Safety and efficiency of ultrasound-guided intermediate cervical plexus block for carotid surgery.

Objective: Since stroke and myocardial ischaemia are major causes of perioperative morbidity and mortality associated with carotid endarterectomy, monitoring the brain and ensuring the best haemodynamic stability are important goals of the management. As regional anaesthesia was reported to improve haemodynamic stability during carotid endarterectomy (CEA), we conducted a prospective observational study on the efficacy and safety of ultrasound-guided intermediate cervical plexus blocks (CPB), with early (immediate postoperative) and mid-term (day 30) outcomes in awake patients undergoing CEA.

Methods: After the ethics committee approval, 50 patients undergoing a carotid endarterectomy with CPB from April 2011 to May 2013 were included.

Diagnostic Performance of a New Rapid Lateral Flow Immunoassay in Patients Suspected of Heparin-Induced Thrombocytopenia and Its Clinical Consequences.

We prospectively evaluated the diagnostic accuracy of a new rapid assay (STic Expert HIT) alone or in combination with a clinical score in 90 HIT-suspected patients. The 4Ts score was calculated, and ELISA and serotonin-release assay (SRA) were performed; the average time taken for test results were 2 and 5 days for ELISA and SRA, respectively. The STic test was performed in our laboratory as an evaluation exercise and the result was available in 1 hour, but results were not communicated to the clinicians so as to not influence management.

[Atrial fibrillation: from cardiology to perioperative management].

Atrial fibrillation (AF) is the most frequent arythmia. During the perioperative period and in intensive care units, management of patients with AF is frequent and difficult. As in cardiology, two main issues are present: the risk of acute hemodynamically instability and the risk of thromboembolic complication.

[Dosimetry with radiosensitive gels in radiotherapy. Methods].

The goal of conformal radiotherapy is to concentrate the dose in a well-defined volume by avoiding the neighbouring healthy structures. This technique requires powerful treatment planning software and a rigorous control of estimated dosimetry. The usual dosimetric tools are not adapted to visualize and validate complex 3D treatment.

[Recognizing interventional biology as a specialty on its own].

Changing therapeutic strategies have led to the development of new techniques where elements of the human body, including cells, tissues or even organs, are removed from the body in order to modify their potential before reintroducing them into the body. The ex vivo manipulations are performed by biologists working in close coordination with clinicians who determine the indications and perform the procurement and reintroduction steps. We propose the term interventional biology for this type of activity and suggest that, beyond the various domains considered including reproduction biology, and cell and gene therapy, it should be recognized as a specific form of practice of medical biology.

In vivo comparison between computed tomography and magnetic resonance image analysis of the distal radius in the assessment of osteoporosis.

In a prospective case-control cross-sectional study, we investigated the usefulness of both computed tomography (CT) and magnetic resonance (MR) image analysis of the distal radius for distinguishing a small sample of fractured osteoporotic women from control women regardless of bone mineral density. The study population included 12 subjects who were divided into two groups according to their bone status. The first group consisted of six women with at least one vertebral fracture occurring in the absence of high-energy trauma, and the second group consisted of six women without disease affecting bone mass or bone metabolism.

Automatic quality assessment protocol for MRI equipment.

The authors have developed a protocol and software for the quality assessment of MRI equipment with a commercial test object. Automatic image analysis consists of detecting surfaces and objects, defining regions of interest, acquiring reference point coordinates and establishing gray level profiles. Signal-to-noise ratio, image uniformity, geometrical distortion, slice thickness, slice profile, and spatial resolution are checked.

Image analysis of the distal radius trabecular network using computed tomography.

Bone texture analysis might provide information about bone structure in a noninvasive manner. In a prospective case-control cross-sectional study we investigated the value of computed tomography (CT) image analysis of the distal radius in the assessment of osteoporosis. Twenty patients suffering from postmenopausal osteoporosis were studied and compared with 21 age-matched controls.

CT scan texture analysis of the distal radius: influence of age and menopausal status.

Objectives: To gain information on bone architecture by performing bone texture analysis in a sample of women covering a broad age range.

Patients And Methods: We studied 29 healthy women aged 23 to 80 years (55 +/- 18 years), 19 of whom were postmenopausal. None was taking drugs known to influence bone mass or bone metabolism.

Coronary artery revascularisation without extracorporeal circulation. Indications and results.

Objective: Coronary artery revascularisation without extracorporeal circulation is a technique which can be performed in selected patients in need of a coronary artery bypass graft.

Methods: Consecutive patients (210) underwent coronary artery bypass graft without extracorporeal circulation. Indications were high risk patients, or single coronary artery lesion.

Lung resection for recurrence after pneumonectomy for metastases.

Resection of pulmonary recurrences after pneumonectomy for metastases is exceptional. Nevertheless in carefully selected patients surgery on the residual lung might be successfully performed. From January 1987 to February 1996, 5 patients underwent metastasectomy on single lung after pneumonectomy performed for the same metastatic disease.

A new video-assisted thoracoscopic surgical technique for interruption of patient ductus arteriosus in infants and children.

Classic surgical interruption of patent ductus arteriosus was partially replaced by transcatheter endovascular closure in 1971. We describe a new technique for ductus closure by video-assisted thoracoscopic surgical interruption, derived from video-assisted endoscopic surgery. With the patient under general anesthesia and intubated, two 5 mm holes were made through the left thoracic wall.

Mediastinal infection after cardiac operation. A simple closed technique.

From March 1984 to March 1987, a simple closed method, previously described for the treatment of osteomyelitis after orthopedic operations, was used to treat deep sternal infection in 11 patients. The basis of this technique is, after meticulous débridement of the wound, to drain all the infected areas with small catheters connected to a bottle inside of which a strong (700 mm Hg) negative pressure is created (Redon drainage device). The method does not require irrigation.

[Postoperative inotropic treatment in cardiac surgery of the newborn infant and infant].

Corrective cardiac surgery in infants and neonates induces acute circulatory and anatomical changes which, together with the myocardial ischaemia of cardiopulmonary bypass, impair cardiac function. Although this cardiac dysfunction usually disappears without any after-effects, inotropic treatment is mandatory for a short time. There, however, is no easy way to monitor cardiac output in these small patients.