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Biomedical subjects

P Rousseau

Publications and source records attributed to P Rousseau.

At least 73 records · Page 4Linked to original sources
PubMed1995

Native-American elders. Health care status.

This article reviews current data relevant to the health care status of elderly Native Americans, a population cohort encompassing American Indians and Alaskan Natives/Aleutians. Several topics are addressed, including the history of Native American health policy, heart disease, diabetes mellitus, cancer, oral health, nutrition, long-term care, and the circumstances of urban Native American elders.

Aged↗
PubMed1994

Hospice care.

Explore the source record for details and available documents.

Hospice Care↗
PubMed1994

Treatment of intracranial ependymomas of children: review of a 15-year experience.

PURPOSE: There are still major controversies in the optimal management of children with intracranial ependymomas. To assess the impact of tumor site, histology, and treatment, the outcome of children treated at the Institut Gustave Roussy was reviewed retrospectively. METHODS AND MATERIALS: Between 1975 and 1989, 80 children aged 4 months to 15.8 years were seen at the Institut Gustave Roussy for postoperative management of an intracranial ependymoma. Location of tumor was infratentorial in 63 cases and supratentorial in 17. Surgical treatment consisted of complete resection in 38, incomplete resection in 38 and biopsy only in 4. Postoperative irradiation was done in 65 patients and chemotherapy in 33. Surviving patients have been followed from 12-197 months with a median of 54 months. RESULTS: The 5-year actuarial survival and event-free survival are 56% and 38%, respectively. Thirty-four patients relapsed from 3-72 months after diagnosis (median 25 months). In 20 patients, the only site of failure was the original tumor site. Three patients failed locally and at distance, while 10 others failed only at distance. Survival at 5 years was significantly better for patients who had complete resection of the tumor (75% vs. 41%, p = 0.001) and for those who received radiation therapy (63% vs. 23%, p = 0.003). Event-free survival at 5 years was superior in patients with complete resection of the tumor (51% vs. 26%, p = 0.002) and in patients who received radiation therapy (45% vs. 0%, p < 0.001). Sex and tumor site had no impact on survival or event-free survival. There was no difference in survival, event-free survival, or pattern of failure between patients treated with local field, whole brain or craniospinal irradiation, while severe longterm sequelae were noted predominantly in the latter two groups. CONCLUSION: Considering that failures were predominantly local and that there was no apparent benefit from prophylactic irradiation, we recommend local field irradiation with doses above 50.0 Gy for all children with intracranial ependymomas, without meningeal dissemination at diagnosis. Special considerations are necessary for children < 3 years of age.

Adolescent↗
PubMed1994

Giant cell arteritis.

Giant cell arteritis is a form of vasculitis affecting medium- and large-size arteries, with a predilection for vessels arising from the aortic arch. The origins of giant cell arteritis are unknown. However, ethnic affinities are prominent, with the majority of cases involving white, elderly patients. In addition, there is evidence of a familial pattern and an association with HLA-DR4, suggesting a genetic predisposition in select cases. With an increase in the elderly population, clinicians must become cognizant of this age-related malady and its treatment to ensure quality care for elderly patients.

Adrenal Cortex Hormones↗
PubMed1994

Respiratory tract eicosanoid measurement using microdialysis sampling and GC/MS detection.

Eicosanoids are important mediators in many physiological and pathophysiological conditions. Sampling the eicosanoids remains a challenge, particularly in the respiratory tract. We examined the possibility that microdialysis might offer a means for sampling the large airways which would provide profiles of local eicosanoid levels before and after challenge. Guinea-pigs were anesthetized by ip injection of urethane and a tracheotomy performed. Microdialysis probes were inserted 2 cm into the tracheal opening, and samples were collected for 1 h intervals over 5 h. Injections of arachidonic acid, leukotriene (LT) D4, or saline vehicle were made iv at the beginning of the third hour. Prostaglandins (PG) E2, D2, F2 alpha and 6-keto-F1 alpha and thromboxane (TX) B2 were determined by GC/MS. Significant post-treatment increases in levels were observed following the injection of arachidonic acid for all eicosanoids except 6-keto-PGF1 alpha. The greatest change was an 8.1-fold increase for PGD2 (P < 0.025) while the smallest change was a 3.5-fold increase for TXB2 (P < 0.025). Intravenous administration of LTD4 caused significant increases in levels of PGE2 (P < 0.025), PGF2 alpha (P < 0.05) and 6-keto-PGF1 alpha (P < 0.025) in the first hour after challenge. No increase was observed in control experiments following saline injection. These results indicate that microdialysis provides a useful methodology for sampling local eicosanoid production.

