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A Beaupré

Publications and source records attributed to A Beaupré.

At least 19 recordsLinked to original sources
PubMed2005

Self-management reduces both short- and long-term hospitalisation in COPD.

The aim of the present study was to assess the long-term impact on hospitalisation of a self-management programme for chronic obstructive pulmonary disease (COPD) patients. A multicentre, randomised clinical trial was carried out involving 191 COPD patients from seven hospitals. Patients who had one or more hospitalisations in the year preceding study enrolment were assigned to a self-management programme "Living Well with COPD(TM)" or to standard care. Hospitalisations from all causes were the primary outcome and were documented from the provincial hospitalisation database; emergency visits were recorded from the provincial health insurance database. Most patients were elderly, not highly educated, had advanced COPD (reflected by a mean forced expiratory volume in one second of 1 L), and almost half reported a dyspnoea score of 5/5 (modified Medical Research Council). At 2 years, there was a statistically significant and clinically relevant reduction in all-cause hospitalisations of 26.9% and in all-cause emergency visits of 21.1% in the intervention group as compared to the standard-care group. After adjustment for the self-management intervention effect, the predictive factors for reduced hospitalisations included younger age, sex (female), higher education, increased health status and exercise capacity. In conclusion, in this study, patients with chronic obstructive pulmonary disease who received educational intervention with supervision and support based on disease-specific self-management maintained a significant reduction in hospitalisations after a 2-year period.

Aged↗
PubMed1992

Effect of negative pressure ventilation in severe chronic obstructive pulmonary disease.

The hypothesis that patients with chronic obstructive pulmonary disease (COPD) have chronic inspiratory muscle fatigue was tested in an effectiveness trial in which negative pressure ventilation (NPV) was used to produce inspiratory muscle rest. In a double-blind study 184 patients with severe COPD were randomly allocated active or sham NPV treatment for a 12-week period of home use. The distance walked in a 6 min walk test was the primary outcome variable. Secondary outcome measures were cycle exercise endurance time, severity of dyspnoea, quality of life, arterial blood gas tensions, and respiratory muscle strength. The percentage reduction in amplitude of the diaphragmatic electromyographic signal multiplied by hours of NPV was used to reflect the dose of NPV so we could examine dose-response relations. Analysis was based on intention to treat. We found no evidence of a clinically or statistically significant difference in any outcome measure between active and sham groups. No dose-response relation was observed. Moreover, the intervention was poorly accepted despite substantial clinical support. We conclude that NPV as used in this study is difficult to apply and ineffective when used with the aim of resting the respiratory muscles in patients with stable COPD.

Aged↗
PubMed1988

Respiratory center output following zopiclone or diazepam administration in patients with pulmonary disease.

Mouth occlusion pressure at 0.1 s (P0.1) and minute ventilation (VE) were measured at rest and during progressive hypercapnia in 32 patients. Under double-blind conditions and according to a 2 x 2 Latin-square design, half the patients received one oral dose of diazepam and its placebo. Using the same design, the other half received zopiclone and its placebo. Normocapnic and moderately hypoxemic patients between the ages of 21 and 69 with moderate to severe chronic obstructive pulmonary disease were included in the study. Diazepam produced a statistically significant decrease (p less than 0.05) over its placebo in delta P0.1/delta PETCO2 values following CO2 rebreathing. Zopiclone did not influence either delta P0.1/delta PETCO2 or delta VE/delta PETCO2, but produced a significant increase in respiratory frequency. However, no statistically significant differences were observed between the two active treatments.

Adult↗
PubMed1987

Death in asthma.

Explore the source record for details and available documents.

Asthma↗
PubMed1986

The Canadian experience with pulsed magnetic fields in the treatment of ununited tibial fractures.

A clinical survey of 56 patients was conducted at four different centers in Canada to evaluate the effect of extremely low frequency pulsed magnetic fields (PMF) on ununited fractures of the tibia. All ten patients with delayed union and 84% of the 44 patients with nonunion healed. One case with a traumatic pseudarthrosis and one with a congenital pseudarthrosis failed to respond to treatment. These results compare favorably to those reported by others using a system with different pulse characteristics. Prolonged immobilization is necessary and poses problems of rehabilitation. Nonunions with a gap between the tibial fragments and pseudarthroses are better treated with bone grafting and internal fixation prior to electrical stimulation.

