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Biomedical subjects

M Salles

Publications and source records attributed to M Salles.

At least 19 recordsLinked to original sources
PubMed2005

[Diagnosis and treatment of congenital bronchopulmonary malformations. A review of 32 cases].

OBJECTIVES: Analysis of our experience and propositions on the diagnosis and treatment of congenital bronchopulmonary malformations (BPM). POPULATION AND METHODS: Retrospective study of BPM diagnosed between 1997 and 2001. Analysis of clinical spectrum, diagnosis tools, treatment, and clinical outcome. RESULTS: Thirty-two cases of BPM have been investigated (11 cystic adenomatoid malformations, 7 pulmonary sequestrations, 7 bronchogenic cysts, 4 congenital lobar emphysema, and 3 complex emphysematous malformations). Nineteen patients had a prenatal diagnosis. For 9 others, symptoms occurred before 4 years of age. Evaluation included a CT-scan in all patients (BPM involution in one). Surgical treatment was performed in 30 patients (lobectomy in 18), with a mean age of 7 months for asymptomatic patients. During the follow-up (mean: 3 years), respiratory symptoms were reported in 10 cases, 3 of them were related to the BPM. DISCUSSION: Improvement in prenatal ultrasound diagnosis modified the management strategy. Considering the risk of pulmonary complications, surgical treatment is required during the first months of life. For congenital lobar emphysema, and some pulmonary sequestrations or small cystic adenomatoid malformations (<3 cm), conservative attitude may be preferred. BPM justify a multidisciplinary management.

Adolescent↗
PubMed2005

[Mefloquine versus halofantrine in children suffering from acute uncomplicated falciparum malaria].

AIM OF THE STUDY: To evaluate mefloquine versus halofantrine in children suffering from acute uncomplicated falciparum malaria. MATERIAL AND METHODS: Prospective non randomized study in hospitalized children during one year. Acute falciparum malaria was defined by fever and a positive thin and/or thick smear. Malaria was presumed to have been contracted in Comoros archipelago and/or Madagascar 6 months previously. Patients were excluded, when quinine had to be used, according to World Health Organization's severity criteria. RESULTS: Forty-nine children were included: 29 were treated with halofantrine and 20 with mefloquine. Patients features in the two groups of treatment were identical, with exception for the mean time between first clinical signs and diagnosis (shorter in mefloquine group). Fever's and hospitalization's duration under treatment were similar. An increase in QTc interval was frequently observed in patients treated with halofantrine (56 versus 0%), although patients with mefloquine experienced vomiting (45 versus 0%). Relapses seemed to be more frequent with halofantrine (14 versus 0%). DISCUSSION: Halofantrine and mefloquine are efficient for falciparum malaria treatment in our pediatric series, despite a high rate of adverse events. Mefloquine's tolerance may probably be improved with changes in regimen and dose. Relapses are more frequent with a single first treatment of halofantrine, than with mefloquine. Unfortunately, features of a second halofantrine treatment are not defined.

Adolescent↗
PubMed2004

[Bronchopulmonary dysplasia and cytomegalovirus pneumonia].

Hyaline membrane disease (HMD) of premature newborn can lead to bronchopulmonary dysplasia (BPD). We report the observation of a 33 weeks premature newborn with HMD, treated with exogenous surfactant and mechanical ventilation. The patient developed respiratory distress with oxygen dependency initially related to BPD. Because of worsening of respiratory condition after 2 months, despite corticosteroid therapy, further investigation was performed. Cytomegalovirus (CMV) was found in urine and in the pharynx and CMV-pneumonia was diagnosed. Treatment with gancyclovir allowed a rapid regression of symptoms. Association between BPD and CMV-pneumonia has been previously reported but the causal relationship is controversial. In premature newborn, CMV-pneumonia can appear clinically and radiologically like a BPD. When evolution is atypical, with persistence of respiratory distress despite BPD treatment, CMV-pneumonia must be considered as a specific antiviral therapy may be discussed.

Bronchopulmonary Dysplasia↗
PubMed1997

[Solitary crossed renal ectopia and congenital vertebral anomalies].

OBJECTIVE: To describe a case of solitary crossed renal ectopia that had been incidentally discovered in a healthy male with a previous history of spinal surgery. METHODS/RESULTS: A 43-year-old male who had undergone two surgical procedures for severe scoliosis of the thoracic spine when he was 7 years of age, consulted for symptoms of unspecific urethritis that had just remitted. Abdominal ultrasound and excretory urography revealed a solitary crossed ectopia on the right side and the spinal x-ray showed congenital fusion of the cervical vertebrae (Klippel-Feil syndrome). CONCLUSIONS: Crossed ectopia of a solitary kidney is an exceedingly rare anomaly of the urinary tract (about 30 cases have been reported) combining renal agenesia of one side, contralateral displacement of the ureter draining the only kidney and agenesia or hypoplasia of the other ureter. It is frequently an incidental finding, although it may be associated with congenital spinal anomalies and even severe genital and anal anomalies.

