Laparoscopic nephrectomy donor death due to cerebral gas embolism in a specialized transplant center: risk zero does not exist.
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Adult↗
Biomedical subjects
Yves Bendavid
Publications and source records attributed to Yves Bendavid.
Giant splenic artery aneurysms: case report and review of the literature.
Although splenic artery aneurysms (SAAs) are the most common visceral aneurysms, giant SAAs >10 cm in diameter have rarely been reported. We present the case of a 67-year-old asymptomatic man who was diagnosed with a 15-cm SAA in the absence of a clear etiologic factor. The patient underwent open surgical repair. A medial visceral rotation was performed to gain good vascular control and subsequently the aneurysm was ligated from within. A systematic review was carried out, allowing us to analyze 12 cases of giant SAAs >10 cm published to date. The difference in terms of demographics, clinical presentation, and arterial location between the giant SAA group and usual SAAs may indicate a different underlying physiopathology that remains unclear at this time.
Aged↗
A study of the effect of temperature on the pharmacokinetic profile of raltitrexed administered by intraperitoneal route in the rat.
BACKGROUND: Because heat can improve the activity of selected drugs when administered heated in the peritoneal cavity in the treatment of peritoneal carcinomatosis from colorectal origin, there is a great interest to evaluate new cytotoxic agents in this context. The purpose of this study is to assess the effect of heat on the pharmacokinetic profile of Raltitrexed administered intraperitoneally in rats. MATERIAL/METHODS: Rats #1 to #40 have been submitted to different doses of intraperitoneal Raltitrexed (2, 4, and 8 mg/m2) at different perfusion temperatures (37, 40 and 43 degrees C). After 25 minutes of perfusion, peritoneal fluid, portal and systemic blood were harvested and prepared for dosage of Raltitrexed. Rats #41 to #50 have been submitted to 8 mg/m2 of intraperitoneal Raltitrexed (37 and 43 degrees C) during 25 minutes. Then, a segment of small bowel and a section of parietal peritoneum were harvested and prepared for intracellular dosage of Raltitrexed. RESULTS: The dose of Raltitrexed administered is a determinant of its concentration in peritoneal perfusate, in portal vein blood and in systemic blood (p < 0.0002). We noticed that perfusate temperature had no significant effect on the concentration of drug in the portal vein blood (p = 0.29) and in the systemic blood (p = 0.25). However, temperature increased significantly (p < 0.04) the intracellular absorption of Raltitrexed. CONCLUSIONS: Because the effect of Raltitrexed is proportional to its intracellular concentration, it seems clear that Raltitrexed is of greatest interest when administered heated in the peritoneum because it can reach greater intracellular concentrations without a significant increase in systemic concentration, which is responsible of toxicity.
Animals↗
What is so odd about odds?
In clinical studies, the relative likelihood of an event occurring between 2 groups is often expressed as the risk ratio (RR) or the odds ratio (OR). The RR is an intuitive parameter that is relatively easy to interpret. Quantitative interpretation of an OR is much more difficult and is often incorrectly equated to that of an RR. The problem is that OR may differ substantially from RR, especially when the outcome of interest is common in the study population. This article explains and clarifies controversial issues surrounding the use and interpretation of the OR. Theoretical concepts relating to ORs are illustrated by examples from the surgical literature. By reviewing articles from 5 surgical journals over a 5-year period, we show that the OR is often presented and misinterpreted as equivalent to the RR. When the discrepancy is large, using OR uncritically as an estimate of RR will strongly bias inferences about treatment effect or cause of disease by amplifying the apparent strength of an association between an exposure and an outcome.
Odds Ratio↗
Phase I study on sentinel lymph node mapping in colon cancer: a preliminary report.
BACKGROUND AND OBJECTIVES: Lymph node (LN) metastasis is one of the most significant prognostic factor in colorectal cancer. In fact, therapeutic decisions are based on LN status. However, multiple studies have reported on the limitations of the conventional pathological LN examination techniques, and therefore, the actual number of patients with LN positive colorectal cancer is probably underestimated. We assume that lymphatic tumor dissemination follows an orderly sequential route. We report here a simple and harmless coloration technique that was recently elaborated, and that allows us to identify the sentinel LN(s) (SLN) or first relay LNs in colorectal cancer patients. The main endpoint of this clinical trial is the feasibility of the technique. METHODS: Twenty patients treated by surgery for a colic cancer were admitted in this protocol. A subserosal peritumoral injection of lymphazurin 1% was performed 10 min before completing the colic resection. A pathologist immediately examined the specimens, harvested the colored SLN, and examined them by serial cuts (200 microm) with H&E staining, followed by immunohistochemical staining (AE1-AE3 cytokeratin markers), when serial sections were classified as cancer free. RESULTS: The preoperative identification of the SLN was impossible in at least 50 of the cases, however, SLNs were identified by the pathologist in 90% of cases. In two patients (10%) SLN was never identified. The average number of SLN was 3.9. Immunohistochemical analysis of the SLN has potentially changed the initial staging (from Dukes B to Dukes C) for 5 of the 20 patients (25%). On the other hand, there was one patient (5%) with hepatic metastasis from adenocarcinoma for whom SLN pathology was negative for metastasis (skip metastasis). CONCLUSIONS: SLN biopsy is readily feasible with identification of SLN in at least 90% of patients with colorectal cancers. Our results indicate that 45% of patients initially staged as Dukes B had tumor cells identified in their SLN when these were subjected to our protocol. This represented a 25% upgrading rate when our complete study population is considered. However, controversy persist about the clinical significance and metastatic potential of these often very small clusters of tumor cells.
Biomarkers, Tumor↗