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Biomedical subjects

M Gaillard

Publications and source records attributed to M Gaillard.

At least 37 records · Page 2Linked to original sources
PubMed1995

Local inhibition of sebaceous gland growth by topically applied RU 58841.

The biological activity of a series of nonsteroidal, pure androgen receptor inhibitors was compared using the Syrian hamster ear skin sebaceous gland model. RU 58841, RU 56187, RU 38882 and cyproterone acetate were applied topically for 4 weeks on the ventral ear pinna of sexually mature male Syrian hamsters. Their order of efficacy was as follows: RU 58841 > RU 56187 > RU 38882 > cyproterone acetate. Maximal reduction of 60% in the size of the sebaceous glands was observed in hamsters treated with RU 58841 at a dose of 10 micrograms per day. This degree of inhibition occurred without any systemic side effects as shown by the absence of inhibition on the contralateral untreated ear pinna. Longer treatment did not produce greater inhibition since extending the treatment period from 4 weeks to 12 weeks showed similar data. The effect of RU 58841 was reversible since the inhibited sebaceous glands returned to normal size within 4 weeks after the cessation of the topical applications. The potent localized inhibition of sebaceous glands by RU 58841 demonstrates the excellent potential of this compound as a topical drug for the treatment of acne and other androgen-mediated disorders.

Administration, Topical↗
PubMed1994

Serotonine and suicide: a preliminary study concerning a sample of violent suicidal patients.

1. A sample of patients having attempted to commit suicide by using violent methods (hanging, jumping) was investigated according to the following procedure: for each patient, some evaluative tests (the MADRS, the SCL 90 and an agressivity scale) were administered and DSM III diagnosis was provided as well as the therapeutical orientation. 2. The 5 HIAA' level was measured in the CSF soon after the suicide attempt except for patients with rachis fracture or exposed to a cerebral oedeme. 3. Results were compared to those of a control group composed with patients having operated with rachi-anesthesia for orthopedic surgery. 4. The preliminary results show that 5 HIAA' levels were lower for suicide patients except for one schizophrenic patient. 5. This study suggests the possible link between a low 5 HIAA' level in CSF and the clinical aspects of severe suicidal behaviour.

Adolescent↗
PubMed1992

Cost-utility analysis of early thrombolytic therapy.

167 patients suffering from acute myocardial infarction (AMI) were recruited from 12 cardiology centres and given thrombolytic treatment. Cost-utility analyses were performed and a cost-utility ratio was computed according to time of initiation of thrombolysis after the AMI and the location of the infarct. Early thrombolysis ( less than 3 hours) proved to cost about the same per QALY ($US3734 vs $US3577) as late thrombolysis ( greater than 3 hours), although posterior infarcts cost slightly more per QALY ($3433 vs $2996) than anterior infarcts. Quality of life coefficients for all patients after the AMI were judged to be about 40% less than before the AMI. Thus, in terms of resources consumed and patient well-being, time of treatment initiation or location of the infarct were less significant than the fact of having an AMI. In terms of quality of life, the best strategy is that which seeks to prevent AMI occurring.

Anistreplase↗
PubMed1992

[Considerations on 2 cases of accidental hanging in 3-year-old children].

Two cases of accidental hanging that occurred at school in comparable circumstances in two three-year-olds are reported. The opposite outcomes in these two cases together with data from a review of the literature highlight the importance of first aid training to give victims of such injuries the best chance of survival.

Accidents↗
PubMed1991

[Emergency medical care and severe home accidents in children. Study of 630 cases over 5 years. Their significance in traumatic accidents].

Among calls put through to the Mobile Emergency Unit of a Paris urban area district for a pediatric problem over a five-year period (n = 630), 19% were for a household injury (with or without physical injury) and 22% (n = 712) were for a physical injury outside the home. Thus, injuries were the reason for over 40% of pediatric calls and half these injuries occurred in the child's home. Household injuries were serious, with a prehospital mortality rate of nearly 5% and intensive care treatment in one-third of cases. Fifty-five per cent (60% in boys) of household injuries occurred in preschool-age children. Half these injuries (burns excluded) were physical injuries (66% in boys). Forty per cent of household injuries (n = 251) were caused by a fall, from over one meter in half the cases. Most of these injuries occurred around mealtimes (3/4 of cases). As compared with out-of-home childhood injuries, prehospital mortality rate was significantly higher (p less than 0.001) and single injuries significantly more prevalent (p less than 0,001) in household physical injuries. Prevalences of lesions of the face, head and neck, chest, abdomen, and pelvis were comparable for out-of-home and at-home physical injuries; conversely, lesions of the upper limbs were more common in household injuries (p less than 0,01), whereas lesions of the lower limbs were more prevalent in out-of-home trauma. Lastly, household physical injuries occurred mainly in children under five, whereas out-of-home childhood injuries were more common after five years of age (p less than 0,001).(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1990

Pre-hospital thrombolysis, is it useful?

Thrombolytic treatment efficacy is greater when the delay between onset of pain and treatment is short. One way to shorten this delay is to give treatment at home, but one cannot recommend this technique if it has not been demonstrated first, that pre-hospital thrombolysis is feasible and safe, and second, that it is useful. We have been able to demonstrate that pre-hospital thrombolysis with APSAC is feasible and safe. Our findings are similar to those of other teams using other drugs. Whether pre-hospital thrombolysis is useful has not been adequately assessed; and we consider that first, the benefit of pre-hospital vs in-hospital thrombolysis must be determined, and second, the results of a study involving many centres, with various levels of training, practicing pre-hospital thrombolysis must be examined. Two large scale studies are currently being performed. One in Seattle, uses left ventricular ejection fraction as the major end-point, whereas the other, the European Myocardial Infarction Project, (EMIP) is using total mortality. Data currently available indicate that pre-hospital thrombolysis with APSAC is feasible, easy and safe. We hope that we will very soon be able to answer the last question: is it useful?

