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P Chastonay

Publications and source records attributed to P Chastonay.

28 records · Page 2Linked to original sources
PubMed1989

[Late disseminated tuberculosis. Anatomo-clinical correlations in 40 cases].

Late disseminated tuberculosis has a diversity of clinical presentations and is difficult to diagnose. This disease has a growing importance in industrialised countries and we decided to study forty cases correlating autopsy findings with the clinical date. This diffuse form of miliary tuberculosis occurs long after the primary infection. It is a disease of the elderly (72.5% greater than 65, 32.5% greater than 80). It represented 42.5% of serious tuberculous cases observed at autopsy over the same period. At the top of the list of clinical presentations is fever (57.5%) followed by loss of weight (42.5%) and respiratory symptoms (32.5%). The diagnosis of tuberculosis was only considered in 37.5% of cases (15/40), however the pulmonary radiograph suggested the diagnosis in the majority of cases. In 62.5% of cases (25/40) tuberculous disease was not recognised in the clinic, the presenting symptomatology was attributed in nearly half the cases to neoplastic disease. Autopsy showed that the primary disease was caseous tuberculosis in 25% of cases and in 25% there was a cancer. Our observations underline the diagnostic challenge of late disseminated tuberculosis in clinical practice and also discern the particular clinical characteristics and anatomo-pathological features.

Adult↗
PubMed1988

[Tuberculosis simulating cancer. An autopsy study of 12 cases presenting diagnostic difficulties in clinical practice].

Tuberculosis may simulate cancer. We report on twelve cases with the clinical diagnosis of cancer in which autopsy revealed tuberculosis. Weight loss and fever were the most common symptoms. Chest x-ray abnormalities were seen in 50% of cases. A debilitating disease other than tuberculosis was present in 6 cases. Miliary disseminated tuberculosis was the most common form encountered at autopsy. Physicians should be aware that the clinical findings of tuberculosis may suggest malignancy.

Aged↗
PubMed1987

[Extensive active tuberculosis at autopsy: retrospective study of a collection of adult autopsies (1961-1985)].

While over the past decades tuberculous morbidity and mortality have steadily declined in Switzerland, tuberculosis has not been eradicated. The present study investigates tuberculosis in an autopsy material. From 1961 to 1985 severe active tuberculosis was seen in 1.9% of autopsies performed; pulmonary tuberculosis accounted for 54% and miliary tuberculosis 35.3%. The majority of cases of severe active tuberculosis were seen in the elderly. Clinically undiagnosed cases made up 44% of the cases. A constant decrease in severe active tuberculosis has been seen over the years, but clinically undiagnosed cases are on the increase.

Adult↗
PubMed1986

Biological tissue markers in benign and malignant disease of the human prostate.

Immunoperoxidase techniques were used to study, the distribution of peanut agglutinin receptors, blood group isoantigens and several epithelial antigens in hyperplasia, adenosis, microcarcinoma and well differentiated adenocarcinoma of the prostate. Intraluminal and luminal surface PNA receptors were seen in all well differentiated carcinomas, 53% of microcarcinomas and 50% of adenosis, while no such sites could be demonstrated in benign hyperplasia. The expected blood group isoantigen was expressed in 75% of benign hyperplasias. When compared to the hyperplastic epithelium nearby, appropriate ABH expression was seen in 60% of adenosis, 47% of microcarcinomas and 25% of well differentiated carcinomas. A keratin antibody specifically labelling the basal cells in the normal prostate identified a subset of well differentiated carcinomas with preferential staining of the apical cytoplasm while microcarcinomas and adenosis were consistently negative. Our study establishes a highly ordered PNA receptor distribution in prostatic epithelia; it confirms early changes in the expression of ABH isoantigens in epithelial proliferative disorders of the prostate; it identifies a subset of keratin-positive well differentiated carcinomas, possibly of different ontogeny.

ABO Blood-Group System↗
PubMed1986

Characterization of different amyloids with immunological techniques.

