Rozprawy doktorskie na temat „Hémorragie méningée – Complications (médecine)”
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Bourgeois, Philippe. "Hemorragies méningées par dissections spontanées des artères intracraniennes". Bordeaux 2, 1993. http://www.theses.fr/1993BOR23121.
Pełny tekst źródłaPetitjean, Marie-Edith. "Etude de l'hypovolémie et de l'hyponatrémie spontanées au cours des hemorragies méningées : à propos de 84 cas". Bordeaux 2, 1989. http://www.theses.fr/1989BOR23088.
Pełny tekst źródłaGoursaud, Suzanne. "Étude de l'activation endothéliale post-hémorragie sous-arachnoïdienne : apport à la compréhension de la physiopathologie de l'ischémie cérébrale retardée". Electronic Thesis or Diss., Normandie, 2024. http://www.theses.fr/2024NORMC403.
Pełny tekst źródłaSubarachnoid hemorrhage (SAH) is a serious neurovascular pathology that most often requires admission to intensive care, because it causes high morbidity and mortality. Delayed cerebral ischemia (DCI) is one of the main complications, which occurs in 30% of patients in the following days after SAH. DCI can be fatal, but is most often the leading cause of functional and/or cognitive disabilities. The pathophysiology of DCI is not elucidated and its treatment are currently limited. Following a review of the literature, we were able to highlight that no experimental murine SAH model currently meets the diagnostic criteria for DCI in humans, which makes research with poor clinical relevance. Early brain injury (EBI) includes several mechanisms involved in the occurrence of DCI. This early phase is a major predictor of clinical outcome, which is difficult to characterize with standard imaging tools. Recent studies have shown that endothelial activation plays a key role after SAH in the occurrence of DCI. Diagnosis approach using new molecular imaging devices to characterize this endothelial activation was the main objective of our work. Using molecular magnetic resonance imaging (MRI) and magnetic particle imaging (MPI), we highlighted an early endothelial activation associated with EBI post-SAH in mice. Using standard methods, we were able to observe the concomitant expression and release of von Willebrand factor (VWF), illustrating the existence of thrombo-inflammatory response at the acute phase. These data make it possible to characterize EBI and its early mechanisms involved in the occurrence of DCI, which offers promising clinical perspectives
Bijon, Bernard. "Cryptococcose méningée révélatrice d'un Sida chez un sujet de 83 ans". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M146.
Pełny tekst źródłaMartin, Nathalie. "Cryptococcose neuro-méningée au cours de l'infection par le virus de l'immunodéficience humaine : à propos de sept cas observés à l'hôpital principal de Dakar". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M121.
Pełny tekst źródłaFalzon, Noe͏̈lle. "Hémorragies graves révélatrices d'ulcère solitaire du rectum : à propos de cinq observations". Bordeaux 2, 1989. http://www.theses.fr/1989BOR25331.
Pełny tekst źródłaBelso, Laurence. "Syndrome de Terson : étude rétrospective à propos de quatre cas". Montpellier 1, 1997. http://www.theses.fr/1997MON11163.
Pełny tekst źródłaAbet, Jacques. "Intérêt des salicylés dans les hémorragies diverticulaires coliques du sujet âgé : à propos d'une observation et revue de la littérature". Montpellier 1, 1995. http://www.theses.fr/1995MON11092.
Pełny tekst źródłaOuk, Thavarak. "Ischémie cérébrale et interactions leucocyte-endothélium : modulation pharmacologique par les récepteurs nucléaires PPARs". Lille 2, 2009. http://www.theses.fr/2009LIL2S004.
Pełny tekst źródłaChassagne, Fabrice. "Hématomes intracraniens et antivitamines K : étude rétrospective à propos de 50 patients". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M123.
Pełny tekst źródłaChehab, Ziad. "La sidérose superficielle du système nerveux central, à propos d'un cas". Bordeaux 2, 1996. http://www.theses.fr/1996BOR23034.
