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Biomedical subjects

D Moreau

Publications and source records attributed to D Moreau.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Ethics: a challenge for education].

Because of new advances in biomedical science and bio-technology, nurses are confronted with dilemmas for which no easy solutions are available. For this reason, it is becoming increasingly crucial that nursing students develop moral judgement. Nursing students find it difficult to relate the principles of ethics (moral conduct, duty and judgment) to concrete nursing situations. Blondeau (1986) believes the case study to be one of the most effective teaching strategies that can be used to raise moral sensitivity. However, it is very difficult to use this strategy with young adult students. The authors believe that if students learn ethical principles prior to the case study they will become aware of ethical problems and will be better prepared to discuss in depth ethical implications. They designed a self-learning module and compared the results with an equivalent group of students. Post-test cognitive results showed a difference between the two groups. Students using the new case study module expressed great satisfaction with the format, utilization and attitudes of this module. The approach proved useful since students were able to learn at their own pace. The time previously used to teach ethical principles was then allotted to class discussions and the process of ethical decision-making.

Education, Nursing↗
PubMed1993

Implementing and evaluating an attending nurse model.

The role of "Attending Nurse" responds to the need for a cost-effective role for experienced clinical nurses which provides increased autonomy and job satisfaction. Using Lewin's Theory of Change, a task force at UCLA Neuropsychiatric Hospital implemented a project in the Adolescent Developmental Disabilities Unit. Response was very positive both from nursing personnel and the multidisciplinary team, all of whom were involved in planning, implementation and evaluation. For Attending Nurses, overall job satisfaction improved, role conflict decreased and retention increased.

Adolescent↗
PubMed1992

The course of major depression in the offspring of depressed parents. Incidence, recurrence, and recovery.

The 2-year course, first onset (incidence), recurrence, and recovery of major depression in 174 offspring at high and low risk for major depression were studied. A variety of predictors of course were examined, including parental diagnosis, demographic and clinical characteristics of the family and offspring, comorbidity and social functioning in offspring, and family risk factors. The 2-year incidence rate was 8.5%. All of the incident cases of major depression occurred in offspring of depressed parents. Additional predictors of incidence were a preceding diagnosis of conduct disorder and subclinical symptoms of depression. The recurrence rate results are tentative because of the small sample. The 2-year recurrence rate was 16.1%. Predictors of recurrence were a previous comorbid diagnosis of dysthymia or problems in social functioning. By the end of 2 years, the majority of offspring (87%) had recovered. The mean number of weeks to recovery was 54 in the offspring of depressed parents and 23 in the offspring of nondepressed parents. Offspring with an onset of major depression at age 13 years or younger, who were exposed to divorce in the family or who had been exposed to more than one parental depressive episode, had significantly more protracted times to recovery. We conclude that there are different predictors of incidence of major depression, its recurrence, and time to recovery in offspring, and that parental depression has an impact on the course in offspring.

Adolescent↗
PubMed1992

Panic disorder in children and adolescents: a review.

OBJECTIVE: Panic disorder has been considered an adulthood disorder that does not occur in children or adolescents. The authors' goals were to critically review the available evidence for panic attacks and/or panic disorder in children and adolescents, to review the limited data on the biological basis of panic disorder as it has been studied in children and adolescents, to discuss the possible treatment approaches for panic disorder in children, and to suggest potential opportunities for further research on panic disorder in children. DATA COLLECTION: Sixty-three articles pertaining to panic disorder in children and adolescents were critically reviewed. These articles included retrospective histories of adults with panic disorder, clinical case reports of children and adolescents with panic disorder, studies of psychiatrically referred children and adolescents, reports from epidemiologic community and school samples of children and adolescents, studies of children and adolescents at risk for psychiatric disorder, reports of panic-like symptoms in pediatric patients, family studies of panic, studies of the biological basis of panic in adults, and studies of treatment for panic. FINDINGS: There is strong evidence that panic disorder occurs in children and adolescents and that its clinical presentation in this population is similar to that found in adults. CONCLUSIONS: Extending the many adult studies of panic disorder to children and adolescents would be extremely fruitful. Like adults with panic disorder, many children and adolescents are brought to emergency and medical clinics for the physical symptoms of unrecognized panic disorder.

Adolescent↗
PubMed1991

The protective role of glucose on ischemic-reperfused hearts: effect of dietary fats.

The dietary polyunsaturated fatty acids are well known to promote the cardiac output and to protect the myocardium against arrhythmias. The exogenous glucose is generally considered as a protective agent against arrhythmias resulting from ischemia and reperfusion. But the effects of dietary fats, which also influence arrhythmias, on this beneficial effect of glucose has not been yet considered. We have studied the effects of a 7 days diet with or without polyunsaturated fatty acids on the cardiac performance and arrhythmias of isolated rat hearts, perfused with saline containing either glucose 5.5 mM or 11 mM. Acute regional ischemia was produced by ligature of the left main coronary artery with subsequent release to achieve reperfusion for some hearts. Previously, our results showed that the dietary polyunsaturated fatty acids led to an enhancement of the cardiac performance and to a decreased susceptibility to arrhythmias. The present data showed that the protective action of the exogenous glucose appeared to be dependent of the dietary lipid profile. Dietary polyunsaturated fatty acids increase cardiac performance under ischemia and decrease ventricular arrhythmias' occurrence under ischemia and on reperfusion. It might be related to endogenous substrate utilization and exogenous glucose availability which was influenced by the coronary flow.