We studied 71 cases of amyloidosis from the autopsy material of our institute. 17 cases were secondary amyloidosis of which 7 had initially been diagnosed as primary amyloidosis; all cases reacted positively with an anti-substance A antibody; 13 showed a suppression and 4 a strong reduction of the Congo red staining following tissue incubation in KMnO4. 25 cases were identified as primary amyloidosis of which 7 had initially not been recognized as such. In 16 cases amyloid deposits reacted positively with antibodies specific for the light chains of the immunoglobulins (3 X kappa, 13 X lambda). A monoclonal plasmacytic cell proliferation in the bone marrow was seen in 14 cases. In all cases deposits were KMnO4 resistant, but 1 case showed a slight reduction of staining intensity. 27 cases were cardio-vascular (senile) amyloidosis; in 20 cases at least 3 organs showed deposits; 12 cases had deposits in 5 and more organs. 2 cases were heredofamilial amyloidosis. In those 29 cases deposits reacted positively with an anti-prealbumin antibody, but were negative for AA and the light chains of the immunoglobulins; the Congo red staining remained strong in all cases when previously incubated in KMnO4. KMnO4-Congo red staining and antisera specific for AA, L-chains and prealbumin proved of value for classification of amyloidosis and for its organ distribution.

Adult↗
PubMed1986

Clinical evaluation of a specific benzodiazepine antagonist (RO 15-1788). Studies in elderly patients after regional anaesthesia under benzodiazepine sedation.

The efficacy, usefulness and side effects of RO 15-1788 (RO), a specific benzodiazepine (BZD) antagonist, have been evaluated. Sixty-two patients (ASA I-III, mean age 72 +/- 9 yr) scheduled for urological surgery under regional anaesthesia and BZD sedation received placebo or RO in a randomized, double-blind fashion at the end of the procedure, following sedation with midazolam. When compared with placebo, RO improved alertness and collaboration for 15 min, and suppressed anterograde amnesia for 60 min. No major side effect was noted, although five patients became anxious after administration of RO. Two cases of a paradoxical reaction to midazolam were treated successfully by RO.

Aged↗
PubMed1982

Evaluation of a new monitoring device for arterial blood pressure and heart rate measurement by automatic sphygmomanometry.

Measurements of arterial blood pressure (BP) and heart rate (HR) using a new non-invasive automatic apparatus were compared with the BP and HR values obtained with an invasive technique, i.e. arterial catheter and pressure transducer. This new device consists of a self-inflating BP cuff and of a microphone which converts Korotkoff sounds into digital values. The comparison was made on 400 measurements in 10 surgical intensive-care patients during 18 hours after open heart surgery. Systolic pressure was underestimated by the new device by 13 +/- 20 mm Hg/1.7 +/- 2.6 kPa (means +/- SD) and the linear correlation coefficient between the non-invasive and the invasive technique was r = 0.70. Diastolic pressure was overestimated by 9.4 +/- 12.0 mmHg (1.2 +/- 1.5 kPa) with an r = 0.63. HR was also underestimated by 7 +/- 17 heart beats per minute (r = 0.58). We conclude that this new device is not adequate for monitoring intensive-care patients, not so much because of the differences noted between the invasive and the non-invasive measurements, but in particular because there are no alarms, no mean arterial pressure measurement and also because it gives aberrant results once out of twenty measurements.

Anesthesia, General↗
PubMedDate not supplied

[An innovative program for public health training at the University of Geneva. Program during employment centered on the student and oriented to the population's health needs].

Switzerland's first Master degree course in public health was launched in the autumn of 1990 at the Geneva University School of Medicine. It is a 3 year, part-time course, which is learner-centred and community-oriented. The aim of the course is to prepare students to use a multi-disciplinary approach to plan, implement and evaluate activities intended to solve public health problems. Throughout the course, studies plan, implement and evaluate projects concerning health problems they have encountered in their work as health professionals. The curriculum includes individual and group work, discussions and seminars with teachers and students, and brainstorming sessions with specially trained facilitators. The students can thus identify and fulfil individual educational objectives while working on community-related health projects. Priority health needs of individuals and communities are thus the pivotal points of the novel approach to public health training.

Curriculum↗