Adolescent↗
PubMed1986

Knee menisci. Correlation between microstructure and biomechanics.

Light and scanning electron microscopy techniques were used to define the microstructure of human knee menisci. Two structurally different regions were shown: a mesial part that included the innermost two thirds and a peripheral part formed by the remaining outer one third. The organization of collagen bundles of the mesial part demonstrated a radial pattern. Those of the peripheral part were larger and circumferential. The articular surfaces of the mesial part were lined by thinner bundles parallel to the surface, while the outer portion was covered by synovium. This structural organization suggested specific biomechanical functions: mainly compression mesially with tension peripherally and a direct translation of forces from the inner wedge-shaped part to the outermost region. The covering layer is well suited for surface to surface motion. Outward displacement of the menisci by the femoral condyles is resisted by solid anchorage of the peripheral circumferential fibers to the intercondylar bone. The resistance to such displacement would force the femoral condyles inwards. Such an organization of menisci has implications in knee joint stability and in the pathology of meniscal injuries.

Biomechanical Phenomena↗
PubMed1982

Factors influencing the bronchodilator effect of a deep inspiration in asthmatic patients with provoked bronchoconstriction.

We have studied 26 asthmatic patients in whom deep inspiration induced a transient but marked bronchodilatation when carbachol-induced bronchoconstriction was present. Changes in bronchial tone were assessed by specific airway resistance measurements. Bronchodilatation after a slow inspiration (eight subjects) or a 10-second breath-hold at total lung capacity (13 subjects) was significantly less than that observed after either a fast inspiration or no breath-holding period. The magnitude of the bronchodilatation induced by a fast inspiration without breath-holding was directly and significantly related to the magnitude of the carbachol-induced bronchoconstriction in five subjects.

Adult↗
PubMed1981

Histamine dose-response curves in asthma: relevance of the distinction between PC20 and reactivity in characterising clinical state.

The aim of the present study was to determine if the measurement of the slope of teh histamine dose-response curve (bronchial reactivity) could provide useful information on the clinical state of asthma. Fifteen adult asthmatic subjects were studied twice at an interval of one year. Their clinical state was assessed by comparing their respiratory symptoms, need for medication, and FEV1 on both visits. Histamine inhalation challenges were carried out in a similar manner both times using a standardised procedure. PC20FEV1 (the histamine concentration causing a 20% fall of FEV1) and reactivity were obtained from the dose-response curves. AS others have shown, we found that PC20FEV1 reflects clinical state. Indeed, changes of PC20FEV1 greater than a single two-fold dilution of histamine were shown by five of six patients who were not in a steady clinical state, and by none of the nine patients who were. Changes of PC20FEV1 were significantly (p less than 0.005) more important in those who were not in a steady state in comparison with those who were. The reproducibility of reactivity was slightly better in those individuals who were in a steady clinical state as compared with those who were not. Nevertheless, changes in reactivity did not allow significant differentiation between the two groups of subjects. We conclude that PC20FEV1 is a more helpful index than reactivity in characterising the clinical state of asthmatics.

Adolescent↗
PubMed1981

[A study of the menisci of the knee by scanning electron microscopy (author's transl)].

Sixty menisci have been studied by scanning electron microscopy. In the frontal plane of the middle third of the meniscus, two distinct parts can be discerned - a central part corresponding to the medial two thirds and a peripheral part corresponding to the lateral third. Collagen fibres can be arranged in four different ways; radial fibres in the central portion; a marginal area underlying each surface of the meniscus made up of mixed collagen fibres; circumferential fibres in the peripheral part and a fascicular layer of fibres made up of loose connective tissue arising from the articular capsule and penetrating into the circumferential fibrous layer. The authors consider that the radial fibres are best adapted to pressure, whilst circumferential fibres are submitted to traction forces; the marginal areas are best adapted to gliding forces. Both menisci comprise a single functional unit.

Biomechanical Phenomena↗
PubMed1979

[Morphology and deformability of erythrocytes in muscular dystrophy].