Animals↗
PubMed1994

Protection of mice and swine against infection with Actinobacillus pleuropneumoniae by vaccination.

CaCl2 and LiCl cell extracts and a crude hemolysin preparation were isolated from Actinobacillus pleuropneumoniae serotype 1 strain 4074 and tested for protection against A. pleuropneumoniae serotype 1 and 5 in mice. The LiCl cell extract adsorbed on AlPO4 and the crude hemolysin preparation adsorbed on Al(OH)3 showed a highly significant protection (P < 0.01) against both serotypes. Different vaccine preparations were used to immunize pigs by intra-muscular injection at days 0 and 14; the pigs were then challenged at day 21 by intra-tracheal inoculation of 1 x 10(8) colony forming units (CFU) of a serotype 1 strain 4074. A vaccine which combined the LiCl extract and the crude hemolysin preparation adsorbed on Al(OH)3 gave the best protection with no mortality and no sign of morbidity in the vaccinated pigs. In the other experimental groups which included a group immunized with a commercial bacterin, mortality, respiratory disease and extensive pulmonary lesions were noted. This mixture shows good potential as a vaccine against pleuropneumonia in pigs.

Actinobacillus Infections↗
PubMed1994

Primary chemotherapy in rhabdomyosarcomas and other malignant mesenchymal tumors of the orbit: results of the International Society of Pediatric Oncology MMT 84 Study.

PURPOSE: The MMT 84 multicentric prospective trial of the International Society of Pediatric Oncology (SIOP) was designed to (1) test the effectiveness of ifosfamide 3 g/m2 on days 1 and 2, vincristine 1.5 mg/m2 on days 1 and 14, and dactinomycin 0.9 mg/m2 on days 1 and 2 (IVA) repeated every 21 days; and (2) reduce late effects of treatment by reserving radiation therapy to the primary site for patients not achieving a complete response (CR) to primary chemotherapy. MATERIALS AND METHODS: Between 1984 and 1989, the MMT 84 study registered 34 children with nonmetastatic rhabdomyosarcomas (RMSs) and other malignant mesenchymal tumors (MMTs) of the orbit in this trial. RESULTS: The 4-year event-free survival rate is 62% +/- 9% (SD) and the 4-year survival rate 86% +/- 7% (SD). A total of 11 local recurrences occurred, 10 among 22 patients treated without initial radiation. Salvage of local failure was achieved in nine of 11 patients with the use of radiation and additional chemotherapy, but three later developed distant metastases and two have died. One isolated regional lymph node failure has occurred, while no patient relapsed with isolated distant metastases. Six of 12 patients who failed are alive with no evidence of disease from 16 to 50 months after relapse. The treatment was well tolerated in all patients, except for one with renal tubular acidosis and one who died of cardiotoxicity. Twelve patients remain in first remission without the use of radiation to the primary tumor from 27 to 84 months. CONCLUSION: Despite a higher incidence of local recurrence when treated by primary chemotherapy, early survival rates were not compromised and a significant number of patients avoided the late effects of radiation. However, longer follow-up is required to assess the ultimate outcome of patients treated in this manner.

Adolescent↗
PubMed1994

Vinorelbine (Navelbine) in the adjuvant and neoadjuvant treatment of non-small cell lung cancer.

Several Canadian centers are studying the favorable activity and toxicity profile of vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Médicament, Paris, France) in current and future trials of adjuvant and neoadjuvant treatment of non-small cell lung cancer. In locally advanced, unresectable disease, the 10-week regimen in cisplatin 100 mg/m2 during weeks 1 and 5, vinorelbine 30 mg/m2 weekly for 5 weeks with a 50% dose reduction planned for week 2 only, and accelerated fractionation thoracic irradiation during weeks 7 to 10 (30 fractions of 2 Gy in 4 weeks, once daily during weeks 7 and 8, and twice daily during weeks 9 and 10). Preliminary data on 17 patients who have completed treatment to date show it has been well tolerated, with only four cases of grade 3 nonhematologic toxicities. Favorable results from combined therapy with cisplatin and vinorelbine in advanced disease have led the National Cancer Institute of Canada Clinical Trials Group to consider testing adjuvant cisplatin and vinorelbine in completely resected non-small cell lung cancer. Surgically staged patients with T2, N0 and T1-2N1 tumors will be stratified according to nodal status and presence or absence of ras oncogene mutations in resected tumor DNA. Patients will be randomized to observation or a 16-week trial of adjuvant chemotherapy with cisplatin 50 mg/m2 days 1 and 8 every 4 weeks during the 16 weeks, and vinorelbine 30 mg/m2 weekly for 16 weeks. All resected tumors will be banked for further correlative studies to identify a clinically meaningful panel of molecular prognostic markers.

