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Biomedical subjects

M Revol

Publications and source records attributed to M Revol.

At least 91 records · Page 5Linked to original sources
PubMed1984

Prevention of recurrent febrile convulsions--a randomized therapeutic assay: sodium valproate, phenobarbital and placebo.

The purpose of this study was to compare three different modes of treatment in the prevention of relapses of febrile convulsions (Phenobarbital = PH, Sodium Valproate = SV, Placebo = PO) in a randomized therapeutic trial. The patients included in the study had shown their first generalized convulsive seizure during a bout of fever (greater than or equal to 38.5 degrees C) and were aged between 6 months and 4 years. They were subsequently followed up as outpatients, and Phenobarbital and sodium valproate levels were measured regularly to ascertain compliance with the treatment and to adjust the dosage accordingly. The patients' families were questioned with respect to the occurrence of feverish bouts and convulsive seizures during the interval between visits, as well as possible adverse reactions. An EEG was carried out yearly. Results were as follows: - 69 patients - 35 boys and 34 girls - with an average age of 24 months were divided into 3 groups according to treatment: 21 cases on PH, 22 cases on SV, and 26 cases on PO. - they were followed up for an average duration of 21 months. - the average number of feverish bouts per child and per year was evaluated at 2.5, no statistically significant difference being noticeable between the various modes of prophylaxis. - 15 relapses of febrile seizures were noted in 14 children, over an average duration of 23 months; on average, relapses occurred after 9 months; among the 14 children who had relapsed, one had been treated with SV, 4 with PH and 9 with PO, leading to estimated relapse rates of 4%, 19%, and 35% respectively. There is a statistically significant difference in the relapse rates between the treated groups (SV and PH) and the Placebo group, and a particularly significant difference between Sodium Valproate and Placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1984

[Controlled study of the effects of Pygeum africanum extract on the functional symptoms of prostatic adenoma].

Two random groups of sixty patients each were given an extract of pygeum africanum in one group, and a placebo in the other. The results highlight the placebo effect (50 per cent of cases), and that the extract provided an overall improvement in the functional symptoms. The differences between the two treatments were statistically significant for nocturnal frequency, difficulty in starting micturition, and incomplete emptying of the bladder.

Clinical Trials as Topic↗
PubMed1984

[Recent urethral rupture. From diagnosis to treatment].

A retrospective study of 30 cases of rupture of the urethra treated over a period of 12 years showed that the membranous urethra was involved in 25 patients. Cases of partial rupture of the anterior urethra treated by transient urine bypass were excluded from the study. As a result of the only moderate results obtained before 1977, the following therapy was instituted for ruptures of the posterior urethra after that date: immediate insertion of a suprapubic bladder drain (percutaneous or surgical); visualization of bladder and urethra on the 5th day using the bladder catheter and retrograde urethrography; deferred emergency repair operation towards the 8th or 10th day for cases with a stable pelvis and absent vital lesions; delayed repair during the 3rd month for the other cases. Results were evaluated as good with respect to urethral permeability in 3 of the 6 cases of emergency repair, 10 of 12 patients receiving deferred emergency surgery and 11 of 12 cases of delayed operation. Only two cases of sexual impotency were noted among the last ten cases treated. The obvious procedure to be adopted whenever possible is therefore an end-to-end urethrography as a deferred emergency operation.

Emergencies↗
PubMed1984

[The surgical treatment of vesico-ureteral reflux in adults. Apropos of 45 cases].

The authors report 45 cases of adult patients treated surgically for vesico-ureteral reflux. They describe the indications and the data provided by preoperative biological and radiological examinations. The most widely used surgical procedure is submucosal advancement, and the authors discuss various technical aspects of this technique. Analysis of the results shows an 89.5% success rate with follow-up periods of at least eighteen months.

Adult↗
PubMed1983

[Monotherapy with sodium valproate in generalized primary epilepsy. 2d phase: Study of long-term efficacy and tolerance].

