ABSTRACT
OBJECTIVE: This study aims to describe the endovascular management of abdominal-aortic- or common-iliac-artery injuries after lumbar-spine surgery. METHODS: Patients treated for abdominal-aortic- or common-iliac-artery injuries after lumbar-spine surgery during a 13-year period were identified from an endovascular database, providing prospective information on techniques and outcome. The corresponding patient records and radiographic reports were analysed retrospectively. RESULTS: Seven patients were treated with acute (n = 3) or subacute (n = 4) injuries of the common iliac artery (n = 6) or abdominal aorta (n = 1) after lumbar-spine surgery. Vascular injuries included arterial lacerations (n = 3), arteriovenous fistulas (n = 2) and pseudo-aneurysms (n = 2). The mean age of the patients was 51.7 years (30-60 years), 71.4% were women. These lesions were repaired by transluminal placement of stent grafts: Passager (n = 3), Viabahn (n = 1), Wallgraft (n = 1), Zénith (n = 1) and Advanta V12 (n = 1). Exclusion of the injury was achieved in all cases. Mortality was nil. There were no procedure-related complications. During a median follow-up of 8.7 years (range 0.3-13 years), all stent grafts remained patent. CONCLUSIONS: Sealing of common iliac artery or abdominal aortic lesions as a complication of lumbar-disc surgery with a stent graft is effective and is suggested as an excellent alternative to open surgery for iatrogenic great-vessel injuries, particularly in critical conditions.
Subject(s)
Aneurysm, False/surgery , Aorta, Abdominal/surgery , Arteriovenous Fistula/surgery , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Iliac Artery/surgery , Lumbar Vertebrae/surgery , Orthopedic Procedures/adverse effects , Vascular System Injuries/surgery , Adult , Aneurysm, False/diagnosis , Aneurysm, False/etiology , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/injuries , Aortography/methods , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/etiology , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Endovascular Procedures/instrumentation , Female , France , Humans , Iatrogenic Disease , Iliac Artery/diagnostic imaging , Iliac Artery/injuries , Male , Middle Aged , Prosthesis Design , Retrospective Studies , Stents , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, Doppler, Duplex , Vascular System Injuries/diagnosis , Vascular System Injuries/etiologyABSTRACT
The childhood cancer survival rate is currently 75% in industrialized countries. Rates in developing countries are much lower. The Franco-African Childhood Cancer Group (French acronym, GFAOP) was founded in 2000 with aim of reducing this unfavorable situation in Africa. The GFAOP has developed two forms of action. The main form consists of organizing two- to twelve-month training sessions for physicians and nurses in France and Morocco. The other form involves assessing the feasibility of modern treatment protocols for various cancers in Africa. The first feasibility trials were carried out on nephroblastoma and Burkitt's lymphoma in 12 pilot units in North Africa, West Africa, and Madagascar. In the first study from 2001 to 2005 we treated 306 cases of Burkitt's lymphoma using French LMB protocols adapted to the African setting and achieved a survival rate of 61%. A second study started in 2005 using Endoxan alone achieved a highly satisfactory survival rate of 73% for neuroblastoma in all stages except bilateral. Altogether from 2001 to 2007 more than 1000 cases of nephroblastoma and Burkitt's lymphoma were treated in African hospitals by African doctors and nurses. No patients were transferred to Europe. The GFAOP supplied drugs when necessary and took care of most travel expenses. African and French doctors worked together on protocol design, trial management, and data analysis. These promising results show that the latest therapeutic techniques can be used to treat childhood cancer in Africa by adapting the protocol to conditions in developing countries. Sanofi-Aventis Laboratories in association with the International Union against Cancer has launched a major campaign to improve Pediatric Oncology in developing countries. Projects in four GFAOP units are being financed through this campaign. In 2006 the GFAOP began assessment of two new treatment protocols, i.e., one for acute lymphoblastic leukemia and the other for Hodgkin's disease. Two other projects are being planned, i.e., one for treatment of retinoblastoma and the other for treatment of some types of brain tumors.
Subject(s)
International Cooperation , Neoplasms/therapy , Africa , Child , Clinical Protocols , Developing Countries , France , HumansABSTRACT
Our actual work studies the effectiveness in vivo of the Benzathin penicillin that is realized on 88 subjects suffering from a stable rheumatic fever. It has shown that: The first hours after an intramuscular injection, the benzathin penicillin is found at an efficient concentration superior to 0.02 ug/ml at the level of the blood. The highest dose in the blood is obtained the first 24 hours. The amount of antibiotic at the level of the blood is very efficient during 4 weeks.
