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P Sabin

Publications and source records attributed to P Sabin.

At least 19 recordsLinked to original sources
PubMed2003

The importance of clinical factors in parenteral nutrition-associated hypertriglyceridemia.

AIMS: The purpose of this study was to establish the relevance of several clinical factors associated with parenteral nutrition (PN) hypertriglyceridemia and to construct a predictive model for this complication. METHOD: This multicenter study included all patients with initial serum triglyceridemia <3 mmol and receiving a minimum of 7 days' PN therapy. The study ended for each patient when hypertriglyceridemia developed or PN was terminated. Two multivariate models were constructed, one to study the clinical factors and the second to predict plasma triglyceridemia. A total of 22 clinical factors studied as independent variables were included in the multiple-step regression models only when they showed a P-value over 0.1. Statistical significance was determined by the confidence interval of the odds ratio (OR) and the partial regression coefficient (b). RESULTS: The study included 260 patients from 14 hospitals. Lipid administration was 0.83+/-0.37 g/kg/day. Among the total, 68 patients (26.2%) showed hypertriglyceridemia. Variables included in both models were serum glucose (OR, 2.63; b, 0.06), renal failure (OR, 10.56; b, 1.70), corticoid administration >0.5 mg/kg (OR, 7.98; b, 0.97), pancreatitis (OR, 4.38; b, 0.64), sepsis (OR, 4.48; b, 0.24), lipids infused (OR, 3.03; b, 0.24) and heparin administration >3 mg/kg/day (OR, 0.11; b, -1.21). CONCLUSION: Although the rate of lipid infusion was low, certain clinical factors modified triglyceridemia. Nevertheless, relatively fast plasma clearance of lipids infused indicates that a reduction in lipid supply could be a quick, effective measure for controlling hypertriglyceridemia. Thus, careful monitoring of patients with clinical factors predicting risk in the model studied, with adjustment of lipid perfusion rates accordingly, is suggested to avoid hypertriglyceridemia.

Adult↗
PubMed2002

[Idiopathic cholestasis associated with progressive ductopenia in two patients with hodgkin's disease].

INTRODUCTION: Jaundice in Hodgkin's disease can be due to several causes. Ductal lesions and ductopenia, which we describe below, have rarely been reported. CASE REPORT: We describe 2 cases of idiopathic cholestasis associated with Hodgkin's disease in which duction lesions and ductopenia were found. In one case, the ductal lesion progressed to ductopenia and the patient died from complications of her oncological disease while in the second case, outcome was favorable with improvement of cholestasis and remission of Hodgkin's lymphoma. DISCUSSION: Ductopenia should be included in the differential diagnosis of cholestasis associated with Hodgkin's disease, for which a high degree of suspicion is required. Hodgkin's disease should be suspected when ductopenia is found.

Adult↗
PubMed2001

[Mandibular distraction osteogenesis and dental rehabilitation by osseointegrated implants. A case report] ].

The authors report a case of mandibular reconstruction by distraction osteogenesis. The patient presented an interrupting mandibular defect secondary to a gunshot injury. The distraction osteogenesis permitted the reconstruction of the mandible without bone grafts or flaps. The attached gingiva on the alveolar ridge was also recreated by the distraction and allowed a dental rehabilitation by osseointegrated implants.

Humans↗
PubMed2001

[Extra-oral implants: indications and contraindications].

Osseointegrated facial prostheses are an interesting solution for maxillofacial rehabilitation when reconstructive surgery cannot be proposed. Progress in epithesis materials and in implantation techniques have renewed interest in maxillofacial prostheses. The best indications are for rehabilitation of nasal, auricular and orbitopalpebral defects. Another indication is complex loss of facial tissue. Endo-osseous epitheses are recommended mainly when there is no possibility of reasonable and satisfactory surgical reconstruction, when local carcinologic prognosis is uncertain, and to respond to the patient's demands. We detail here the precautions necessary when irradiation has been performed previously and finally present the contraindications against epitheses on osseointegrated implants.

Biocompatible Materials↗
PubMed2001

[Localized loss of facial tissue. Criteria of use of extra-oral implants and clinical cases].

Osseointegrated maxillofacial epitheses are an interesting therapeutic response for rehabilitation after loss of facial tissue when reconstructive plastic surgery cannot be proposed. We analyzed the criteria used for deciding on this type of treatment for the loss of local areas of auricular tissue, the nasal pyramid and the orbitopalpebral region, presenting individual clinical examples.

