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Biomedical subjects

Christine Rivet

Publications and source records attributed to Christine Rivet.

11 recordsLinked to original sources
PubMed2005

[Eosinophilic esophagitis: 3 case reports].

Eosinophilic esophagitis is a rare entity, characterized by eosinophilic infiltration of the oesophagal mucosae, with no gastroesophageal reflux. Food allergies are often involved. We report 3 paediatric cases of eosinophilic esophagitis, revealed by dysphagia, with or without stricture. Eosinophilic esophagitis is a rare disease, but its frequency is probably underestimated. Symptoms are sometimes unusual. Oesogastroscopy with biopsy is essential for the diagnosis. Food allergies can be involved and must be systematically investigated.

Child↗
PubMed2005

Defining core procedure skills for Canadian family medicine training.

OBJECTIVE: To create a list of core and enhanced procedures suitable for family medicine training. DESIGN: Mailed or e-mailed survey using a Delphi technique. SETTING: Randomly selected family physician practices across Canada. PARTICIPANTS: Family physicians from urban, small-town, and rural practice locations and academic family physicians. All were experienced family physicians with from 3 to 36 years in practice. INTERVENTIONS: Participant physicians were asked to rate each of 158 procedures as to whether they would expect a graduate from a Canadian family practice training program to have learned and be capable of performing that procedure in their own community. In a second survey, participants were asked to verify the core and enhanced procedures lists produced from the first survey. MAIN OUTCOME MEASURES: Physicians' opinions about a comprehensive list of skills. RESULTS: Twenty-two physicians responded to the first survey (92% response rate) and 14 to the second (58% response rate). Sixty-five core procedures and 15 enhanced procedures were identified in the surveys. More procedures were ranked on the core list and were performed by rural and small-town physicians than by urban physicians. Physicians' agreement with placement of procedures on the core list ranged from 55% to 100% and of procedures on the enhanced list from 50% to 64%. Fifty-five of the procedures on the core list had agreement from more than 70% of participants. CONCLUSION: Procedure lists represent the opinions of Canadian family physicians about the importance of specific procedure skills for new family physicians in their communities. Procedure lists will be helpful for family medicine training programs to evaluate and refine their teaching of procedure skills.

Canada↗
PubMed2003

Training medical students to communicate with a linguistic minority group.

Effective communication is central to a successful physician-patient relationship. Communication is usually enhanced when the linguistic and cultural attributes of patients are incorporated in health care delivery. With this purpose in mind, the Faculty of Medicine at the University of Ottawa has developed a French-language stream to train future physicians for the francophone minority population of Ontario. As part of this project, a communication skills laboratory was created for francophone students in 1996, since all three tertiary care teaching hospitals operated in English only. The laboratory consists of a controlled environment where francophone students conduct interviews in French while being observed by clinicians trained in observation and feedback techniques. It makes use of simulated patients trained to play specific roles and to give feedback to students. Laboratory sessions take place throughout the first and second years and expose students to 15 scenarios covering different themes in each year. Each scenario includes a communication problem. Facilities are in place for filming the encounters for review by students. The project has had favorable outcomes. Both students and clinician-supervisors find that the laboratory offers an excellent learning environment and describe the cases as realistic and instructive. Clerkship preceptors are pleased with the students' communication skills. Because of the success of the laboratory, faculty authorities plan to translate the scenarios and offer similar sessions to students in the English-language stream. The teaching methods used in the communication skills laboratory may be of interest to other medical schools that serve linguistic minority populations.

Communication↗
PubMed2002

Urological manifestations associated with chronic intestinal pseudo-obstructions in children.

PURPOSE: Chronic intestinal pseudo-obstruction syndrome is a rare pathological condition characterized by chronic intestinal occlusion without any anatomical or mechanical lesion. Recent progress in the treatment of these children has led to improved survival and development of associated urological complications. We define urological manifestations of chronic intestinal pseudo-obstruction to optimize evaluation and treatment. MATERIALS AND METHODS: We evaluated retrospectively the charts of 20 girls and 19 boys with a mean age of 11.2 years (range 3 days to 26 years) diagnosed with chronic intestinal pseudo-obstruction from January 1975 to February 2000. Urological evaluation included prenatal and postpartum ultrasonography, serum renal function assessment, voiding cystourethrography and urodynamics. RESULTS: Urological involvement was present in 27 of the 39 children (69%). Megacystis in 26 children (96.3%) was isolated in 12 (46.2%) and associated with ureterohydronephrosis in 14 (53.8%), including 4 with vesicoureteral reflux. One patient presented with a complex urinary anomaly. Prenatal diagnosis of megacystis was made in 16 patients (59%), including 4 with neonatal urinary retention and 12 with urinary tract infection. At followup 24 patients had 1 or greater febrile urinary tract infections while 3 had afebrile infections. In the 14 patients with megacystis and ureterohydronephrosis, 3 or greater febrile urinary tract infections developed while 10 patients with isolated megacystis had only 1 febrile urinary tract infection. Twelve patients underwent 17 urodynamic studies, all of whom initially presented with hypocontractile detrusor, increased age corrected capacity (194% +/- 44%) and compliance (42 ml./cm. H O, range 13 to 214). Bladder proprioception was also diminished. Presently voiding is achieved by abdominal pressure in 14 cases and intermittent catheterization in 10. Antibioprophylaxis was given to 17 patients, at one point in time. Renal failure (1 iatrogenic, 1 complex anomaly) developed in 2 patients. CONCLUSIONS: The presence of megacystis on prenatal ultrasound should alert the physician to the possibility of chronic intestinal pseudo-obstruction. Bladder adynamia represents the dominant urological complication. Urological evaluation and management are required to ensure adequate bladder emptying to reduce the risk of urinary tract infection and preserve long-term renal function.

Adolescent↗