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Biomedical subjects

O Leduc

Publications and source records attributed to O Leduc.

10 recordsLinked to original sources
PubMed2003

[Limb edema and lymphoscintigraphy].

Lymphoscintigraphic investigations represent techniques of nuclear medicine very contributive for the management and treatment of the limb edemas, either primary or secundary. Their principle is presented and methodologies proposed in the literature are reviewed. Their diagnostic contributions are detailed. The sensitivities and specificities of several protocols of investigation are reported. Some limitations of these examinations are analyzed and discussed. Clinical indications for their use are proposed and their interest with regard to the various treatments that can be applied to these limb edemas is discussed.

Adult↗
PubMed2003

[Lower limb edema and steatorrhea: value of scintigraphic technics].

The authors report the case of a young woman with right lower limb edema who also presented one steatorrhea. Her clinical history is typical for one primary lymphedema and the lymphoscintigraphic investigation of the lower limbs confirms the diagnosis. The scan showed the absence of the right iliac and lomboaortic lymph nodes but also that the thoracic duct was normally present. One C14-triolein breath test is pathological and proves the malabsorption of the fats. The authors discuss the interest of the scintigraphic techniques in such case and review the problem of the association between lower limb lymphedemas and fatty malabsorption.

Adult↗
PubMed1998

Imaging techniques in the management and prevention of posttherapeutic upper limb edemas.

BACKGROUND: Upper limb edema remains the most frequent complication after treatments for breast carcinoma. Various imaging techniques can be used to prevent these complications, to manage them, and to diagnose the possible lymphonodal evolution that may underlie these events. In the present paper, these techniques are reviewed. METHODS: Based on clinical experience as well as on the data from the literature, these imaging techniques are presented, and their contributions are analyzed. RESULTS: The pre- and post-operative imaging and research techniques of the so-called sentinel nodes (using blue dye, and/or lymphoscintigraphy, and/or gamma probe) appear to be very promising for defining patients in whom axillary node clearance either might be avoided or is indicated. Lymphoscintigraphic investigations also can be used after surgery and/or radiation therapy to define patients who either are at risk to develop upper limb edema or present with latent edema. In patients with clinically obvious edema, even if it is limited, lymphoscintigraphic techniques can provide a morphologic and functional definition of the condition. Venous echo Doppler can be used when abnormalities of the venous return are suspected. In diagnosing the lymphonodal evolution of the disease, techniques like immunoscintigraphy, positron emission tomography (using 18-fluoro-2-deoxy-D-glucose), X-ray computed tomography, and nuclear magnetic resonance imaging can contribute. CONCLUSIONS: Various imaging techniques can be used to prevent and/or to manage the upper limb edema that may complicate the treatment(s) of the patients with breast carcinoma.

Arm↗
PubMed1998

The physical treatment of upper limb edema.

BACKGROUND: Edema of the upper limb, without any doubt, constitutes the most invalidating complication of breast carcinoma treatment. The swelling of the limb results from decreased liquid evacuation by surgical intervention at the axillary level and also by the eventual treatment by cobaltotherapy. METHOD: The physical treatment for edema of the limb consists of a combination of therapies that were tested for their effectiveness in laboratories on healthy students and also on patients who underwent surgery for breast carcinoma. The treatment consists of the application of manual lymphatic drainage (type Leduc), the use of multilayered bandages, and the use of intermittent pneumatic compression. The population studied was represented by 220 patients who underwent breast surgery. The authors followed their evolution during the first 2 weeks of treatment. Patients were not hospitalized. The edema was measured by using marks tattooed on the skin. RESULTS: The limb that developed edema was compared with the healthy limb. The most important reduction was obtained in the first week. The decrease was equivalent to 50% of the average of the difference between both upper limbs. During the second week, the results obtained stabilized; however, there was a slight decrease at the end of the second week. CONCLUSIONS: The physical treatment of edema represents the preferred therapeutic approach. However, it must answer to well-defined criteria to be efficient and for long-lasting effects. The physical treatment is used to treat outpatients, allowing them to follow a normal lifestyle.

