Biomedical subjects

O Moranne

Publications and source records attributed to O Moranne.

6 recordsLinked to original sources

PubMed2006

French peritoneal dialysis registry (RDPLF): outline and main results.

The Registre de Dialyse Péritonéale de Langue Française (RDPLF Registry) is a non-profit association that has been set up to assist physicians and nurses in evaluating their practical experience and results regarding peritoneal dialysis (PD). Five French-speaking and two Spanish-speaking countries have participated in this initiative (which includes 21 000 patients). In France, 82% of all PD patients are included in the registry and the main results for the period from 1995 to January 2006 form the basis of this report: of 11 744 incident patients with a median age of 71 years, 21.5% were over 80 years of age and 56% were not able to perform PD treatment at home without assistance. Eighty-six percent of the latter group received external assistance from a private nurse and 14% were aided by their family. The overall average rate of peritonitis was one episode every 29 months. The probability of being peritonitis-free appeared to be better for patients on automated PD (59.4% at 2 year) than for those on continuous ambulatory PD (55.3%), but this finding requires further validation. The average waiting time before transplantation was about 2 years. In patients who had undergone transplantation, the peritonitis rate was one episode per 42 months before transplantation compared to one episode per 29 months for patients who had not received a transplant. Eighty-three percent of patients had a hemoglobin level greater than 11 g%. Catheter survival was 92% at 2 years post-insertion and 85% at 5 years, with 94% being implanted by experienced surgeons. In conclusion, the RDPLF results demonstrate that PD may be successfully prescribed for older patients who receive assistance either from their family or from a nurse. Further, a larger number of younger patients should also be prescribed this technique in France. Patients eligible for transplantation and on short-term PD have the lowest risk of developing peritonitis; PD before transplantation may help prolong residual renal function, and initial treatment by PD may also help to preserve vascular access for the future.

Age Distribution↗

PubMed2005

[Calcific arteriolopathy (Calciphylaxis)].

PURPOSE: Calcific arteriolopathy (CA), also known as " Calciphylaxis " describes a phenomenon of necrosis, mainly cutaneous and sometimes systemic, due to the obliteration of the arteriole's lumen. Initially there are under-intimal calcium deposits, and then the thrombosis occurs leading to the necrosis. CA affects mainly the renal insufficient hemodialysed patient, but not exclusively. We present 4 cases which illustrate well the etiologic spectrum of CA: terminal renal insufficiency, neoplasia, primary hyperparathyroidism, proteinuria, vitamin K inhibitors. We describe the AC's epidemiology, its cutaneous and systemic clinical presentations, its treatment. We make the hypothesis that CA is a strong risk marker in matter of cardiac mortality and we discuss this point. CURRENT KNOWLEDGE AND KEY POINTS: In this article we describe the numerous breakthroughs that have been made in matter of research about calcification over the past few years: inhibitors of calcium phosphate deposition, vitamin D and PTH1R, protein-calcium complexes, cell death, induction of bone formation. These data are analysed from a clinical point of view with practical purposes. We present CA not only as a cutaneous disease but as a systemic pathology. FUTURE PROSPECTS AND PROJECTS: The CA epidemiology is an incentive to more diagnosis suspicion in front of organ infarct involving a patient likely to be concerned by CA. The scientific and therapeutic breakthroughs in matter of calcification enable a better prevention of the disease. Nevertheless it remains very difficult to cure when installed.

Aged↗

PubMed2004

[Important elevation of uric acid associated with vomiting at the third trimester of pregnancy: report of five cases with favorable outcome].

We report five cases of vomiting associated with a very important increase of maternal plasma uric acid (> 595 mmol/l, 100 mg/l) at the third trimester of pregnancy. In all cases, elevation was transitory and regressive with rehydratation. Pregnancies proceeded normally to term and delivered healthy babies. An important rise of plasmatic uric acid during pregnancy can be found in severe hypertensive disorders (preeclampsia, HELLP syndrome, acute fatty liver). Nevertheless, it can be related to transient renal insufficiency without any severe pathology. In our five observations, digestive disorders seem to be the reason for this phenomenon and spontaneous prognosis was excellent in all cases.

