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Biomedical subjects

P Elbaz

Publications and source records attributed to P Elbaz.

At least 19 recordsLinked to original sources

[Vocals in silence and noise. A simple test of resistance of intelligibility in noisy environment].

We have all noticed that there was no coincidence between the conventional audiometric tests--tonal, vocal, Metz tests--and the degree of impairment of understandability in noisy environments that the patients report. Some of them handle this problem better than these conventional tests suggest, others less well. The aim of this study is to take account of this dominating functional complaint: impairment in noisy conditions, and to assess it in order to follow up its evolution after medical, surgical and prosthetic treatments. The aim of the authors has been to describe an easy examination to be implemented in any ENT surgery fitted with a free-field vocal testing equipment. The results show that this test cas differentiate between "noise-resistant" subjects and those that do not "resist" well. The discussion defines the limitations of this test, which are due to its deliberate simplicity, and the caution required for its psychoacoustic and physiological interpretation. The conclusion confirms its merits, since it can discriminate and help choose more accurate tests--temporal tests, frequency selectiveness charts, twin-ear tests, cognitive AEP.

Audiometry, Speech

[ORL versus naso-sinusal allergy].

Clinical examination of the nasal fossae and sinuses, and the picture formed by the Rhinologist allows him to classify the patient into one of the following three categories: Local inflammation, of which the solution is often surgical. Nasal sinus inflammations that have their origin in a disturbance, perhaps in the mucociliary system (mucoviscidosis) or perhaps in the immune system (allergy, repeated infections). Non-specific inflammation, eosinophils, associated or not with asthma (Nares, polyps, Fernand-Widal) and intolerances of drugs or chemicals. Some arguments plead in favour of allergic origin of inflammation. But the Rhinologist must give constant regard to the physico-pathological mechanisms of the nasal and sinus mucosae. The multiplicity of the mediators of inflammation. The mechanism of nasal vasomotricity. The role of the eosinophil in inflammation. Are such elements that are indispensible to his understanding.

Drug Hypersensitivity

[Colonic cancer. Indications and results apropos of a continuous series of 223 patients].

The authors report a retrospective study of 223 surgical colonic carcinoma (1978-1987), the rectal carcinoma left out of them because of disparity in technical aspects. The total post-operative mortality rate was 9.4 per cent, made of great mortality in emergency (31 per cent) and in palliative surgery (17 per cent). Out of emergency, the mortality of curative surgery is 3.7 per cent. Surgical procedure was mechanical in 96 per cent with incidence of leakage in 3.9 per cent. The total survival rate is 53 per cent after 5 year follow-up, 70 per cent after curative surgery and 89 per cent for the first level (A) in DUKE'S classification. There is only a problem for the choice in size of resection for the sigmoid side (50 per cent of the cases). Contrary to recent studies, in our experience the post-operative mortality rate and survival rate are different with sigmoidectomy or left colectomy. Then the authors think that every model of resection has to be choice according age of patient and classification of carcinoma.

Adenocarcinoma

[High frequency audiometry].

The authors have performed a series of high frequency audiograms in order to assess its value in routine otological practice. Initially, they conducted a statistical study on subjects with so-called normal hearing in order to establish standardised normal values. As in the earlier studies, a physiological alteration was observed in the high frequencies which was progressively accentuated with age. Audiometric results should therefore always be considered in relation to the patient's age. A standard graph is proposed for the presentation of the results. The authors subsequently performed high frequency audiometry in patients with internal ear disorders. High frequency audiometry allowed early detection of an alteration in the internal ear, when conventional audiometry was normal. The authors believe that high frequency audiometry should be part of the otological assessment as its allows early detection of internal ear disease.

Adult

[Testing and re-education of candidates for the SIVO prosthesis].

The SIVO prosthesis, developed by Pr A. Fourcin (London), is an aid to lip reading for profoundly deaf patients with residual hearing at low frequencies below 500 Hz. This prosthesis reduces the complexity of the acoustic wave of speech to sa simple sinusoidal wave, allowing better perception of the fundamental frequency of the voice and its variations, i.e. pitch and intonation. The inclusion assessment of patients is twofold: evaluation of the perception of language (audiometry and computerised video tests evaluating the capacities for recognition of sounds and for lip reading), evaluation of voice production and language. Orthophonic re-education depends on the results of the various tests performed and is based on computer programmes, allowing better feed-back by visual control. As a result of the progress in computer and video technology, these tests can be standardised and used not only for candidates for the SIVO prosthesis, but also for all profoundly deaf subjects.

Audiometry

Flunarizine and betahistine. Two different therapeutic approaches in vertigo compared in a double-blind study.

One hundred and seventeen adult patients suffering from vestibular vertigo were treated in a multicentre double-blind study with flunarizine (10 mg before sleeping) or betahistine dichlorhydrate (8 mg 3 times daily). The study took 2 months. The results revealed that flunarizine is significantly more active against attacks of vertigo and associated symptoms (mainly neurovegetative disorders, anxiety and headaches). The global superiority of flunarizine was confirmed by both the evaluation by the investigators and the patient. Significantly fewer patients treated with flunarizine reported side effects or interrupted the trial therapy prematurely. This study confirms the value of the calcium antagonist flunarizine in the treatment of vestibular vertigo.

Adult

[Comparison of 3 antibiotics, cefaclor, josamycin and penicillin V in the treatment of acute throat infections. A multicenter study: 581 cases].

Five hundred and eighty one patients, both adults and children, of either sex, with acute throat infections, with or without associated pharyngitis, were randomized into three groups comparable as to age, general condition and temperature before treatment, previous infectious episodes, history of allergy and underlying conditions. Cefaclor was administered to the first group (C), josamycin to the second group (J) and penicillin V to the third group (V); duration of therapy was practically the same, respectively 8.41, 8.20 and 8.14 days. Concurrent administration of paracetamol was allowed and was comparable for all three groups. Response was assessed on the basis of clinical criteria only, including onset of apyrexia in particular. In group C apyrexia was obtained within 48 hours or less in 54.4% of the patients versus 35.7% only in Group J (p less than 0.001) and 41.5% in group V (p less than 0.02). Onset of overall clinical improvement was 3 days or less in 69.5% of the patients receiving C versus 50.3% for those receiving J (p less than 0.001) and 57.2% for those receiving V (p less than 0.02). Adverse reactions were significantly more frequent in the josamycin group (p less than 0.001) and penicillin group (p less than 0.05) than in the cefaclor group. The most common type of adverse reactions was gastrointestinal upsets in the josamycin (43/49) and the cefaclor group (9/10) and skin reactions in the penicillin group (9/20).

Acute Disease

[Evaluation of the extravascular distribution of cefotiam (SCE 963) by the skin blister technic].

Extravascular diffusion of cefotiam was studied by a suction blister technique. Maximal cefotiam concentration in blister fluid (18.4 +/- 6.4 micrograms X ml-1) was found one hour after intravenous injection of a 1 g bolus. The area under the curve (AUC) of blister fluid concentrations was 35.4 micrograms X ml-1. Apparent elimination half-life from blister fluid was 0.72 hour. The AUC plasma/AUC blister fluid ratio approximated 1.

Adult