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Biomedical subjects

C Infante-Rivard

Publications and source records attributed to C Infante-Rivard.

At least 91 records · Page 5Linked to original sources
PubMed1988

Self-palpation to assess cervical changes in relation to mucus and temperature.

Women experienced in cervical self-palpation recognize fertile characteristics when the cervix is high, open, soft, and straight; this happens under estrogenic influence. The cervix is said to show infertile signs when it is low, closed, firm, and lying against the vaginal wall; that change occurs quickly under progesterone influence. The objective of this study was to assess the time relationship among changes in the cervix observed by self-palpation, changes in cervical mucus as observed by women, and the shift in basal body temperature during ordinary cycles. A total of 215 symptothermal charts from natural family planning users were analyzed. The duration of the change from the maximum fertility characteristics to the postovulatory return to definite signs of infertility was measured. This duration ranged from 1 to 7 days, with a mean of 2.65. The timing of maximum fertility signs in the mucus was compared with that of maximum fertility signs in the cervix: it varied from 3 days before to 6 days after, with a mean of 0.48 day. The timing of the first high temperature was compared with that of return to definitely infertile characteristics: it varied from 6 days before to 3 days after, with a mean of -0.69 day. Some of the variation may be due to the presence of inexperienced users in the sample. However, a mean difference of half a day between the most fertile cervix and the most fertile mucus on one hand and between the first day of infertile cervix and the first high temperature on the other hand suggest that the cervical changes could be useful indicators of estrogen and progesterone actions.

Adult↗
PubMed1988

Myasthenia gravis after general anesthesia and hepatitis B vaccine.

A 48-year-old man presented with the first symptoms of myasthenia gravis one month after a general anesthesia and a second dose of hepatitis B plasma vaccine. Whether either event may have acted as a nonspecific challenge to the patient's immune system is speculative, but the case is described to discover similar observations, if any.

Anesthesia, General↗
PubMed1987

Quality of care in public health well child clinics: a neglected issue.

The process of well child care in public health clinics was evaluated using a peer review approach based on explicit criteria formulated by the peers themselves. The criteria defined what should be done in order to ensure good preventive care during a client-provider encounter. The data from this study suggest that the traditional goals of public health are being pursued, but that a broader spectrum of preventive care, including attention to the child's psychosocial development, is still lacking.

Child↗
PubMed1987

Emergency portacaval shunt for variceal hemorrhage. A prospective study.

Emergency portacaval shunt for variceal bleeding is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of variceal bleeding when used systematically after hemodynamic stabilization and control of the bleeding episode with balloon tamponade, if necessary, in patients with mild or moderate liver disease. The population studied comprised 62 consecutive patients who rebled from varices while participating in a controlled trial of propranolol for the prevention of rebleeding. Of the 62 patients, nine died of massive hemorrhage and 53 survived the hemorrhage. Of the 53 survivors, 11 had severe liver disease and were not considered for shunt surgery. Of the remaining 42 patients with mild or moderate liver disease, 36 had emergency central portacaval shunt. The interval between endoscopic diagnosis of variceal bleeding and surgery averaged 19 +/- 3 hours (mean +/- SE). The operative mortality rate, defined as in-hospital mortality, was 19%. One- and 2-year survival rates were 78% and 71%, respectively. The incidence of postoperative hepatic encephalopathy was 36%; all patients responded favorably to protein restriction and lactulose. Thus, under specific conditions, emergency portacaval shunt results in an acceptable long-term survival rate. In patients with mild or moderate liver disease, emergency portacaval shunt should be considered when other forms of treatment for the prevention of variceal rebleeding have failed.

Emergencies↗
PubMed1987

The changing frequency of childhood asthma.

