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Biomedical subjects

M H Boucand

Publications and source records attributed to M H Boucand.

8 recordsLinked to original sources

[Ehlers-Danlos syndromes: we are all concerned].

UNLABELLED: EHLERS-DANLOS SYNDROMES (EDS): A heterogeneous group of hereditary conditions having in common a molecular anomaly of the extracellular matrix comprise EDS. Clinical and genetic features are used for classification and in some cases the molecular anomaly can be demonstrated. Six main types are recognized and termed classic, hypermobile, vascular, cyphoscoliotic, arthrochalasic and dermatosparaxis. CLINICAL MANIFESTATIONS: Skin and joint signs predominate, visceral disease is fortunately rare. The skin is hyperelastic and heals poorly. Joint involvement may lead to luxations and early-onset osteoarthritis causing chronic pain. The prognosis is severe in certain types such as vascular EDS where arterial ruptures may be life-threatening. Patients with cyphoscoliotic EDS may become bedridden due to the scoliosis and muscular hypotrophy. Minor forms as well as rapidly fatal major forms often go undiagnosed or are identified late after a complication which could have been avoided. MANAGEMENT: A multidisciplinary approach is needed as certain interventions, technical procedures or explorations may have catastrophic consequences. The creation of an EDS association would be helpful in federating specialists and allow global management. The gravity of certain forms, the poorly understood epidemiology and the progressive nature of EDS point to the need for a national registry.

Ehlers-Danlos Syndrome↗

Paraplegia and decompression sickness.

Decompression sickness may include spinal cord damage, which sometimes persists. Casual divers are exposed, as well as professionals. In this study we have reviewed the clinical records of divers admitted with symptoms of spinal cord injuries in our area in the last 6 years. This study is divided into two groups: those who fully recovered (19 divers) and those with neurological sequelae (12 divers).

Adult↗

[Intensive care ... and after?].

The relations between reanimation's and reeducation's sets are very important. Reanimation's set prepare brain or spinal injured patients to go to the reeducation unit. Aims of reeducation open on quality of life and rehabilitation.

Adaptation, Psychological↗

Effects of bethanechol and adreno-blockers on thermoregulation in spinal cord injury.

The authors report two cases of hypothermia due to a treatment associating Bethanechol and Adreno-Blockers. They emphasize the mechanisms of thermoregulation and discuss the pathophysiology of such hypothermia incidents. The most evident explanation is heat loss, principally mediated through Bethanechol, whereas mechanisms of heat preservation are prevented by Adreno-Blockers. Patients susceptible to this risk must be carefully monitored.

Adult↗

[Value of studying spinal evoked potentials in patients with thoracolumbar spinal cord lesions].

31 control subjects and 14 patients with dorso-lumbar spinal cord lesions were studied using the spEP (spinal evoked response). The presented responses were recorded by subcutaneous needle electrodes following stimulation of the peroneal nerve. Results from control subjects are presented first (triphasic negative potential, latency increasing with level of recording). The 14 patients were grouped according to their clinical symptoms. The prognostic value of the spEP response was considered. Results were as follow: flaccid paraplegia with no motor response to stimulation: no spEP was recorded; complete anatomoclinical paraplegia: the spEP was normal caudal to the lesion and negative rostral to the lesion; complete paraplegia with minor anatomical lesions: prognosis was good when spEP rostral to the lesion was recorded and poor when no response was detected; motor paraplegia: the spEPs rostral and caudal to the lesion were normal. In all cases, the levels of the lesions were in accordance with the upper level at which changes in spEPs were observed.

Adult↗

[Alveolar cancer and localized parieto-alveolar fibrosis].

We report a case, cytologically diagnosed, of broncho-alveolar cancer associated with localised interstitial pulmonary fibrosis. This association of fibrosis with bronchiolo-alveolar cancer is classical and a pathogenic affiliation has been deduced by the majority of authors. We review the pathogenesis in relation to recent datas concerning the activation of successive oncogenes: the first stage of carcinogenesis may correspond to the activation of an oncogene coding for a fibroblastic growth factor leading to fibrosis.

Adenocarcinoma↗

The female paraplegic: a statistical survey.

From November 1969 to December 1979, 1234 patients with spinal cord lesions were treated at the Henry Gabrielle Hospital. Of these 386 were from medical causes and 848 from trauma. The computer study of these cases brings out statistical differences between the sexes as the overall incidence in females is 30 per cent and even lower if one considers traumatic cases only 22.4 per cent out of the 848 cases. Furthermore, the average female paraplegic is two years older and it was noted that more females are married. In females the causes of spinal cord injuries are more frequently car accidents and suicidal falls from high places, whereas in males the causes are related to direct blows, that is sport injuries, motorcycle accidents and industrial falls. Clinical symptoms are similar in the two groups with the exception that there is less heterotopic ossifications and fewer bladder stones in females. The duration of hospitalisation is shorter in females. A well equipped household is more important for the handicapped females than for males.

Adolescent↗