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See detailRadiothérapie externe ou anti-inflammatoire non-stéroïdien pour la prévention des ossifications hétérotopiques après prothèse totale de hanche?
Zouhair, A; Ozsahin, M; Mouhsine, E et al

in Schweizerische Medizinische Wochenschrift (1999), 129(9), 370-376

External radiotherapy or non-steroid antiinflammatory drugs for prevention of heterotopic ossification following total hip replacement Heterotopic ossification (HO) is defined as the development of ... [more ▼]

External radiotherapy or non-steroid antiinflammatory drugs for prevention of heterotopic ossification following total hip replacement Heterotopic ossification (HO) is defined as the development of abnormal ossification in soft tissues. HO is a common disease after total hip replacement. Many therapeutic modalities have been proposed to prevent HO. The most commonly used modalities are nonsteroidal anti-inflammatory drugs (NSAID) or ionizing radiation administered just before or immediately after total hip replacement. As far as external radiation therapy is concerned, there are several published randomized studies aimed at investigating its efficacy and timing related to surgery, and at comparing ionizing irradiation to NSAID. In this article we review the published data in order to define guidelines which could be used in daily practice for the choice of prophylactic treatment against HO. [less ▲]

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See detailApports et perspectives des dérivés de l'hémoglobine
Remy, Bernadette ULg; Deby, Ginette ULg; Lamy, Maurice ULg

in Schweizerische Medizinische Wochenschrift (1997), 127(25), 1088-96

Anoxia-reoxygenation leads to severe metabolic alterations, which result in a generalized inflammatory reaction and multiple organ dysfunction. Direct blood transfusion limits these alterations, but is ... [more ▼]

Anoxia-reoxygenation leads to severe metabolic alterations, which result in a generalized inflammatory reaction and multiple organ dysfunction. Direct blood transfusion limits these alterations, but is accompanied by risk of transmission of infections or viral diseases. To avoid these risks, "blood substitutes" have been designed. The modified hemoglobins are not true blood substitutes because they do not possess the complex functions of erythrocytes. They are only oxygen carriers, with a short intravascular life, adapted for temporary use. They are stable, devoid of toxicity and antigenicity, and are able to carry and deliver O2 without regulation of this oxygen transport and without chemical reaction with O2. They possess rheologic properties and an oncotic pressure like those of blood. The use of natural hemoglobin solutions, obtained after lysis of erythrocytes, remains "at risk" because these solutions easily form methemoglobin, increase the oncotic pressure, present renal toxicity, and possess a too high affinity for O2. For these reasons, 5 types of modified hemoglobin solutions have been designed, prepared from human or bovine hemoglobin or by genetic engineering. These hemoglobins are highly purified to eliminate trace amounts of stroma, lipids and endotoxins, which are responsible for acute toxicity. They are modified by internal cross-linking between the monomers, or by binding to macromolecules. Afterwards, they can be polymerized or encapsulated in liposomes. The purpose of these modifications is to modulate the affinity for O2 (by decreasing the binding of O2 and increasing its delivery to tissue), to reduce the dissociation into monomers and to guard against oxidation into methemoglobin. Encapsulation in liposomes allows co-encapsulation of effector molecules and protective substances. Genetic engineering allows the production of recombinant hemoglobin with selective modifications. The modified hemoglobin solutions are essentially used in hemorrhagic shock and perioperative hemodilution. Experimental work in animals has afforded good results: restoration of normal O2 pressure and no toxicity. These assays allow frequent observation of an unexpected rapid hypertensive effect, transient, reversible, and that could be controlled by antihypertensive drugs. The mechanisms of this hypertensive effect remain controverted (stimulation of endothelin production, inhibition of nitric oxide effects, etc.). In humans, studies with healthy volunteers have been completed, while phase II clinical studies are under way in hypovolemic shock, in major abdominal, orthopedic and cardiac surgery, in stroke and in intensive care patients after surgery. The detailed results are awaited, but the modified hemoglobin solutions already appear to be without toxicity and present the same hypertensive effect as observed in animals. However, until now only low doses have been used, and the catabolism of these solutions remains largely unknown. [less ▲]

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See detailRadioprotection de l'intestin grele dans le petit bassin par implantation de prothese siliconee gonflable
Cuttat, J-F; Delaloye, J-F; COUCKE, Philippe ULg et al

in Schweizerische Medizinische Wochenschrift (1991), 121(29), 1055-61

The combination of radiotherapy and surgery plays a major role in treating pelvic cancer. However, this technique is chiefly limited by the radiosensitivity of the small bowel following postoperative ... [more ▼]

The combination of radiotherapy and surgery plays a major role in treating pelvic cancer. However, this technique is chiefly limited by the radiosensitivity of the small bowel following postoperative radiotherapy. In this situation the small bowel is not protected because of its lack of mobility. A radioprotective prosthesis is presented which is readily removable and whose purpose is to push the small bowel out of the pelvis during radiotherapy, thus protecting it from radiotherapy. If required, a simple system allows the prosthesis to be emptied and refilled between courses of radiotherapy, if required, without reoperation. This technique has been used in 4 patients: 2 had rectal carcinoma secondary to ulcerative colitis in one case and to Crohn's disease in the other; the other 2 cases were recurrent rectal carcinoma, one of which was partially resectable. When radiotherapy was completed the prosthesis could be deflated and removed through a short incision under local anesthetic. In the medium term, no small bowel complications were observed in spite of high-dose radiotherapy. When used for radiosensitive pelvic tumors, this technique combines low cost and ease of use with very low morbidity and the possibility of administering high-dose radiotherapy [less ▲]

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See detailHistamine modulation of neutrophil chemotaxis and T-lymphocyte proliferation in man
Bury, Thierry ULg; Radermecker, Maurice ULg

in Schweizerische Medizinische Wochenschrift (1991), 121(9), 35

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