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101.
Biron S Hould FS Lebel S Marceau S Lescelleur O Simard S Marceau P 《Obesity surgery》2004,14(2):160-164
Background: Comparative evaluation of weight loss after bariatric surgery is difficult without definition of success and without
a norm for presenting results. We explored the pertinence of defining success: a residual BMI <40 or <35 kg/m2, and the need for reporting results with stratification by initial obesity and length of follow-up. Methods: Results of 1,271
consecutive biliopancreatic diversion (BPD) patients were compared when presented with or without stratification, and we searched
for landmarks of success which would be shared by patients themselves. Results: Presented globally, after a mean follow-up
of 7.9 ± 4.2 years, BMI decreased from 48.4 ± 9.4 to 31.3 ± 6.5, and only 10% and 26% of patients would have been considered
failures with a residual BMI ≥ 40 or ≥ 35 respectively. Because heavier patients were losing less in terms of percentage (
P <0.0001) and regained weight faster ( P <0.0001), global and cumulative results failed to show a failure-rate doubling every
5 years and a very high failure-rate in heavier patients. The landmarks of BMI 40 and 35 were the same unconsciously used
by patients to express their own perception of failure. For patients with an initial BMI <50, a residual BMI of 35 caused
a significant drop in the degree of satisfaction from 90 to 40%. For super-obese, the same critical point was found at a BMI
of 40 where satisfaction dropped from 91 to 57%. Conclusion: Landmarks of success at BMI 40 and 35 were realistic, reasonable
and coincided with patients' own expectations. Since initial obesity and duration after surgery made so much difference in
results, a comparison of different surgical approaches was useless without stratification for both factors together. 相似文献
102.
Outcome of Pregnancies after Biliopancreatic Diversion 总被引:4,自引:0,他引:4
Background: Severe obesity has deleterious effects on fertility and pregnancy outcomes. Although surgery is the best long-term treatment
for severe obesity, there is a risk of gestational undernutrition in operated mothers because bariatric surgery reduces nutrient
availability. This is a follow-up report of our initial findings regarding pregnancy and neonatal outcomes in biliopancreatic
diversion (BPD) patients, with addition of a new cohort of children born to mothers after BPD. Methods: All women (n = 916) who had successfully undergone BPD in our hospital were mailed a questionnaire containing multiple-choice
and essay questions concerning gynecologic and obstetric history, and pregnancy and neonatal outcomes in both preoperative
and postoperative pregnancies. Patients operated between 1984 and 1995 (n = 568) were mailed an additional questionnaire regarding
children's weight and height progress, and school performance. Perinatal records from our patients' obstetric clinics were
also reviewed. Results: The questionnaire was completed by 783 women (85.5%). 251 postoperative pregnancies in 132 women resulted in 166 infants
by 109 mothers. 47.0% of patients who were unable to become pregnant preoperatively were successful postoperatively. 90 out
of 109 women (82.6%) reported an appropriate weight gain (9.1 ± 5.9 kg) during postoperative pregnancies. The incidence of
fetal macrosomia decreased from 34.8 to 7.7%, with a concomitant increase in normalweight babies from 62.1 to 82.7%. The elevated
miscarriage rate (26.0%) in these obese women persisted after surgery. Conclusion: Major weight loss following BPD improves the reproductive function of severely obese women. BPD provides major beneficial
effects for both mother and child, including normalization of gestational weight changes, reduction of fetal macrosomia, and
normalization of the infant's birth-weight. Our results speak in favor of delaying pregnancy in obese women until after the
substantial surgical weight loss has occurred. 相似文献
103.
The study investigated the responsiveness of a recombinant Saccharomyces cerevisiae yeast strain to screen estrogen-like chemicals in order to use it as a first level short-term bioassay for environmental preventive medicine purposes. We used the yeast strain RMY326 ER-ERE, containing the human estrogen receptor alpha and a reporter gene lacZ encoding the enzyme b-galactosidase. We tested the natural steroid hormone 17beta-estradiol, diethylstilbestrol, colchicine, some phytoestrogens and pesticides, and organochlorine insecticides. The relative inductive efficiency (RIE) and EC50 values confirmed the sensitivity and specificity of the yeast strain. A statistically significant reproducibility of results in repeated experiments was assessed. 相似文献
104.
