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Biomedical subjects

C Goulet

Publications and source records attributed to C Goulet.

At least 37 records · Page 2Linked to original sources
PubMed1996

Adverse effects of enalapril in the Studies of Left Ventricular Dysfunction (SOLVD). SOLVD Investigators.

In the Studies of Left Ventricular Dysfunction (LVD), enalapril or placebo was administered in a double-blind fashion to 6797 participants with ejection fraction < or = 0.35. During 40 months' average follow-up, 28.1% of participants randomized to enalapril reported side effects compared with 16.0% in the placebo group (p < 0.0001). Enalapril use was associated with a higher rate of symptoms related to hypotension (14.8% vs 7.1%, p < 0.0001), azotemia (3.8% vs 1.6%, p < 0.0001), cough (5.0% vs 2.0%, p < 0.0001), fatigue (5.8% vs 3.5%, p < 0.0001), hyperkalemia (1.2% vs 0.4%, p = 0.0002), and angioedema (0.4% vs 0.1%, p < 0.05). Side effects resulted in discontinuation of blinded therapy in 15.2% of the enalapril group compared with 8.6% in the placebo group (p < 0.0001). Thus enalapril is well tolerated by patients with LVD; however, hypotension, azotemia, cough, fatigue, and other side effects result in discontinuation of therapy in a significant minority of patients.

Aged↗
PubMed1996

Effects of transcutaneous electrical nerve stimulation on H-reflex and spinal spasticity.

The purpose of this study was to investigate the short-term effects of transcutaneous electrical nerve stimulation (TENS; 99 Hz; 250 ms pulses) on H-reflex and spinal spasticity. Considering the reflex hyperexcitability commonly displayed in spinal cord-injured subjects, it was hypothesized that repetitive low threshold afferent stimulation would have an inhibitory effect on the triceps surae H-reflexes which could also be reflected by a decrease in plantarflexor spasticity. Clonus, Achilles tendon reflex and modified Ashworth evaluations were performed on 14 spinal cord-injured subjects prior to and after 30 minutes' application of TENS. Non-parametric statistical analyses (n = 14; alpha = 0.05) failed to reveal significant effects of TENS on H-reflex amplitude. However, there was a significant decrease in scores for the Achilles tendon reflex and the modified Ashworth test. The clonus score decreased in most subjects post-TENS, although not in a statistically significant manner. The present pilot results thus suggest that TENS appears to be effective in reducing spinal spasticity, as measured clinically.

Adult↗
PubMed1995

Prenatal peer counseling: an answer to the persistent difficulties with prenatal care for low-income women.

Our intention in this article is to provide the reader with the theoretical framework of prenatal peer counseling. A second article describing a prenatal peer program that is functional in the province of Quebec will be presented subsequently with its outcomes and recommendations. However, before planning the implementation of such a program or even assessing its effectiveness, one must understand how peer counseling can be used as an assistive strategy and why it is perceived to be a community approach worth considering with pregnant women from poor socioeconomic backgrounds. This approach addresses most problems encountered when prenatal programs fail to meet the specific needs of these women. Principles of the therapeutic community and its derivatives are put forward to lay the theoretical foundation of prenatal peer counseling. The studies reviewed show that psychosocial variables associated with pregnancy outcome and poverty such as anxiety, social support, and self-esteem can be positively influenced through a prenatal peer counseling program. We strongly recommend that nurses working with low-income families consider prenatal peer counseling as an empowering strategy for mothers within a given community.

Counseling↗
PubMed1994

Comparison of the EMG power spectrum of the human soleus and gastrocnemius muscles.

The purpose of this study was to compare the behaviour of electromyographic (EMG) power spectrum statistics, mean power frequency (MPF) and median frequency (MF), across increasing force levels of the soleus (SO), gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) muscles. Surface EMG signals of these three muscles were recorded in 12 men and 10 women during both (1) ramp (single ongoing contractions with the force increasing linearly from 0 to 100% of the maximum voluntary contraction (MVC); and (2) step (steady force levels: 10, 20, 30, 40, 60 and 80% MVC) static (isometric) plantar flexions. Power spectral analysis of these signals was performed on single 256-ms windows at all of the above-mentioned force levels, for both types of contraction. The MF and MPF were calculated from each of the obtained spectra. A less pronounced increase in the MF or MPF was expected for the SO because of its higher type I fibre content. The main results are as follows: (1) similar behaviours were found in the value of MPF and MF across increasing force for the SO and GL muscles, while the GM gave rise to a different behaviour; (2) no difference was found between ramp and step contractions in the behaviour of either MF or MPF across force levels; and (3) different behaviours were observed between the MF and MPF across increasing force levels, for both ramp and step contractions. Our initial expectations were thus not confirmed. It is concluded that the present results support the hypothesis that the EMG power spectrum may be more sensitive to the diameter of the fibres than to the fibre type proportion of the triceps surae muscles. Furthermore, the sensitivity of the power spectrum statistics of a given muscle to the low-pass filter effect of its skin layer was also emphasized.

Adult↗
PubMed1994

Absence of consistent effects of repetitive transcutaneous electrical stimulation on soleus H-reflex in normal subjects.