From the analysis of 115 cases of primary generalized epilepsies treated for a mean duration of 43 months with sodium valproate as sole therapy, it appears that: the mean effective daily dosage is 21 mg/kg; the efficacy of valproate proved excellent in 82.6% of cases (seizures fully controlled: 74%, seizures occurring exceptionally: 9%); a loss of activity was never observed; in these circumstances of prolonged administration of the drug, no signs of major intolerance were seen; side-effects occurred in 29% of cases, including 20% long-term effects (weight gain, essential tremor); 64 series of laboratory tests including 15 parameters made it possible to evaluate the hematological, hepatic and pancreatic tolerance of valproate: the majority of the tests were normal. The authors believe that during long-term therapy with valproate, monitoring does not need to include the routine performance of liver function tests, but that it would be more advisable, should a suggestive clinical sign be noted, to investigate the platelet count, coagulation (partial activated thromboplastin time) and protein synthesis (fibrinogen).

Adult↗
PubMed1983

Skin problems in the treatment of the finger "en crochet".

The study of 33 fixed flexion contractures of the finger shows that after tenolysis or teno-arthrolysis a skin gap appears when the finger is extended. Only 10 cases out of 33 had previous cutaneous involvement. The necessary skin plasties have been 14 heterodigital flaps and 19 local dorsal-lateral flaps. Results are comparable in both series and the surface of the skin defect has no influence on the choice of the type of flap. Therefore, whenever possible, a local flap is preferred to a distal flap.

Cicatrix↗
PubMed1983

Fixed post-traumatic flexion-contractures of digits. Review of thirty-three cases.

A fixed post-traumatic flexion contracture of a finger is usually secondary to multiple previous operations. We have observed that a former flexor tendon laceration is not constant and is missing in 18% of our cases. The flexor tendons are, nevertheless, always involved in the contracture. A volar skin contracture was present in all cases, but only in half of them was noted a retraction of the volar components of the PIP joint. This articular involvement has no statistical correlation with the time elapsed from the onset of the contracture. We have reviewed 33 cases of post-traumatic flexions contractures of the digits all secondary to volar trauma. In every case there was at least a flexor tendon adhesion and skin contracture. They have all been submitted to both objective and statistical analysis. Results have been evaluated by comparison between the normal functional range of motion for each digit and the actual post-operative active range of motion. On the basis of our study we conclude that the age of the patient is an important prognostic factor. We obtained 75% satisfactory results in patients younger than 27 years, but only 22% in the older group. Good results are more easily obtained in radial (65%) than ulnar digits (31%). While the authors rated 39% of the results bad, half of the patients in this group were satisfied with the result. A volar PIP joint release has been necessary in half of the cases with no significant secondary joint stiffness. A skin flap is necessary to cover the cutaneous defect secondary to the release. There is no statistically significant advantage to cross finger flaps. Therefore we feel that local flaps are indicated except in the cases where local scar tissues would not make it, feasible. The prognosis is independent of the number of previous operations and of associated nerve lesions. Therefore amputation is not the only solution for a multi-operated finger fixed in flexion.

Adolescent↗
PubMed1983

[Early diagnosis of Lafora disease. Significance of paroxysmal visual manifestations and contribution of skin biopsy].

The early diagnosis of Lafora's disease is often difficult, from primary generalized epilepsy and other progressive myoclonic epilepsies. The authors emphasize the diagnostic interest of paroxysmal visual manifestations, reported in only 25 per cent of the cases in the literature, and present in 17 of their 31 personal cases. These visual manifestations can be elementary or complex. The elementary ones appear often early, before other symptoms of the disease. Two demonstrative cases are reported. In one of them an occipital seizure was recorded, demonstrating the epileptic critical nature of these elementary visual manifestations. They have a high diagnostic value since they do not occur neither in primary generalized epilepsy (Grand Mal type), nor in the other progressive myoclonic epilepsies. In the 2 reported cases, skin biopsy, as proposed by Carpenter and Karpati, demonstrated the specific storage in the sweat ducts and glands. The interest of this skin biopsy is underlined, its positivity seeming both constant and specific in Lafora's disease.

Adolescent↗
PubMed1983

[Refractory urinary incontinence].

