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Biomedical subjects

M Laskar

Publications and source records attributed to M Laskar.

At least 55 records · Page 3Linked to original sources
PubMed1994

[The causes of intracranial hemorrhagic complications induced by antivitamins K].

Cerebral haemorrhage is the main life-threatening complication of oral anticoagulant therapy. In order to identify a means of prevention, the authors undertook a retrospective study of 68 consecutive cases of anticoagulant-related intracerebral haemorrhage. The mortality was 38.5%. The respective frequency of intracerebral haemorrhage, subarachnoid haemorrhage, acute and chronic subdural haematomas was 63.2, 16.2, 10.3 and 10.3%, respectively. On admission, nearly half the patients (53%) had prothrombin ratios inferior to 25%. A predisposing factor was found in 58% of cases: hypertension (30.6%), head injury (14.5%), alcoholism or drug interaction (11.2%), and one case of intracerebral aneurysm. A history of a transient ischaemic attack or of a cerebrovascular accident was found in 10.2% of cases and 11.7% had a previous anticoagulant related extracranial haemorrhage. The initial indications for oral anticoagulation were ischaemic heart disease (32%), atrial fibrillation (20.5%), secondary prevention of venous thromboembolic disease (17.6%) and primary prevention of venous thrombosis (11.7%). The duration of treatment for isolated ischaemic heart disease was over 6 months in all cases: the average duration of treatment was 12.4 months in phlebitis and pulmonary embolism. A critical review of the indications of treatment in the light of recent recommendations showed that if inappropriate indications were rare, the sometimes unnecessary prolongation of treatment was more common. Nearly half of these cases were receiving anticoagulants when the potential benefits were questionable at the time of the haemorrhagic complication. Clinical and biological follow-up is necessary for patients on anticoagulants; minor bleeding complications may be the prelude to major haemorrhage. Biological follow-up is based on control of the international normalised ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Hydroxycoumarins↗
PubMed1994

[Ehlers-Danlos type IV syndrome presenting as renovascular hypertension].

The association of Ehlers-Danlos type IV syndrome and acrogeria with renovascular hypertension is reported. Ultrastructural abnormalities observed in our case were different of those associated with acrogeria. We propose that acrogeria associated with Ehlers-Danlos type IV syndrome be a different disease of acrogeria of Gottron. The occurrence of renovascular hypertension in Ehlers-Danlos is unusual.

Adult↗
PubMed1993

[Popliteal venous aneurysm. Apropos of 2 cases].

The authors report two cases of primary popliteal venous aneurysm. This condition is rare. The lesion may be clinically asymptomatic and may remain unrecognised since it is discovered most often during the investigation of thrombo-embolic complications. The diagnosis is based upon ultrasonography and phlebography. Asymptomatic forms should merely be monitored. Apart from anticoagulants, the treatment of symptomatic forms is surgical. Methods remain controversial.

Aged↗
PubMed1993

[Isolated iliac aneurysms. Sixty-seven cases in forty-eight patients].

77 pure iliac aneurysms where detected in a group of 48 patients along a period of 21 years, and represented 12.3% of all patients having aortic, iliac, or aorto-iliac aneurysms. The study group comprised 42 men and 6 women, 48-86 years old (mean 67.8 years). The aneurysm was located on the right side in 51.9%, on left side in 48.1%. The affection of the common iliac arteries (70.1%) was more frequent than it was on the internal iliac arteries (18.2%), or in the external iliac arteries (11.7%). The diameter was from 2 to 10 cms. 44 patients out of 48 (91.6%) where symptomatic, and 15 presented a rupture syndrome (31.3%). 10 patients (20.8%) had a pulsating mass. The etiology was unknown in 8 cases (16.7%); 2 patients had a mycotic aneurysm (4.2%). The remaining 38 patients (79.1%) had an aneurysm of atheromatous origin. 5 arteritic patients (10.4%) did not have any cure for their aneurysm, because it was considered threatening for 4 of them. The fifth patient was not treated because the artery was so calcified that it could not be clamped. A lumbar sympathectomy on the same side of the lesion was realised, in addition to the peripheral surgical act for arteritis. One patient had an endoaneurysmorrhaphy, another had an exclusion by ligature section of the aneurysm. For the remaining 41 patients (83.1%) the aneurysms where flattened, and vascular continuity was re-established by a prosthesis. 7 patients (12%) decreased post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Listeria monocytogenes femoral aneurysm].

