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Biomedical subjects

C Berger

Publications and source records attributed to C Berger.

At least 289 records · Page 16Linked to original sources
PubMed1980

Hypertension management: the computer as a participant.

A computerized system called ARTEMIS has been taking part in the management of a referral hypertension clinic since September 1975. From January 1, 1976 to January 1, 1979, 3,624 patients' records were set up and updated, all of them accessible on line. The mean rate of response to 17 questions with obligatory answers concerning patients' past history was 97.6 per cent. The 10 routine laboratory tests included in the initial in-hospital work-up were registered in over 92 per 100 of the 2,651 hospital records examined. Negative responses were registered with the same accuracy as positive ones, when the computerized questionnaires were appropriately drafted. Standardized collection of information insured homogeneity of the medical staff and has already made possible epidemiologic studies. ARTEMIS has detected strategical errors such as the lack of yearly programmed tests for cardiovascular risk-factors associated with hypertension. The computer has helped to achieve a high rate of patient compliance at one year (81.3 per cent), by providing patients up-dated editions of their personal summary reports as well as sending periodical letters of recall to them and to their physicians. At a total annual cost of 11 dollars per patient, the computer provides continuous information on process and outcome, for each patient and physician, and for the entire population followed up at the clinic. It facilitates physician adherence to predefined protocols and reinforces follow-up continuity by creating a communications network between the referral clinic, the patient and the general practitioner.

Computers↗
PubMed1980

[A computerized medical record for the follow-up of hypertensive patients (author's transl)].

The authors present a computer system for hypertension control in a specialized department in Paris. The hypertension clinic performs the initial evaluation of the disease in ambulatory care or during a short hospitalization period. The general practitioner (GP) is mainly in charge of the long term follow-up. The objective of the system is to improve the communication between the patient, the clinic and the GP. Data are collected during each visit at the clinic. The computer is used to produce evolutive summary reports for each patient and to control the appointment system. Thus, the data processing system improves the quality of the individual follow-up and, at the same time, a medical data bank is available for epidemiological and pharmacovigilance studies.

Ambulatory Care↗
PubMed1980

["Serratia marcescens" in neonatology: epidemiology of a hazard (author's transl)].

A case of meningitis, caused by Serratia marcescens in a 6-day old newborn triggered a search for Serratia in the Neonatology ward. Fifteen out of 38 newborns were found fecal carriers of S. marcescens. The source of S. marcescens was found in flasks containing almond oil with 1% cetyltrimethylammonium bromide used for skin care. All strain of S. marcescens belonged to pigmented biotype A6a and serotype 014 : H10. The spread of S. marcescens was controlled by heat sterilizing and renewing twice a week the almond oil flasks. Means of control of contamination sources are discussed.

Dermatologic Agents↗
PubMed1979

[Analysis of the geographical variations of twinning rate in France. An indirect approach to study spontaneous abortions (author's transl)].

The hypothesis of the existence of spatial variations of spontaneous abortion rates has two logical consequences on dizygotic twinning rates: they must be heterogeneously distributed and show a positive correlation with natality. French data available on dizygotic twinning rates from 1950 to 1974 are in agreement with both implications. Although alternative explanations are possible, these findings do reinforce the relevance of dizygotic twinning rate variations as a tool for the assessment of reproduction failures.

Abortion, Spontaneous↗
PubMed1979

[Forceps deliveries in epidural or general anesthesia (author's transl)].

It was the aim the present study to evaluate maternal morbidity and fetal outcome of 832 pelvic outlet forceps deliveries during the years 1974 through 1977 with special reference to the method of anesthesia (Epidural anesthesia (EA) with Bupivacain 0,5% or general anesthesia (GA) with Methohexital-Na and Succinylcholin). Maternal vaginal and/or cervical injuries were seen significantly (p less than 0,001) more often in the forceps group than in spontaneous, vacuum, or breech deliveries. Vaginal injuries occurred less often (p less than 0,01) in the EA- than in the GA-group. Forceps deliveries were not associated with increased maternal morbidity in fetuses weighing 3750gr or more. The cardiotocography scores (Hammacher et al. 1974) of the 30 minutes preceeding delivery (final scores) were better with EA than with GA (p less than 0,01). Arterial cord pH and 1 minute Apgar values were similar in both groups. The same was true for fetuses with a birthweight of 3750gr or more. The time for cervical dilatation from 7 to 10 cm and duration of the second stage of labor did not influence maternal morbidity or fetal outcome, regardless of the method of anesthesia.

Anesthesia, Epidural↗
PubMed1979

[Society of Nephrology, Computer Technology Commission. Dialysis computer program. VI. - Survival and risk factors].

