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J M Chabot

Publications and source records attributed to J M Chabot.

79 records · Page 5Linked to original sources
PubMed1992

[Iatrogenic disease observed in a hospital setting. II. Analysis of causes and suggestions for novel preventive measures].

In a previous article, we reported the results of a survey of iatrogenic illness in teaching hospitals. In the second part of this study, we shall consider the origins of the 109 adverse events which occurred in a 24-hour period among 1733 hospital patients in a total of 43 units (mean prevalence, 6.28%). In a total of 89 cases (83 of which were drug-related and 6 of which were of various non-instrumental causes), self-treatment and/or poor patient compliance appeared to be the main cause in 16 (18%); negligence or erroneous prescription (non-respect of a contraindication, wrong indication or dosage, excessive duration of treatment, inadequate monitoring, etc...) appeared to be responsible in 27 cases (30.3%). It may be that at least some of these cases of iatrogenic illness due to errors or negligence on the part of the patient and/or physician (48.3%) could be avoided in future by better training of health personnel and improved public health education. The human and financial costs of iatrogenic illness show that risk-prevention measures are required; we propose a number of strategies concerning both initial training in medical school and ongoing education in therapeutics, together with ways of improving the behaviour of both physicians and the pharmaceutical industry. The latter suggestions are addressed at the media and the health authorities; some concern legislation, while others are aimed at improving early public health education, an essential element in this setting.

Hospitals, University↗
PubMed1992

[Iatrogenic illness observed in the hospital environment. I. A report of 109 cases collected in a cross-sectional APNET study].

In an "on a given day" study, we analysed the prevalence and causes of drug-related and non-drug-related iatrogenic illnesses for educational and preventive purposes. Forty-three hospital departments of various specialties and involving 62 APNET members participated in the study. From a total of 112 cases reported, 109 were considered iatrogenic illnesses on the basis of the French criteria for adverse effects. Four major types of iatrogenic illness were defined, as follows: I--drug-related cases (n = 83); II--miscellaneous cases (n = 6); III--cases due to therapeutic instrumentation (n = 16); IV--cases due to diagnostic instrumentation (n = 4). Overall, 6.28% of the patients admitted presented an iatrogenic illness; 67 (61.46%) of the 109 cases concerned women and 66 (60.55%) concerned patients aged 65 years or more. The types of illness in the "drug-induced" and "miscellaneous" categories were endocrine and metabolic disturbances (n = 14), gastrointestinal conditions (n = 13) and hematological disorders (11 cases of bone marrow aplasia). Instrument-related iatrogenic illnesses comprised cardiovascular conditions (n = 6), locoregional anatomic lesions (n = 5), infectious complications (n = 3), bleeding (n = 3) and others (n = 3). Seventeen incidents were benign, 38 dangerous and 51 serious; there were three deaths. The main drug categories concerned in the 89 cases of "drug-related" and "miscellaneous" iatrogenic illnesses were as follows: cardiovascular agents (n = 20), antiinflammatory and analgesic drugs (n = 18), hormone and nutritional treatments (n = 11) and neuropsychiatric drugs (n = 11). Instrument-related iatrogenic illnesses chiefly involved venous approaches (n = 8), surgery (n = 4), intensive care procedures (n = 2), renal dialysis (n = 2) and radiation therapy (n = 2). The main causes of drug-related iatrogenic illnesses were self-treatment (n = 8), poor compliance (n = 8), and therapeutic errors (n = 27) [non-respect of a contraindication (n = 2), wrong indication (n = 6), excessive dose (n = 13), over-prolonged treatment (n = 2) and other errors (n = 4). A cost-analysis of 74 of the 109 cases gave a minimum figure of 2 million French francs. The human and financial costs of iatrogenic illnesses show that risk-prevention measures are required; these will be dealt with in a later paper, but should be based on stricter regulations and educational programmes aimed at doctors, patients, the general public, the pharmaceutical industry and the health authorities.

Cross-Sectional Studies↗
PubMed1990

Simultaneous dorsal dislocation of interphalangeal joints in a finger.

Simultaneous proximal and distal interphalangeal joint dislocations in a single finger are rare. Even though the joints above and below are routinely evaluated, one of the joint dislocations can be missed. When phalangeal dislocations are suspected, special attention should be given to obtaining sufficient roentgenographic views both before and after reduction. The joints should be thoroughly examined in an attempt to distinguish capsular contraction from soft-tissue interposition. Failure to recognize initial simultaneous dislocations may result in capsular contraction and require surgical intervention.

Adult↗
PubMed1988

[A study of hematology questions on the competitive examination of medical residents 1984, 1985 and 1986].

The recently (1984) introduced new modalities for selecting the residents in France is based upon multiple choice (MCQ) questions (2/3) and written answers to patients managements problems (PMP) (1/3). MCQ and PMP are selected by a group for 8 hematologists from the 42 French schools of medicine. The process of selecting the questions, the major topics explored by these questions, the docimological quality of the questions and the most surprising errors made by the candidates are studied. Results argue for a sustained effort in order to improve the teaching of the basis of hematology in our country.

Educational Measurement↗
PubMed1984

Patient-management problems as a learning tool for the continuing medical education of general practitioners.

The value of Patient-Management Problems (PMPs as a learning tool for continuing medical education was studied by using two frequently seen cardiovascular problems (angina and high blood pressure) and a province-wide sample of full-time general practitioners. The results indicate that PMPs can be a motivating and effective means of CME for the general practitioner; that knowledge was gained through the successive resolution of three pmps; that corrective feedback enhanced learning; and, that most of the knowledge gained on the paper cases was transferred to practice as reported by the participants on a questionnaire. Furthermore, while cueing may be a confounding factor when PMPs are used for evaluation purposes, it was shown to facilitate learning in the present learning context.

Education, Medical, Continuing↗