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Biomedical subjects

M Magne

Publications and source records attributed to M Magne.

13 recordsLinked to original sources
PubMed1999

A matched comparison of the combination of prehospital thrombolysis and standby rescue angioplasty with primary angioplasty.

This study sought to assess the rate of acute Thrombolysis In Myocardial Infarction (TIMI) trial grade 3 patency that can be achieved with the combination of prehospital thrombolysis and standby rescue angioplasty in acute myocardial infarction. No large angiographic study has been performed after prehospital thrombolysis to determine the 90-minute TIMI 3 patency rate in the infarct-related artery. Hospital outcome and artery patency were compared to 170 matched patients treated with primary angioplasty. Prehospital thrombolysis was applied 151+/-61 minutes after the onset of pain in 170 patients (56+/-12 years, 86% men), using recombinant tissue-type plasminogen activator, streptokinase, or eminase. Emergency 90-minute angiography was performed in every case. All patients in whom thrombolysis failed underwent rescue angioplasty. After thrombolysis alone, TIMI grade 3 flow in the infarct-related artery was observed in 108 patients (64%), TIMI grade 2 in 12 (7%), and TIMI grade 0 or 1 in 50 (29%). Rescue angioplasty was successful in 47 of 50 attempts. Overall, TIMI 3 patency was achieved in 91%, and additionally TIMI 2 flow in 7% of patients, an average of 113+/-39 minutes after thrombolysis and 55+19 minutes after admission. Therefore, < 2 hours after thrombolysis, only 2% of patients had persistent occlusion (TIMI 0 or 1) of the infarct-related artery. In-hospital mortality was 4% overall (7 of 170), and 3% in the 155 patients in whom TIMI 3 was obtained during the acute phase. Severe hemorrhagic complications occurred in 14 patients (8%) with 2 fatal cerebral hemorrhages (7% of patients required transfusions). The matched comparison with primary PTCA showed no significant difference in hospital outcome. Combined prehospital thrombolysis, 90-minute angiography, and rescue angioplasty yield a high rate of acute TIMI 3 patency rate early after thrombolysis and hospital admission. A randomized, prospective comparison between these 2 reperfusion strategies may be now warranted.

Adult↗
PubMed1999

The esthetic width in fixed prosthodontics.

With the evolution of adhesive dentistry and the increasing use of porcelain veneers, single-unit crowns generally are restricted to the replacement of pre-existing full-coverage crowns and the restoration of nonvital and/or severely damaged teeth. Porcelain-fused-to-metal restorations are still widely used to generate single-unit crowns and fixed partial dentures. Collarless metal-ceramic restorations represent the most successful evolution among efforts to meet maximum esthetic requirements using porcelain-fused-to-metal restorations. Extended metal frameworks and opaque aluminous ceramic cores are associated with unpleasant optical effects in the soft tissues surrounding such restorations. This problem is particularly evident in the presence of the upper lip, which can generate an "umbrella effect" characterized by gray marginal gingivae and dark interdental papillae. Based on the concept of the biologic width, a systematic approach is proposed for the elaboration of an "esthetic width," including: 1) positioning of preparation margins; 2) reduction of the metal framework; and (c) appropriate marginal design of porcelain-fused-to-metal restorations. Strategic features of pontics and a specific interdental design are suggested to compensate for deficient anatomical features of the soft tissue and the edentulous ridge.

Crowns↗
PubMed1997

[Evaluation of acute pain in prehospital medicine].

OBJECTIVE: To evaluate acute pain in prehospital setting. STUDY DESIGN: Prospective survey. PATIENTS: All eligible patients during a 3-month-period, excepted children less than 10-year-old. METHOD: Pain intensity was evaluated by verbal rating scale with 5 points (VRS), visual analog scale (VAS), demand for antalgics by the patient and the relief obtained. These data were collected at the beginning (T0) and the end (Tend) of medical management. Analgesic treatments were let at the physician's choice. RESULTS: A series of 255 patients were included (mean age 58 +/- 1.5 SEM, sex-ratio 57M/43F). Among them, 42% experienced pain at VRS. VAS could be used in 60% of patients. VRS evaluated by the patient was correlated to the VAS (P < 0.001). Among those with significant pain (defined by a VAS > or = 30 mm), only 31% asked for analgesia and 64% received analgesics. Pain scales (VRS and VAS) were significantly improved (P < 0.001) at the end of the medical management, except for patients who did not receive any treatment. However, mean VAS was still above 30 mm, even in patients receiving analgesics. Only 49% of patients expressed a good relief at the end of the medical management. CONCLUSION: Acute pain is frequently observed in prehospital emergency medicine. Pain scales such as VRS and VAS are used easily and convenient for the assessment of pain intensity in this context. However, even if pain is correctly evaluated, it is still inadequately treated. The reasons of these inadequacies must be assessed and corrected with pain treatment protocols including opioids.

Acute Disease↗
PubMed1996

The diagnostic template: a key element to the comprehensive esthetic treatment concept.

Provisional restorations represent a key element in the realization of extensive esthetic rehabilitations. In particular, they provide indispensible diagnostic information contribute significantly to adjacent soft tissue conditioning, and ensure the patient's comfort during the intermediate phase of treatment. The-treatment outcome strongly depends on the treatment approach chosen. This article describes a treatment rationale comprising the use of a diagnostic template. This type of work strategy, documented with clinical cases, integrates diagnostic waxups and indirect provisional restorations using simplified and efficient fabrication techniques.

Dental Impression Technique↗
PubMedDate not supplied

[Chronic ischemia of the anterior horn of the lumbar swelling of the spinal cord. Angiographic study in a subject with herniation of the T12-L1 discs].

On the basis of a case of almost pure involvement of the anterior horn with chronic progression in an individual with a low thoracic herniated disc (T12-L1), the hypothesis is discussed of the role of ischaemia of the lumbar swelling. Angiographic arguments (displacement of the anterior spinal axis and unusual distribution of anterior spinal afferents) perhaps make it reasonable to speak of "chronic ischaemic poliomyelitis" in the absence of pathological examination.

Adult↗