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Biomedical subjects

M Gosselin

Publications and source records attributed to M Gosselin.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Prognosis and prognostic factors of hemorrhage by rupture of varices in cirrhotic patients in the era of endoscopic sclerotherapy].

The aim of this study was to evaluate the prognosis and the determinants of survival in cirrhotics presenting with variceal bleeding. One hundred and ninety one consecutive patients with cirrhosis (alcoholic 93 percent) were enrolled between 1983 and 1988. Treatment was principally but not exclusively based on early endoscopic sclerotherapy. At admission all patients were classified according to Child-Pugh's classification (class A = 16 percent; class B = 53 percent; class C = 31 percent). The rebleeding rates at 48 hours and for the entire hospitalisation were 11 and 30 percent respectively. Actuarial survival rates were 45, 40, and 37 percent at 12, 18, and 36 months, respectively. Prognostic factors, as determined by uni- and multivariate analysis (Cox model), corresponded to Child-Pugh's score, to the five components, and the occurrence of early bleeding recurrence. This study also showed that: i) the role of Child-Pugh's classification on long-term prognosis is determined during the 3 months following index bleeding; ii) early rebleeding is a significant prognostic factor, particularly in Child-Pugh's class B patients; iii) there are few indicators of early rebleeding (serum albumin level, presence of gastric varices at initial endoscopy). Prognosis of variceal bleeding is still severe in cirrhosis but efforts made to prevent early bleeding recurrence seem to be fully justified.

Actuarial Analysis↗
PubMed1991

[Digestive hemorrhage following gastroduodenal ulcers caused by non-steroidal anti-inflammatory agents].

The aim of this retrospective study was to describe the clinical and prognostic characteristics of bleeding ulcers following gastrotoxic agent use. From 1984 to 1988, 244 patients were admitted in our Intensive Care Unit for bleeding ulcers; 133 (54.5 percent) were using gastrotoxic agents. Patients not taking gastrotoxic agents were compared with patients taking non steroidal antiinflammatory drugs (n = 77) or aspirin (n = 35). Patients receiving non steroidal antiinflammatory drugs differed (P less than 0.05) from patients not taking gastrotoxic agents: they were older, had less history of ulcer, hemorrhage, and alcohol abuse. Patients taking aspirin had less severe hemorrhage and took anticoagulant therapy less frequently than patients not taking gastrotoxic agents. Patients taking aspirin were younger, had less severe hemorrhage and had more frequent history of alcohol abuse and ulcer disease than patients taking non steroidal antiinflammatory drugs. There was no difference with regard to endoscopic data and mortality (7 percent). Two thirds of hemorrhages following non steroidal antiinflammatory drugs occurred during the month following the onset or the modification of treatment. The distribution of non steroidal antiinflammatory drugs in the group of patients who bled after non steroidal antiinflammatory drugs differed from that of regional sales. These results suggest that upper gastrointestinal tract bleeding associated with the use of gastrotoxic agent are frequent, particularly in elderly patients, are not associated with poor prognosis, and occur soon after the beginning of treatment.

Adult↗
PubMed1991

[Gastroduodenal duplication and chronic hepatitis: fortuitous association?].

Gastroduodenal duplication is a rare congenital entity. Preoperative diagnosis is difficult because symptoms are usually non specific and can mimick pancreatitis. We report 2 cases of gastric and duodenal cystic duplication in adults presenting as pancreatitis. Chronic pancreatitis was observed on endoscopic retrograde pancreatography and confirmed at laparotomy in both cases. Pancreatitis was probably related to alcoholism in one case, but might have been secondary to duplication in the other. In both cases, duplication was misinterpreted initially as a pseudocystic complication of pancreatitis until laparotomy was performed. These 2 cases lead us to discuss the relationship between duplication and pancreatitis.

Adult↗
PubMed1990

Pseudoaneurysms and bleeding pseudocysts in chronic pancreatitis: radiological findings and contribution to diagnosis in 8 cases.

Pseudoaneurysms and bleeding pseudocysts are rare but life-threatening complications of chronic pancreatitis. This report summarizes our experience in 8 cases collected from among 250 patients admitted for chronic pancreatitis. We describe the radiological findings of nine vascular lesions and especially emphasize the contribution of recent radiological imaging, ultrasound and computed tomography scanning in establishing the diagnosis of vascular complication. We also report a case of successful embolization of a splenic pseudoaneurysm that ruptured into the colon.

Adult↗
PubMed1990

[Gastroduodenal invagination. Radio-endoscopic aspects].

Gastroduodenal intussusception is a very rare entity and is generally associated with benign tumor of the stomach. We report a new case of central gastroduodenal intussusception related to schwannoma. We emphasize the radiologic features which can be misinterpreted as well as the endoscopic aspect hitherto unreported.

