[Trigeminal sensory neuropathy disclosing sarcoidosis].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M Dupuy.
Explore the source record for details and available documents.
Slowly progressive cervical cord symptoms over a 2 year period led to the diagnosis of Waldenström macroglobulinemia in a 32 year old man. Diagnosis was made on the finding of circulating monoclonal IgM and lymphocyte infiltration of the bone marrow. Perimedullary infiltration of cervico-dorsal cord was visualized by CT scan. No other tumor tissue was found. Intrathecal secretion of IgM in the CSF was demonstrated. Cervico-dorsal cord radiotherapy followed by systemic chemotherapy led to a rapid improvement in the neurological signs. Reports of spinal cord lesions in Waldenström macroglobulinemia are rare and the relationship of this condition with respect to so-called secreting neurolymphomatosis is discussed.
Over a 20 months' period, 230 patients were treated in an intensive care unit for acute cerebral vascular accident. There were 157 ischaemic accidents and 73 haemorrhages. The mean age of the patients was 61.7 years. Mechanical ventilation was used in a quarter of the cases, and tracheotomy was performed in 7%. Surgery was considered necessary in only less than 5%. The overall mortality in the unit was 20% for patients with established ischaemia and 44% for those with cerebral haemorrhage. After 6 months, 64% of patients with ischaemia and 44% of patients with haemorrhage were still alive; 82% were independent, usually without sequelae, and 6% were bed-ridden; 15% of those who had mechanical ventilation survived. Prognostic factors are analyzed and the role of intensive care units in the management of cerebral vascular accidents is discussed.
In this article, we propose a new hypothesis concerning biological semipermeable membranes, the walls of vessels or tubules of the human organism. As regards the properties of diffusion of the membranes, this hypothesis includes the phenomena of active and passive transport; as far as the properties of diffusion and osmosis are concerned, it takes into account the orientation of the phenomena, which explains its name: hypothesis of selectivity. By applying this theory to the problem of the transport of salts and urea in the nephrons, we demonstrate that this property is a necessary and sufficient condition to explain the part and working of the functional unit of the kidney, i.e., the nephron, and to validate its operating model, subject of our study. No contradiction has appeared within the present experimental results.
After a short review of the functional anatomy of the kidney, we express the usual hypotheses about the phenomena of reabsorption and filtration in the loop of Henle and the collecting duct. Starting from these hypotheses and the laws of biophysics, we formulate the equations of the model. This model accounts for the great increase in concentration of electrolyte and urea in the loop of Henle, the collecting duct and the interstitium, as we "go down" from the outer medullary area towards the inner areas, the active transportation of sodium in the loop of Henle being limited to the thick ascending limb.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A computer-assisted patient-care management system is currently operating in two patient-care units as part of a pilot project at the Hôpital Cardiologique, a member institution of the Hospices Civils de Lyon. The system includes the management of administrative records (notice of admission set to the patient-care unit, appointment for admission sent to the patient, notice of admission set to the physician requesting hospitalization, admissions and discharges, patient census) and of patient-care records (orders, examinations, laboratory tests, medications, injections and treatments, a summary list or orders to be carried out during the day, labels for laboratory specimens and requistions for the tests and examinations to be performed); and the medical management of the patient (clinical summary of patient status at admission, results of tests and examinations, summary of hospitalization, data for research and statistics). Computerization was begun in 1977, following the implementation of individualized patient-care records in 1976. The system will be evaluated in 1978 and extended to the remainder of the hospital (18 patient-care units) by the end of 1979.
Assessment of clinical health care focuses on 'what is really done' in order to describe day-to-day practice. These data could be compared with standards or guidelines. The method used, the 'clinical audit', aims to improve the quality of care through specific actions. Finally, a second data collection could assess the efficacy of these actions. Many protocol designs could be used; they are illustrated by two examples in this article. The choice of protocols depends on the field and on the objectives of the work. Most of the time, assessment of clinical health care is included in a continuous quality improvement programme.