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Biomedical subjects

C Chapuis

Publications and source records attributed to C Chapuis.

17 recordsLinked to original sources
PubMed2005

[Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

OBJECTIVES: In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. MATERIAL AND METHOD: The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. RESULTS: 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p < 0.001) and from 2.2% to 0.9% (p < 0.001). This evolution was compared with the evolution of collected risk factors. CONCLUSION: In spite of the methodology limits, general value of surveillance and infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

Adolescent↗
PubMed2005

[Acute pulmonary edema during nicardipine and salbutamol therapy for preterm labor in twin pregnancy].

We report the case of a 38-year-old parturient at 30 weeks 2 days term of a multiple pregnancy who experienced acute pulmonary edema more than 48 hours after tocolytic treatment with nicardipine and salbutamol. The patient was transferred from a level 1 perinatal center to a level 3 perinatal center by the Grenoble mobile intensive care unit in application of the in utero transfer protocol for preterm labor before 33 weeks with twin pregnancy. This case illustrates the risk of tocolytic treatment and potential adverse effects in the event of preterm labor on twin pregnancy. The question of associating a second tocolytic after failure of the first is also raised.

Adult↗
PubMed2004

[Management of infectious risk associated with therapeutic pools].

UNLABELLED: There is no specific legislation concerning pools and others medical hydrotherapy equipments relating hygiene and security rules. For this reason, the hydrotherapy pools use the public swimming pools legislation. METHOD: This article is based on literature review (database Medline and Embase--manual research). RESULTS: This article offers a review of pool associated infections along with the description of the measures designed to minimise the possible transmission of infection during hydrotherapy activities such as: Technical measures: pool and premises conception, water treatments, feed tanks, air quality. Hygiene rules for patients and hospital staff and pathologies which are contra-indications to hydrotherapy activities. Microbiological and physico-chemical monitoring. DISCUSSION: The infectious risk remains low with therapeutic pools. However, the development of specific legislation and surveillance should be enhanced. CONCLUSION: All these measures are part of the quality assurance program that must be implemented to control the safety of these installations.

Equipment Contamination↗
PubMed2003

Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial.

OBJECTIVE: To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue. DESIGN: Double blind randomised placebo controlled trial. SETTING: Academic primary care centre and eight general practices in western Switzerland. PARTICIPANTS: 144 women aged 18 to 55, assigned to either oral ferrous sulphate (80 mg/day of elemental iron daily; n=75) or placebo (n=69) for four weeks. MAIN OUTCOME MEASURES: Level of fatigue, measured by a 10 point visual analogue scale. RESULTS: 136 (94%) women completed the study. Most had a low serum ferritin concentration; <or= 20 microg/l in 69 (51%) women. Mean age, haemoglobin concentration, serum ferritin concentration, level of fatigue, depression, and anxiety were similar in both groups at baseline. Both groups were also similar for compliance and dropout rates. The level of fatigue after one month decreased by -1.82/6.37 points (29%) in the iron group compared with -0.85/6.46 points (13%) in the placebo group (difference 0.95 points, 95% confidence interval 0.32 to 1.62; P=0.004). Subgroups analysis showed that only women with ferritin concentrations <or= 50 microg/l improved with oral supplementation. CONCLUSION: Non-anaemic women with unexplained fatigue may benefit from iron supplementation. The effect may be restricted to women with low or borderline serum ferritin concentrations.

Adolescent↗
PubMed2001

Asymmetric induction in the [4+2]cycloaddition of cyclopentadiene and furan to chiral derivatives of fumaric acid.

[4+2]Cycloaddition reactions of cyclopentadiene (1a) and furan (1b) to N,N'-fumaroyldi[(2R)-bornane-10,2-sultam] (2) and to N,N'-fumaroyldi[(2R)-bornane-10,2-(2'-phenyl-pyrazol-3'-one)] (3) are presented. A correlation between the solvent polarity and the logarithm of the diastereoisomer ratio (dr) was found for the uncatalyzed [4+2]cycloaddition of 1a to 3.