Our purpose was to determine the effects of transcutaneous electrical nerve stimulation (TENS) on the soleus H-reflex amplitude in normal subjects. Eleven subjects were tested in five experimental sessions, the purpose of which was to compare the effects of 30 minutes of TENS delivered at either 50 or 99Hz (250 microseconds pulses) on a mixed (common peroneal nerve or CPN) versus a sensory (sural) nerve. The soleus H-reflex was elicited according to the classic protocol of Hugon (1973). Control values (Hctrl) were measured for 5 minutes prior to and for 10 minutes after the TENS was administered at twice the sensory threshold. No statistically significant session (treatment) effects (two-way ANOVAs for repeated measures; alpha = 0.05) resulted from the stimulation of the CPN or the sural nerve at 50 or 99Hz. However, although no specific trends were shown across all subjects, there was a definite tendency towards inhibition (> or = 10% Hctrl) of the H-reflex in 63% of the subjects after 30 minutes of TENS at 99Hz over the CPN, and in 50% of the subjects when TENS was applied over the sural nerve at 99Hz. The inherent variability of the H-reflex amplitude in normal subjects as well as the use of different stimulation paradigms and TENS parameters could explain the controversial findings present in the literature.

Adult↗
PubMed1994

{Importance and realization of expectations of the experience of childbirth in primaparas}.

The discrepancy between childbirth as planned and childbirth as actually experienced raises concerns about the consideration accorded to women's demands. This descriptive study examines the importance and fulfillment of primiparas' child-birth expectations. The sample was formed of 125 pregnant women recruited from groups attending prenatal classes in community health care centres. Participants completed structured prenatal and postnatal questionnaires about six variables related to childbirth experience: control, partner's support, nurse's support, pharmacological pain relief, obstetrical interventions, and first contact with the baby. Childbirth expectations are numerous and their importance varies from one woman to another. Also, their fulfillment varies depending on their nature and is rarely associated with the importance given to them by the woman. Overall, three variables, control, partner's support, and nurse's support were ranked equally as the most important by participants. Nurses should make more efforts to fulfill women's expectations and individualize their approach. They are instrumental in having this short but intensely meaningful event in a woman's life contribute to the development of a healthy identity as a mother.

Adult↗
PubMed1993

[Comparative study of two methods of holding premature infants: the kangaroo method versus the traditional method].

This study compared two methods of holding preterm infants: 1) the kangaroo, or skin-to-skin method (K) and 2) the traditional method, or normal handling (T). Skin temperature, heart rate, respiratory rate and oxygen saturation were monitored during both the kangaroo and the traditional handling methods. After testing with the two methods, the mothers indicated their satisfaction and preference. Sixty-one pairs of mothers and babies were tested once with the K method and once with the T method. The first method tested was determined at random: 50% began with K and 50% with T. Skin temperature, heart rate and respiratory rate were similar with both K and T methods. Whereas oxygen saturation was significantly lower (92.8% vs 90.5%, p < 0.0001) under the T method, time of testing was longer (29.5 min vs 25.3 min, p = 0.02) for the K method than for T method. In summary, the findings suggested that mothers preferred the K method because the cold stress factor was avoided, oxygenation was better maintained, and mothers felt closer to their infants.

Adolescent↗
PubMed1992

[Attentional requirements for preparing to return a serve in tennis].

Recent studies demonstrated that athletes use more efficient strategies than novices in sports with high perceptual requirements (Abernethy and Russel, 1984; Goulet et al., 1989; Starkes, 1987b). The aim of the present study was to investigate the attentional cost of information processing preceding action in tennis players of different calibers. The dual-task paradigm was used. The primary task consisted of identifying the type of serve (flat, slice, or top-spin) presented on 16-mm file. The secondary task was a manual response to an auditory probe. Results demonstrated that attentional requirements during information processing do not differ between experts and novices. Nevertheless, the experts' results on the primary task are significantly higher than those of novices, whether the primary task is performed alone or simultaneously with the secondary task. The attentional cost of information processed during the ritual phase of the serve is significantly higher than the costs for processing information from the preparation and execution of the serve. It appears, therefore, that attentional input effort is maximal before identification of the most important cues necessary for adequate performance.

Adult↗
PubMed1988

[Analysis of advance visual indices in receiving a tennis serve].

The aim of this study is to analyse the differential visual patterns of expert and non-expert tennis players preparing to return a tennis serve. Two 16 mm films were used for testing purposes; 27 services were delivered and recorded on each film. The subjects had to identify verbally the type of serve delivered. During film viewing, eye movements were recorded by an Eye Mark Recorder NAC V. Results revealed that the expert players seem to use cues from the general position of the body during the ritual phase and cues from the racquet position during the execution phase.

Adult↗
PubMed1986

Optimal detection of the progression of coronary artery disease: comparison of methods suitable for risk factor intervention trials.

