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P Patra

Publications and source records attributed to P Patra.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Evaluation of a computer graphic representation of echo-Doppler (Echotrace) in the assessment of atherosclerosis of the legs].

The problems generally encountered in interpreting written reports of echo-Doppler examinations led us to develop a graphic software system to visualize the vascular network: Echotrace. The objective of the present work was to evaluate the reliability of Echotrace in patients with atherosclerosis of the lower limbs using arteriography as the standard for assessing sonographic findings. This prospective study was conducted in 29 consecutive patients. Nineteen strategic sites of the arterial network were investigated with duplex-scan and arteriography: lesions scores were attributed for each examination and data for a given site were compared. On the 551 sites compared, we found 26 disagreements including 23 concerning lesion quantification and 3 on localizations. There were also 21 minor disagreements with a single variation in the pathology score. The statistical comparisons could not be made on these scores so the results were compared with the arteriography data on the basis of therapeutic decision taking into account all the arterial lesions and the patient's general status. We observed a perfect agreement between the two imaging techniques in 12 patients, one disagreement which would not change the treatment in 15 patients and, in 2 patients, a disagreement which would modify treatment. This study demonstrated that graphic visualization of arterial lesions with Echotrace is a reliable, easy-to-interpret method.

Adult↗
PubMed1995

Fulminating strongyloidiasis complicating Indian kala-azar.

Infection with Strongyloides stercoralis in an immunocompetent host usually remains unrecognized. Sometimes, however, it may cause serious problems in the immunocompromised host due to its enhanced invasiveness. We present here details of three kala-azar patients with fulminating strongyloidiasis manifested by acute diarrhoea with blood and mucus, severe dehydration, cough and dyspnoea with low peripheral blood eosinophils and filariform larvae of S. stercoralis in faeces. No larvae could be detected in the sputum in spite of radiological evidence of infiltration. The impact of albendazole was dramatic with a disappearance of parasites from the faeces and of pulmonary infiltration and an increase in blood eosinophil count. It is emphasized that S. stercoralis infection in kala-azar patients should be considered a serious infection and treated accordingly.

Adolescent↗
PubMed1993

[Ehlers-Danlos syndrome type IV, revealed by a primary dissecting aneurysm of the left subclavian artery].

The authors report an unusual dissecting aneurysm of the left subclavian artery occurring in a patient suffering from the Ehlers-Danlos syndrome. Clinical history and skin biopsy permitted this diagnosis. Surgical treatment associated resection of the aneurysm, ligation of the proximal part of the subclavian artery and a prosthetic bypass between carotid and subclavian artery. Spontaneous dissecting aneurysm is a rare disease and one must think before surgery to arterial dysplasia. Technical features of the surgical treatment are discussed.

Adult↗
PubMed1992

[Diagnosis of bacterial infections on vascular prosthesis. Histological and microbiological analysis].

A retrospective study of 212 vascular graft failures, using different criteria of infection evidenced a relatively high incidence of infectious complications. Vascular graft infection was assessed on one of the following criteria: clinical infection, positive bacteriological and/or virological examination of the graft, presence of characterized micro-organisms and of microstructures 0.1 to 0.5 micron in size at the blood/prosthesis surface at scanning electron microscopy, and presence of foci of persistent polymorphonuclear cells and lymphocytes at histological microscopy. In the absence of overlapping between these criteria, the present results raise the question of the adequacy of conventional bacteriological sampling on explanted artificial surfaces.

Blood Vessel Prosthesis↗
PubMed1992

Antileishmanial activity of hamycin: a polyene antibiotic.

Hamycin, a polyene antibiotic, now in extensive use in the treatment of candidiasis and otomycosis, is found to be remarkably effective in killing Leishmania donovani promastigotes in a liquid medium at a concentration of 0.2 microgram/ml. The glucose stimulated respiration and the uptake of 2-deoxy-D[U-14C]-glucose was inhibited in cells treated with the drug at a growth inhibitory concentration. An immediate release of isotopic glucose from preloaded cells could be demonstrated after exposure to hamycin. All the above effects could be effectively prevented in the presence of ergosterol. The primary site of action of hamycin on L. donovani promastigote cells appears to be membrane sterols that result in the loss of the permeability barrier to small metabolites. The lower minimum inhibitory concentration of hamycin compared to other established drugs warrants further study in the context of increasing reports of clinical resistance to pentavalent antimonials.