Antineoplastic Agents↗
PubMed1994

[Bereavement evolution in mothers and families after perinatal death].

Semi-structured interviews were conducted with 33 mothers one to 9 years after the death of a child in the perinatal period: 15/33 mothers (45.5%) are dissatisfied with care givers attitudes, 8/33 (24.2%) showed pathological grief reactions, 11/29 (37.9%) had established a pathological relationship with at least one of their living children, 5/29 (17.2%) were in disagreement with the child's father. Univariable analysis of interviews and obstetrical data showed that some factors where significantly correlated with pathological evolution. The relative risk (RR) of mothers' dissatisfaction was significantly decreased by positive attitudes: support by their obstetrician (RR 0.22, p < 0.01), by midwives and nurses (RR 0.24, p < 0.05), showing the dead baby (RR 0.39, p < 0.05), and increased by caregivers negative altitudes RR 13.18 p < 0.01) as well as by a concurrent bereavement (RR 2.29, p < 0.05). Pathological grief was more frequent amongst foreign culture mothers (RR 5.25, p < 0.01). Pathological mother-child relationships were increased by negative attitudes (RR 8.13, p < 0.05), by dissatisfaction (RR 4.82, p 0.01), by another bereavement (RR 2.86, p < 0.05) and decreased by seeing the dead baby (RR 0.35, p < 0.05) and understanding the cause of the death (RR 0.35, p < 0.05).

Analysis of Variance↗
PubMed1993

Immobility in the aged.

Bed rest has historically been used therapeutically in the management of many chronic maladies prevalent in elderly persons. Unfortunately, the deleterious consequences of immobility predispose elderly persons to significant functional decline and reduced quality of life. Prolonged inactivity reduces the physiologic reserve of most organ systems, particularly the musculoskeletal and cardiopulmonary systems. Consequently, muscle weakness, contracture formation, postural hypotension, and thrombogenic events are common in bed-bound patients. Fortunately, contemporary studies have dispelled the myth that inactivity fosters healing and have suggested techniques that may prevent immobility-induced dysfunction and ensure beneficial outcome in fragile and aging populations.

Aged↗
PubMed1993

Comparison between patient-controlled analgesia and intramuscular meperidine after thoracotomy.

A prospective randomized controlled study was performed to assess the efficacy and safety of patient-controlled analgesia (PCA) in patients undergoing thoracotomy. This method was compared with a conventional pain management technique consisting of regularly scheduled im injections of analgesics. Forty adult patients were randomly assigned to receive intravenous PCA or im meperidine treatment over a 48-hr period after surgery. Care was taken to optimize analgesia in patients of both groups. The McGill Pain Questionnaire, visual analogue and verbal-numeric scales were administered at regular intervals to measure various components of the patients' pain experience, degree of pain relief, adverse side effects and overall treatment efficacy. Functional recovery after surgery was also examined. The results showed good and comparable analgesia with both pain-control methods. However, a greater number of patients receiving im injections required dosage adjustments than in the PCA group. Patients' and nurses' evaluations of overall treatment efficacy also favoured PCA treatment. There were no major group differences in the side effect profile. Recovery pattern was also comparable in the two groups except for the length of hospitalisation. There were fewer long-stay patients in the PCA than in the im group. Meperidine intake was similar in both groups but considerable interpatient variation was seen. In conclusion, PCA is a safe, effective and individualized treatment method for controlling pain after thoracotomy. There appears to be some clinical advantages of PCA over im dosing regimens for analgesia after thoracotomy.

Adult↗
PubMed1993

Post-traumatic pancreatic pseudocyst: non-operative conservative management--report on 3 cases.

The authors report on 3 cases of post-traumatic pancreatic pseudocysts in children. Complete healing occurred with non-operative conservative treatment and total parenteral nutrition. Daily follow-up with clinical evaluation, abdominal ultrasound and lab exams are detailed under definite criteria of selection and follow-up. This mode of treatment might be considered as an alternative to exploratory laparotomy and external drainage.

Amylases↗