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Biomedical subjects

J P Berger

Publications and source records attributed to J P Berger.

At least 19 recordsLinked to original sources
PubMed1999

Ultrasonography as an aid to diagnosis and treatment in a rural African hospital: a prospective study of 1,119 cases.

The aim of this study was to assess the utility of ultrasonography in a rural African hospital in Cameroon with scarce resources. A prospective questionnaire was administered and completed for each of the 1,119 consecutive cases included in the study. Among these 1,119 cases, the diagnosis made by clinicians and by echography could be verified by another means for 323 patients. Ultrasonography showed abnormal findings in 78% of the cases. In the group of 323 patients in which the diagnosis made by echography could be verified, it was correct in 95.4% of the cases, erroneous in 4.6% of the cases, judged useful for diagnosis in 67.8% of the cases, and not contributive in 27.6% of the cases. Ultrasonography was judged useful when treatment was decided upon in 62% of the cases. This study demonstrated the value of ultrasonography in the context of a developing country and the conditions by which its use could be delineated.

Adolescent↗
PubMed1995

[Hemi-arthroplasty of the shoulder: radiological, functional and dynamic studies].

From September 1973 to October 1992, forty-three shoulder arthroplasties were performed in forty-one patients with complicated fractures or degenerative disease. Radiological and functional assessment with a mean follow-up time of forty-five months permitted us to review twenty patients with fifteen Neer II prosthesis, three isoelastic prosthesis and two total shoulder replacements. Of these, eleven presented with traumatic injuries and four with degenerative disease. The mean age at operative time was 61 years. Radiological evaluation showed that all cases had a retroversion of about 30 degrees. Normal humeral length and lateral shifting were not achieved in most patients; in fact only one had a restored length and lateral shifting. The mean scapulothoracic range of motion was found to be half that of a normal gliding shoulder (angle 30 degrees instead of 60 degrees). The subacromial space was diminished by one third in all cases. Relief of shoulder pain was the most significant finding. Mobility was restored to a level of about 75% of normal according to Constant's Scale. Dynamometric measures showed an important loss of force (47% of normal) despite a normal external rotation force. Recent improvements in implant conception (modular prosthesis) and a better understanding of physiological shoulder mechanisms should improve the functional results of this arthroplasty in the future.

Adult↗
PubMed1993

[Hepatitis C: from pathogenesis to treatment].

Hepatitis C virus (HCV) belongs to the greater family of Flaviviridae. It is probably responsible for the majority of NANB hepatitis. Serologic evidence in the term of antibodies against certain parts of HCV persists in 60 to 100% of patients with NANB hepatitis after blood transfusion. The evidence for the existence of a second virus responsible for NANB has not been excluded as inactivation-studies would suggest. HCV is also a common cause for sporadic acute hepatitis. It is the purpose of this article to present diagnosis, course and treatment of this form of hepatitis.

Antiviral Agents↗
PubMed1993

[Psychiatric morbidity in the medical service of a non-university general hospital].

The aim of this study was to assess the nature and extent of psychiatric pathology in the internal medicine service of a small general hospital. During a three months' period, 315 consecutive patients were enrolled in this prospective study. 92 persons (29% of the admitted patients) exhibited a psychiatric disorder which was recognized by the internists and then discussed with the psychiatric team. The disorders were diagnosed according to the DSM-III-R classification. The age of the patients with psychiatric disorders was lower (median 56 years versus 63 years) and women were more numerous. In 75% of cases the psychiatric problem influenced medical management. A psychiatric consultation was indicated in 12%. Concerning the nature of this pathology, 29% of the 120 diagnoses established in these 92 patients were linked to the use of psychoactive substances; alcohol and male sex predominated. Among the women, anxio-depressive and personality disorders predominated. Two-thirds of the patients were sent to a general practitioner following their discharge from the hospital. The role of the general hospital as a site of care for these patients is discussed. It can be considered positive if a good climate of cooperation exists with the psychiatric team.

Aged↗
PubMed1992

[Blood pressure measurement during tachyarhythmia: validation of a graduated measuring technique with an intra-arterial technique].

Use of the usual technique to measure blood pressure is known to be unsatisfactory in tachyarrhythmia. An easy and non-invasive technique, called the stage by stage method, has therefore been proposed. The aim of the present study is to verify the precision of this method by comparison with intraarterial measurements. The study was performed in 9 tachyarrhythmic patients with heart rate over 90/min and wide systolic pulse amplitude variations. For systolic pressure, the results show an excellent correlation between the blood pressure values obtained by the stage by stage method and those obtained by intraarterial measurements (r = 0.99; p > 0.01). For diastolic pressure, the best practical approximation is the value of the last stage before all sounds have disappeared plus 5 mm Hg. We conclude that the bedside stage by method is worth performing in patients presenting with tachyarrhythmia and wide systolic pressure variations from one systole to the other.

Aged↗
PubMed1990

Cerebrospinal fluid lactate in 78 cases of adult meningitis.

In a retrospective study of 78 cases of adult meningitis, the CSF lactate was measured on the first spinal tap (ST); 25 had a bacterial meningitis, 28 a viral meningitis; 22 other cases had been on antibiotics prior to admission; 3 cases had meningitis of rare aetiology. The median CSF lactate level among the 25 bacterial cases amounted to 13.6 mmol/l (range: 3.5-24.5) whereas it remained low in the 28 viral cases: 2.7 mmol/l (range: 1.4-4.2). These differences are highly significant. The comparison of the CSF lactate level with the other tests routinely performed showed that the CSF lactate level had the highest sensitivity, specificity and predictive values. The CSF lactate level on the first ST had no prognostic value, but a rapid decrease of the CSF lactate during the treatment is indicative of good prognosis. Among the pretreated cases, a high lactate level could be an indication that bacteria were the causal agents. In conclusion, the measurement of the CSF lactate, quickly performed and inexpensive, is worth performing when a meningitis is suspected, as it appears to be the best way of distinguishing bacterial from non-bacterial meningitis.

Adolescent↗