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Biomedical subjects

C Mercier

Publications and source records attributed to C Mercier.

At least 145 records · Page 8Linked to original sources
PubMed1988

Atherosclerotic lesions of the aorta and renal arteries: results of simultaneous surgical treatment.

Between 1975 and 1985, 43 patients underwent simultaneous aortic and renal artery reconstruction. Twenty-two patients had infrarenal abdominal aortic aneurysms and 21 had aortoiliac occlusive disease. In addition, 40 patients had severe lesions of one or both renal arteries and three patients had a lesion in an accessory renal artery. Hypertension was present in 29 patients, 15 of whom had impaired renal function. Four patients had chronic renal insufficiency without hypertension. Ten patients underwent prophylactic renal artery reconstruction. Infrarenal aortic repair was carried out simultaneously with thromboendarterectomy of one or both renal arteries, or reimplantation of a renal artery into the aorta, in two cases with contralateral nephrectomy. In one patient, the celiac and superior mesenteric arteries were also bypassed. Three patients (7%) died in the immediate postoperative period, two of these from myocardial infarction. Long-term survival was studied in 37 patients. Sixty-seven percent of patients with preoperative hypertension and less than 50% of those with preoperative renal insufficiency had good results.

Aorta, Abdominal↗
PubMed1987

MRI contribution to the stereotactic management of cerebral tumours.

Of 67 patients with cerebral tumours studied by MRI, 60 underwent stereotactic biopsy for histological diagnosis. The data from MRI were compared with those obtained from the CT scan with regard to the pathological diagnosis. The tumoural nature and extent of a lesion were better revealed by MRI. The single or multiple localization of the process was also seen better by MRI. Moreover, the sagittal-plane views shown by MRI provide much more accurate target placement and probe guiding for an orthogonal stereotactic approach. Finally, a post-biopsy MRI can show the biopsy site in relation to the tumour better.

Biopsy↗
PubMed1987

Removable, adjustable and reusable implants for stereotactic interstitial radiosurgery of brain tumors.

Sixty primary brain tumors (gliomas) were treated by interstitial radiosurgery using 192Ir according to a protocol based on the size of the tumor. In all cases, the radioactive wires were left in place for periods ranging from 5 to 10 days, according to dosimetry calculations, and then removed, which was made possible by the use of removable implants. The stainless steel tubes are occluded on their inner side and adjustable in length depending on the depth of the tumor, and are introduced through screws inserted into the skull in an array depending on the preliminary dosimetry. The tubes were afterloaded with 192Ir and removed at the end of the calculated time. Forty-six patients (18 low-grade and 28 malignant gliomas) were treated using this method. One small hematoma was evacuated and no sepsis occurred.

Brachytherapy↗
PubMed1987

[Psychiatric chronicity and organization of services].

A study conducted in a Montreal area psychiatric institution focuses on the impact of chronic patients on in-patients services delivery system. This article shows a disarticulation of the system, from the first to the second line and within the second line. The authors suggest that when the length of stay is extended beyond a certain time frame, it becomes increasingly difficult to reconcile continuity and complementarity of services: by congesting the system, chronic psychiatric population is decreasing the accessibility of services.

Chronic Disease↗
PubMed1987

[Quality of life : theoretical and empirical perspectives.].

The idea of maintaining or improving ' 'quality of life' ' is frequently raised as a desired objective in mental health intervention. Furthermore, this notion is primarily brought up with regard to people who experience severe difficulty in living within their community. This article outlines the evolution of such a concept, describes certain theoretical models and deals with research data concerning factors associated with a positive perception of living conditions. Also discussed is the concept's usefulness in the planning and evaluation of mental health services.

English Abstract↗
PubMed1987

Penetrating chest trauma: a 20-year experience.

From 1965 to 1985, 76 patients were admitted to Sacré-Coeur Hospital, Montreal, with a diagnosis of penetrating chest trauma (PCT). The majority were under the age of 30 years and almost two thirds suffered gunshot wounds. Sixty-seven (88.1%) sustained a lateral or thoracic (T) injury and in nine (11.8%) the lesion was central or mediastinal (M). In the first group (T), 53.7% were treated surgically with thoracotomy, laparotomy, and chest tube (CT) insertion or both; 46.2% were managed conservatively. In the second group (M) the pericardium or the heart was involved, eight patients (88.8%) were managed surgically without the use of extracorporeal circulation and one patient was observed only. Eight (11.9%) died in the thoracic group; all survived in the mediastinal group, for an overall mortality of 10.5%. Shock was associated with increased morbidity and mortality in the thoracic group (T) and infection was the most frequent complication for the entire group of patients under study. There has been a steady increase in the total number of PCT at our hospital during the last two decades suggesting an increase in crime and violence in our urban surroundings.

Adolescent↗
PubMed1987

Surgical treatment of bronchogenic carcinoma: the importance of staging in evaluating late survival.