Adolescent↗
PubMed2001

[Permanent percutaneous connections and osteointegration].

Passage through the skin of an abutment anchored on an implant fixed on the underlying one constitutes a Permanent Percutaneous Connection of which the principal applications are stabilization of maxillofacial prosthesis (MFP) or bone anchored hearing aid (BAHA) support. The long-term outcome of a PPC depends on a variety of different parameters. We analyzed the influence of the most important factor: osseointegration.

Biocompatible Materials↗
PubMed2001

[From the concept of permanent percutaneous connections to that of permanent percutaneous electrical connections].

Percutaneous abutment of an extra-oral implant provides two main functions: support of bone anchored hearing aid (BAHA) and fixing maxillofacial prosthesis (MFP). Further developing this concept, and using available surgical strategies and materials, leads to a new application in extra-oral implantology. We analyzed the evolution of concepts in the field of permanent percutaneous connection (PPC) to the new concept of PPEC (permanent percutaneous electric connection), presenting a clinical case.

Biocompatible Materials↗
PubMed2000

Influence of surgical stress and parenteral nutrition on serum leptin concentration.

UNLABELLED: Experimental studies suggest that leptin may be an important metabolic signal for energy regulation. AIM: To assess whether surgical stress produces changes in serum leptin concentration and to investigate and compare the effect of total parenteral nutrition and hypocaloric parenteral nutrition on serum leptin levels. PATIENTS AND METHODS: Twenty-two surgical patients (11 male and 11 female) in need of parenteral nutrition were recruited. Parenteral nutrition was always initiated 24 h after surgical procedure. Group I (n=15) received total parenteral nutrition, while Group II (n=7) were treated with hypocaloric parenteral nutrition. Serum leptin concentration was determined before surgical procedure (day -1), after surgery and before parenteral nutrition was started (day +1), and after 5 days of treatment with parenteral nutrition (day +6). RESULTS: A tendency to increase serum leptin levels was observed after surgical procedure (6.0+/-1.9 vs 9.9+/-2.7 ng/ml;P= 0.07). After starting parenteral nutrition no significant changes on serum leptin concentrations were found in both groups, but a trend to raise serum leptin was observed in Group I (6.2+/-1.7 vs 8.3+/-2.7 ng/ml) whereas a trend to decrease serum leptin was detected in Group II (4.6+/-2.5 vs 1.6+/-0.5 ng/ml). On day +6 an increase of serum leptin and insulin levels was observed in Group I in comparison with Group II (8.3+/-2.7 vs 1.6+/-0.5 ng/ml;P<< 0.05 and 58+/-41 vs 12+/-15 microU/l;P<< 0.05 respectively). Finally, a positive correlation at day +6 between insulin and serum leptin levels was observed (r= 0.66;P<< 0.01). CONCLUSIONS: a) Surgical stress is associated to an increase of serum leptin concentrations; b) Total and hypocaloric parenteral nutrition produces quite different effects on serum leptin levels that could be related to distinct insulin response.

Energy Intake↗
PubMed1999

[A new application of extraoral implants: the permanent percutaneous electrical connection. Apropos a case].

The principle of EOI is an implant fixed to the bone supporting a percutaneous abutment. Placed through the skin, the abutment allows a permanent communication between inside and outside of the organism. A rigorous very precise surgical protocol has allowed good results of the technique for over 20 years and shown the reliability of this two-piece device. This surgical protocol and device concept have been used by the authors to design a percutaneous electrical connector experimented in a rabbit model since 1996. A percutaneous electrical connector called PEP (percutaneous electrical plug) directly steming from the Sweden and German extra oral implants as been design for human applications. Authors describe the surgical placement and loading of there first PEP, under Huriet law, in an otologic application: the treatment of sever, drug-resistant tinnitus by electrical stimulation of the internal ear. The anatomical implantation area of these new extra-oral implants is retro-auricular. So the implants placements should be realized by ENT and maxillo-facial surgeons.

Animals↗
PubMed1999

[Functional complementation of intra- and extra-oral implants. Apropos of a case of extensive loss of substance of the face].

The respective indications for oral or extra-oral implants lead to no confusion: stabilization of dental prostheses for the first, stabilization of maxilo-facial epitheses for the others. We demonstrate that the complementarity of the two types of implants can prove to be very useful in maintaining the maxillary dental prosthesis and the epithesis in a case of severe loss of facial substance affecting particularly the pre-maxilla. This complementary characteristic made it possible to recover fairly rapidly phonation and deglutition, and to remedy somewhat the esthetic damage. In other words to create the essential conditions for a return to everyday life.