Amphotericin B↗
PubMed1992

Behçet's disease revealed by double peripheral arterial involvement.

We report the case of a 62-year-old man with Behçet's disease revealed by double aneurysmal involvement of the posterior tibial and popliteal arteries. The diagnosis was suggested because of repeated phlebitis, buccal aphthous ulcerations, and results of human leukocyte antigen gene typing. The different arguments leading to the diagnosis of Behçet's disease and appropriate treatment are presented.

Aneurysm↗
PubMed1991

[Infected aneurysms of the aorta].

Mycotic aneurysms, a quite rare syndrome, are classified into three groups: primary (the most frequent one), secondary to bacterial endocarditis, and secondary to direct inoculation (infections focus or trauma). Primary aneurysms are related to bacteremia with bacterial setting of an atheromatous lesion, most often. Clinical presentation is often misleading or delayed from infectious process. However, presence of clinical aneurysm, pain, and infectious syndrome should suggest diagnosis and lead to immediate antibiotic therapy and rapid surgical management, as rupture of the aneurysm is a frequent, serious and ineluctable complication. Importance of microbiologic search is to be emphasized as the diversity of the responsible microorganisms is very high; waiting for bacteriological results, a bactericidal double antibiotherapy should be instituted.

Aneurysm, Infected↗
PubMed1991

Human vascular graft failure and frequency of infection.

Among 212 vascular prostheses collected in a vascular explant retrieval program, 50 exhibited one or more criteria of graft infection i.e., (a) clinical evidence of graft infection, (b) positive bacteriological analyses of the graft, and (c) presence at the blood-prosthetic interface of characterized microorganisms. Whereas each of these criteria was noted respectively in 25, 26, and 20 cases, there was no complete overlapping among the three criteria, but their combination led us to consider 50 cases of infected vascular grafts among the 212 collected. These results, and the occurrence in two cases among six investigations for viral infection, suggest that extensive bacteriological investigations of vascular explants should be included in an implant retrieval program, and that infection may represent a high risk in graft failure.

Aneurysm↗
PubMed1991

Medial fibrodysplasia and aneurysm of the popliteal artery.

Fibromuscular dysplasia of the popliteal artery is rare. We report a case in a 20-year-old man complicated by aneurysm revealed by recurrent synovial effusion of the right knee. Diagnosis was based on pathology reports which showed severe destruction in the media. Two other cases with histopathological documentation were found in the literature.

Adult↗
PubMed1991

[Vascular manifestation of thoracic outlet syndrome. Prospective study of 104 patients].

On the basis of a prospective study of 104 patients, the authors discuss the diagnostic value of the clinical symptoms revealing the thoracic outlet syndrome (TOS), as well as the specificity of the vascular functional exploration carried out to establish the diagnosis. Non-systematized pain and dysesthesia in the upper limb, with a postural or nocturnal onset, and Raynaud's sign are the most frequently observed signs. The "candlestick" maneuver still is the most reliable clinical triggering maneuver. The clinical features and the vascular functional explorations (capillaroscopy and digital plethysmography) allow demonstrating the existence of a true Raynaud's syndrome secondary to the TOS. The results of the arterial Doppler study distinguish the symptomatic and asymptomatic sides in the same patient, though without any correlation with the symptoms observed. The Doppler examination therefore seems to be reliable to demonstrate an anatomical duct, but remains insufficient to establish a causal relationship with the signal symptoms in most cases.

Adolescent↗
PubMed1991

[Chronic rupture of an aneurysm of the abdominal aorta].

The chronic rupture of an aneurysm in the abdominal aorta produces an atypical clinical picture. Computed tomography is the method of choice for diagnosis. This is a therapeutic emergency because of the risks involved by evolution.

Angiography↗
PubMed1990

[The Dacron vascular prosthesis in men. Mechanical performance, lesions and molecular stability].

The causes of failure of vascular prostheses implanted in man were investigated by means of histological, ultrastructural and scanning electron microscopic techniques as well as mechanical performance and macromolecular structure studies. These investigations concerned 22 out of 212 explanted prostheses from about 10 vascular surgery departments, examined over a 3-year period. The changes observed in the mechanical properties of the explanted prostheses (2 to 75 per cent reduction of resistance to rupture) and the finding of broken fibers and migrating polyester particles were confirmed by the presence of structural alterations in the polymer with, in particular, diminution of its crystalline structure. No correlation was found between the occurrence of these lesions and the type of prosthesis used and/or the duration of implantation.

