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Biomedical subjects

E Tissot

Publications and source records attributed to E Tissot.

At least 37 records · Page 2Linked to original sources
PubMed1999

Medication errors at the administration stage in an intensive care unit.

OBJECTIVE: To assess the type, frequency and potential clinical significance of medication-administration errors. DESIGN: Prospective study using the observation technique as described by the American Society of HealthSystem Pharmacists but eliminating the disguised aspect. SETTING: Medical intensive care unit (ICU) in a university hospital. PATIENTS AND PARTICIPANTS: 2009 medication administration interventions by nurses. INTERVENTIONS: Pharmacist-performed observation of preparation and administration of medication by nurses, comparison with the original medical order and comparison with the data available in the literature. MEASUREMENTS AND RESULTS: 132 (6.6% of 2009 observed events) errors were detected. Their distribution is as follows: 41 dose errors, 29 wrong rate, 24 wrong preparation technique, 19 physicochemical incompatibility, 10 wrong administration technique and 9 wrong time errors. No fatal errors were observed, but 26 of 132 errors were potentially life-threatening and 55 potentially significant. CONCLUSION: According to this first observation-based study of medication administration errors in a European ICU, these errors were due to deficiencies in the overall organisation of the hospital medication track, in patient follow-up and in staff training.

France↗
PubMed1996

[Role of surgery in gastrointestinal lymphomas].

The role of surgery in primary gastrointestinal non-Hodgkin lymphoma is still controverted. The author reviews the advantages of surgery, which alone allows diagnosis in emergencies, serves to assess the extent of the disease, offers a means of preventing complications chemotherapy and radiotherapy, and has a therapeutic function. He also assesses the drawbacks of surgery and provides exact surgical indications depending on the circumstances and localization of the lymphoma. In an area which has seen rapid changes in 1995, surgery still retains an important role in the therapeutic arsenal.

Contraindications↗
PubMed1994

[Triple association: extramembranous glomerulonephritis, renal adenocarcinoma and splenic hamartoma. Apropos of a case].

We report the case of a 36 year old woman who presented a renal cell carcinoma, associated to a membranous nephropathy as a paraneoplastic syndrome. The concomitant association with a splenic hamartoma was probably fortuitous. Five years after nephrectomy, the patient was asymptomatic and her proteinuria was very low. We studied in the literature 93 cases which reported a such association between cancer, nephrotic syndrome and membranous nephropathy. Carcinoma of the lung and adenocarcinoma of the gastrointestinal tract are the most frequently implicated. This association can occur at every age and more often in men (75%) than in women. The survival is directly linked to the evolution of the cancer. Proteinuria and membranous nephropathy can totally disappear after surgical resection of the carcinoma. The glomerular injury is mediated by immune complexes composed at least in part of tumour associated antigens. The development of several types of glomerular injury in patients with carcinoma have been described but membranous glomerulonephritis is the most commonly observed.

Adenocarcinoma↗
PubMed1993

Results of splenectomy for idiopathic thrombocytopenic purpura. Review of 72 cases.

Seventy-two patients underwent splenectomy for idiopathic thrombocytopenic purpura between 1979 and 1990. Mean age at splenectomy was 36.4 years (range 11-73). Indications for splenectomy were corticodependence in 21 cases and resistance to steroids in 44 cases. Thirty-five patients had platelet kinetic studies by 51Cr alloplatelets; 22 of them had splenic sequestration. Hematologic results were evaluated on discharge, at 3 months and in the long term (median follow-up 5.4 years). We had no mortality, morbidity was seen in 7% of the cases. None of the patients suffered from secondary infectious complications. 89% had good results on discharge (> 120 x 10(9)/l), 72.6% at 3 months and 90% on long-term follow-up. Factors associated with good response to splenectomy included a high postoperative platelet count (more than 120 x 10(9)/l on discharge), younger age at the time of surgery, preoperative corticodependence and predominantly splenic sequestration.

Adolescent↗
PubMed1992

[Diverticulosis and Crohn's disease of the sigmoid].

Crohn's disease and diverticulitis of the sigmoid may be combined in old patients, this association could lead to difficulties in diagnosis and treatment. Three cases of Crohn's colitis associated with diverticula, two females and one male, aged between 66 and 80 years are reported by the authors. In a review of the literature, some clinical, radiological and endoscopic findings may suggest the diagnosis, which guides subsequent treatment. A high morbidity is observed after surgery. In our series, sigmoidectomy cured both Crohn's colitis and diverticulitis.

Aged↗
PubMed1991

Microalbuminuria is acutely increased during anesthesia and surgery.