Hospital admission rates for childhood asthma have increased markedly in many countries since the beginning of the 1970s. Prevalence of asthma, as reported by parents or children in occasional surveys, has also increased during this period. In Montreal, 7.2 per 1000 3-year-old children were admitted to the hospital with a diagnosis of asthma in 1980-1981, whereas the rate was 11.9 per 1000 in 1984-1985. For 7-year-old children, these rates were 3.2 per 1000 and 4.8 per 1000, respectively. On the other hand, the length of hospital stay decreased steadily during this period, and the mean number of admissions per child did not show a tendency to increase. For 3- and 7-year-old children together, the prevalence of asthma, determined from health insurance data, increased by 71%, from 3.76% in 1980 to 6.45% in 1983. Prevalence of other medical conditions also increased in this community, but much less than for asthma. An increase in the incidence of the disease cannot be excluded as the cause for the changing prevalence of asthma.

Asthma↗
PubMed1987

[The relation between unemployment and health : a prospective study : brief presentation and preliminary results of a study.].

In 1984, the authors undertook a major study on the multiple interrelations between unemployment and health. Tlie methodology in use is prospective, longitudinal, with a control group. Their presentation consists of a synthesis of work carried out so far followed by corresponding results. These results are in compliance with the four hypotheses developed through a priori reasoning. However, these results are not definitive. The analysis continues.

English Abstract↗
PubMed1986

Folate deficiency among institutionalized elderly. Public health impact.

All patients 65 years and older who had been living in an institution for at least six months had a measurement of red blood cell folate (RBCF), serum folate (SF), vitamin B12, hemoglobin, and mean corpuscular volume. Twenty-two percent of the 97 studied subjects were found deficient in RBCF, although only 6% had anemia. Length of stay at the institution was significantly associated with deficiency in RBCF and this association was uncon-founded by age. The proportion of RBCF deficiency among the studied subjects attributable to length of stay is 80%. The prophylactic administration of folate among long-term nursing home type of patients should be considered.

Age Factors↗
PubMed1985

Maintenance chemotherapy for childhood acute lymphoblastic leukaemia: better in the evening.

The course of 118 children with acute lymphoblastic leukaemia who had achieved complete remission with a standard induction protocol and had also received meningeal prophylaxis with intrathecal methotrexate (MTX) and cranial irradiation was reviewed. Maintenance chemotherapy consisted of daily 6-mercaptopurine (6-MP), weekly MTX, and monthly vincristine and prednisone. 82 children took 6-MP and MTX in the morning and 36 in the evening. Disease-free survival as determined by Kaplan-Meier analysis was better for children on evening chemotherapy. Regression analysis (Cox proportional hazards model, with evening vs morning schedule as exposure variable, and age at diagnosis, leucocytosis at diagnosis, and sex as covariates) showed that, for those surviving free of disease for longer than 78 weeks, the risk of relapsing was 4.6 times greater for the morning schedule than for the evening one.

Adolescent↗
PubMed1981

[Use of health services and drugs by old people of Montreal receiving home care].

A survey was conducted among 160 persons aged 64 year or more in Montreal who were receiving home care. They answered at home a questionnaire on their use of health care services and drugs, and showed the interviewer all the drugs they were taking. In comparison with similar data from elsewhere, the use of health care services (an average of 8.0 encounters with a physician per person per year) and of drugs (an average of 5.3 per person) by this group seems high. Perhaps this group of people was obviously sicker than others of the same age, but this remains to be shown. Moreover, despite the reported frequency of health problems, it is uncertain whether such use of services and drugs was necessary. The question is raised whether the home care system is doing for the patient what it was intended to do.

Aged↗
PubMedDate not supplied

Prognostic value of the aminopyrine breath test in cirrhotic patients.