The authors present 3 cases where the diagnosis of ectopic insertion of the ureter, responsible for incontinence, had been missed: -- 2 cases of refluxing urethral insertions, including 1 case of single ureter, -- 1 case of vaginal ectopic ureter with duplicity. The authors stress that an ectopic insertion of the ureter can be asymptomatic until adulthood when it may present as simply as urinary stress incontinence. The diagnosis is suggested by a history of incontinence developing since childhood, accompanied by radiological signs of pyeloureteric duplicity or a small atrophic kidney. When the diagnosis is missed, successive surgical treatments are bound to fail, while excision of the renal segment drained by the ectopic ureter results in cure.

Adult↗
PubMed1982

[Discriminant analysis of graphic elements of the EEG. Application to the detection of episodes of diffuse spike-waves].

A database of EEG information was collected from EEG recordings performed in epileptic patients with diffuse spike-wave complex discharges. Normal activity, spike-waves, slow waves and artefacts were mixed up in these recordings. The analysis of EEGs stored in the database was performed, channel by channel, through a 2.56 s moving window. For each so defined EEG sequence, a set of 22 variables chosen for their discriminatory power was computed. A subset of 8 highly discriminating variables was selected by the means of a stepwise discriminant analysis. Each class of the learning set contained 40 up to 100 EEG sequences. A classifying algorithm that takes into account zones of uncertainty is proposed. It has been evaluated on a test set which was composed of 1981 EEG sequences issued from 15 different patients. The results have been checked by two neurologists. The agreement rate between each of them and the proposed algorithm was more than 92%; this result is comparable to the agreement rate between the two neurologists (94%). A contextual analysis algorithm, using bi-dimensional smoothing techniques, allowed to improve the agreement rates which exceeded 94%.

Computers↗
PubMed1981

[12-hour pattern of the waking state in the normal infant and in the infant who has survived the 'syndrome of sudden infant death' (author's transl)].

The authors report the results of 16 sleep EEGs carried out on 5 infants said to have survived the syndrome of sudden infant death (near-miss group) and 5 controls. The recordings were performed at 1.5 months, 3 months and 4.5 months, times when the risk of sudden death is maximum. The EEG appearance and the organization of sleep patterns have been studied in both groups. The various states of wakefulness, and the modalities of sleep and waking were subjected to statistical analysis with respect to age. The study showed no significant difference between the percentages of different states of wakefulness in the control and 'near-miss' group, but there were more sleep onsets in active sleep (REM) in this group compared with the controls and there were fewer waking periods, although when they occurred these were more prolonged.

Circadian Rhythm↗
PubMed1981

[Use of a coagulum for the ablation of renal calculi (author's transl)].

The authors report an experiment using the cadaver kidney with a fibrin coagulum injected into the pelvis and calices in order to extract multiple calculi. They used a mixture of cryoprecipitated plasma and a combination of thrombin and calcium chloride. This mixture was made up immediately before use, and injected into the pyelocaliceal cavities using a small Foley catheter previously inserted into the renal pelvis. This catheter was used to empty completely the pyelocaliceal cavities of urine immediately before injection. Extraction via a pyelotomy incision was used to withdraw the compact mold which had imprisoned the stones. In 20 kidneys studied experimentally, removal of stones was complete in only 12. The authors blamed this on their initial technical inexperience. The limitations and advantages of the method are discussed.

Fibrin↗
PubMed1981

[Reflexions on techniques of preoperative radiotherapy in the treatment of carcinoma of the bladder. Initial results and discussion of a therapeutic protocol based upon histo-prognosis (author's transl)].

Basing their indications on the histo-prognosis of Opperman and Bittard in malignant tumours of the bladder, the authors decided to irradiate before cystectomy those bladder tumours in which the histo-prognostic index indicated that it was a local disease with metastatic potential with a spontaneous life expectancy of 18 to 30 months. Radiotherapy was given spread over 23 or 27 fractions providing a total of 46 Gy. Four to 6 weeks later, cystoprostatectomy with trans-ileal cutaneous ureterostomy was performed, before chemotherapy for one year. Amongst 11 patients treated, in 6 cases the bladder was completely "sterilised" from a histological standpoint. However there was persistence of tumour in 5 bladders with an increase in the histo-prognostic index. Amongst these 11 patients, with a minimum follow-up of 18 months, there has been a pelvic recurrence in two cases and three developed fatal metastases. In the opinion of the authors, these preliminary results represent an encouragement to continue along the same lines.

Adult↗