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Biomedical subjects

B Bouvier

Publications and source records attributed to B Bouvier.

12 recordsLinked to original sources
PubMed1997

Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study.

PURPOSE: This study was completed to determine whether there were differences between sterile versus clean dressing change technique for open surgical wounds in the postoperative period with respect to (1) rate of wound healing and (2) cost of supplies. METHODS: A two-group design was used for this pilot study. Of a sample of 30 patients undergoing elective gastrointestinal operations with wounds healing by secondary intention, 15 were men and 15 were women. Mean age was 40.6 years (SD 13.0 years). Patients were randomly assigned to receive clean or sterile dressings, and the intervention was begun on the first postoperative day and repeated three times a day until discharge from the hospital. Analysis of rate of healing was performed with the Mann-Whitney U test: cost analysis was completed with a t test. FINDINGS: Subjects were studied for 3 to 9 days. Groups were homogeneous of the start of treatment with respect to age, length of operation, wound volume, nutritional status, and perfusion. There was no difference in rate of wound healing between the clean and sterile groups. Mean cost was significantly less for the clean group than for the sterile group. CONCLUSION: These pilot study data show no difference in rate of wound healing with clean versus sterile technique, and clean technique is less expensive. These findings need to be confirmed with a larger sample; type II error cannot be ruled out.

Adult↗
PubMed1997

Postoperative Serratia marcescens wound infections traced to an out-of-hospital source.

From 25 August to 28 September 1994, 7 cardiovascular surgery (CVS) patients at a California hospital acquired postoperative Serratia marcescens infections, and 1 died. To identify the outbreak source, a cohort study was done of all 55 adults who underwent CVS at the hospital during the outbreak. Specimens from the hospital environment and from hands of selected staff were cultured. S. marcescens isolates were compared using restriction-endonuclease analysis and pulsed-field gel electrophoresis. Several risk factors for S. marcescens infection were identified, but hospital and hand cultures were negative. In October, a patient exposed to scrub nurse A (who wore artificial fingernails) and to another nurse-but not to other identified risk factors-became infected with the outbreak strain. Subsequent cultures from nurse A's home identified the strain in a jar of exfoliant cream. Removal of the cream ended the outbreak. S. marcescens does not normally colonize human skin, but artificial nails may have facilitated transmission via nurse A's hands.

Adult↗
PubMed1992

[Benign non-parasitic splenic cysts. 9 cases].

Benign non-parasitic splenic cysts are uncommon. Their diagnosis can benefit from ultrasounds and computed tomography. However, it may be difficult, before surgery, to distinguish between true cysts, which are congenital with epidermal lining, and false cysts, which are consecutive to a trauma, inflammatory or degenerative, without epidermal lining. We report nine cases of non-parasitic splenic cysts and try to determine the preoperative diagnostic approach. To prevent the overwhelming post-splenectomy infection syndrome, conservative surgical treatment is mandatory. Various surgical methods are discussed.

Adult↗
PubMed1990

[Synchronous bilateral cancer of the kidney in the adult. Apropos of a case].

Following a case of synchronous bilateral renal cancer, we carried out a review of the literature and defined the specific therapeutic and prognostic characteristics of this clinical condition. Conservative surgery should be proposed as first line treatment. Results in terms of survival depend on the histological characteristics of the more affected kidney. The prognosis is relatively good in general and better than that of unilateral cancer.

Aged↗
PubMed1989

Epidemic keratoconjunctivitis in a university medical center ophthalmology clinic; need for re-evaluation of the design and disinfection of instruments.

During the period from early December 1987 to late January 1988, an outbreak of epidemic keratoconjunctivitis (EKC) caused by adenovirus type 8 occurred at a university medical center eye clinic. A telephone survey of patients revealed an attack rate of 17% among patients seen during the epidemic period. A case-control study demonstrated that development of EKC was associated with exposure to pneumotonometry and to three caregivers. After controlling for exposure to pneumotonometry, however, only exposure to one caregiver was significantly associated with risk of the disease. On January 19, 1988, after recognition of the outbreak, the eye clinic instituted additional infection control measures. A survey of patients seen the following week showed a substantial decrease in the attack rate (1.9%). Before these control measures were implemented, clinic personnel had followed the manufacturer's recommendations and disinfected pneumotonometer tips with 70% isopropyl alcohol, fearing that other disinfectants would corrode the instrument metal. Isopropyl alcohol, shown to have limited activity against adenovirus in vitro, also was being used to "disinfect" pneumotonometer tips between uses at six other area eye clinics polled by telephone. The results of this study demonstrate the need for changes in the design and manufacture of equipment used in the eye clinic.

Academic Medical Centers↗
PubMed1989

Considerations and controversies of AIDS.

The statistical probability of seroconversion is proportional to the number of needlesticks incurred and the likelihood that the needlesticks will be with HIV infected blood. Careful adherence to recommended operating room practices, combined with meticulous attention to handling needles and sharps, should result in few, if any, cases of occupational HIV seroconversion among OR personnel. HIV testing is not feasible in the management of emergency patients; these are often the individuals at highest risk for HIV infection and over whom the surgical team has the least control. Non-operative treatment of HIV-infected patients is not an option; many procedures are performed either to enable the individual to lead a more comfortable, productive life or for diagnostic purposes.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Saccular aneurysm of the superior vena cava].

The authors report a case of a saccular aneurysm of the superior vena cava in a 38 year old female. The diagnosis could only be made at thoracotomy because of the additional difficulty posed by a complete thrombosis of the aneurysmal pocket, which produced a particularly deceptive CT image. This type of lesion is exceptionally rare as a cause of a mediastinal "tumour" since only 24 cases of congenital aneurysm of the superior vena cava have been reported, of which only 4 were of the saccular type.

Adult↗
PubMed1984

[Dissecting osteochondritis of the patella. Apropos of 12 cases].

The authors report 12 cases of osteochondritis dissecans of the patella. The relative rarity of this condition (one hundred published cases) is perhaps only apparent, as the diagnosis is sometimes difficult early in the disease. Drawing from their personal cases and from data in the literature, the authors recall the clinical and radiological signs, describe the place of complementary investigations and therapeutic indications and discuss the various pathogenic theories, none of which are fully satisfactory.

Adolescent↗
PubMedDate not supplied

[Pleuro-pulmonary complications of typhoid fever. 1case].

The authors report a case of typhoid fever with pleuro-pulmonary complications and recall their characteristics: Usually early (second week), may appear under treatment, whereas the disease evolves normally. Characterised by the absence of infective phenomena, the multiple manifestations, the fleeting course and the favourable prognosis. This corresponds to the pleuro-pulmonary typhus syndrome described long ago, which is probably due to immunological phenomena. Sometimes late, evolving towards suppuration, abscess formation and empyema with presence of typhoid bacilli, rarely seen nowadays.

Humans↗