paid is often a laxity of the elbow and diminished strength. Indications are inveterate disabling dislocation, in case of immediate or late failure of open reductions.

Adolescent↗
PubMedDate not supplied

[Open reduction of the elbow. Apropos of 29 neglected dislocations].

The authors describe results and technical difficulties faced in a series of 29 elbow dislocations using the open technic, then observed over a period between 5 years and 4 months. Results obtained are satisfactory, taking into consideration the primary stiffness. Results on stability are better than those obtained by resection of the lower part of the humerus. Dislocations by the open technic have to be envisaged first in neglected luxations. Indications are limited to patients crippled and limited to non-functional position.

Adolescent↗
PubMedDate not supplied

[Malignant melanoma among the ethnic Melanesian population of New Caledonia].

Melanesian population amounts to 61,270 out of 145,368 inhabitants in New Caledonia according to the last census. Melanesians of phototype VI have no predisposition in regard to malignant melanoma. From 1977 to 1987, 7 cases have been reported. Localisations are always in some zones not exposed to sunlight: 3 acral-lentiginous melanoma of the sole, 2 tumorous nodules of the anus margin and the vulva, 2 choroidal localisations. So, incidence of cutaneous malignant melanoma is very low (0.7/100,000 per annum) and in accordance with classical data regarding black people. But one has to keep in mind its being in some characteristic localisations. All the above referred cases have been detected at an advanced local extension.

Adult↗
PubMedDate not supplied

[A makeshift miniature fracture-fixation device: the "domino" apparatus].

The fixation of an external synthetic apparatus on fingers or metacarpals is often relevant to an emergency. In such a condition, particularly overseas, the surgeon does not get all the time and adequate apparatus. So, several expedient measures may be utilized. The authors describe a makeshift apparatus, simple and cheap, giving satisfactory stability when more sophisticated apparatus is not available.

Finger Injuries↗
PubMedDate not supplied

[Cutaneous malignant melanomas in New Caledonia. Study of the Cancer Registry (1977-1987)].

Investigation of cancer registration files in New Caledonia over a period of 11 years (1977-1987) draws the following conclusions: --The uncorrected incidence rate of cutaneous malignant melanoma is 3.63/100,000 inhabitants/year, for all ethnic groups together. --The incidence rate in the "non-European" population is 0.6/100,000 inhabitants/year. This low incidence and the anatomo-clinical manifestations observed (lentiginous melanoma of extremities) are common in coloured people. --The incidence rate in the "European" population is 8.75/100,000 inhabitants/year is noticeably higher than the incidence in the metropolitan population. Such conclusions are in accordance with the admitted data regarding epidemiology of cutaneous melanoma in high insolation countries. Cumulated incidence rate and topography of lesions are similar in this series whatever the sex.

Adult↗
PubMedDate not supplied

[Chondrosarcoma with a myxoid component. Apropos of a "giant" tumor recurrence].

Reporting on a giant tumorous recurrence of a chondrosarcoma with a myxoid component, without perceptible locoregional or general extension, the authors recall the possible long-term evolution of this type of tumor. They underline the difficulty of anatomopathologic diagnosis of tumors with cartilaginous structure, and the necessity for frequent monitoring after exeresis.

Chondrosarcoma↗