Aged↗
PubMed1997

[Bone-anchored implants: comparison of the techniques and values of endo- and juxta-bone implants].

Extra-oral implants have been used for well-defined application for nearly 20 years; for tupoorting maxillo-facial prostheses and for bone anchored hearing aids (BAHA). In both of these applications, the bone-anchored prostheses support transcutaneous abutments. It is the junction between the implant and the abutment which ensures, given certain preconditions, the permanent percutaneous connection (PPC). The authors describe the two types of implants currently in use-intra- and juxta-osseous implants. They then give a brief description of the two techniques. The advantages and disadvantages of each system are summarised, as well as the conditions required for permanent survival of a PPC.

Bone Plates↗
PubMed1997

[Implant-supported prosthesis. The significance of endosseous and peri-osseous implants].

The new extra-oral of Farmand (EPITEC system) is a plate-implant. This concept is really different from the Brånemark's implant and the use of EPITEC system give the authors opportunity of a first assessment. It seems that if, of course, Brånemark system is still the reference, the EPITEC system certainly has a real interest in thin osseous implantation areas.

Adolescent↗
PubMed1997

[The management of extra-oral implants. Anachronisms and paradoxes].

Used in France for ten years and in Sweden since 1977. Extra-Oral Implants (EOI) represent one of the new therapeutic approach of facial defects treatment by maxillo-facial prostheses fixed on implants and of some transmission deafnesses. Audiologic applications are free of charges for the patient but not the prosthetic applications; the authors note this paradox and some other anachronisms. Finally the authors wonder why Extra-Oral implantology is a "correct" science and why Intra-Oral Implantology remains absent from the Administrative texts as if it was a sort of doubtful therapy without scientific principles.

Aged↗
PubMed1997

[Permanent percutaneous electric connection. General principles].

The Swedes for more than twenty years, and the Germans for over five years have been able to maintain inert or active prostheses with permanent percutaneous connections, thanks to the dependable and proven material and techniques of extraoral implants. The significant improvement extra-oral implants have brought about is not only in a new therapeutic approach to the treatment of important facial defects or transmission deafness; it is also because for some twenty old years now, the few millimeter wide cylinders of Titanium, the < > affixed on the implants, have crossed the cutaneous barrier for extended periods without complications. The percutaneous abutment thus creates a permanent communication between the interior and the exterior of the organism. If the abutment, instead of simply carrying a Maxillo-Facial Prosthesis or an auditive prosthesis, is modified by placing an electric conductor inside it, the simple "percutaneous peg" will turn out to be, in a way, a "percutaneous electric plug". By adapting classic "mechanical" abutments and implants, authors have created a Permanent Percutaneous Electric Connection (PPEC) which has been successfully experimented on rabbits to record EEG. Clinical applications on humans would make it possible either to receive "bio-electrical information" coming from within the organism, or to send electrical energy into the organism. This last application opens vast perspectives of improvement both in diagnosis and therapy in many fields.

Humans↗
PubMed1995

[Maxillofacial prosthesis fixed on endosseous implants. Apropos of 15 cases].

In the light of 15 cases of craniofacial defects due to trauma of carcinomas, the authors propose a new approach of the indications for craniofacial prostheses. Progress in materials (silicons) and treatments of maxillo-facial defects (titanium implants) have renewed the interest in maxillo-facial prostheses in maxillo-facial surgery. The advantages and disadvantages of classical methods of prosthesis fixation (on glasses or adhesives) and modern techniques of extra-oral implants (Swedish) are cause of the recent interest for prostheses in plastic surgery. New implants (German) and easier techniques induce a growing interest for extra-oral implants.

Head and Neck Neoplasms↗
PubMed1993

[Maxillofacial prostheses on endosseous implants. Various modes of fixation].

Both mechanical and magnetic types of fixation can be used with extra-oral implants, with the possibility of positioning maxillofacial prostheses by either mechanical, magnetic or mixed fixation, the latter by a combination of the two methods. These different modes of fixation allow precise positioning, avoid the use of adhesives, limit maintenance problems and, in addition, facilitate oncologic surveillance, providing a non-negligible complement to reconstructive surgery.

Adult↗