Subject(s)
Penicillin G Benzathine/blood , Penicillins/blood , Rheumatic Fever/blood , Rheumatic Fever/prevention & control , Acute Disease , Adult , Child , Female , Humans , Male , Penicillin G Benzathine/therapeutic use , Penicillins/therapeutic use , Time FactorsABSTRACT
Les cancers de l'enfant sont actuellement gueris dans 75des cas; dans les pays developpes. Dans les pays en developpement; les resultats sont beaucoup moins bons. Le Groupe Franco-Africain d'Oncologie Pediatrique (GFAOP) s'est constitue en 2000 avec pour objectif de redresser cette situation defavorable enAfrique. Les actions du GFAOP comprennent; d'une part la formation des medecins et des infirmieres avant tout par des stages en France et au Maroc; d'autre part des essais de traitement par des protocoles adaptes des lymphomes de Burkitt et des nephro- blastomes dans douze unites pilotes situees en Afrique du Nord; Afrique de l'Ouest et a Madagascar. Dans une premiere etude 2001-2005; 61des lymphomes de Burkitt ont gueri. Une seconde etude a commence en 2005 avec un traitement a base d'Endoxan seul. Pour les nephroblastomes; le taux de guerison; 73; est tres satisfaisant. Plus de 1000 cas de nephroblastome et de lymphome de Burkitt ont deja ete traites dans ces conditions de 2001 a 2007; tous en Afrique; dans les hopitaux africains; par desmedecins et des infirmieres africains. Ces resultats encourageants permettent de conclure a la faisabilite du traitement des cancers de l'enfant en Afrique; grace a des traitementsmodernes; adaptes de protocoles utilises dans les pays developpes. Le laboratoire Sanofi-Aventis; associe a l'Union Internationale Contre le Cancer; a lance une grande entreprise d'aide a l'Oncologie Pediatrique dans les pays en voie de developpement.Quatre projets d'unites du GFAOP sont ainsi finances. Le GFAOP a lance en 2006 deux nouveaux protocoles : le traitement des leucemies aigues lymphoblastiques et celui de la maladie de Hodgkin. Deux autres projets sont en preparation : le traitement des retinoblastomes et celui de certaines tumeurs cerebrales
Subject(s)
Burkitt Lymphoma , Child , Drug Therapy , Genes, Wilms Tumor , NeoplasmsABSTRACT
Les cancers de l'enfant sont actuellement gueris dans 75des cas; dans les pays developpes. Dans les pays en developpement; les resultats sont beaucoup moins bons. Le Groupe Franco-Africain d'Oncologie Pediatrique (GFAOP) s'est constitue en 2000 avec pour objectif de redresser cette situation defavorable enAfrique. Les actions duGFAOP comprennent; d'une part la formation des medecins et des infirmieres avant tout par des stages en France et au Maroc; d'autre part des essais de traitement par des protocoles adaptes des lymphomes de Burkitt et des nephroblastomes dans douze unites pilotes situees enAfrique du Nord;Afrique de l'Ouest et a Madagascar. Dans une premiere etude 2001-2005; 61des lymphomes de Burkitt ont gueri. Une seconde etude a commence en 2005 avec un traitement a base d'Endoxan seul. Pour les nephroblastomes; le taux de guerison; 73; est tres satisfaisant. Plus de 1000 cas de nephroblastome et de lymphome de Burkitt ont deja ete traites dans ces conditions de 2001 a 2007; tous enAfrique; dans les hopitaux africains; par desmedecins et des infirmieres africains. Ces resultats encourageants permettent de conclure a la faisabilite du traitement des cancers de l'enfant en Afrique; grace a des traitementsmodernes; adaptes de protocoles utilises dans les pays developpes. Le laboratoire Sanofi-Aventis; associe a l'Union Internationale Contre le Cancer; a lance une grande entreprise d'aide a l'Oncologie Pediatrique dans les pays en voie de developpement.Quatre projets d'unites du GFAOP sont ainsi finances. Le GFAOP a lance en 2006 deux nouveaux protocoles : le traitement des leucemies aigues lymphoblastiques et celui de lamaladie de Hodgkin. Deux autres projets sont en preparation : le traitement des retinoblastomes et celui de certaines tumeurs cerebrales
