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Biomedical subjects

C Barbe

Publications and source records attributed to C Barbe.

14 recordsLinked to original sources
PubMed2001

[The education level of elderly diabetics].

OBJECTIVE: The education of diabetic subjects has been the object of numerous studies which have demonstrated its importance as an integral part of treatment. Few studies have focused on the particular problem of education in the elderly. PATIENTS AND METHODS: An inquiry was conducted in 60 elderly patients with diabetes in order to assess their knowledge of the disease, comparing those who had received specific education and those who had not, and to determine the characteristic features of patients who had received education. A specific questionnaire was designed for this study. The maximal score was 50. RESULTS: Mean age of the 60 patients was 77 years (range 65-94). Lack of knowledge was most patent concerning acute metabolic decompensation with hypoglycemia an hyperglycemia and concerning foot care. Only one-third of the patients had received diabetic education. The average score in the educated group was 42 +/- 0.4 versus 23 +/- 7 in the non-educated group (p = 0.0001). The best results were obtained in educated and younger patients. The inquiry showed that education had been distributed preferentially to the youngest patients, to men, and to patients treated with insulin. CONCLUSIONS: Our findings demonstrate that elderly diabetics can benefit from an education program and prove a real insufficiency in current education of elderly diabetics. These results should also lead to further work on an educational tool specifically designed for elderly diabetics.

Aged↗
PubMed1999

Accurate guidance for percutaneous access to a specific target in soft tissues: preclinical study of computer-assisted pericardiocentesis.

In the field of percutaneous access to soft tissues, our project was to improve classical pericardiocentesis by performing accurate guidance to a selected target, according to a model of the pericardial effusion acquired through three-dimensional (3D) data recording. Required hardware is an echocardiographic device and a needle, both linked to a 3D localizer, and a computer. After acquiring echographic data, a modeling procedure allows definition of the optimal puncture strategy, taking into consideration the mobility of the heart, by determining a stable region, whatever the period of the cardiac cycle. A passive guidance system is then used to reach the planned target accurately, generally a site in the middle of the stable region. After validation on a dynamic phantom and a feasibility study in dogs, an accuracy and reliability analysis protocol was realized on pigs with experimental pericardial effusion. Ten consecutive successful punctures using various trajectories were performed on eight pigs. Nonbloody liquid was collected from pericardial effusions in the stable region (5 to 9 mm wide) within 10 to 15 minutes from echographic acquisition to drainage. Accuracy of at least 2.5 mm was demonstrated. This study demonstrates the feasibility of computer-assisted pericardiocentesis. Beyond the simple improvement of the current technique, this method could be a new way to reach the heart or a new tool for percutaneous access and image-guided puncture of soft tissues. Further investigation will be necessary before routine human application.

Animals↗
PubMed1997

Computer assisted pericardial puncture: work in progress.

Until now, computer assisted surgery has focused primarily on surgical procedures involving rigid anatomical structures. Because soft tissues can be highly mobile and deformable, they may require specific imaging devices, suitable modeling tools, and guiding systems. Percutaneous pericardial puncture is a good clinical target for computer assisted surgery; this procedure is often performed without direct visualization and is dangerous even though echographic control is used. Computer assistance can greatly improve this technique and will allow accurate puncture of preplanned targets. This paper describes a new approach for computer assisted pericardial punctures (CASPER) and describes a first feasibility analysis of CASPER demonstrated with anesthetized animals. The approach is based on the use of echographic data localized in space, from which an optimal strategy is defined. Because of the specificity of the pericardial effusion, a stable target can be selected despite the heart motions. A passive guiding system is used. We have demonstrated the feasibility of the approach.

Animals↗
PubMed1978

Somatostatin in mucosa of stomach and duodenum in gastroduodenal disease.