From 1971 to 1980, 1292 patients with lung cancer were admitted to the Hôpital du Sacré-Coeur de Montréal. This diagnosis represented 0.5% of admissions in 1971 and 1.7% in 1980 (240% increase). Only 4% of patients were nonsmokers. Patients ranged in age from 30 to 93 years with a male to female ratio of 5.5 to 1. Of 414 cervical mediastinoscopies carried out for right and left pulmonary tumours, 120 (29%) showed mediastinal lymph-node metastasis (positive biopsy). For 35 left-sided lesions, both cervical and left parasternal mediastinoscopies produced 13 (37%) positive biopsies. For 45 left upper lobe and left hilum tumours, left parasternal mediastinoscopy alone yielded 18 (40%) positive biopsies. Only 297 (23%) of the 1292 patients were considered to have operable lesions and they underwent thoracotomy - 164 (55%) lobectomies, 104 (35%) pneumonectomies, 2 (1%) segmentectomies and 27 (9%) exploratory thoracotomies. The most common postoperative complication was respiratory failure - in 27 cases (9%); there were 12 (4%) bronchopleural fistulas. The operative death rate was 5% - 1.8% for lobectomy, 7.4% for exploratory thoracotomy and 9.6% for pneumonectomy. Causes of death were respiratory failure (60% of the deaths), hemorrhage (13%), cardiac events (13%) and bronchopleural fistula (13%). The overall 5-year survival was 9.2%. For the 297 patients operated on, the survival at 5 and 10 years was 55% and 36% for stage I disease, 30% and 20% for stage II disease and 10% and 8% for stage III disease, respectively. The mean postoperative follow-up was 41.5 months (range from 3.5 to 14 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Consumption coagulopathy and meningioma].

A twenty year old man died after coagulation disorders following neurosurgery. Disseminated intravascular coagulation and fibrinolysis occurring after neurosurgery of brain tumours are discussed.

Adult↗
PubMed1986

Aneurysms of the renal artery and its branches.

During the last ten years, 29 aneurysms of the renal artery, observed in 20 patients were operated on. These cases represent 10% of the total number of renal vascularization procedures performed during the same period. Diagnosis was made most often during the workup for arterial hypertension (16 patients). There were 20 cases of sacciform aneurysms, eight cases of fusiform aneurysms, usually associated with stenotic lesions, and one case of dissecting aneurysm. Fibromuscular dysplasia was the principal etiological factor. A total of 22 kidneys were involved. Restoration was performed "in situ" in 15 cases (21 aneurysms), using aortorenal bypass in fusiform aneurysms and usually aneurysmorrhaphy for sacciform aneurysms. Six cases (seven aneurysms) were treated with "ex situ" surgery. Primary nephrectomy was performed in one patient. There was no operative mortality. Early occlusion occurred in two cases, resulting in secondary nephrectomy. During a mean follow-up period of 51 months, there were no secondary occlusions. Blood pressure control was obtained in 14 patients (87%). Surgical management is recommended for most renal artery aneurysms. Repair using "in situ" techniques is usually feasible and provides satisfactory long-lasting results in most cases.

Adult↗
PubMed1986

[The psychiatric hospital: from yesterday to tomorrow].

A study carried out in a psychiatric hospital in the Montreal region reveals that in spite of deinstitutionalization, long-term stay remains an important factor in the use of beds. For some patients the hospital remains a permanent home, either from their first admission or from the time they are institutionalized after multiple admissions. For both in- and out-patients, return to the hospital and long-term care are almost inevitable. Generally speaking, the services of the hospital are used by the same long-term patients, and this to the extent that the hospital cannot provide services to other establishments or play its second-line role. This is frustrating for other institutions in the network, even though they accept the inevitability of the situation given the lack of adequate community resources for these patients. One of the primary functions of a psychiatric hospital also seems to be to fill in the gaps in the service network. In this regard, its expertise in the field of intervention in chronic psychiatric patients must not be overlooked. Given the current situation, the hospital's responsibility in regard to second-line services cannot be clarified until it has been determined just how much of the responsibility for care of psychiatric patients can be assumed by the community itself.

Adult↗
PubMed1986

Intervention in the psychiatric hospital in the era of deinstitutionalization.

This article, written following a survey of staff in a psychiatric hospital, analyzes how the trend toward deinstitutionalization has influenced institutional practice. Interviews reveal that intervenors support the objective of social reintegration, even if they find it a source of contradictions. In their daily activities, the staff are concerned mainly with improving their patients' quality of life, but this concern is also accompanied by the apprehension of encouraging dependency on the institution. Thus intervenors experience difficulty in focusing their practice on a system of representation capable of reconciling the ideal of rehabilitation with the characteristics of their clientele. Recognizing the paradoxes associated with work in the institutional setting does, however, make it possible to start a process of clarification that is likely to support intervenors and improve the quality of their relationship with chronic psychiatric patients.

Activities of Daily Living↗
PubMed1986

[Supervised housing : from tenants' perspective.].

A field survey of the tenants involved in a program of < > reveals the impact of their participation in this program on their daily experience in the community. From the interviews, it appears that in many ways those people value their quality of life favourably in comparison with that of the general population. Along with most of the population they have mixed judgments on their financial situation and their health. However, regarding family relationships, their main occupation and their free time they are not as contented. The analysis of the quantitative and qualitative data puts into perspective the possible assets and the inherent limitations of the services foreseen for maintaining chronic psychiatric patients in the community.

English Abstract↗
PubMed1986

[Detection of arterial thrombi using blood platelets labeled with indium-111].

Scintigraphy with Indium 111-labelled platelets was carried out in 62 patients (37 transient cerebral ischaemic accidents, 21 lower limb ischaemic episodes and 4 aortic aneurysms) to detect arterial thrombi. The results of this investigation were compared with the surgical findings and showed this to be a satisfactory method of detecting haematologically active thrombi.

Blood Platelets↗