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Biomedical subjects

P Erny

Publications and source records attributed to P Erny.

66 records · Page 4Linked to original sources
PubMedDate not supplied

Road accident statistics: discrepancies between police and hospital data in a French island.

In most developed countries, information on road crashes are routinely collected by the police. However, comparison of police records and hospital data underlines a deficit of the number of road accidents in the routine statistics. In La Réunion, a French overseas dependency, an epidemiological study of injuries leading to hospitalisation or deaths has been performed from June 1993 to June 1994. The comparison between hospital data and police records showed that only 37.3% of non-fatally traffic-injured in-patients were recorded by the police. Length of stay in hospital, physician in charge of the first aid, urban place of the crash, type of vehicle involved, day and time of the crash and blood alcohol concentration were significantly associated with the presence in the police file. Police overestimated the severity of the injuries. Police notified 100 deaths on the 115 counted by the study. In France, non-fatally traffic-injured should be followed 30 days to improve quality of police death records. A capture-recapture method was used to estimate the total number of injured people. The capture-recapture method consists in merging information from several sources of notification to determine the real number of cases in the population and the exhaustivity of each source. We estimated that 346 subjects were injured in one month whereas police data recorded only 87 and hospital data 137. This method seems interesting to use in routine after validation when unique personal identifiers are available.

Accidents, Traffic↗
PubMedDate not supplied

[Metabolic acidosis and intravenous injections of fat emulsions (role of phospholipids. Experimental study)].

In explanation of metabolic acidosis during parenteral nutrition, the authors considered the supply of H+ ions by fat emulsion, containing phospholipids of egg or soy. During intravenous infusions of 24 grams of lecithins to two healthy subjects, they observed an increased output H+ ions in urine, about 74,05 and 75,88 mEq, and a metabolic acidosis of the plasma. The theorically forcasted supply of production was 74,6 mEq. Indeed the metabolism of phospholipids supplies phosphoric ions (PO4H3), giving H+ ions at pH 7,40. The most used fat emulsions are able to give between 37 (intralipid 10%) and 61 (lipihysan 15%) mEq of H+ ions/liter.

Acidosis↗
PubMedDate not supplied

[Prevention of iatrogenic effects of artificial ventilation with transcutaneous monitoring of PO2 and PCO2 in the newborn infant].

The authors have monitored Tc PCO2, Tc PO2 and mean airway pressure in 25 ventilated newborns, during 68 days. They show that the best blood gases values are not even obtained with the most aggressive artificial ventilation (A.V.). Tc PCO2 and Tc PO2 transcutaneous monitoring and mean airway pressure measurement allow an "à la carte" adaptation of the A.V. to bring in each case the most efficient and the least aggressive A.V. This method may decrease the iatrogenic complications of the A.V.

Carbon Dioxide↗
PubMedDate not supplied

[Value of prealbumin in the 1st and after the 12th day of life].

From a series of 129 neonates, well defined with regard to weight and gestational age, the authors established that serum concentration of prealbumin (PA) in an aseptic neonate depends on its gestational age on the first day of extrauterine life (p less than 0.001). Serum concentrations of PA are significantly different in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates; this may be the consequence of insufficient materno-foetal transfers in the majority of SGA children. The study of the ratio maternal PA/neonatal PA at the time of delivery helps to establish the cause of SGA. On and after the 12th day of life, serum concentrations of PA are closely correlated with the usual data of anthropometry (weight, height, skull circumference) (p less than 0.001), when correlation is less close with gestational age at the time of sample taking: it may be used as a marker of the appropriateness of gestational age rather than of maturity. However, the ratio PA/weight varies from one child to another and from one week to another for a same child, giving PA a value different from ordinary anthropometry for the evaluation of the appropriateness of gestational size in neonates.

Anthropometry↗
PubMedDate not supplied

A comparison between lidocaine alone and lidocaine with meperidine for continuous spinal anesthesia.

BACKGROUND AND OBJECTIVES: Experimental investigations have demonstrated a synergistic interaction between opioids and local anesthetics. This study aims to assess the effective benefit-risk ratio of continuous spinal anesthesia (CSA) induced with either 1.6% lidocaine alone or in combination with 1% meperidine. METHODS: Thirty-four elderly patients (80.7 +/- 7.3 years) operated on for fracture of the neck of the femur were randomly allocated to two groups. In the first group (n = 15), CSA was induced with lidocaine 1.6% plain, whereas in the second group (n = 19) 1% meperidine was added. Reinjections were performed in both groups using lidocaine 1.6% alone. RESULTS: In the lidocaine group, 43 +/- 13 mg was used for induction whereas in the other group the addition of 18 +/- 5 mg of meperidine significantly reduced the dose of lidocaine required to 28 +/- 8 mg (p < 0.001). Delay between two reinjections was increased to 51 +/- 7 minutes in the lidocaine plus meperidine group, compared to 35 +/- 6 minutes in the lidocaine group (p < 0.001). Ephedrine was required for 9 out of the 19 patients in the lidocaine plus meperidine group, whereas it was required for only two patients in the other group (p = 0.05). Mean plasma concentrations of meperidine 1 hour and 3 hours after induction was 45.5 +/- 12 ng/ml and 59 +/- 22 ng/ml, respectively, and drowsiness was observed in 95% of the patients in the second group. Delay before requirement for pain medication was 2.2 +/- 2 hours in the lidocaine group and 14.1 +/- 8 hours in the lidocaine plus meperidine group (p < 0.001). CONCLUSIONS: The association of 1% meperidine with 1.6% lidocaine during the induction of CSA decreases the initial induction dose, prolongs analgesia, produces initial drowsiness, and provides long-lasting pain relief. However, such benefits are offset by some impairment of hemodynamic stability that is likely to make this combination of drugs unacceptable as an enhanced analgesic technique.

Aged↗