In order to study the distribution of somatostatin in the upper digestive tract in man, biopsies were taken through endoscopy or at surgery from the fundus, antrum, and duodenal bulb in 15 subjects with no gastroduodenal lesion, 12 patients with severe antral and/or fundic atrophy in the sampling area, 28 patients with an active duodenal ulcer, and 14 patients with a nonmalignant gastric ulcer. The specimens were extracted in 2 N acetic acid and tested for somatostatin content with a specific radioimmunoassay. In the control subjects, the somatostatin concentration (nanograms per milligram of wet weight) was 0.60 +/- 0.12 in the fundus, 1.68 +/- 0.33 in the antrum, and 1.35 +/- 0.30 in the duodenal bulb. Atrophy of the gastric mucosa was associated with a reduction of the somatostatin concentration in the fundus and the antrum. No significant variation was observed in the present series of patients with gastric ulcer. Duodenal ulcer was associated with a reduction of the somatostatin concentration in the antrum (P less than 0.02). These results indicate that somatostatin is widely distributed from fundus to duodenal bulb in adult human subjects, and that lower antral concentrations are observed in patients with duodenal ulcer.

Adult↗
PubMedDate not supplied

[Stability of a lipid emulsion in formulations for total parenteral nutrition].

The complex nature of "all in one" formulas for TPN, makes it difficult to ensure the stability of the lipid emulsions in these preparations. Despite the fact that studies on this issue are increasing, official guidelines on maximum acceptable particle size and the methods to control it are still lacking. The objective of this study was to assess the stability of a lipid emulsion in four standard mixtures also containing amino acids, glucose or F-G-X, electrolytes and vitamins or trace elements. Lipid stability was assessed visually through electronic counts and microphotographs. The pH of mixtures ranges between 5.3 and 5.9, not changing with time nor storage temperature. Visual observation showed a possible rupture of the emulsion in one mixture after storing 96 hours at room temperature, but not when stored at 4 degrees C. Mean diameter of fat particles did not change. The percentage of droplets having a diameters under 1.2 micron was higher than 90%, although particles greater than 6 micron appeared in all mixtures. Micrographic observation revealed the presence of aggregates with a diameter greater than 8 microns in one mixture. According to the results obtained, one of the mixtures may be considered physically unstable. The clinical viability of this mixture and of the other three stable mixtures, depends on the limits considered acceptable regarding particle size. Due to the slight composition differences of the mixtures studied, it is difficult to explain the difference in behavior observed. Therefore, it would be adviceable to study standard "all in one" mixtures of known stability, while waiting for more conclusive studies to be performed, especially in the case of critical mixtures.

Drug Stability↗
PubMedDate not supplied

[Epidemic of pulmonary histoplasmosis after visiting a cave in New Caledonia].

We report an epidemic of acute pulmonary histoplasmosis which occurred in February 1994 among a group of 24 persons after they had once or twice visited a cave in New Caledonia. This study describes the physical and laboratory findings, which lead to the diagnosis of histoplasmosis. Each test was evaluated. All members of the group had a physical examination, early and late serological tests, pulmonary X-rays (including CT) and some had mycological examination of bronchoalveolar washes. Mycological investigations were made on samples collected from the cave. Histoplasmic skin testing was not possible. We defined a case as a person who visited the cave in January 1994, had evocative radiological features and at least four symptoms among the following: weakness, fever, headache, arthralgia, thoracic pains, dyspnea, cough and nausea. Of the 24 exposed persons, 7 cases were considered as severe, 8 cases as moderate, and 6 cases as mild, for a total of 21 cases and an attack rate of 87.5%. There was no progression towards disseminated histoplasmosis and no recorded death. The incubation period lasted from 5 to 17 days. The symptoms were divided into three groups. In the first group, the symptoms of fever, headache and arthralgia were common and nonspecific. In the second group, the symptoms of chest pain, cough, and dyspnea which often occurred later, were less common and more specific. In the third group, the symptoms of vomiting, diarrhea and dizziness were less common. The chest X-ray showed abnormalities in 100% of the cases, and in 11 of the 21 cases the characteristic finding was a miliary.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