Animals↗
PubMed1991

Cold blood cardioplegia and warm cardioplegic reperfusion in heart transplantation.

The major cause of early death after heart transplantation is graft failure. In 99 consecutive heart transplantations two protocols of myocardial protection were employed. In group 1 (n = 38) initial cold crystalloid cardioplegia combined with cold saline storage and peroperative surface cooling was used. In group 2 (n = 61) cold crystalloid cardioplegia was injected initially and cold blood cardioplegia (Buckberg) was infused every 30 min as soon as the graft arrived in the operating room. No surface cooling was used. Warm blood cardioplegic reperfusion was administered before removal of the aortic clamp. There were 8 early (within 30 days) deaths in group 1 and 6 in group 2 patients. In group 1 there were 5 cardiac deaths against 3 in group 2. Mean ischemic time was 153 +/- 37 min in group 1 and 158 +/- 51 min (p greater than 0.05) in group 2. The post-transplantation need for catecholamines was ten times higher in group 1 patients than in group 2. The first endomyocardial biopsy (after 1 week) showed cytologic lesions compatible with ischemia in 40% of group 1 and only 9% in group 2 patients. We conclude from this initial experience that intermittent cold blood cardioplegia and warm blood cardioplegic reperfusion are useful in heart transplantation in restoring the damage suffered by the graft during brain death and graft storage.

Adult↗
PubMed1991

Interpersonal psychotherapy for adolescent depression: description of modification and preliminary application.

Interpersonal psychotherapy (IPT) is a brief treatment developed and tested specifically for depressed adults. This paper describes a modification for use with depressed adolescents (IPT-A) that will be tested in a controlled clinical trial. A description of IPT, its efficacy in adults, a rationale for developing IPT-A, and preliminary experience with depressed adolescents treated with IPT-A are presented. Data available on the treatment of depressed adolescents using drugs and/or psychotherapy is more than a decade behind that of adults. The specification and testing of psychotherapy will accelerate a rational, scientific basis for their treatment.

Adolescent↗
PubMed1990

Effects of increased heart work on release of norepinephrine and ventricular arrhythmias following reperfusion in the isolated rat heart.

The influence of increasing left atrial pressures (0.5, 1.0, and 2.0 kPa) on the incidence of ventricular arrhythmias and the liberation of prelabeled norepinephrine (3H-NE) was investigated in the isolated working rat heart. Acute regional myocardial ischemia (30 min) was produced by ligature of the left main coronary artery with subsequent release of the ligature to achieve reperfusion, which consistently provoked ventricular arrhythmias. The magnitude of regional ischemia was measured by microspheres, and the efflux of 3H-labeled NE compounds was measured in the coronary effluent. Our data show that an increase in atrial pressure enhanced reperfusion arrhythmias, but the magnitude of NE release was not directly related to the occurrence of arrhythmias. It is proposed that increased heart work has an arrhythmogenic effect by enhancing the severity of regional ischemia.

Animals↗
PubMed1990

Parents' awareness of children's suicide attempts.

In independent psychiatric interviews with 175 children and their mothers, either the mother or the child reported that 13 (7%) of the children had made a suicide attempt. Eight of the 13 children reported attempts that were not reported by their mothers.

Adolescent↗
PubMed1989

The hydrolysis of extracellular adenine nucleotides by arterial smooth muscle cells. Regulation of adenosine production at the cell surface.

The extracellular reaction sequence ATP----ADP----AMP----adenosine participates in regulating the time course of cellular response during crisis or signaling events, such as thrombus formation or neurotransmission. We have investigated the whole time course of hydrolysis of ATP to adenosine by recirculating adenine nucleotide substrates over smooth muscle cells attached to polystyrene beads. Kinetic parameters were estimated for each reaction by fitting observed time courses to models of the pathway. In spite of the inhibition of 5'-nucleotidase by ADP, adenosine was produced very rapidly by smooth muscle cells. Comparisons of the apparent Km values of ADPase and 5'-nucleotidase (determined from experiments in which each substrate was used as the initial substrate with Km values observed when each substrate was supplied from the upstream reaction) suggest that the local concentrations of substrate supplied from the preceding reactions are very much higher than those in the bulk phase. This enhancement of efficiency overcomes the effect of the feed-forward inhibition to give rise to very rapid adenosine production from ADP or ATP. These observations are in marked contrast to our previous findings with endothelial cells (Gordon, E. L., Pearson, J. D., and Slakey, L. L. (1986) J. Biol. Chem. 261, 15496-15504), on which feed-forward inhibition causes a profound lag in adenosine production from adenine nucleotides and on which there are no apparent surface effects on substrate delivery.

Adenine Nucleotides↗
PubMed1989

[Durability of the Carpentier-Edwards porcine bioprosthesis in aortic or mitral positions. 10 years' results on 458 surgically treated cases].