Journal Article↗
PubMed1999

The Distance to the Soft Gamma Repeater SGR 1627-41.

We report millimeter observations of the line of sight to the recently discovered soft gamma repeater SGR 1627-41, which has been tentatively associated with the supernova remnant (SNR) G337.0-0.1. Among the eight molecular clouds along the line of sight to SGR 1627-41, we show that SNR G337.0-0.1 is probably interacting with one of the most massive giant molecular clouds (GMCs) in the Galaxy, at a distance of 11 kpc from the Sun. Based on the high extinction to the persistent X-ray counterpart of SGR 1627-41, we present evidence for an association of this new soft gamma repeater (SGR) with the SNR G337.0-0.1; they both appear to be located on the near side of the GMC. This is the second SGR located near an extraordinarily massive GMC. We suggest that SGR 1627-41 is a neutron star with a high transverse velocity ( approximately 1000 km s-1) escaping the young ( approximately 5000 yr) SNR G337.0-0.1.

Journal Article↗
PubMed1996

An economic approach to the MIC.

The determination of the Inhibitory Concentration in Diffusion (ICD) is proposed as an alternative to the agar dilution Minimal Inhibitory Concentration (MIC) that is time-consuming and cumbersome for routine use. Based on the technique of the disk diffusion test, it consists in calculating a continuous variable, the ICD, corresponding to the antibiotic concentration in the agar at the edge of the inhibition zone. Six antibiotics were tested (ampicillin, cefotaxime, erythromycin, gentamicin, nalidixic acid and rifampicin) each against 17 to 51 strains of enterobacteria, Staphylococcus aureus and Enterococcus spp. and six other antibiotics (cefsulodin, ceftazidime, imipenem, piperacillin, ticarcillin and tobramycin), against 13 to 25 strains of Pseudomonas aeruginosa. A total of 284 antibiotic-strain combinations were tested. Three different antibiotic charges were obtained for each antibiotic by cutting commercial disks in two and four equal pieces. The ICD was calculated for each strain from the size of inhibition zones around a full disk, a half and a quarter of a disk. Concurrently, the MIC was performed, using a conventional agar dilution method. There was a good correlation between the two methods and reproducibility for the ICD proved to be correct. This reliable technique is very efficient both in terms of laboratory time and cost of materials and could be proposed for widespread use in clinical laboratories.

Ampicillin↗
PubMed1994

Mathematical model of the interactions between Micrococcus spp. and Pseudomonas aeruginosa on agar surface.

The interactions between six different Micrococcus species and two strains of Pseudomonas aeruginosa were studied on an agar surface. This type of interaction on solid surface could act as a model of situations occurring either in the environment, in food or in man. The hypothesis of an amensalistic relationship between a Micrococcus spp. and Pseudomonas aeruginosa, due essentially to Ps. aeruginosa bacteriolytic enzymes, is retained as the basis for a mathematical model of the variations of the colony surface of Micrococcus spp. (S) with respect to the distance (d) from Ps. aeruginosa cells. The diffusion of the bacteriolytic substance in agar explains the limitation of the growth of the Micrococcus spp. This model S = Smax (1-e-md2) is shown to be adapted to all the interactions studied.

Agar↗
PubMed1994

[Post-antibiotic effect of three aminoglycosides against Klebsiella pneumoniae].

This paper introduces a new method to quantify post antibiotic effect. This method was applied to the study of the effect of three aminoglycosides antibiotics on seven strains of Klebsiella pneumoniae. The antimicrobial was removed by filtration, washing with peptone broth and neutralization by heparin. Growth curves were monitored by automated measurement of optical density with Urimat-ATB (bioMérieux). The inoculum fluctuation bias was eliminated with the help of a mathematical analysis of results. Absence of carry-over was controlled for each bacteria-antibiotic combination. A significant post antibiotic effect was observed with the three antibiotics after 2 hours exposure to a concentration equivalent to 2 x MIC. There was no significant difference between the 3 aminoglycosides tested.

Amikacin↗
PubMed1993

A randomised controlled trial of a low-molecular-weight heparin (Enoxaparin) to prevent deep-vein thrombosis in patients undergoing vascular surgery.

