Biomedical subjects

Isabelle Ingrand

Publications and source records attributed to Isabelle Ingrand.

4 recordsLinked to original sources

PubMed2006

Management of digestive bleeding related to portal hypertension in cirrhotic patients: A French multicenter cross-sectional practice survey.

AIM: To investigate the conformity of management practices of gastrointestinal hemorrhage in cirrhotic patients with relevant guidelines. METHODS: A questionnaire on the management of digestive bleeding was completed for all consecutive cirrhotic patients admitted to 31 French hospitals. RESULTS: One hundred and twenty-six bleeding events were recorded. It was the first bleeding episode in 79 patients (63%), of whom 40 (51%) had a prior diagnosis of cirrhosis and 25 (32%) had previously undergone an endoscopy. The bleeding episode was a recurrence in 46 patients (37%). The median time between onset and admission was 4 h, but exceeded 12 h in 42% of cases. There was an agreement between centers for early vasoactive drug administration (87% of cases), association with ligation (42%) more often than sclerosis (21%) at initial endoscopy, and antibiotic prophylaxis (64%). By contrast, prescription of beta-blockade alone or in combination (0 to 100%, P = 0.003) for secondary prophylaxis and lactulose (26% to 86%, P = 0.04), differed among centers. CONCLUSION: In French hospitals, management of bleeding related to portal hypertension in cirrhotic patients is generally in keeping with the consensus. Broad variability still remains concerning beta-blockade use for secondary prophylaxis. Screening for esophageal varices, the use of antibiotic prophylaxis and patients information need to be improved.

Adrenergic beta-Antagonists↗

PubMed2004

Prevention of viral hepatitis C: assessment of a comic strip-based information campaign targeting adolescents.

BACKGROUND: The risk of exposure to hepatitis C virus increases markedly in adolescence, and students are thus a preferential target for information campaigns. The aim of this study was to evaluate the results of a hepatitis C information campaign targeting secondary-school students. METHODS: The study was done in 52 classes of 11 general and vocational secondary schools. Before the information meetings and two months afterwards, the students received an anonymous questionnaire to test their knowledge of hepatitis C. The information session was backed up by a comic strip depicting scenarios involving hepatitis C. RESULTS: The students were aged from 14 to 24 years (mean 15.9 years, SD 0.9 years). Respectively 1509 and 1419 questionnaires were completed before and after the information session. Answers to the first questionnaire showed that the students' knowledge of hepatitis C was poor. Scores improved significantly after the information session, from an overall mean of 6.2 (SD 2.0) to 8.5 (SD 1.7) (p<0.001). The largest score improvement concerned transmission due to illicit drug use, the potential severity of the disease, and lack of a vaccine. The improvement was significantly larger among pupils who said they read the comic strip than among those who did not (p=0.02). CONCLUSIONS: General and vocational secondary school students in France have mediocre knowledge of hepatitis C, particularly its modes of transmission and the lack of a vaccine. Knowledge improved significantly when measured two months after an information session, suggesting that subsequent at-risk behaviours might be reduced.

Adolescent↗

PubMed2003

[Epidemiology and management of care of hepatitis C infection in the Poitou-Charentes region in 1997 and 2000].

OBJECTIVES: A repeat cross-sectional survey was performed in 1997 and 2000 in the Poitou-Charentes district of France to compare screening and management of hepatitis C virus infection. METHODS: The "Hepatitis C Network" asked the biological laboratories in the region to provide anonymous results of serology tests performed during two two month periods at a 3 year interval. An epidemiological and follow-up questionnaire was sent to the medical practitioner who prescribed the test for all positive tests. RESULTS: More serology tests were prescribed in 2000 (7074) than in 1997 (6168). The access to screening differed significantly between the 4 counties of the district (P<0.0001). Sixty-nine and 58 patients were first diagnosed respectively in 1997 and 2000. In 2000, these patients were younger (P=0.05) and were infected later (P=0.03). The risk factors were similar for the two periods. Respectively 23% and 26% underwent a liver biopsy, and 12% were treated. CONCLUSION: Screening improved after a press campaign, but there was no increase in the number of newly detected patients. In 2000, one third of patients were still inadequately cared for.

Adult↗

PubMed2002

Reliability of bedside ABO testing before transfusion.

BACKGROUND: Previous studies of bedside transfusion compatibility tests have shown high rates of erroneous transfusion decision, due to defective techniques and poor user performance. An experimental study was conducted to evaluate the error rate obtained with a new ready-to-use device (Vu-Test, Medigis), in comparison with the most popular bedside card used in France (Safety-Test ABO, Diagast Laboratories). STUDY DESIGN AND METHODS: A stratified random sample of nurses performed, in the clinical departments where they worked, cross-matches on 12 randomly and blindly selected paired donor-recipient blood samples with Safety-Test ABO and Vu-Test. The nurses detected agglutination, interpreted compatibility, decided whether to transfuse, and gave their opinion of the two devices. Three independent experts reviewed photographs of each test result. RESULTS: Thirty-five trained nurses and 10 student nurses carried out 268 tests with each device. One-hundred ninety tests (70.9%) performed with Safety-Test ABO and 177 tests (66.0%) performed with Vu-Test were entirely error-free (p=0.23). The risk of erroneous detection of agglutination was not different between the devices (p=0.69), but was significantly lower when the nurse had experience in transfusion (p < 0.001). According to the experts, Vu-Test was significantly better than Safety-Test ABO. CONCLUSION: Although the experts considered Vu-Test to be better than Safety-Test ABO, error rates were high with both devices.

ABO Blood-Group System↗