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Biomedical subjects

P Magnenat

Publications and source records attributed to P Magnenat.

At least 19 recordsLinked to original sources
PubMed1992

[Anatomo-clinical discordance: analysis of a series of consecutive autopsies].

In order to assess the level of agreement between clinical and autopsy diagnoses in the medical wards of a city and teaching hospital, we studied 94 consecutive patients autopsied during a 12 months' period. The rate of autopsy in this study was 59%. The main diagnosis was confirmed at autopsy in 80% of the cases, more precisely defined in 11% and discovered in 9%. Among 124 secondary diagnoses, 34% were diagnosed by the pathologist. The retrospective analysis of the cases in which there was disagreement between clinical and autopsy diagnosis showed that in 8 of them (8.5% of all patients), a clinical impact on survival was possible. However, all of these patients were over 80 and had multiple and/or terminal diseases. Thus, the real impact of these diagnostic errors is debatable.

Adult↗
PubMed1992

Detrimental effect of alcohol intoxication on severity of injuries in male traffic accident victims: a cross-sectional study.

A cross-sectional emergency room study was performed among traffic accident victims aged 16 to 75 years in order to investigate the prevalence of alcohol intoxication (blood alcohol concentration (BAC greater than or equal to 0.8 g/kg) and its potential detrimental effect on injury severity. A BAC greater than or equal to 0.8 g/kg was present in 29% of the male patients. Intoxicated patients had a similar propensity to require inpatient hospital care (65 versus 60%) but had significantly longer hospital stays than the non-intoxicated patients (36 versus 20 days; p less than 0.05), observations which may be explained by the higher prevalence of serious injuries (head and internal injuries) among the intoxicated cohort. This study supports and emphasizes the detrimental effect of alcohol intoxication on the severity of injuries in traffic accident victims, and reinforces the need for further legal and public health measures in preventing alcohol-related traffic accidents.

Accidents, Traffic↗
PubMed1992

Drinking patterns among medical in-patients with reference to MAST categories: a comparative study.

The aim of the study was to describe the drinking patterns and alcohol consumption of patients screened by the Michigan Alcoholism Screening Test (MAST) in a sample of medical patients from a general hospital of a French-speaking, wine-drinking country. Data were recorded using a structured interview administered to 103 consecutively admitted 20-75-year-old MAST-positive patients and 103 age-matched and sex-matched MAST-negative controls admitted to the same ward. Relevant differences between MAST-positive and MAST-negative patients included the frequent report of recent and total abstinence in MAST-positive patients (23% versus 4% in controls), their tendency to drink alone, and less often during mealtimes, at home, or with family or friends than MAST-negative patients. Alcohol consumption was significantly higher in MAST-positive patients of both sexes with 250 and 270 g per week being the optimal discriminative cut-off level of consumption for men and women, respectively (kappa coefficient, 0.70 and 0.81, respectively). Regular drinking was the predominant drinking status of both MAST-positive and MAST-negative patients. This study suggests that a screening test such as the MAST, developed in an English-speaking country may be useful in a French-speaking, wine-drinking country. The test identified patients with drinking patterns that are culturally abnormal, yet in certain respects similar to those of alcoholic patients from other drinking cultures. These findings therefore emphasize the worldwide relevance of the concept of the alcohol dependence syndrome in addition to the transcultural usefulness of alcoholism screening tests.

Adult↗
PubMed1990

Characteristics of 167 consecutive traffic accident victims with special reference to alcohol intoxication: a prospective emergency room study.

This prospective study examined the characteristics of 167 consecutive traffic accident victims admitted to the emergency room of a major Swiss hospital with particular attention to the presence of a detectable blood alcohol concentration (BAC). The majority of the study population were male (71%), 16-29 years of age (56%) and occupants of an automobile or motorcycle (70%). Most patients were injured during the daytime, with nighttime accidents increasing towards the end of the week. Seventy-five percent of the injured were drivers of the crash vehicle and the majority (56%) were involved in multi-vehicle accidents. Fifty-three percent of all injuries consisted of internal lesions and/or fractures with motorcyclists and pedestrians being the most severely injured. There was a 21% incidence of alcohol intoxication (BAC greater than = 0.8 g/kg); 97% of intoxicated patients were male, of which 38% were 16-29 years of age. There was a distinct age-related alcohol intoxication pattern among males, with an intoxication rate of 20% in the 16-29 age range and 40% in the 30-75 age range. Alcohol-related accidents occurred predominantly in the nighttime and towards the end of the week, and victims of single-vehicle crashes were more likely to be intoxicated (28%) than those injured in multi-vehicle crashes (17%). Moped drivers exhibited the highest rate of intoxication (45%) followed by pedestrians (42%). Our study confirms the high prevalence of acute alcohol intoxication among traffic accident victims in Switzerland, a fact which needs to be considered by the treating medical care providers for the early detection and referral of alcohol-related problems, and which should be limited by effective preventive measures.

Accidents, Traffic↗
PubMed1989

[Medicosocial characteristics of hospitalized alcoholic patients in 2 internal medicine departments of hospitals in French-speaking Switzerland].