Pełny tekst źródłaDackey, Komla. "Analgésie péridurale et hémorragies de la délivrance". Bordeaux 2, 1988. http://www.theses.fr/1988BOR25029.
Pełny tekst źródłaMoussa, Mouhamed Djahoum. "Déterminants cliniques, physiopathologiques et pronostics associés aux complications liées à l’hémostase au cours des assistances circulatoires de courte durée à pompe centrifuge". Electronic Thesis or Diss., Université de Lille (2022-....), 2022. http://www.theses.fr/2022ULILS055.
Pełny tekst źródłaThe purpose of this dissertation is to characterize hemostasis-related complications in patients supported by peripheral VA-ECMO to improve their prevention and to optimize the antithrombotic therapeutic approaches in use. In a first study, we qualitatively and quantitatively described the composition of thrombi collected from the VA-ECMO circuits. We observed that these thrombi are mainly made of VWF, fibrin and in a lesser proportion of platelets and RBCs. Our quantitative approach also allowed us to demonstrate the presence of NETs while there was no active septic, confirming the possibility of aseptic NETosis under VA-ECMO. By hierarchical cluster analysis, we identified 2 types of thrombi, each of which may be related to a different mechanism of formation. In this study, the location of thrombi on the VA-ECMO circuit did not impact their compositions, highlighting the heterogeneity of thrombi formed within VA-ECMO and the multifactorial mechanisms that support thrombosis in this setting. In a second study, we compared the performance of surface coatings on VA-ECMO circuits to reduce thrombinoformation and its clinical consequences. Two of the most used coatings in daily practice were compared: the phosphorylcholin-based coating and the polysaccharide-albumin-based coating. We observed a higher rate of thrombotic complications in the phosphorylcholin group without any excess bleeding events or mortality in either group. In addition, compared with thrombi from phosphorylcholin-coated circuit junctions, those from polysaccharide-albumin-coated circuits were poorer in VWF. Our work suggests that the level of anticoagulation should be modulated according to the type of coating of the ECMO circuit.The aim of our third study was to identify the most relevant bleeding events that may guide clinical decision-making for more aggressive clinical management and a greater investment in research. To this end, we compared the association between 3 bleeding classifications with 28-day mortality. The ELSO definition already in use and the BARC classification classes ≥ type 2 were associated with 28-day mortality and thus retained as definitions of major bleeding. Laboratory parameters that are predictors major bleeding according to the ELSO definition were decreased fibrinogen, platelet count, and hemoglobin at cannulations. Body mass index and postcardiotomy etiology were also predictive of ELSO major bleeding. In an additional work related to the topic of the thesis, we studied two of the most used laboratory tests for the monitoring of systemic heparin during VA-ECMO, the APTT and the Anti-Xa activity, to identify the most relevant. First, we studied the relationship between these two tests and then analyzed in a second objective the impact of biological influencing factors on this relationship. Next, we determined their associations with thrombotic and hemorrhagic complications. Although linearly associated, the rate of discordance between their measurements was 39 % for an Anti-Xa reference range of 0.3 - 0.7 IU/mL. Neither APTT nor Anti-Xa was associated with thrombotic or bleeding complications. Taken together, our results highlight the heterogeneity of thrombi from peripheral VA-ECMO, the involvement of numerous causal factors that underline thrombotic and hemorrhagic complications, both not predictable by routine tests. Finally, our work underscored the need for new approaches in thrombotic or hemorrhagic complications management with targets set at an individual level considering both patient and ECMO circuit characteristics
Pulcrano-Nicolas, Anne-Sophie. "Recherche de biomarqueurs circulants de la survenue du vasospasme chez des patients souffrant d'hémorragie sous-arachnoïdienne". Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS312.