Blood Vessel Prosthesis↗
PubMed1989

The infratemporal fossa: a trial clarification.

The contents of the infratemporal fossa have been studied using CT scans, anatomical dissections and radiography of the anatomical specimens. On the strength of this, 3 distinct regions are discernable: the anterior part of the fossa contains the fat pad of the cheek and this area corresponds to the retromaxillo-zygomatic region; the region of the pterygoid m. contains vascular structures and lies behind the preceding region; the pterygopalatine fossa, formerly considered the deepest part, extends the infratemporal fossa superiorly and medially. These anatomical and radiographic findings could serve as a guide to maxillo-facial surgeons dealing with expanding lesions within the infratemporal fossa, or invading it from adjacent regions.

Adipose Tissue↗
PubMed1989

Retrograde dissections of the aortic arch after exclusion-bypass of the descending thoracic aorta: a report of three cases.

We report three cases of fatal retrograde dissection of the aortic arch after exclusion-bypass with metal clamps according to Carpentier's thromboexclusion method. All three patients were male, aged 59, 66, and 73 years. Initial operative indications were chronic dissections in two cases and atheromatous aneurysm of the descending thoracic aorta in the other. Two of these patients were operated on in an emergency setting for a ruptured aneurysm. In all three cases, an extraanatomic bypass between the ascending aorta and abdominal aorta was performed as the first step: The proximal clamp was then placed distal to the origin of the left subclavian artery. Death occurred two hours, 12 hours, and eight days after operation, respectively. Autopsy revealed retrograde dissection initiating in the aortic arch and reaching the aortic ring as the cause of death. Pathological examination of aortic specimens confirmed that the dissections began just proximal to the site of clamping. To explain this complication, two etiologic factors, occurring either alone or together, have been postulated: postoperative hypertension and trauma to the aortic wall from the clamp.

Aged↗
PubMed1989

[Mechanical obstruction of the duodenum after surgery of the abdominal aorta].

The authors report two cases of duodenal obstruction occurring after insertion of an aorto-iliac prosthesis. This form of mechanical obstruction is much rare than the other forms of post-operative mechanical intestinal obstruction. While the need for surgery is often evident, precise diagnosis before the procedure is seldom obtained. CT scan appears to be the investigation of choice. This complication could be prevented by an epiploplasty covering the graft implant region.

Aorta, Abdominal↗
PubMed1988

Stability of performances of vascular prostheses retrospective study of 22 cases of human implanted prostheses.

Twenty-two cases of vascular graft failures (thrombosis, pseudoaneurysm, dilation, infection) were investigated by means of physicochemical, histological, and ultrastructural studies. A general decrease of mechanical resistance to stress of the prostheses was observed. Its magnitude ranged from 2 to 75% of the values of identical virgin prostheses and there was no relation with the duration of implantation. In addition to the breakage of yarn filaments (SEM), migration of fiber debris (histology) was observed in 7 cases. The structure of the polyester molecule had evolved after implantation. A decrease of crystallinity (x-ray diffraction and differential scanning calorimetry) was noted. These observations raise the question of the established stability of vascular prostheses and emphasize the need for further investigations in human graft retrieval programs.

Biocompatible Materials↗
PubMed1988

Physiologic variations of the internal jugular vein surface, role of the omohyoid muscle, a preliminary echographic study.

The action of the omohyoid muscle on the hemodynamics of the internal jugular vein is controversial. For some authors, contraction of this muscle, by tightening the cervical fascia, promotes jugular venous return. For others, contraction of this muscle compresses the jugular vein in its cervical path. With this latter point in mind, the hemodynamics of the internal jugular vein have been studied in its cervical path by echography in 10 healthy volunteers. One hundred twenty measurements of the venous surface were made at rest, with the mouth open and during deep inspiration. In the last 2 situations, evidence of a significant increase in the venous surface was found above the omohyoid muscle. These data confirm the role of compression of the vein by the omohyoid muscle, leading to modifications in intracerebral venous hemodynamics, which can be affected in yawning.

Adult↗