Two prospective studies were performed in the medical services of two hospitals located in the French-speaking part of Switzerland to assess the prevalence of alcoholism and the comparative medico-social characteristics of alcoholic and nonalcoholic patients aged 18 to 75. Both investigations used the Michigan Alcoholism Screening Test, with a cut-off score of 5. The prevalence of alcoholism was similar in the two institutions (19.6 and 20.5%) and was much higher in males (30 to 32%) than in females (3 to 5%). Among alcoholics, the percentage of unmarried or divorced patients was higher than in nonalcoholics, as was the percentage of unemployed and subjects from lower socio-economic brackets. The most frequent type of alcohol-related disease was alcoholic liver disease, encountered in 25% of alcoholics in both services. Cigarette smoking was also much more frequent in alcoholics (60%) than in nonalcoholic patients (29%). The length of stay was 2 days longer for alcoholics in both hospitals, despite the lower mean age of these patients.

Adolescent↗
PubMed1989

[Cure of recurrent ascites in alcoholic hepatitis following transient placement of a LeVeen shunt].

Three cases of severe alcoholic hepatitis associated with refractory ascites are reported. A LeVeen shunt was inserted which was effective and well tolerated. However, the shunt was removed in all 3 patients 8 months, 12 months and 9 years after insertion because of spontaneous migration (n = 2) or superior vena cava thrombosis (n = 1). At time of shunt removal all 3 patients had micronodular cirrhosis, but none had recurrent ascites during the 1-3 years of observation and despite the absence of diuretics. The eventual transient aspect of refractory ascites associated with alcoholic hepatitis is discussed, together with the potential beneficial and temporary role of LeVeen shunts in this condition.

Adult↗
PubMed1989

Accuracy of the Michigan Alcoholism Screening Test for screening of alcoholism in patients of a medical department.

To measure the applicability and validity of the Michigan Alcoholism Screening Test in a medical hospital department situated in the French-speaking part of Switzerland, the test was administered to 300 patients. The results of the test were validated in relation to the clinical diagnosis of alcohol abuse or alcoholism through a concordance analysis. The applicability rate was 89% and the agreement between test and clinical diagnosis was good, especially in young men. Positive and negative predictive values of the test were 0.69 and 0.92, respectively. These results suggest, therefore, that the Michigan Alcoholism Screening Test could be considered as a standardized, valuable, and transcultural screening and research instrument.

Adult↗
PubMed1986

Effect of oral triiodothyronine during amiodarone treatment for ventricular premature complexes.

Whether there is a link between the antiarrhythmic efficacy of amiodarone and its blocking effect on the peripheral conversion of tetraiodothyronine (T4) to triiodothyronine (T3) is uncertain. If such a link exists, oral intake of T3 during amiodarone treatment could reverse, at least partially, the antiarrhythmic efficacy of amiodarone. To assess the safety of oral intake of T3 during amiodarone treatment and gain further insight into the relation between the antiarrhythmic action of amiodarone and its metabolic effect on T4, 7 patients (aged 32 to 62 years) with multiple ventricular premature complexes (VPCs) but no underlying heart disease were studied. Antiarrhythmic treatment was indicated for symptomatic relief only. Each patient underwent a 48-hour ambulatory electrocardiographic recording, electrocardiography and thyroid function tests, including plasma T4, T3, reverse T3 (rT3), free T4, free T3 and thyroid-stimulating hormone without treatment (baseline) after 1 month of amiodarone therapy and after a second month of amiodarone therapy with increasing doses of oral T3 (up to 75 micrograms/day). Treatment with amiodarone resulted in a decrease in plasma T3 and free T3, an increase in plasma rT3, a marked diminution in the frequency of VPCs and a prolongation of the corrected QT interval (QTc). During treatment with amiodarone and T3, plasma T3 and free T3 increased and plasma T4, free T4 and rT3 levels decreased; the frequency of VPCs remained low despite shortening of the QTc to values not different from baseline. Thus, in patients with frequent VPCs and no underlying heart disease, oral intake of T3 during amiodarone treatment is safe and does not abolish the antiarrhythmic efficacy of amiodarone, despite a shortening of the QTc.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1979

[The physiopathology of ascites].

Sodium and water retention is constant in decompensated cirrhosis with ascites and edema. Sodium retention is due to several factors. Renal hemodynamic disturbances appear first: decrease in glomerular filtration and renal plasmatic perfusion, redistribution of renal perfusion to the juxtamedullar area where the longer nephrons reabsorb more sodium. Metabolic disorders of estrogens, natriuretic hormonal factor, prostaglandins and the kallikrein-kinin system contribute to greater sodium retention. Water retention is secondary to greater sodium reabsorption and to hyperactivity of the antidiuretic hormone. Sodium and water retention, associated with portal hypertension, with reduced oncotic pressure and with dynamic lymphatic insufficiency, is responsible for the production of ascites. The latter results in a decrease in the effective plasmatic volume, with non-suppression of the renin-angiotensin system, increased aldosterone production and additional sodium retention.

Ascites↗
PubMed1978

The displacement of albumin bound bilirubin by free fatty acids in vivo.

Variations in bilirubinaemia in response to alterations of the free fatty acid level was studied in conscious and unstressed Gunn rats. When only one molecule of bilirubin is bound to albumin (without bilirubin overload), no displacement of bilirubin is observed, even if the protein binds as much as 6 molecules of free fatty acids. After overloading with exogenous unconjugated bilirubin, the second site of fixation of bilirubin on albumin is partly occupied; in this situation, a displacement is observed, but only when more than 3.5 molecules of free fatty acids are simultaneously bound to the protein. In vivo, free fatty acids do not spontaneously reach such levels as those responsable for the observed displacement of bilirubin. In the ranges of bilirubin and free fatty acids concentrations likely to be encountered clinically, free fatty acids might not represent an effective agent of displacement for bilirubin, as it is commonly thought.

Animals↗