Secondary infection of arterial aneurysms being a constantly possible complication, the bacteriological examination of peroperative specimens appears to be appropriate. Among responsible organisms, the presence of Listeria monocytogenes is very rare since only 13 cases have been reported in the literature. It is for this reason that it was felt to be of interest to report a new, entirely similar case of femoral aneurysm.

Aged↗
PubMed1992

Variations of blood PAF-acether levels during coronary artery surgery.

Extracorporeal circulation (ECC) is associated with thrombocytopenia and transient leukopenia. After ECC and coronary artery bypass graft (CABG) surgery, some patients can develop pulmonary and cardiac dysfunction, which might be related to the release of various mediators such as thromboxane A2, C5a, and C3a anaphylatoxins. The involvement of PAF-acether (PAF), a potent vasoactive thrombocytopenic and leukoneutropenic agent, has not been determined. Therefore, 10 patients were studied during and after CABG. The release of PAF, lipo PAF (PAF bound to blood lipoproteins), and lyso PAF (PAF precursor and metabolite) was measured in blood from the left atrium, radial artery, and pulmonary artery before and after CABG. PAF, lipo PAF, and lyso PAF were also determined during ECC at the entry and exit points of the oxygenator. Hemodynamic parameters, platelet, and leukocyte counts in the pulmonary artery were measured simultaneously. PAF did not increase significantly during ECC; it showed a transitory six-fold increase immediately after CABG in the radial artery (0.18 +/- 0.13 v 1.09 +/- 0.36 ng/mL, P < 0.05), but not in the pulmonary artery (0.10 +/- 0.03 v 0.56 +/- 0.21 ng/mL, P > 0.05). Blood PAF amounts in the radial artery were significantly higher than in the left atrium following ECC (1.09 +/- 0.36 v 0.06 +/- 0.04, P < 0.05), probably indicating PAF production in the heart. No variation of blood lipo PAF and lyso PAF was observed. No correlation was seen between PAF amounts and blood cell count.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1992

[Cannonball pulmonary hamartochondroma. Apropos of a case--review of the literature].

Chondroid hamartomas disseminated in both lung fields were discovered in a 76 year old man presenting with recurrent haemoptysis. In view of this metastatic cannonball appearance and the negative investigations, exploratory thoracotomy was performed, revealing the correct diagnosis. Although classical, this form of hamartoma is rare and warrants a case report.

Aged↗
PubMed1992

[Bacterial endocarditis complicated by popliteal and mesenteric aneurysms].

The authors report about one case of bacterial endocarditis complicated by fungal aneurysms in a superior mesenteric and a popliteal site. While the diagnosis was easy for the popliteal aneurysm, it was not so for the mesenteric aneurysm. Arteriography must have wide indications. The treatment of such aneurysms must always be medical, but surgical as well. The surgical tactics must be carefully discussed, and the restoration of vascular continuity with autologous venous material through an extra-anatomic course should be preferred.

Adult↗
PubMed1992

[Necrotizing fasciitis: a medical and surgical emergency. Apropos of a case].

We report about a 66-years-old obese and diabetic female patient, treated with anti-inflammatories for osteoarthritis of the hip and operated for varices of the lower limbs by a bilateral stripping of the internal saphenous veins, who presented with a mortal necrotizing fasciitis during the postoperative period. Necrotizing fasciitis is a severe, infrequent disease jeopardizing the vital prognosis, in which an appropriate and early treatment (medical, using antibiotics, and surgical by extensive debridement) can prevent a fatal outcome. The most often involved germs are streptococci (45%). The association of anaerobic and aerobic germs sometimes causes mixed cellulitis. The vital prognosis is always threatened by postoperative fasciitis. The mortality rate ranges from 50 to 75%, the main causes of death being a septic shock or pulmonary embolism. The functional prognosis of the surviving patients depends on the extent and quality of surgery.