The incidence of postoperative deep vein thrombosis (PDVT) after aortic surgery and lower limb revascularisation has not been assessed by a large prospective study. In a prospective randomised trial the effect of a low-molecular-weight heparin fragment, Enoxaparin (ENX) 4200 anti factor Xa IU once daily was compared to that of unfractionated heparin (UFH) 7500 IU twice daily. Two hundred and thirty-three consecutive patients were classified into three groups, aortic or aortoiliac and aneurysmectomy (n = 75), aorto-femoral bypass for atherosclerotic disease (n = 71), and femoropopliteal or femorodistal bypass (n = 87). Patients were analysed for development of deep vein thrombosis by Duplex scanning and, if positive, by venography between the seventh and tenth postoperative day. PDVT was present in 10 patients in the ENX group and in four patients in the UFH group (8.2 and 3.6% respectively, NS). The incidence of PDVT was 8% after aortic or aortoiliac aneurysmectomy, 7% after aortofemoral revascularisation, and 3.4% after femoropopliteal or femorodistal bypass. The overall incidence of PDVT after aortic surgery was 7.5% (95% CI 5.4-9.7). There was no pulmonary embolism. Intra-operative blood loss and postoperative bleeding events did not differ significantly between the ENX and UFH groups. After 1 month follow-up, no clinical event or death could be related to PDVT or pulmonary embolism. In conclusion, in vascular surgery ENX is as safe and effective in the prevention of PDVT as is UFH.

Aged↗
PubMed1992

[The role of practitioners in pre- and postgraduate education of internal medicine and general medicine].

The gap between medical teaching based on hospital experience and ambulatory medical practice is widening. This may be one of the reasons why the number of students who are candidates to be trained in internal medicine and/or family practice is now decreasing. Some of the means which could help to reverse this trend (increased use of ambulatory settings, increased interaction between students and practitioners, development of research in medical practice, stronger links between internal medicine and family practice) are discussed.

Education, Medical, Graduate↗
PubMed1990

Two cases of severe infection with beta-haemolytic group A streptococci associated with a toxic-shock-like syndrome.

Two cases of severe infection due to Streptococcus pyogenes associated with a toxic-shock-like syndrome (TSLS) and also with serious soft-tissue infection are described. Serotyping and detection of A, B and C exotoxins were carried out on strains isolated from blood cultures and skin samples. The strain of serotype M1 T1, which produced 10 ng/ml of exotoxin A and also synthesised exotoxins B and C, caused severe TSLS associated with major skin lesions. The second strain of serotype M12 T12, which produced only 1 ng/ml of exotoxin A and synthesised exotoxin B, was associated with clinical manifestations of adult respiratory distress syndrome. The relationship between the magnitude of exotoxin production and the severity of clinical manifestations cannot be established from these two cases.

Adult↗
PubMed1978

Treatment of mediastinitis in children after cardiac surgery. A study of 20 cases.

Twenty-three cases of mediastinitis after cardiac surgery in children were treated by us between 1973 and 1976. Three patients died within 6 hours of admission. Treatment used in the tweny other cases are discussed. The mean age of the patients was three years and three months. The mediastinitis was evident an average of twelve days after extracoporeal circulation. A staphylococus was always responsible for the infection. Treatment was a combination of surgery, antibiotics and respiratory and nutritional supplies. The surgical treatment consisted of a careful mediastinal cleansing with resection of the sternal edges. In fifteen patients the thorax was closed after surgery, and an irrigation system installed using a solution of 4% Dakin in physiologic saline. Recovery was simple in 5 patients. In the 10 other patients of this group the thorax had to be reopened; one patient died after 90 days from Serratia marcescens endocarditis. The thorax was left open initially in five patients: one patient of this group died from candida endocarditis. All patients needed endotracheal ventilation through a nasotracheal tube (7 to 90 days of ventilation). Treatment with bactericidal antibiotics was pursued for three months and a monotherapy was kept for nine months. After reviewing the observed complications, our methods and results are compared with others in the literature.

Child↗