To assess the best method of quantitating progression of coronary disease, we studied four measurements in 114 coronary segments from 35 medically treated patients from whom angiograms were obtained 5 years apart. Only stenoses of less than 70% that were visualized in nearly identical projections on both angiograms were evaluated. Vessel edges were measured by use of catheter calibration and an automated computer algorithm yielding two "absolute dimensions" (mean and minimum diameters) and two measurements (percent stenosis and atheroma area) that required a "normal reference" diameter. The coefficient of variation for repeated segment measurements was less for mean and minimum diameter than for percent stenosis and area of atheroma. The best measure of progression of coronary disease as determined by t test comparison of different methods was the change in mean diameter over time (6.7 +/- 14.1% decrease), whether calculated on a per coronary segment or per patient basis (p less than .001). Based on this measurement and its standard deviation of progression of coronary disease in this patient subset with relatively benign disease, it is estimated that 470 patients per group would be required for an interventional study to demonstrate a 33% reduction in disease progression (207 patients for 50% reduction) at a 95% confidence level and 90% power.

Cardiac Catheterization↗
PubMed1985

Spontaneous regression of coronary artery obstructions: incidence in 313 consecutive repeat angiograms.

We studied the incidence of reversibility of coronary obstructions in a consecutive series of 313 patients with nonoperated coronary artery disease catheterized twice 3 to 118 (mean 38) months apart. Recanalization was observed in three patients and regression from an initial less than 100% obstruction in six patients. Progression in a different location occurred in six of the nine patients who demonstrated one recanalized or one regressive lesion. We conclude that true regression is an infrequent event in the natural history of medically treated patients with coronary artery disease; moreover, the pathophysiology and clinical relevance of angiographic regression remain poorly defined.

Angina Pectoris↗
PubMed1984

Clinical and angiographic predictors of new total coronary occlusion in coronary artery disease: analysis of 313 nonoperated patients.

A new coronary artery occlusion was found in 98 of 313 consecutive patients (31%) with coronary artery disease treated medically who underwent catheterization twice, 39 +/- 25 months apart. Multivariate logistic regression displayed 8 independent predictors of new occlusion. Four were available at the time of the second angiogram: the interval between the 2 studies (p = 0.005), a decrease in ejection fraction (p less than 0.01), the appearance of bundle branch block (p less than 0.01), and an interim myocardial infarction (p less than 0.05). Four other predictors were found at the time of the first angiogram: 2 angiographic characteristics, 1 related to the severity (presence of an 80% or greater luminal diameter narrowing of an artery supplying a non-akinetic left ventricular segment [p less than 0.005]) and 1 to the extent (count of the lesions narrowed 75% or less in luminal diameter in a 15-segment coding system [p less than 0.05]) of coronary artery disease, and 2 risk factors: smoking status (p less than 0.05) and male sex (p less than 0.05). The 140 male smokers with at least 80% diameter stenosis or at least 4 segments with moderate (75% or less) stenosis were at a higher risk of occlusion than the 173 other patients after intervals of less than 2 years (13 of 53 vs 7 of 74, p less than 0.01), 2 to 4 years (23 of 40 vs 10 of 47, p less than 0.005) and more than 4 years (27 of 47 vs 18 of 54, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Can the mode of death be predicted in patients with angiographically documented coronary artery disease?

To determine whether sudden versus non-sudden cardiac death could be predicted in high risk patients, 1157 medical patients were followed for an average of 46 months after a diagnostic coronary angiogram and 18 clinical, hemodynamic, and angiographic variables known to be associated with a high risk of mortality were analyzed. The total group of 141 deaths was classified into 3 subgroups: (1) 82 sudden deaths (less than 1 hour after onset of symptoms); (2) 46 deaths due to acute myocardial infarction with or without heart failure, and (3) 13 deaths unrelated to cardiac symptoms. In a subset of 64 patients, the duration of electrical systole (QTc) was calculated before angiography and before death. A comparison was made of QTc measurements at entry with QTc values of subjects with normal coronary arteries and normal left ventricular function. Deaths from cardiac causes could often be predicted from older age, male sex, history of myocardial infarction, unstable angina, congestive heart failure, abnormal cardiothoracic ratio, multivessel disease, abnormal left ventricular contraction, and abnormal ejection fraction. However, these variables did not discriminate between sudden and nonsudden cardiac deaths and both modes of death were characterized by depressed left ventricular function and multivessel coronary disease. During follow-up the incidence of acute myocardial infarction was not different in patients with cardiac and noncardiac deaths and in long-term survivors. However, patients dying from cardiac causes had a higher incidence of heart failure. Patients dying suddenly did not present new infarctions during follow-up whereas patients dying from acute myocardial infarction had a 13% incidence of prior infarction and a higher incidence of heart failure. In addition, QTc at entry was longer in nonsurvivors than in normal subjects (p less than 0.0001) and patients experiencing sudden death exhibited the highest incidence of QTc prolongation (greater than or equal to 440 ms) during follow-up (p less than 0.05). We conclude that: (1) although the severity of coronary disease and left ventricular dysfunction are closely related to cardiac mortality, they do not discriminate between sudden and nonsudden cardiac deaths; (2) patients experiencing sudden death are characterized by a low incidence of new myocardial infarction or congestive heart failure and prolongation of the QTc interval during follow-up.

Adult↗