Duodenal Diseases↗
PubMed1988

[pHmetry and manometry of the esophagus in patients with pain of the angina type and a normal angiography].

The role of gastroesophageal reflux and esophageal motility abnormalities in patients with angina-type chest pain and normal coronary angiogram is not clear. The aim of this study was: a) to assess the importance of these two disorders in the same patients, b) to study the diagnostic usefulness of provocation tests, c) to determine final outcome in these patients. Seventeen patients with angina-type chest pain and normal coronary angiograms were studied to determine the diagnostic value of esophageal manometry, postprandial esophageal pH monitoring, provocation tests (methylergometrine stimulation, acid perfusion test) and endoscopy. Baseline esophageal motility was abnormal in 10 patients. Esophageal motility disorders were nonspecific in seven patients. Eight patients had reflux. The mean lower esophageal sphincter pressure was decreased in these patients as compared with normals, and endoscopy showed a high Z line, and/or a large opening of the cardia in 7 of them. Neither conventional manometry nor postprandial esophageal pH monitoring allowed to consider the esophagus as responsible for chest pain. The methylergometrine test was positive in 4 patients (simultaneous occurrence of familiar pain and esophageal dysmotility). Baseline manometric studies did not allow to forecast the response to methylergometrine injection. The acid perfusion test was negative (no symptoms were reproduced) in all patients. After esophageal evaluation, 16 patients were followed for a mean of 26 +/- 9 months. No cardiac disorders appeared, but all patients continued to have pain, and 7 were incapable of working.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Quality-control scheme for blood glucose measured outside the laboratory.

We propose a quality-control (QC) scheme to evaluate the performance of blood glucose estimates made with a reflectometer in hospital wards or at home. We constructed a chart illustrating the comparison by regression analysis of the results of 254 reflectometer readings (y) and simultaneous capillary blood glucose analyses in the laboratory (x). Arbitrary acceptance limits around the regression line (y = 0.5 + 0.87x; r = 0.97, Sy/x = 0.8 mmol/L) were established, based on the mean +/- 2 SD of the reflectometer readings of a series of classes of 1.1 mmol/L interval, made with the results from the laboratory analyzer. Each ward using a reflectometer is provided with the QC chart, and the first blood glucose estimation with the reflectometer on each working shift is controlled by re-assay in the laboratory. If the reflectometer reading is outside the limits, the next glucose estimation is also re-assayed. If two consecutive readings are outside the limits, the reflectometer procedure is considered to be failing, the instrument's readings are not used for medical decisions, and remedial action is taken. The chart can also be used as a teaching tool for training the patients or the nurses and to evaluate individual performance.

Blood Glucose↗
PubMed1987

Calcifying pancreatitis of a congenital short pancreas: a case report with successful endoscopic papillotomy.

We report a case of partial pancreatic agenesis in a 25-yr-old man with insulin-dependent diabetes who exhibited abdominal pains in relation to a calcifying chronic pancreatitis. An endoscopic retrograde pancreatography through the accessory papilla revealed an abnormal duct configuration thought to be consistent with an obstruction of the main duct. Ultrasonography and computerized tomography scanning could not identify any pancreatic tissue in the region of the body or tail. Another endoscopic investigation revealed the main papilla in the third part of the duodenum. The ducts of Santorini and Wirsung were identified. Santorini's duct was dilated and contained calculi. Wirsung's duct was nearly normal. The junction between the two ducts was slightly narrowed. After papillotomy of the accessory papilla, the patient's abdominal pains disappeared. This new case of congenital short pancreas is discussed in relation to four other cases reported in the English and French literature.

Adult↗
PubMed1984

A simple isocentric technique for irradiation of the breast, chest wall and peripheral lymphatics.

The major problem with the standard technique for irradiation of the breast or chest wall and peripheral lymphatics is field matching at the junction between the supraclavicular and tangential fields. Overdosing or under-dosing across the junctions is unavoidable because of beam divergence. Various techniques using a half-blocked supraclavicular field in conjunction with special tangential fields have been introduced recently to eliminate the junction problem; they are, however, complicated, involving couch motions and machine isocentre repositioning when changing from the supraclavicular to the tangential fields. The breast treatment technique which we have used over the past twelve months utilises a supraclavicular half-blocked field, two tangential half-blocked fields and an optional posterior axillary field. The technique is simple and easy to set up since the same machine isocentre is used for all treatment fields and no couch movement or patient repositioning is required. The same half-block collimator which is used to define the caudad border of the supraclavicular field is used to define the cephalad edges of the two tangential fields. The margin of error of treatment is reduced and the dose measurements demonstrate excellent dose homogeneity through the entire treatment volume with no overdose or underdose at the field junction.

Breast Neoplasms↗