Adult↗

PubMed2004

[Pregnancy and hemodialysis].

Pregnancy is a rare occurrence in patients on chronic hemodialysis (CHD). The rate of successful pregnancies amounts to almost 60%, thanks to modifications of the dialysis schedule and a specifically adapted obstetrical and neonatal management. We report on seven pregnancies occurring between 1995 and 2001 in six women with a mean age of 32 years (22-39 years), on HD for a mean period of 36 months (12-96 months). Maternal and fetal complications, and the long-term outcome of mothers and children are reported, and the collaborative approaches adopted by obstetrician, pediatrician and nephrologist are discussed. The frequency and length of HD was systematically increased. One patient chose to terminate her pregnancy at 20 weeks of gestation. The mean gestational age for the six other pregnancies was 31 weeks (24-34 weeks) with an average weight at birth of 1495 g (660-1920 g). One neonate born at 24 weeks died 2 days following delivery. One patient was treated with uterine artery embolization for post-partum haemorrhage. Pediatric evaluation of the five children, who were followed up for a period ranging between 2.5 to 5.5 years, showed a good long-term outcome. In conclusion, pregnancy needs not be counterindicated or systematically terminated in patients on CHD, particularly if transplantation is not possible, if the patient refuses it, or if she is relatively old and there is a long waiting period before transplantation.

Adult↗

PubMed2003

[Leptospirosis in Espiritu Santo, Vanuatu, 8 case reports].

Our review of the literature on leptospirosis in Vanatu turned up only one previous report describing 3 cases at the Central Port Vila Hospital in 1992. The purpose of this report is to describe 8 cases of leptospirosis in patients admitted to the North District Hospital on Espiritu Santo Island in 1997. There were 6 men and 2 women with a mean age of 45 +/- 16 years. At the onset of the disease patients presented fever, myalgia, and diarrhea. After an average of four days initial symptoms were followed by visceral involvement with severe jaundice in all cases. Kidney failure occurred in 6 cases and neurological manifestations in 5. Subconjunctival hemorrhage was observed in 2 cases. Laboratory studies demonstrated hyperleukocytosis in 6 cases and liver enzyme abnormalities in 6 cases. Three patients presented Weil syndrome. Microscopic agglutination testing performed more than a week after the onset of disease was positive at 1/800 in 6 cases and at 1/200 with typical clinical abnormalities and positive serum PCR in 2 cases. All patients responded favorably to antimicrobial therapy using penicillin IV and symptomatic treatment. The estimated incidence of leptospirosis in the North District of the Island of Espiritu Santo, in 1997 was 40/100,000 person-year but this was probably an underestimation because of unawareness of the disease, poor access to medical care, and underdiagnosis.

Adult↗

PubMed1998

[Medicine in Vanuatu: a voyage to the end of the earth to Espiritu Santo Island].

INTRODUCTION: The republic of Vanuatu, which was previously termed the Hebrides, has been independant since 1981. Colonization by both France and England has left its numerous marks on this country over the years. The authors spent the year 1997 on the Espiritu Santo Island and report their experience as practitioners at the northern district hospital. CURRENT KNOWLEDGE AND KEY POINTS: As Vanuatu is a developing country, medical practice is subject to changes in government, development aid provided by foreign countries and socio-economical conditions. Numerous chronic diseases with historical complications and malpractice are encountered. As well, numerous infectious diseases such as tuberculosis and malaria are still endemic. Means of fighting and preventing infections are great problems, with, for example, deficiencies in immunization programs. Though medical structures are well organized, due to its immature governments and assistance rather than cooperation policies of various helping countries, latitudinarianism is important and medical practice is not continuously organized. FUTURE PROSPECTS AND PROJECTS: Several objectives should be considered: epidemiological studies in order to reconstitute diseases profiles in this archipelago and, most of all, cooperation that would aim at training and education.

Adult↗