The sixth report of the "Diaphane Dialyse Informatique" Program concerns 2,518 adult patients (age 15 and over) treated by chronic hemodialysis or hemofiltration in 33 French dialysis centres between June 1972 and December 1978. 1) The number of centers participating to the program is progressively increasing. Overall duration of follow-up represents 4,192 patient-years, allowing precise evolutive studies of terminal renal failure treated by hemodialysis. 2) Mean age at start of treatment continues to increase. Among 709 patients who started treatment in 1977-1978, 8,8 p. 100 of men and 11 p. 100 of women were over 69 years old. 3) Patients with diabetic nephropathy represent 4,4 p. 100 of all patients dialyzed between 1972 and 1978 and 5,9 p. 100 of the patients starting treatment in 1977-1978. 4) The percentage of patients temporarily treated by peritoneal dialysis before hemodialysis decreases from 32,9 p. 100 in 1973-1974 to 15,9 p. 100 in 1977-1978. 5) In 1978, 65,3 p. 100 of patients are dialyzed 3 times a week with a mean weekly duration of 14,0 h for male and 12,9 for female. 73 p. 100 of the patients are dialyzed during the night. 6) Disposable parallel plate hemodialyzers (71,8 per cent of dialysis sessions in 1978) and hollow fiber hemodialyzers (11,6 per cent) progressively replace disposable coil dialyzers and non disposable Kiil dialyzers. 7) Transient hypotensive episodes during dialysis sessions remain the most frequent complications (21,7 per cent of sessions in 1978). Transient hypotensive episodes are more frequently observed with coils than with parallel plate hemodialyzers or with hollow fiber dialyzers. 8) Mean diastolic blood pressure (DBP) +/- SD is 101,9 +/- 21,7 mmHg at start of dialysis and 81,4 +/- 11,8 mmHg when dialysed. During the course of treatment 28,7 per cent of the patients receive long term antihypertensive treatment. In spite of dialysis and antihypertensive treatments 11 per cent of all patients followed up maintain DBP greater than or equal to 95 mmHg. 9) Viral hepatitis remain the most prominent infectious problem with 30 per cent of patients being chronic Hbs antigen carriers. 10) Annual death rate calculated in the 2,518 patients dialyzed between 1972 and 1978 (78/1000) is 12 times superior to the death rate of the French population, adjusted for sex and age to the dialysis population. 43,1 per cent of deaths are of cardiovascular origin. Risk factors for overall mortality are age, sex (male), existence of a vascular or diabetic nephropathy, twice weekly dialysis strategy, elevation of systolic or diastolic blood pressure during the course of dialysis treatment, hypocholesterolemia and to a lesser extent hypotriglyceridemia. On the contrary, hypercholesterolemia, hypertriglyceridemia and hyperuricemia do not appear as risk factors for overall mortality or cardiovascular mortality. These results plead for a perfect control of hypertension and to the extension of thrice weekly dialysis for the whole population of patients treated by maintenance hemodialysis.

Adolescent↗
PubMed1979

The etiology of human dizygotic twinning with special reference to spontaneous abortions.

The comparison of 622 twin and 622 singleton births allowed us to confirm the association of dizygotic twinning with maternal age, parity, and maternal weight and height, as well as the occurrence of unlike-sex twins in the mother's family. It was also shown that none of these associations, except for maternal height, can be explained by the others. Dizygotic twinning was also found to be negatively correlated with previous use of oral contraceptives and with irregularity of menstrual cycle. Finally, the relationship between spontaneous abortion in previous pregnancies and maternal exposure to medical irradiation was investigated.

Abortion, Spontaneous↗
PubMed1978

[Parturition under peridural anesthesia (author's transl)].

Basing on a study of 205 "matched pairs", it is shown to what extent peridural anesthesia (PA) influences the course of parturition, the type of termination of birth, and the intrapartal and post-partal condition of the child. The method of PA application is accurately described in the section "Material and Methods". The first stage of labor, or period of dilatation (PD) is not in any way effected by PA. However, PA will almost double the expulsion period (EP). Hence, elective termination of birth via technically simple, complication-free outlet forceps is usually propagated and employed significantly more often. Emergency sections or delivery by forceps due to mandatory indication, are not more frequent under PA than otherwise. The intrapartal condition of the child, measured with the cardiotocogram employing in the score according to Hammacher et al. (6) before and after application of PA, as well as during the last 30 minutes of birth (final score), is influenced only irrelevantly. The Apgar scores one minute and five minutes post partum, as well as the arterial umbilical cord pH values, do not differ significantly between the peridural and the control groups. The authors agree with the widespread opinion that, at the present moment, PA is the best obstetric analgesic method with simultaneous maximum possible safety for the fetus.

Anesthesia, Epidural↗
PubMed1978

[Value of the abdominal electrocardiogram for cardiotocography (author's transl)].

The value of abdominal Electrocardiogram (abd. ECG) for cardiotocography has been studied prospectively in 183 ante- and 93 subpartum patients. The indications for using abd. ECG have been worked out and the influence of various factors on the quality of registration were tested. It was found that neither location of the placenta nor obesity nor the state of the membranes influenced the quality of abd. ECG-records. Furthermore abd. ECG was used successfully in cases with advanced labor.

Body Height↗
PubMed1978

Twinning rate and reproduction failures.

Spontaneous abortion of one of the zygotes is shown to explain some of the main epidemiologic features of dizygotic twinning: its decrease at higher maternal ages and its spatial and secular variations. Conversely, the dizygotic twinning rate offers a precious tool for the study of the etiology of reproduction failures.

Abortion, Spontaneous↗