Abnormalities, Multiple↗
PubMed1996

Prevention and control of nosocomial infections in Spain: current problems and future trends.

Spain is a state member of the European Union, with more than 180,000 hospital beds and 800 public and private institutions. Only 6.9% of our gross national product is devoted to health expenditures. All citizens receive free health care through the National Health System. This system has given increasing attention to the prevention and control of nosocomial infections since 1986. In this article, results of serial prevalence surveys of antibiotic use and resistance patterns of microorganisms isolated from nosocomial infections are discussed. The needs for future development of infection control and quality assurance training programs in Spain also are discussed. Overall, a clinically and epidemiologically oriented approach to infection control is preferred, with greater emphasis in the role of infection control practitioners and infection control committees.

Anti-Bacterial Agents↗
PubMed1995

A cluster of fever and hypotension on a surgical intensive care unit related to the contamination of plasma expanders by cell wall products of Bacillus stearothermophilus.

OBJECTIVE: To evaluate an outbreak of fever and hypotension after cardiac surgical procedures and the role of polygeline, a plasma expander. DESIGN: Unmatched case-control study. SETTING: A six-bed cardiac surgery intensive care unit (SICU) of the Hospital Clinic of Barcelona (Spain), a 940-bed public teaching hospital. PATIENTS: Eight cases and 25 control patients admitted to the SICU over a 4-week epidemic period. MAIN OUTCOME MEASURES: Development of hypotension (systolic blood pressure < or = 90 mm Hg or a drop of 40 mm Hg from baseline systolic blood pressure) and fever (axillary temperature > 38.5 degrees C) within 24 hours of a cardiac surgical procedure. RESULTS: The single risk factor significantly different between cases and controls was the total volume of polygeline used throughout the surgical procedure for extracorporeal circulation: a median of 1,250 mL (mean, 1,312.5 +/- 842.5 mL) in cases versus 500 mL (mean, 566.0 +/- 159.9 mL) in controls (P = .0029). By multiple logistic regression analysis, polygeline use was the single risk factor significantly related to the outcome (odds ratio, 8.75; CI95, 1.36 to 56.2; P = .01). Neither blood cultures from patients nor cultures of the polygeline used yielded growth of any microorganism. Stopping use of the implicated polygeline lot controlled the outbreak. CONCLUSIONS: Use of polygeline was associated with an outbreak of fever and hypotension in a SICU. Information from the manufacturer indicated the likelihood of contamination of the product with Bacillus stearothermophilus components. The manufacturer has since changed the production and control processes, and no further adverse events have been seen.

Bacterial Proteins↗
PubMed1988

[Practical problems of ethmoidectomy by a mixed approach].

A mixed ENT and neurosurgical approach is employed widely at present for exeresis of malignant ethmoidal tumors. The stability of the reconstruction of the anterior stage by bone graft is satisfactory in the long term even after radiotherapy. The transfacial approach, with or without conservation of the maxillonasal bone flap, procures a remarkable opening allowing in most cases a monobloc excision.

Adenocarcinoma↗
PubMed1987

[Intracranial hypertension and hydrocephalus caused by spinal cord tumors. Apropos of 3 cases].

Three cases of spinal cord tumor, revealed by hydrocephalus, are reported. Two patients showed symptoms of increased intracranial pressure and the third one presented himself with ataxic gait without intellectual impairment nor incontinence. In two cases ventriculo atrial shunt was initially inserted and the correct diagnosis was made only later on myelogram because lombosciatalgia or syndrome of the cauda equina. Clinical outcome was satisfying after surgical removal of the tumor. The nature of which was a neurinoma of the cauda equina; a lumbar intradural granuloma and an ependymoma of the cauda equina. The mechanism by which spinal cord tumors raised intracranial hypertension is discussed.

Adolescent↗
PubMed1981

[Transfer of CO after prolonged artificial ventilation (18 young people after their stay in the neuro-surgery department) (author's transl)].

We studied the transfer of CO (TLCO) on 18 young people after their stay in the neuro-surgery department, during which they had been submitted to prolonged artificial ventilation. The values of TLCO measured after the single breath method and that of the steady state are all reduced. No statistical correlation has been brought to light between the length of artificial ventilation, or the FiO2 and the lowering of TLCO, or between the seriousness of the pulmonary complications which occurred and the disturbance of the pulmonary function test. To explain the change of the alveolo-capillary diffusion, different factors can be brought in, such as: artificial ventilation, the toxicity of oxygen, the adult respiratory distress syndrome, but also the presence of brain lesions which by reflex artery, modify the local hemodynamic conditions and the surfactant synthesis.

Adolescent↗