458 patients with a Carpentier-Edwards porcine bioprosthesis (aortic (Ao): 169, mitral (Mi): 289) operated between January 1975 and December 1981, were studied during the first trimester of 1987. Forty seven patients underwent an associated operation. The total follow-up was 3,001 patient-years with a maximum follow-up of 11.4 years and a mean follow-up of 6.5 years. Only 5.6% of patients were lost to follow-up. The patients were aged between 20 and 80 years. The actuarial 9-year survival rate was 69.2 +/- 6.3% for aortic prostheses and 79.6 +/- 3.9% for mitral prostheses. The principal cause of valve failure, appearing with a considerable frequency after 5 years, was primary tissue degeneration which alone represented 67.8% of the causes of valve failure. The rate of absence of valve failure, for all causes combined, was 77.8 +/- 5.9% for the aortic position and 74.9 +/- 4.9% for the mitral position. The actuarial rate of absence of primary tissue degeneration at 9 years was 79.7 +/- 4.1% for aortic prostheses and 75.2 +/- 4.4% for mitral prostheses. The frequency of tissue degeneration decreased with increasing age, representing 2.9%, 1.9% and 1.5% patient-years respectively for the age-groups: 20 to 39 years, 40 to 59 years and 60 to 80 years. However, this difference was not statistically significant. Tissue degeneration was the principal cause for reoperation (n = 59) with an operative mortality of 7.8%.

Actuarial Analysis↗
PubMed1988

Liver phospholipidosis induced by parenteral nutrition: histologic, histochemical, and ultrastructural investigations.

Histochemical and electron microscopic examinations of the liver were performed in 5 adults receiving parenteral nutrition for greater than 18 mo and in 4 adults receiving parenteral nutrition for less than 5 mo. Phospholipidosis, reflected by the presence of cytoplasmic phospholipid deposits at histochemical examination and the presence of multilamellar lysosomes at electron microscopy, was marked and present in hepatocytes, Kupffer cells, and portal macrophages in all 5 patients receiving parenteral nutrition for greater than 18 mo. Mild phospholipidosis, affecting only hepatocytes, was demonstrated in 3 of the 4 patients receiving parenteral nutrition for less than 5 mo. These findings indicate that liver phospholipidosis is relatively common in patients receiving parenteral nutrition and that the degree of liver phospholipidosis depends on the duration of parenteral nutrition. Liver phospholipidosis might be due to intrahepatic accumulation of intravenous phospholipids provided by fat-emulsion sources.

Adult↗
PubMed1988

Role of catecholamines in regulation by feeding of energy balance following chronic exercise in rats.

Two experiments examined the contribution of the two catecholamines--epinephrine (EPI) and norepinephrine (NE)--to the control of food intake and body weight gain in male rats during chronic exercise. Urinary excretion of both catecholamines rose significantly and was positively correlated to food intake inhibition (NE, n = 54, r = 0.394, p less than 0.01; EPI, n = 54, r = 0.428, p less than 0.01). Oral ingestion of the non-selective beta-adrenoceptor blocking drug, pindolol, abolished the food intake reduction induced by exercise. Furthermore, rats that were treated with pindolol gained weight at a higher rate than untreated rats. These findings are consistent with the idea that catecholamines contribute to post-exercise inhibition of food intake and reduction of body weight in male rats. However, the exact physiological mechanism of catecholamine-induced decrease in food intake remains to be elucidated.

Animals↗
PubMed1988

[Direct cardiac effects of angiotensins I and II and 2 converting enzyme inhibitors (captopril and perindopril). Indirect demonstration of a converting enzyme in the rat heart].

In order to establish the possible existence of a cardiac converting enzyme and its role in the pathophysiology of the myocardial ischemia, the direct cardiac effects of IEC and AI or AII were studied on the isolated rat heart perfused through the left atria. Three series of seven hypertensive rats (SHR) were used. The reduction of the aortic flow (QAO) due to ischemia (produced by a left coronary artery ligation of 10 mn) was brought into line with the reduction of the coronary flow (QCORO) and the weight of the heart. This reduction was 2.06 +/- 1.8 for the control, 1.96 +/- 1.27 when captopril (CAP) (10(-5) M) was added to the perfusion liquid and 1 +/- 0.42 when perindopril (PER) (1.2 x 10(-5) M) was added to the perfusion liquid (p less than 0.05 vs CAP). Four series of 10 rat hearts (Sprague Dawley) were used to study the changes on the working heart caused by short perfusions of AI or AII (10(-7) M) in the presence of IEC or saralasin (SAR 10(-7) M). AII caused a reduction of the QCORO of 2.1 +/- 0.26 ml/mn, an increase of the QAO of 2.5 +/- 0.9 ml/mn and an increase of the heart rate (HR) of 9 +/- 3.24 beats/mn. In the presence of CAP or PER the effects of AII were the same, however in the presence of SAR these effects were prevented. AI caused a reduction of the QCOR of 2.5 +/- 0.4 ml/mn, an increase of the QAO of 2.5 +/- 0.8 ml/mn and an increase of the HR of 18 +/- 4 beats/mn.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin I↗