Biomedical subjects

C Soltner

Publications and source records attributed to C Soltner.

6 recordsLinked to original sources

PubMed2006

Information booklets to patients' family and relatives. Survey of practice in a sample of 59 intensive care units, in France.

OBJECTIVE(S): To assess the content of the intensive care unit (ICU) information booklet delivered to patient families, and that of the general information booklet of the hospital in a sample of intensive care, in France. STUDY DESIGN: Survey. METHODS: A sample of 105 ICU was obtained at random from a national database. A survey form was sent to each ICU medical director. The ICU information booklet, that one from the hospital and the corresponding questionnaire of each participating ICU have been studied to assess the percentage of information items present which matched the recommendations of at least one of three different professional guidelines. RESULTS: Fifty-nine ICU answered. We observed a significant (P<0.01) heterogeneity by the kind ICU considered (general, medical, or surgical). The percentage of information items matching guidelines remained low (median: 41%) even if higher (P<10(-3)) than the percentage of items not matching guidelines (median: 6%). Among a panel of items we considered as important, we observed a significant discrepancy (P<10(-3)) between a low citation rate in ICU booklets (median: 14%) and the opinion of doctors who judged it should included in booklets (median: 68%). CONCLUSION: Guidelines in terms of patient and family information in ICU seem to have a mild impact on the information booklets which are also very different among the types of ICU. There is a gap between what doctors judge to be included in booklets and what they effectively write in these documents.

Data Collection↗

PubMed2005

Supratentorial primitive neuroectodermal tumours of the brain: multidirectional differentiation does not influence prognosis. A clinicopathological report of 18 patients.

AIMS: To examine the clinical and pathological characteristics of supratentorial primitive neuroectodermal tumours (PNETs) in a retrospective series of 18 patients, according to the strict definition of the World Health Organization classification of tumours that excludes other types of malignant embryonal tumours of the brain. METHODS AND RESULTS: Eleven children and seven adults with supratentorial PNETs were diagnosed between 1993 and 2002 and their medical records were reviewed. An immunohistochemical study was performed on formalin-fixed paraffin-embedded tissue of 18 primary tumours and five recurrences with antibodies for neuronal (neuron specific enolase, synaptophysin, neurofilament, chromogranin A), epithelial [epithelial membrane antigen (EMA), cytokeratin], glial [glial fibrillary acidic protein (GFAP)], muscle (desmin, h-caldesmon, alpha-smooth muscle actin, myogenin) differentiation and with two anti-CD99 antibodies. All tumours showed at least one neuronal marker except chromogranin A; a variable number of cells were GFAP+ or EMA+ in 18/23 tumours. Six primary tumours and one recurrence were positive for cytokeratin and/or one muscle antigen except myogenin. CD99 was observed in 33% of the cases. The mean duration of overall survival was 20 months. The estimated overall survival rates were 61% at 1 year, 29% at 2 years, and 18% at 3 years. Two factors of poor prognosis were identified by univariate analysis: a positive cerebrospinal fluid cytology at diagnosis and the absence of complete resection. No distinct immunophenotype was statistically related to survival. CONCLUSIONS: A multidirectional differentiation is a frequent event in supratentorial PNETs but has no apparent influence on the outcome of this aggressive neoplasm.

12E7 Antigen↗

PubMed2004

[Voice recognition applied to ICU medical reports].

OBJECTIVE: Medical reports in ICU are usually tape recorded and then typed by transcriptionist. Digital voice recognition (DVR) has considerably improved and may be a time saving method. The purpose of this study was to test IBM Viavoice (Pro Edition, Release 8, French version) for the generation of medical reports in a surgical intensive care unit. METHODS: A senior resident (Int) in anaesthesia, a senior academic (AS) anaesthesiologist and a confirmed medical secretary (Sec) all working in the same surgical ICU participated to the study. First, Int and AS trained Viavoice according to the software requirements. Then 60 medical records (text files) served to automatically train the software. For the study, we prospectively used 20 consecutive medical records, which had been dictated on tape by either Int or AS. The transcription time by Sec, the number of typing errors and time needed for corrections were recorded. Int and AS with Viavoice processed the same records. Turnaround time and errors were assessed for comparison to Sec work. RESULTS: Accuracy was 97, 92 and 95% for Sec, Int and AS, respectively. Transcription by Viavoice was always significantly faster whatever the speaker than conventional transcription by a secretary. However, Int required significantly longer time to correct recorded text than did Sec and AS. The total turnaround time was significantly faster for AS than Sec (p < 0.01) but Int did not differ from Sec. The performance of Viavoice did not rise with the number of records. CONCLUSION: Viavoice is as efficient as a confirmed transcriptionist.

Anesthesia↗

PubMed2004

[French residents in anaesthesia and critical care - a nationwide survey].

OBJECTIVE: We surveyed the residents in their first (R1) and fourth (R4, last) years of residency in anaesthesia and intensive care in France. METHODS: The questionnaires mailed to each resident were designed to obtain personal data, motivation for specializing in anaesthesia and their opinion of their training. RESULTS: The response rates were 48% for the R1 residents and 77% for the R4 residents. There were 40% females in this population and the R1 residents were 25 +/- 1 year old, 29 +/- 2 year-old for the R4 residents. Almost half (46%) of the R1 responders were married as were 74% of the R4 residents. They spent an average of 726 each year on books, computers and other educational items. Most (71%) had opted for anaesthesia after considering other medical specialties, but only 12% had considered surgery. Half (51%) were on a training program that was far away from their home. They thought highly of their training, with the clinical training being rated above the non-clinical component. About half of them had obtained specialized certificates (mainly additional certification in intensive care and antibiotic therapy) during their residency. Two thirds of those in R4 expected to work in a public hospital and about one third expected to work in intensive care. Money was an important factor in their choice of profession. A majority planned to remain in the area where they had graduated in anaesthesia after their residency. Finally, 96% declared that they would choose anaesthesia again if they had to do so. CONCLUSION: French residents in anaesthesia are satisfied of their initial choice for anaesthesia and don't regret it at the end of their residency training.

Adult↗

PubMed2004

Gas embolism: an exceptional complication of radial arterial catheterization.

BACKGROUND: We report a rare complication of radial arterial catheterization in a 74-year-old man who had undergone retroperitoneal surgery for an infra-renal aortic aneurysm. A right subclavian venous catheter and a right radial artery catheter were inserted for hemodynamic monitoring. RESULTS: The patient suddenly went into a coma, with dyspnea and bradycardia, 1 day postsurgery, as a result of a cerebral gas embolism produced by the accidental entry of pressurized air into the artery via the arterial catheter. Cerebral Magnetic Resonance Imaging revealed multiple, diffuse brain lesions. Six months later the patient still had a left hemiparesis and a cognitive deficit. He walks with assistance. CONCLUSION: Misuse of an arterial catheter can lead to a severe gas embolism. The infusion system used to flush arterial catheters should be checked regularly to ensure it contains no gas.

Aged↗

PubMed2001

[Severe metabolic alkalosis following hypokalemia from a paraneoplastic Cushing syndrome].

Metabolic alkalosis is frequently observed in critically ill patients. Etiologies are numerous but endocrinal causes are rare. We report a case of a patient with severe respiratory insufficiency, metabolic alkalosis and hypokalemia. The evolution was fatal. Further explorations revealed an ectopic Adrenocorticotropine Hormone syndrome. The initial tumor was probably a small cell lung carcinoma.

ACTH Syndrome, Ectopic↗