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Biomedical subjects

P Hardy

Publications and source records attributed to P Hardy.

At least 19 recordsLinked to original sources
PubMed1992

[Osteochondritis dissecans of the acetabulum. Apropos of a case].

Osteochondritis dissecans acetabuli is a rare affection. The observation presented is one of a 23 year old man, who presented hip blockages in external flexion rotation. X-ray only allowed to find a sequestrum in the acetabulum by tomography-Arthroscanner confirmed the osteochondritis without cartilage rupture. Arthroscopy eliminated a cartilage lesion and directed towards a cavity filled by spongious bone through an extra articular approach.

Acetabulum↗
PubMed1992

[Bipolar endoprosthesis in fractures of the femoral neck. Apropos of 201 cases, 116 after a 6-year follow-up].

We report our experience with 201 SEM bipolar prostheses used to treat femoral neck fractures in patients with a mean age of 70 years and a mean follow-up of 57 months (median 75 months). Clinical outcome was favorable with 94 per cent satisfactory results (very good and good). Femoral complications requiring reoperation (conversion to total hip replacement) occurred in 2.2 per cent of cases. Among the 163 patients for whom roentgenographic data were available, 5 (3.6 per cent) developed evidence of acetabular wear but remained symptom-free and did not require reoperation. As compared with Moore's prosthesis, the SEM bipolar prosthesis seems to provide substantially better clinical and roentgenographic results. For the treatment of femoral neck fractures, total hip replacement seems to provide results comparable to those reported here but requires a more sophisticated operative technique and carries a greater risk of subsequent dislocation. Two factors prevent the widespread use of the bipolar prosthesis at present: the need for femoral grouting which carries a well-documented risk of hemodynamic complications, and the higher cost of the device.

Adult↗
PubMed1992

[Embolization of the circumflex femoral artery for recurrent hemorrhage after total hip arthroplasty. Apropos of a case].

Reoperation of an haemorrhagic complication after total hip arthroplasty may be not efficacious when, as in the case report, bleeding's origin is not found. The vital prognosis can be quickly set in action and then the arterial embolization be the swift and efficacious solution. The selective arteriography that precedes it allows to locate the bleeding's origin, to estimate gravity of leak and to set indication of embolization. So it is fitting to think of this therapeutic solution that may avoid new operation and new failure.

Aged↗
PubMed1991

On the transverse relaxation rate enhancement induced by diffusion of spins through inhomogeneous fields.

The design of magnetic particles as a magnetic resonance contrast agent will rely on the prediction of their ability to induce transverse relaxation among the surrounding protons. There exists several divergent predictions of the contribution of these agents to 1/T2. This article points out a problem, commonly overlooked, in the development of expressions for the relaxation enhancement which has led some workers to the derivation of results inappropriate for large magnetic particles. The size of the magnetic inhomogeneity created by the particle precludes the averaging of the interaction over a single proton unless it experiences an average field in the time tau between pulses. Computer simulations following the trajectories of diffusing water molecules in inhomogeneous fields are shown to be the correct approach to dealing with large inhomogeneities.

Computer Simulation↗
PubMed1991

Antibiotic-resistant oral streptococci in dental patients susceptible to infective endocarditis.

The aim of this study was to determine the incidence of amoxycillin and erythromycin resistance in oral streptococci in patients at risk from infective endocarditis. Samples of gingival crevicular flora were taken from 65 patients at the site of dental treatment, prior to the prophylactic administration of amoxycillin (54 patients) or erythromycin (11 patients). Samples were also taken from 65 dental patients who were not considered to be at risk from infective endocarditis. No isolate had a minimum inhibitory concentration (MIC) of amoxycillin greater than 24 mg/L. However, erythromycin-resistant oral streptococci with MIC values greater than 3.5 mg/L were isolated from 22% of patients receiving amoxycillin prophylaxis, 9% of patients receiving amoxycillin prophylaxis, 9% of patients given erythromycin prophylaxis and 9% of patients not at risk from infective endocarditis. The antibiotic-resistant streptococci comprised mainly Streptococcus sanguis biotype II, although S. sanguis biotype I, S. mitis and S. salivarius were also frequently recovered.

Amoxicillin↗
PubMed1991

The estimated density of D2 striatal receptors in schizophrenia. A study with positron emission tomography and 76Br-bromolisuride.

The striatal D2 receptors of 19 untreated schizophrenics and 14 normal control subjects were investigated with PET and 76Br-bromolisuride. The ratio of radioactivity in the striatum to that in the cerebellum was taken as an index of the striatal D2 receptor density. There was no significant difference between the control and the schizophrenic groups, nor any difference between subgroups of patients defined by clinical type or course of illness, and no relationship between the striatum:cerebellum activity ratio and SANS or SAPS ratings of symptoms. Unlike in the controls, this ratio was not correlated with age in schizophrenics. This study suggests that there is no quantitative abnormality of striatal D2 dopamine receptors in schizophrenia.

Adolescent↗
PubMed1991

[Psychosocial factors of depressive risk].

The influence of psychosocial factors on the incidence and evolution of depressive illness is well established. The joint study of different aspects of the psychosocial field involved in the risk of depressive illness substantiated interactions between these various factors, modulating the risk of depression. Several psychosocial models of depression, as Harris and Brown's model, have taken into account those interactions, discriminating vulnerability factors and precipitating factors (stressful life events, lasting difficulties): vulnerability factors, not inducing depression per se, increase the depressing effect of precipitating factors when both factors happen to be combined. However the validity of those models has to be confirmed, and mechanisms underlying interactions between psychosocial factors call for further elucidation. Other studies will also have to specify the role of psychological and biological variables in the way psychosocial factors interfere with the occurrence of depression.

