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Biomedical subjects

C Hervé

Publications and source records attributed to C Hervé.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Epidemiology of gyneco-obstetric emergencies (within the framework of emergency medical care)].

The authors studied over a period of four years emergencies in pregnancy. These were seen in patients who were brought in from an outside hospital to a perinatal centre or when transferred from hospitals to a general maternity unit or to a high risk unit for neonatal and maternity care. 382 pregnant women needed to be looked after (293 from outside hospital and 89 transferred from another hospital). Treatment was given especially in the 3rd trimester of the pregnancy to three groups: before labour (60 cases); during labour (211 cases) and; after delivery (30 cases). There were in the same categories 37 cases before labour, 9 cases during labour and 30 cases after labour transferred from one hospital to another. The diagnosis were, in particular, 47 cases with a high risk of premature labour, 5 cases with haemorrhage and placenta praevia, 27 cases of pre-eclampsia, 211 cases in labour of which 120 were outside hospital. There were 14 cases of maternal illness, 3 cases of trauma and 4 cases of cardiac arrest. There was a high risk of prematurity in 33 cases of labour outside a maternity hospital. The neonatal mortality rate for the first six days after delivery was ten times higher than that for all neonates born in the same county in the same period of time as this series took. But the authors noted that pre-eclampsia cases received care at high risk units but premature cases did not necessarily.

Adolescent↗
PubMed1989

[Epidemiology of severe cranial injuries in children and the prognosis of injured patients hospitalized in neurosurgery units].

Over five years (1979-1983), 1,058 children who sustained injuries in the Val de Marne District (near Paris) were treated by the Emergency and Intensive Care Mobile Unit. Among these patients, 17.8% had an isolated, severe head injury (Glasgow score less than 12) and were admitted to a neurosurgical unit; the age and sex distribution in this group was comparable to that of the entire group of injured children (2/3 boys). The severe head injury was caused by a motor vehicle accident in 47% of cases and a fall in 34% of cases. One half of patients had a skull fracture; all patients with an extra-dural (14 cases) or sub-dural (7 cases) hematoma had a skull fracture. Seventy per cent of patients had cerebral edema and 25% had a meningeal hemorrhage. Immediate severe neurologic disorders (Glasgow score less than 9) were present in 53% of cases and 27% of patients had focal neurologic signs. Mean duration of the stay in the neurosurgical unit was 6 to 15 days. Mortality was 15.3%; in most cases (75%) death occurred within the first 48 hours. One-year morbidity was very significant; 67% of surviving children had residual disease, and 40% had severe sequelae.

Adolescent↗
PubMed1988

[Home thrombolysis for myocardial infarction. A multicenter study of the feasibility and evaluation of short-term prognosis].

It has been proven since 1986 that in myocardial infarction the sooner thrombolysis is performed the better. Forty-four patients were selected to enter a double-blind randomized trial in which they received either an acylated plasminogen streptokinase activator complex or a placebo. The injections were given intravenously at home within the first 3 hours (within the first 2 hours in 26 of them), by doctors from Mobile care units. This home treatment in the acute phase made it possible to gain 75 minutes on average, and up to 90 minutes when it was performed by an anaesthetist trained in emergency management. No serious complication, such as haemorrhagic or allergic reaction, occurred, and arrhythmia was no more frequent in the treated group than in the placebo group. Home thrombolysis did not delay admission to a cardiology Intensive Care unit (66 min. versus 64 min). Mean coronary patency was 75 per cent, and up to 82 per cent, in patients treated within 2 hours of the first symptoms. There was no significant difference between areas of reperfused or not reperfused patients in relation to time (P less than 0.08). Diagnosis sensitivity was 100 per cent. Thus, home thrombolysis is feasible and safe when performed by trained emergency medical teams and when criteria for inclusion and exclusion are fulfilled.

Double-Blind Method↗
PubMed1987

Treatment in serious lower limb injuries: amputation versus preservation.

A study of patients with serious lower limb injuries is presented. With these injuries it is important to decide whether the limb should be salvaged at the risk of losing a life. Seventy-six patients are described and compared with a group of patients with similar injury severity scores but without serious lower limb injury. It is concluded that it is often preferable to amputate the limb rather than to risk the patient's life. Attempts at preservation of a limb were unsuccessful in 20 of the 54 patients in whom this was attempted. Secondary amputation was often performed in unsatisfactory conditions because of general complications that had resulted from the delay.

Accidents, Traffic↗
PubMed1987

Early medical care and mortality in polytrauma.

This study attempts to objectively estimate the efficiency of early medical care. It is based on the comparison of two series of multiple injured patients. Ten years separated the two groups and during this period, an Emergency Medical Aid Service (SAMU 94) was created. The positive effect of early medical care was established through the variations of injury severity indices currently used in polytrauma: after the institution of Mobile Intensive Care Medical Units on the site of accidents cardiac arrests were ten times less numerous although lesions were more serious in the second series. Without taking into account the mortality rate of lower-limb trauma, where crush syndromes were very numerous, mortality rate decreased as far as spinal, chest, abdominal, and pelvic traumas were concerned. An estimation of the cost of such a system raised the problem of maximizing the efficiency of improved early medical care.

Efficiency↗
PubMed1987

[New thrombolytic agents. Effect on the organization of care in myocardial infarction].

In the last few years, intravenous thrombolysis has widely become the treatment of reference in the acute phase of myocardial infarction. Among the new thrombolytic agents which are currently being evaluated, two are particularly ahead of the group: 1) the plasminogen tissue activator, known at this time for a revascularizing effect exceeding that of streptokinase for a lesser fibrinogenolytic activity; its effectiveness in terms of mortality remains to be defined; 2) the acyl-streptokinase presents the advantage over the classic streptokinase of being injected in one single injection of 5 minutes. The revascularizing activity of this product seems to exceed that of streptokinase, and the fibrinolytic activity is the same as streptokinase's. The effectiveness in terms of mortality remains to be evaluated. The better effectiveness of the new thrombolytic agents should not let us forget that the main problem is to organize patient's care and that improvement of the effectiveness of thrombolytic therapy is mainly obtained through improvement of the screening and an early diagnosis of myocardial infarctions. Organization or patient's care in central hospitals and at the level of emergency transportation services will perhaps enable, in the years to come, to increase a great deal the number of patients who can benefit from thrombolysis and thus to decrease hospital and post-hospital mortality of myocardial infarction.

Fibrinolysis↗
PubMed1987

[Tubal choriocarcinoma].

The authors report a case of tubal choriocarcinoma discovered by chance during an ectopic pregnancy. The literature was reviewed on this subject. The treatment vary according to the authors, but, it would seem that chemotherapy has clearly modified the prognosis. But, we must realize that, with such a rare disease, diagnosis and treatment are sometimes difficult to obtain.

Adult↗
PubMed1986

[Treatment of severe injuries of the lower limbs. Identification of clinical criteria of severity].

The choice and timing of therapeutic methods for injuries of the lower limbs were evaluated in 60 patients. Primary amputation had to be performed in 18 of them, and conservative treatment was attempted in the others. Sixteen secondary amputations were necessary, mostly for arterial lesions. These results were not in agreement with the general severity of injury, as evaluated by the Injurity Severity Score. There was a significant difference in mortality depending on whether it was decided to amputate secondarily or to preserve the limb. When local signs of complication were present, this difference was highly significant. Age over 50 and arterial lesions were aggravating factors. When present together with an already high severity score, these factors should suggest immediate amputation as a life-saving measure.

Adolescent↗