The aminopyrine breath test has been proposed as a quantitative test of hepatic function, but its long-term prognostic value in patients with cirrhosis has not been determined. The aim of this study was to examine the usefulness of the aminopyrine breath test in assessing prognosis and to compare it with traditional methods of evaluating liver function. One-hundred eighty-seven patients with histologically confirmed cirrhosis were studied prospectively. An aminopyrine breath test was obtained at the time of inclusion in the study and results were expressed as per cent of the dose excreted in 2 hr. At inclusion, the severity of liver disease was also assessed according to the Pugh modification of the Child-Turcotte classification based on ascites, neurological status, serum albumin, serum bilirubin and prothrombin time. Mean follow-up was 844 days. During that period, 59 of 187 patients died of their liver disease. Two-year survival decreased with increasing Child-Turcotte classification score: survival was 98% in Child Class A patients (n = 62), 66% in Child Class B (n = 76) and 36% in Child Class C (n = 49) (chi 2 = 65.6, p less than 0.001). Two-year survival also decreased significantly with increasing degree of aminopyrine breath test abnormalities: survival was 90% in patients with aminopyrine breath test greater than 4% (n = 56); 78% in patients with aminopyrine breath test = 2 to 4% (n = 66), and 43% in patients with aminopyrine breath test less than 2% (n = 65) (chi 2 = 36.9, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Propranolol for the prevention of recurrent variceal hemorrhage: a controlled trial.

We conducted a prospective, randomized single-blind trial of propranolol for the prevention of recurrent variceal bleeding. Seventy-nine patients shown to have variceal hemorrhage at endoscopy were included in the study within 72 hr following diagnosis. Fifty-seven patients had alcoholic cirrhosis, 10 cryptogenic cirrhosis, 6 posthepatitic cirrhosis, 4 biliary cirrhosis, 1 portal vein thrombosis without cirrhosis and 1 idiopathic portal hypertension. The severity of liver disease at inclusion was assessed according to the Pugh modification of the Child-Turcotte classification: 9 (11%) had Class A; 41 (52%) Class B, and 29 (37%) Class C disease. Patients were randomly assigned by sealed envelope to the propranolol group (42 patients) or the placebo group (37 patients). Propranolol dosage was titrated in order to produce plasma concentrations of propranolol of 50 to 150 ng per ml. beta-blockade was also confirmed by isoproterenol testing. The cumulative percentages of patients free of rebleeding 1 and 2 years after inclusion were 31 and 21% in the propranolol group, and 25 and 17% in the placebo group; both differences were not significant. Cumulative 1 and 2 years survival were also comparable: 64 and 54% in the propranolol group vs. 70 and 63% in the placebo group. There was no evidence for a therapeutic effect of propranolol after adjusting for potential confounding variables by multiple logistic regression. We conclude that propranolol is not effective for the prevention of variceal rebleeding, when administered early following the initial bleed, in cirrhotics unselected with respect to the severity of the liver disease.

Clinical Trials as Topic↗
PubMedDate not supplied

Clinical and statistical validity of conventional prognostic factors in predicting short-term survival among cirrhotics.

The objective of this study was to assess the prognostic validity of Child-Turcotte classification with regard to short-term (1-year) survival. The Child-Turcotte classification, as modified by Pugh et al., was recorded on admission in 177 cirrhotic patients. The variables that comprise the Pugh modification are ascites, encephalopathy, serum albumin, serum bilirubin and prothrombin time. Using multiple logistic regression, we evaluated the contribution of different models to the likelihood of survival, defining different ways to use the Pugh score. The Pugh score categorized in three strata (5 to 6, 7 to 9 and 10 to 15) captured less variance in the survival than the Pugh score counted from 5 to 15. This, in turn, captured less variance than a model in which the parameters of the Pugh score were analyzed according to their original units. The prediction rule based on the last model was tested in another sample of cirrhotics. The "original unit" model was studied in both training and testing samples, using receiver-operating characteristic curves to evaluate its clinical validity (sensitivity and specificity). The prediction rule based on the "original units" Pugh score allowed for a good discrimination of patients who lived and those who died. (At the point of maximum discrimination, sensitivity and specificity reached a mean of 80%). Validity of the prediction rule was confirmed by the testing sample. The qualities of simplicity, availability, low cost and good discriminating power for a life or death outcome make the Pugh score a very useful method to estimate prognosis in patients with cirrhosis.

Adult↗