Aged↗
PubMed1989

[Aortic valve replacement with extracorporeal circulation in a pregnant woman. Apropos of a case].

The authors report a case of surgical treatment of aortic stenosis in a pregnant woman (first pregnancy after four years treatment of sterility). The aortic valve replacement was performed at 16 weeks of amenorrhea. The valve was replaced by an Ionescu-Shiley bioprosthesis. Delivery was performed by caesarean section after 39 weeks of amenorrhea. There was no complication either for the mother or the child. Review of the literature allows analysis of the influence of aortic stenosis on pregnancy, and of the pregnancy on the tolerance of aortic stenosis. Some aspects of cardiopulmonary bypass for valve replacement in pregnant women are also analysed.

Adult↗
PubMed1988

[Post-pneumonectomy bronchial fistula. Treatment by resection of the carina].

A technique for the surgical treatment of bronchial fistulae developed after pneumonectomy is presented. This technique, which resembles that of Abruzzini, consists of resection of the carina followed by tracheo-bronchial suture in a healthy area away from any purulent focus of infection. It is easy to perform and facilitates the treatment of thoracic empyema which is no longer maintained by the fistula.

Bronchi↗
PubMed1988

[Vascular anastomoses of small caliber vessels. Comparison between continuous or interrupted sutures].

Continuous sutures are generally used to perform anastomoses on vessels less than 2 mm in diameter, but some surgeons advocate interrupted sutures which they claim cause less stenosis and provide better vascular potency in the long term. Arteriovenous fistula for chronic haemodialysis is a good model of anastomosis on 1 to 2 mm wide vessels. We used this model to compare the 2 techniques in 2 randomized groups of 20 patients each. The type of suture (continuous or interrupted) was drawn by lot in non diabetic patients who were having their first fistula for chronic haemodialysis. All anastomoses were performed by end-to-side implantation of a superficial vein onto the radial artery. Prolene 8/0 was used as suture material. The maximum follow-up period was 2 years. No significant difference in vascular potency could be demonstrated between the 3 groups. Thus, continuous sutures performed under suitable conditions can be used to perform with greater ease anastomoses which are as patent as those performed with interrupted sutures.

Arteriovenous Shunt, Surgical↗
PubMed1988

[Obstacle to left ventricle ejection after mitral valvular replacement with a Carpentier-Edwards bioprosthesis. Apropos of 2 cases].

Impairment of the left ventricular ejection induced by a mitral prosthesis remains an infrequent complication, perhaps because it often is unrecognized. This complication would mainly be seen with ball prostheses or standard bioprosthesis used in mitral valve replacements with a small ventricle. Two cases have been recently reported during mitral valve replacement. The two patients were successfully re-operated upon, one after five weeks and the second immediately after the first procedure. A review of the literature enable to specify the etiology and diagnostic criteria with the assistance of Doppler-sonocardiography. Early re-operation may prevent death, often due to a post-operative myocardial dysfunction.

Bioprosthesis↗
PubMed1985

[Aortocaval fistulas. Apropos of 5 cases].

UNLABELLED: 5 cases of aorto-iliac aneurysms which fistulised into the inferior vena cava are described. They illustrate the problems encountered in this condition. - DIAGNOSIS: although a classical diagnosis, it is only recognised in 27 p. 100 of cases because the clinical presentation can be very variable. A pulsating, expansive, abdominal mass very suggestive of an aneurysm of the abdominal aorta should alert to the possibility of a fistula within the inferior vena cava when the patient has unexplained cardiac failure, shock, lower limb deep vein thrombosis, urinary or psychological problems. In the absence of a continuous abdominal murmur, the diagnosis may be confirmed by complementary investigations; the investigations of choice are non-invasive. Abdominal ultrasonography showing an aneurysm of the abdominal aorta associated with dilatation of the inferior vena cava is very suggestive of the diagnosis. - The only treatment is surgery. The operative risk depends on the presence of absence of associated retroperitoneal rupture of the aneurysm, the respective mortalities being 83 p. 100 and 15 p. 100. - The principal causes of death are pulmonary embolism and renal failure which necessitate special prophylactic measures (surgical and anaesthetic).

Aged↗