Pełny tekst źródłaSubarachnoid hemorrhage (SAH) morbidity and mortality are not solely due to the aneurism rupture but also to the delayed neurological ischemic disorders (DNI) that could happen. Among these, vasospasm is a severe complication occurring between the 4th and 12th day after the bleeding for one third of the SAH patients. To date, there exists no predictive marker of its happening, which force physician to give any SAH patient a preventive treatment against its occurrence not exempt of severe side effects. VASOGENE cohort was built up to search by omic approaches biomarkers of vasospasm occurrence to identify at risk patients. The thesis' aim is to identify circulating biomarkers of vasospasm occurrence post SAH. Two groups of patients were present in this cohort: aSAH patients developing (VSP+) or not (VSP-) a vasospasm. A first study comparing whole blood microRNA between VSP+ and VSP- enabled us to identify has-miR-3177-3p and LHDA as good candidate biomarkers. A second work was performed on transcriptomic data comparing mRNA levels between VSP+ and VSP-. We identified another candidate gene that is currently submitted
Debry, Nicolas. "Complications ischémiques et hémorragiques des procédures de réparation valvulaire aortique percutanée". Electronic Thesis or Diss., Université de Lille (2018-2021), 2021. http://www.theses.fr/2021LILUS040.
Pełny tekst źródłaIschemic and haemorrhagic complications during percutaneous aortic valve interventionsPercutaneous aortic valve repair including balloon aortic valvuloplasty (BAV) and TAVI has experienced significant improvements over the past twenty years, allowing patients with severe aortic stenosis (SAS) to benefit from a curative treatment, mostly with a minimalist approach under local anesthesia associated with a drastic reduction of procedural complications.However, the management of specific clinical emergency situations or of high-risk patients is still poorly explored and requires an accurate assessment of the ischemic and hemorrhagic complications of percutaneous procedures.In the first part of this thesis, we confirmed that some urgent complex clinical situations such as cardiogenic shock secondary to SAS, or the need for urgent extracardiac surgery in SAS patients still constitute a grey zone where the optimal treatment is unclear and requires further investigations. During cardiogenic shock or urgent extracardiac surgery, the risk of hemorrhagic and especially ischemic complications and short-term mortality remain very high. During cardiogenic shock, complications are mainly related to the timing of the BAV. When urgent extracardiac surgery is required, routine BAV does not improve the prognosis of SAS patients compared to medical treatment.In the second part of this thesis, we compared the axillary and carotid access in intermediate or high-risk patients contraindicated to transfemoral route for TAVI. These accesses have similar rates of ischemic complications and mortality, but carotid artery has more local hemorrhagic complications.The third and final part of this thesis analyse the significant incidence of microbleeds during the TAVI procedure. Their appearance seems to be related to the duration of the procedure and the lack of correction of the von Willebrand factor deficiency acquired during SAS; these lesions have no impact on the neurological evolution in the short term.Studies are underway to better define the link between the risk of cerebral hemorrhage, the vWF factor and cardiac valvular or circulatory assist device
Barus, Romain. "Effet du sexe sur les mécanismes induits par une microhémorragie cérébrale et leurs conséquences cognitives dans un modèle murin et évaluation d’un traitement par atorvastatine". Thesis, Lille 2, 2020. http://www.theses.fr/2020LIL2S025.
Pełny tekst źródłaCerebral microhemorrhages (CMH) are small lesions whose prevalence increases withage. CMH are associated with a risk of cognitive impairment. The mechanisms by which CMHimpair cognitive function and an eventual sex effect on CMH remain under-explored. The firstgoal of this work was to characterize the mechanisms induced by a cortical CMH, in male andfemale mice. The second objective was to determine the effects of atorvastatin (AT), a drugknown for its pleiotropic effects, on those mechanisms and on cognition. Six weeks after theformation of a CMH, induced by an injection of collagenase in the cortex of C57BL/6J mice,sex-specific cellular, protein, genomic, and metabolic modifications were observed in thecortex and hippocampus of male and female mice, suggesting an impairment of the corticohippocampalnetwork explaining the cognitive impairment in males. AT has modified theCMH-induced sex-specific modifications and has improved cognition in males. This studyhighlights the necessity to take sex into account in preclinical studies to increase ourcomprehension of pathophysiological mechanisms and develop the most appropriate treatment