Causality↗
PubMed1990

Obsessive-compulsive disorder: a clinical, neuropsychological and positron emission tomography study.

The authors compared 16 nondepressed obsessive-compulsive patients (OCS) with 8 normal controls (NC) of similar age for resting-state regional cerebral glucose metabolic rates (rCMRglu) using positron emission tomography with the fluorodeoxyglucose method. OCS were rated for clinical data, and a neuropsychological battery was administered to 14 patients on the day of the scan. Absolute rCMRglu for whole cortex, and normalized prefrontal lateral cortex metabolic rates, were both significantly lower in OCS than in NC. No significant difference between treated (n = 10) and drug-free (n = 6) OCS was found for those variables. OCS were significantly impaired in the neuropsychological tasks assessing memory and attention. The rCMRglu for prefrontal lateral cortex were negatively correlated to Stroop-test subscores. This "frontal-oriented" task assessed the ability of OCS to inhibit immediate but inappropriate responses. These results suggest, in OCS, a modification of the general activating systems of cortical function and a relationship between the lateral prefrontal rCMRglu decrease and a selective attention deficit.

Adult↗
PubMed1990

Left prefrontal glucose hypometabolism in the depressed state: a confirmation.

The resting-state cerebral metabolic rates for glucose of 10 severely depressed patients (seven bipolar and three unipolar) were compared, before and after treatment with tricyclic antidepressants, to those of 10 control subjects of similar age by means of positron emission tomography and the fluorodeoxyglucose method. Significant left-right prefrontal asymmetry was present in the patients before but not after successful treatment, suggesting that medication can reduce this asymmetry. Also, significant hypofrontality and whole-cortex hypometabolism were found in the patients in the depressed state and persisted in the treated state, despite clinical improvement, suggesting that these abnormalities are not state dependent.

Adult↗
PubMed1990

[Depression with panic attacks: clinical characteristics and prevalence in hospital].

Seventy-three patients successively hospitalized in psychiatry and meeting the criteria of the DSM-III for diagnoses of major depressive episode with or without melancholia (n = 64), dysthymia (n = 5) or adjustment disorder with depressed mood (n = 2) were studied. Of these 73 patients, 50.7% also exhibited, at the time of their hospitalization, panic disorder as defined by the DSM-III criteria (53.4% having exhibited this disorder at some time in their life). Moreover, eight of the 73 patients (11%) exhibited, or had exhibited at some time in their life, a "sub-panic" state characterized by recurring rudimentary attacks, while five of the 73 patients (6.8%) exhibited "permanent panic anxiety" tending to fluctuation rather than paroxysm. These two forms of anxiety raise the question of the limits of panic disorder. The comparison of depressions with and without panic disorder shows an even distribution of endogenous and nonendogenous forms in both groups. Depressions with panic disorder, moreover, registered greater intensity (according to the HDRS score), a higher lever of anxiety (according to the AMDP-AT score), and a higher degree of nervousness (according to the EPI score) than depressions without panic disorder. The study of the chronology of the associations between depressions and panic disorder shows that in more than one-half of the cases these disorders began within one month of each other. In one-third of the cases, panic disorder preceded the depressive episode by more than one month. And finally, in just over 10% of the cases, panic disorder appeared more than one month after the beginning of the depressive episode.

Adolescent↗
PubMed1990

[Synovial osteochondromatosis of the knee and synovial chondrosarcoma. Report of 2 cases].

The possible transformation of synovial osteochondromatosis into chondrosarcoma is rarely reported in the literature, as well as the coexistence of the two entities. The authors have observed two such cases. The first one was discovered by arthroscopy in the course of a synovial osteochondromatosis associated with a posterior tumour proved secondarily as being a chondrosarcoma. On the contrary, the second case presented as a destroying tumour invading the entire joint and proved secondarily as being a benign osteochondromatosis. Cartilaginous masses very important may lead to bone destruction in the course of benign osteochondromatosis. However, in such cases, the possibility of an associated or a secondary chondrosarcoma must be looked for using radiology, arthroscopy and microscope examination.

Chondromatosis, Synovial↗
PubMed1990

[Early reoperation for infection in orthopedic surgery of the leg (arthroplasties and hip surgical procedures excluded)].

The authors report 32 cases of post-operative infections reoperated before the first month of which 12 articular fractures of the tibia. 6 tibial osteotomies of valgisation, 6 tibial diaphyseal fractures, 2 fractures of the lower extremity of the femur, 2 bimalleolar fractures, 1 serious knee sprain, 1 patellar fracture, 1 calcaneum fracture and an arthroscopic arthrolysis of the knee. Twelve of them had an articular infection. Globally, they have obtained 22 satisfactory results (very good or good) and 10 non satisfactory results out of which 2 deaths and 1 amputation. The bad results were due either to a particularly aggressive germ (streptococcus and gas gangrene), or to an articular infection insufficiently controlled: 5 out of the 10 arthrites on infected articular fractures have had a non satisfactory result. As for metaphyseal infections, a simple cleaning has given 4 very good results out of 6, the 2 excluded being very serious and special cases. For the 6 diaphyseal leg infections after osteosynthesis, the early reoperation has not avoided a secundary graft in a picture of infected pseudoarthrosis. In view of this series, the authors propose to adapt the cleaning operation to the localisation and to the presence or not of an articular infection.

Adolescent↗