In recent years, the presence of red cell morphological abnormalities in patients with Muscular Dystrophy has made the object of numerous, often contradictory reports. A possible source of such confusion may lie in the fact that human erythrocytes are extremely sensitive to morphologic transformations resulting from various manipulations or environmental conditions in vitro. We have examined the morphology and deformability of erythrocytes from 7 patients with Duchenne and 9 patients with Steinert (myotonic) Muscular Dystrophy. To avoid preparation artifacts, fresh, unwashed red cells suspended in their own plasma were examined under phase contrast microscopy for the presence of either echinocytes and stomatocytes. Deformability was measured by filtration of dilute cell suspensions at constant flow rate through nucleopore membranes (nominal pore diameter = 3 micrometer). No significant difference was found between the patients' cells and those of 22 healthy volunteer controls. We conclude that previously reported abnormalities may have been the result of preparation artifacts. It appears possible, however, that erythrocytes from Muscular Dystrophy patients may be more sensitive than normal ones to certain stimuli originating from red cell manipulations in vitro.

Erythrocytes↗
PubMed1979

Comparison of histamine bronchial challenges with the Wright nebulizer and the dosimeter.

In twenty adult asthmatics studied in a stable state, histamine bronchial challenges were carried out at one-week intervals with the Wright nebulizer and with the dosimeter-DeVilbiss apparatus. Dose-response curves were analysed for sensitivity, defined as the minimal histamine dose causing a 20% fall in FEV1 (PC20), and for reactivity, defined as the slope of the dose-response curve once the reaction starts to occur. A significant relationship (r=0.80) was found for the sensitivity obtained with the two nebulizers. PC20 was indeed reproducible within a two folds concentration of histamine in sixteen of the twenty patients. A significant difference (P less than 0.01) was found in the reactivity to the two different apparatus, reactivity being greater with the Wright nebulizer in twelve out of fifteen patients so tested. Sensitivity and reactivity showed a borderline relationship (r=0.47) with the Wright nebulizer but not with the dosimeter. A significant correlation (P less than 0.05) was found to exist between the initial FEV1 (in % of the predicted value) and the observed sensitivity and reactivity as assessed with the Wright nebulizer, but not as assessed with the dosimeter. We conclude that histamine bronchial challenges with the Wright nebulizer and with the dosimeter yield reproducible results if the threshold of a 20% fall in FEV1 is taken as positive. However, the two methods produce different results in terms of reactivity.

Adolescent↗
PubMed1979

The three syndromes of iliac osteomyelitis in children.

Iliac osteomyelitis was diagnosed, in many cases after considerable delay, in twenty (2.3 per cent) of 867 children with hematogenous osteomyelitis. In ten patients coagulase-positive Staphylococcus aureus was identified. The symptoms and signs of iliac osteomyelitis depend on the direction of spread of the inflammation. The children presented with one of these syndromes: gluteal, abdominal, or lumbar disc. The diagnosis can be established early be careful physical examination: manual compression of the pelvis produces pain on the affected side, and palpation reveals tenderness over over the site of infection. The inflammatory process can be located even in early cases on a bone scan with radioactive technetium. When diagnosed early, the infection can be cured with intensive intravenous antibiotic therapy alone.

Adolescent↗
PubMed1978

[Morphology and deformability of erythrocytes in muscular dystrophy].

In recent years, the presence of red cell morphological abnormalities in patients with Muscular Dystrophy has made the object of numerous, often contradictory reports. A possible source of such confusion may lie in the fact that human erythrocytes are extremely sensitive to morphologic transformations resulting from various manipulations or environmental conditions in vitro. We have examined the morphology and deformability of erythrocytes from 7 patients with Duchenne and 9 patients with Steinert (myotonic) Muscular Dystrophy. To avoid preparation artifacts, fresh, unwashed red cells suspended in their own plasma were examined under phase contrast microscopy for the presence of either echinocytes and stomatocytes. Deformability was measured by filtration of dilute cell suspensions at constant flow rate through nucleopore membranes (nominal pore diameter = 3 micron). No significant difference was found between the patients' cells and those of 22 healthy volunteer controls. We conclude that previously reported abnormalities may have been the result of preparation artifacts. It appears possible, however, that erythrocytes from Muscular Dystrophy patients may be more sensitive than normal ones to certain stimuli originating from red cell manipulations in vitro.

Adolescent↗