Blanchard N Kremer S Klein O Schmitt E Bracard S Picard L 《Journal of neuroradiology. Journal de neuroradiologie》2004,31(5):413-416
Intra spinal primary melanoma is a rare entity. We report a new case, atypical in relation to its primary radicular location, and to its early metastatic intradural and extra-medullary location, six months later. MRI is the more valuable examination, showing a spontaneously hyper-intense lesion on T1-weighted MR images, intense enhancement after gadolinium administration, and decreased signal on T2-weighted MR images, thus suggesting a diagnosis of melanocytic or hemorrhagic lesion. Signal abnormalities are not specific and definitive diagnosis is established after histological analysis. 相似文献
105.
Cordebar A Bracard S Kremer S Schmitt E Anxionnat R Martin-Bertaux A Picard L 《Neuroradiology》2004,46(11):940-946
Two pilot studies on a small number of patients demonstrated the feasibility of transcranial Doppler ultrasound evaluation in the follow-up of intracranial aneurysms treated with detachable coils. This prospective study aimed to assess the sensitivity of contrast-enhanced transcranial echo-Doppler in detecting partial aneurysmal occlusion following endovascular treatment. Transcranial Doppler sonography (TCD) with contrast administration and magnetic resonance angiography (MRA) or angiography were carried out after endovascular treatment in 92 patients for 98 aneurysms of the anterior circulation. In 18% of cases, the quality of ultrasound exploration was deemed unsatisfactory for evaluation of the aneurysmal site. Results were concordant in 63% of patients (49/78). When occlusion appeared satisfactory at angiography or MRA, the result was concordant with TCD in 68% of cases (44/77). When a residual aneurysm was detected, TCD sensitivity was 38% (8/18). An analysis of subgroups failed to disclose anatomic or morphological aneurysm features in which transcranial echo-Doppler is sufficiently sensitive and specific to detect possible residual aneurysm or recanalisation. In our experience, even after contrast administration TCD is not sufficiently sensitive or specific in the detection of residual aneurysm to replace angiography or MRA. 相似文献
106.
Hommais F Gouriou S Amorin C Bui H Rahimy MC Picard B Denamur E 《Infection and immunity》2003,71(6):3619-3622
Correlations between FimH mutations and virulence were established by studying a collection of human commensal and extraintestinal pathogenic Escherichia coli natural isolates. Pathoadaptive (A27V and, to a lesser extent, A119V) and "commensal-adaptive" (A202V) mutations were evidenced in B2 phylogenetic group strains. fimH phylogenetic analysis indicates that these pathoadaptive mutations occurred several times. 相似文献
107.
108.
Dréno B Ramel F Aymard M Braig S Judlin P Malkin JE Morand P Picard O 《Pathologie-biologie》2002,50(7):436-439
Herpes is a viral infection which increases, specifically genital herpes. The aim of this survey was to assess the perception of herpes in the general population and in patients with herpes in France using a self-administered questionnaire. A total of 10,000 persons answered the questionnaire among which 128 patients presented herpes. This study showed that only 5% of the French population knew that herpes was a viral infection, and 7% a sexually transmitted disease. Among patients with genital herpes only 34% indicated a sexual relationship and a mode of contamination. The interference with sexual and social life is important. Development of information and communication on herpes appears crucial. 相似文献
109.
Tiguemounine J Picard A Laure B Bonin B Ballon G Fassio E Goga D 《Revue de stomatologie et de chirurgie maxillo-faciale》2002,103(6):373-378
The anterolateral thigh free flap is a cutaneous or fasciocutaneous flap vascularised by one or several perforating arteries arising from the descending branch of the lateral circonflex femoral artery. Venous drainage occurs via the perforators or a similar route to the deep femoral system or the femoral vein. This flap is commonly used in Asia (China, Japan) where for certain teams, it replaces the classical radial forearm flap or the rectus abdominis myocutaneous flap for the reconstruction of head and neck defects after tumor ablation. We briefly describe the anatomy and vascularization of this flap and present the harvesting technique as well as the properties of the flap. 相似文献
110.