Adult↗
PubMed1994

Resistance to activated protein C: evaluation of three functional assays.

Resistance to Activated Protein C (APC) was evaluated using 3 different methods: two of them were based on the prolongation of the Activated Partial Thromboplastin Time (APTT) using 2 different APTT reagents in the presence of APC, whereas the third method was based on the prolongation of prothrombin time when APC is added. The three methods were significantly correlated. APTT-based assays were sensitive to factor XII deficiency, whereas thromboplastin-based assay was sensitive to factor VII deficiency (< 0.5 UI/ml), which surestimates the response to APC. In contrast, an increase in factor VIII (F. VIII) level is associated with a decreased response to APC, when APTT-based assays are used, whereas thromboplastin-based assay is unmodified. During pregnancy, a decreased response to APC is observed, which is not only due to the increase in F. VIII, since thromboplastin-based assay is also modified. In Protein S (PS) immuno-depleted plasma, the low response to APC is corrected by addition of free PS: the thromboplastin-based assay was the most sensitive one to PS deficiency. However, in patients with congenital PS deficiency, there was no correlation between APC-resistance and free PS level. In patients with lupus anticoagulant, discrepancies were observed between the 3 methods, but with a high frequency of low response to APC. For the 3 assays, there was a good differentiation and correlation between normal and pathological results, the thromboplastin-based assay being perhaps the most discriminating. However, 3 unrelated thrombophilic patients showed normal results using thromboplastin-based assay, although they were APC-resistant using APTT-based assays. For 2 patients, this discrepancy can be explained by high levels of F. VIII. For the last patient, an abnormal F. VIII, resistant to APC can be suspected.

Adult↗
PubMed1990

[Hemodynamic impact of pressotherapy].

We study the hemodynamic effects of pressotherapy in 11 patients (mean age : 68 +/- 10 years) with uncomplicated acute myocardial infarction (n = 6) or with chronic ischemic heart failure (n = 5). We measure the right auricular pressure (RAP), the mean pulmonary arterial pressure (MPAP) and the pulmonary wedge pressure (PWP), before, during pressotherapy (MPAP) and the pulmonary wedge pressure (PWP), before, during pressotherapy (T 20 min) and 30 minutes after the end of pressotherapy (T 30 min). We use five-chambered leg garments with 80 mm Hg pressure during 20 minutes. The wavelike action (from the bottom to the top) is intermittent: the compression time is 10 second (sec); compression is maintained during 60 sec; deflation time is 15 sec. After 20 minutes pressotherapy (t 20) the 3 variables increase: RAP: from 3.6 +/- 5 to 7 +/- 7 mm Hg (P less than 0.001), MPAP: from 25 +/- 14 to 29 +/- 17 mm Hg (p less than 0.01) and the PWP from 10 +/- 8 to 17 +/- 11 Hg (p less than 0.01). This rise is particularly important in heart failure patients: from 18 +/- 8 to 29 +/- 8 mm Hg for the PWP, with cough in one patient. At T 30 these 3 variables decrease and return nearly to initial values: respectively 2.7 +/- 4.7 (RAP), 24 +/- 14 (MPAP), 12 +/- 8 mm Hg (PWP). In conclusion pressotherapy increases RAP and pulmonary pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Rehabilitation protocol in upper limb lymphedema.

Edema of the upper limb is, frequently, very invalidating. The physical treatment for edema of the upper limb consists on a combination of different therapies: manual lymphatic drainage (MLD), intermittent sequential pressotherapy (IPP) with a very low intensity, multilayer bandages (MLB), and compression sleeves. Patients are not hospitalized. In the first step of physical treatment, the patients are treated daily during 2 or 3 weeks with different therapies (MLD, IPP and MLB). During the second step, bandages are no more used. The compression garments are applied after this 2 or 3 weeks period. The physical treatment consist now in: manual lynphatic drainage and intermittent sequential pressotherapy (with low intensity). The frequency of the physical treatment is progressively decreased.

Arm↗