Microalbuminuria is known to increase in various diseases with potential repercussion on the kidneys and indicates an increase in glomerular intracapillary pressure or changes in permeability characteristics. In this study, we measured whether albumin excretion is affected in patients undergoing anesthesia and surgery, which are both known to induce dramatic changes in renal function and in the release of vasoactive substances such as catecholamines, vasopressin, angiotensin, and prostaglandins. Seven patients with normal renal function and physiological microalbuminuria prior to surgery were studied. Urine samples were collected before anesthesia, just before the beginning of surgery, and thereafter 30 min following incision, and 30 min after the end of surgery. Anesthesia induced a significant increase in microalbuminuria, which further increased during surgery. After the end of surgical procedure, microalbuminuria decreased but remained significantly higher than control. This phenomenon may be due to an increase in intracapillary glomerular pressure and/or an alteration in glomerular permeability induced by a direct effect of drugs, or to the action of vasoactive substances on the glomerular structure.

Adult↗
PubMed1990

[Abrikossoff's granular cell tumors of the esophagus. Apropos of 2 cases].

Two cases of granular-cell tumors of the esophagus, occurring in two heavy drinkers and smokers, are reported. One of them had increased in volume, while the other caused dysphagia. Both were treated by local exeresis followed by an immediate histological study. The postoperative period was quite uncomplicated. The authors discuss the merits of ultrasound in the preoperative diagnosis, the problems of the relationships with cancer and the choice of treatment.

Adult↗
PubMed1988

Low molecular weight heparin compared with unfractionated heparin in prevention of postoperative thrombosis.

Three consecutive randomized open studies have been carried out to determine the optimal dosage of low molecular weight heparin (LMWH) in the prevention of postoperative thrombosis in general surgery (892 patients). All patients undergoing abdominal, gynaecological, thoracic or urological surgery were over 40 years old and presented at least one of the following risk factors for thrombosis: previous thromboembolism, obesity, varicose veins, malignancy (30 per cent), pre-operative hospitalization over 5 days, oestrogen therapy, chronic cardiac disease or bronchitis. Isotopic venous thrombosis and bleeding complications were assessed after subcutaneous administration of a LMWH fragment (LMWH, Enoxaparine) or unfractionated heparin (UH). The three studies compared 3 X 5000 units UH daily with 1 X 60 mg, 1 X 40 mg, 1 X 20 mg LMWH daily. Thromboembolic events rates were not significantly different from group to group (UH: 3.8 per cent, 2.7 per cent, 7.6 per cent respectively compared with LMWH: 2.9 per cent, 2.8 per cent, 3.8 per cent). Bleeding episodes including wound haematoma formation, perioperative blood losses and systemic haemorrhage were not significantly different in patients receiving LMWH or UH. Significant decreases in haematocrit and haemoglobin were only observed in patients receiving 60 mg Enoxaparine (as compared to UH). An analysis using the 'intention to treat' approach gave results consistent with those of an analysis of good compliers. An overview of isotopic thromboses in the three studies gave no evidence of differences amongst the effects of the three doses of LMWH (P = 0.20), and pooling the results of the three studies using the Mantel-Haenszel procedure gave no evidence of a global difference between Enoxaparine and UH (P = 0.54). These results suggest that an optimal dosage of 20 mg/day of Enoxaparine is safe and effective in the prevention of postoperative thrombosis in this population.

Aged↗
PubMed1988

[Preoperative diagnosis of a subacute perforation of a duodenal diverticulum].

Duodenal diverticula are very rarely complicated by perforation (less than 100 cases published) and it is unusual to diagnose the lesion prior to operation. This was possible, however, in a 71 year old patient admitted with a picture of cholecystopancreatitis explored by CT scan imaging and barium meal examination. Study of relevant documented data showed that apart from the progressive character, characterized by duodenocolic fistula, the diagnosis can be made in acute or subacute manifestations: previous knowledge of a diverticulum, air bubbles in paraduodenal region on straight abdominal image and urgent examination of transit using water soluble contrast medium.

Acute Disease↗
PubMed1986

[Leiomyoma and leiomyomatosis of the esophagus. Apropos of 2 cases].

The authors present two cases of leiomyoma of the oesophagus treated by enucleation. They review the literature on this subject and distinguish single leiomyomas (97%) from multiple leiomyomas (2.4%). The early diagnosis is based on endoscopy and oesophagogastric barium studies. Biopsies are controversial. Surgical treatment remains the general rule, but the anatomical extension may be slow so that surgical abstention with regular follow-up is justified in asymptomatic patients.

Adult↗