PubMed Health⌕ Search

Biomedical subjects

M Noirclerc

Publications and source records attributed to M Noirclerc.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Prognostic nutritional index in digestive surgery].

It is difficult to select and combine the nutritional parameters most useful in predicting the outcome of major gastrointestinal surgery. The aim of this study was to define retrospectively a multifactorial prognostic nutritional index adapted to this purpose. Seventy-eight patients on whom one or more total or partial visceral resection were performed in nonemergency conditions were included in this study. Statistical analysis was carried out to determine correlations between the preoperative nutritional parameters and the postoperative complications such as: a) wound rupture and anastomotic leakage; b) severe sepsis; c) death. Delayed hypersensitivity, assessed as normal or abnormal, together with plasmatic albumin and transferrin levels, the thresholds of which were respectively determined at 35 g/l and 2.2 g/l, were selected as the factors with the greatest predictive value. For the prognosis of postoperative severe complications and death, the sensitivity and specificity of an index using the association of these three parameters were respectively 82.7 p. 100 and 51 p. 100 with positive and negative predictive values of 50 p. 100 and 83.3 p. 100.

Adolescent↗
PubMed1981

Surgical approach to corrosive injuries of the stomach.

The surgical management of corrosive injuries of the stomach has not yet been clearly defined. This work analyses the results achieved with a surgical protocol included in a new therapeutic approach. This approach applied to 111 consecutive patients was based upon three points: (a) early fibroscopic examination, (b) protection of severe burns by total parenteral nutrition and (c) reparative surgery in the complete healing phase. The stomach was involved in 89 per cent of the 93 cases with proved gastrointestinal lesions; gastric lesions were isolated in 42 per cent of cases. The frequency of gastric involvement is partly related to the type of product ingested; the intensity of lesions is correlated with the quantity and the concentration of corrosive products. After a 3-month total parenteral nutrition period, reparative surgery can be performed without local complications in severe cases. Limited resections of the stomach must then be preferred when possible. In cases with total involvement bypass techniques can be carried out. Indications for early surgery are not yet well defined.

Adolescent↗
PubMed1980

New therapeutic approach to corrosive burns of the upper gastrointestinal tract.

The therapeutic approach to the management of corrosive burns of the upper gastrointestinal tract leaves a considerable morbidity and a heavy mortality rate. This work evaluates the effectiveness of a new therapeutic approach given to 94 consecutive patients. The management has been based on three major points: (1) the definition of extent of upper gastrointestinal lesions by immediate fibroendoscopy; (2) immediate protection of the upper gastrointestinal tract by total parenteral nutrition in cases with serious burns (41 cases), normal oral nutrition being allowed for minor burns (35 cases); (3) reparative surgical procedures for any of the sequelae of such burns during the fibrosing phase. The results were as follows: (a) healing, depending upon the degree of burn, occurred between eight to 90 days; (b) the frequency of subsequent local complications was small with total parenteral nutrition started a few hours after ingestion of the corrosive product; (c) after reconstructive surgery no serious complications occurred; (d) the overall morbidity stayed at a very low level (four patients). We conclude that the general prognosis of a severe burn of the upper gastrointestinal tract, without other trauma, is appreciably improved by the very early institution of total parenteral nutrition.

Adolescent↗
PubMed1980

Functional evaluation of the transplanted lung after long-term preservation.

In dogs the immediate value of transplanted lungs was tested after preservation in Collins 3 solution and administration of aprotinin. 15 animals received a left or right homograft, which had been preserved for 24 h. In 3 cases preservation time was prolonged to 48 h, and in another 2 dogs both of the lungs were replaced by 24-hour preserved organs in a one-stage operation. The value of the transplants was tested by several physiological, morphological and clinical phenomena. (1) A positive O2 uptake of the transplant after a temporary occlusion of the opposite pulmonary artery documented its capacity for gaseous exchange. (2) Scintigraphic visualization of perfusion and ventilation in 3 dogs demonstrated satisfactory results. (3) A positive response to acetylcholine of the bronchial muscular system was observed in all transplants. (4) Normal light microscopy showed a lack of obvious morphological change. (5) Only slight alterations in electron microscopy were found when compared to those found before preservation. (6) The absence of acute bronchial edema excludes the possibility of irreversible altertions of the alveolocapillary wall. The results demonstrate that preservation of the lung is possible up to a period of 48 h.

Acetylcholine↗
PubMed1977

[Early mortality after ingestion of caustic substances].

The authors define the management of a patient following emergency admission for the ingestion of a caustic liquid: immediate assessment by fibroscope oesophagoscopy; avoidance of all corticosteroid therapy and of the insertion of a gastric tube; parenteral alimentation. The frequency of early deaths has considerably decreased since the applications of this method, either as a result of shock or of the inhalation of caustic liquid.

Caustics↗
PubMed1977

[Surgical treatment of caustic esophagogastric stenosis in the chronic phase].

The authors report the results of 26 oesophagoplasties carried out using the descending colon for oesophageal stenosis as a result of a caustic lesion. Superior: in 5 cases the anastomosis being made to the pharynx. Inferior: 8 associated gastric lesions being treated either by resection or by short circuit. The remaining oesophagus was removed in two cases. There were two postoperative deaths. In all the remaining patients a satisfactory functional result was obtained.

Caustics↗
PubMed1977

[Preoperative assessment: value and limitations in the preparation for surgery of esophageal or cardia carcinoma].

Pre-operative assessment of a patient suffering from a carcinoma of the oesophagus demonstrates numerous pathological features and marked malnutrition. The authors give details of their method of nutritional preparation: operation is scheduled only when the patients are restored to a state of anabolism, i.e. when daily potassium balance is greater than 40 mEq and daily nitrogen balance exceeds 4 g. Carolies are provided either intravenously or via a gastric tube. Alimentation consists on average of 2,000 to 2,6000 calories as carbohydrate and lipids and 12 to 14 g of nitrogen. This preparation lasts on average for one week. It is associated with a reduction in mortality and the number of postoperative complications.

Cardia↗
PubMed1976

[Effect of acetylsalicylic acid on immunologically induced morphologic changes after experimental lung transplantation (light and electron microscopic study)].

In 3 comparing series the behavior of platelets after experimental lung transplantation was examined in 33 dogs. After allogenic transplantations (21 animals) the ultrastructural findings were pathologic changes of the platelets, such as hyperaggregability with irreversible aggregation prevailing, as well as capillary wall alterations. X-rays showed considerable reduction of functioning parenchyma. Since these findings were absent in animals which underwent merely pulmonary re-implantation (4 animals) and can be considered a controll group, the authors conclude that these alterations are caused by mainly immunologic reactions. Acetylsalicylic acid given to animals with grafted lungs significantly inhibited is specific and certainly immuneinduced pathologic development. Absolutely necessary, therefore, appears the application of such aggregation inhibitor as additional treatment in lung transplantations.

Animals↗