Anistreplase↗
PubMed1990

Cost-benefit analysis of thrombolytic therapy.

Thrombolysis is a new treatment for myocardial infarct patients, 162 such patients were studied: 62 received thrombolytic treatment and 100 a classical therapy. For cost-benefit analysis, all patients were followed for at least 1 year and received an identical questionnaire to assess the costs induced by this disease. At 1 year, 10% had died in the two groups. Patients who received thrombolytic treatment had a hospital stay 2 days longer, on average, but were readmitted for shorter periods (10.3 days less). Thrombolysis was more expensive (10,550 pounds vs 8998 pounds). Therefore, it is necessary to invest 150 pounds to reduce rehospitalization time by 1 day. Benefits were almost 31% greater for thrombolysis patients and the cost-benefit ratio was about 0.7. Thus the monetary benefits, initially rather negative, became positive at the end of the first year.

Anistreplase↗
PubMed1990

Mortality prognostic factors in chest injury.

1,026 multiple trauma patients (P) were compared to P with chest injuries (PCT) (407). Severity indices were related to type of thoracic injury and mortality. The Injury Severity Score (ISS), Glasgow Coma Scale (GCS), Trauma Score (TS), CHOP, and the Respiratory Index (RI) were used. The mortality rate of P was 27.1% but increased to 32.9% for PCT (p less than 0.05). We noted that mortality rate was highly dependent on major chest trauma: 68.6% for flail chest (FC), 56% for lung contusion (LC), 42.3% for hemothorax (HA), and 38.1% for pneumothorax (PN). ISS and RI scores for PCT survivors were greater than ISS + RI scores for P survivors (p less than 0.05 and p less than 0.01). ISS values for LC, HA, and PN PCT survivors were greater than the ISS of P survivors (p less than 0.01). Nonsurviving PCTs, especially those with lung contusion, showed a highly significant increase in ISS and RI scores.

Adolescent↗
PubMed1990

[Short- and long-term outcome of 250 patients admitted in surgical intensive care units after multiple injuries].

Two hundred and fifty polytrauma patients (mean age: 30 years) had been hospitalizated in the same trauma center, along a period of two years. Hospital mortality rate was 33% (11% in the first day). The mean I.S.S. of alive patients was 25, and 35 for dead patients. Long term survey was analysed by three questionnaires (before one year, between one and two years and after two years). Answer rate was about 80%. Sixty hundred p. cent of patients worked less than one year after multiple trauma, and 80% between one and two years; 75% noted that their family life was normal less than one year after injury; 80% presented sequelae two years after; they were subjective in 60% of cases. These sequelae did not interfere with family life or work. There was no parallelism between objective sequelae and duration of work stop in one side and gravity of lesions (I.S.S.) in other side.

Adult↗
PubMed1990

[Activity in an emergency care unit: experience of a patient care team].

An emergency and intensive care medical team (physicians, specialised nurses in anesthesia, paramedics) works in a mobile intensive care unit and in a Emergency room. The functions are to provide intensive care, to validate the pre-hospital diagnosis and also to prepare the optimal hospital admission. This organisation realize a "short route" to emergency hospitalisation. A questionnaire to this medical team enquired for their appreciation of the activity, for their implication and feeling, individual and collective, of death's experiences, of works organisation, and of requirements. Mainly, it appears that, with high level of education and various qualification, occupational stress and negative impact on patient care are not described. Further studies are needed to verify.

Attitude of Health Personnel↗
PubMed1990

[Severe suicides: short- and long-term outcome. Assessment of their quality of life].

From January 1977 to December 1982, 160 patients (10 to 55 years old) were admitted in a traumatic Intensive Care Unit after serious attempted suicides. Hospital mortality rate was about 34%. A questionnaire was sent to alive patients in 1983 (median delay between attempted suicide and questionnaire: 3.5 years); 68 were alive in 1983, 46 answered to questionnaire, 3 were died (two according to a new suicide); 32 could not be found; 85% of contacted patients answered (they were comparable in age, sex and means used in their suicide attempts, to the others). One patient about two must be rehospitalised one or more times. One patient about two must be always take drugs; 85% worked. Over 50% of the patients considered they had returned to their former way of life but 50% presented increased difficulty to work, and 25% said that they had no sequelae. Any of these 46 patients had made an other attempt suicide.

Adolescent↗
PubMed1989

Prehospital use of APSAC: results of a placebo-controlled study.

Thrombolytic treatment efficacy is greater when the delay between onset of pain and treatment is short. To give treatment before admission to a coronary care unit, responsibility needs to be transferred from cardiologists to other physicians working in mobile care units. We conducted a 2-part feasibility study to investigate this strategy. Part 1 evaluated the diagnostic accuracy of mobile care unit physicians. Results from this study indicate that with regard to the diagnosis of acute myocardial infarction, the risk of a wrong diagnosis is low. Part 2 was a placebo-controlled trial involving 100 patients in which 57 received anisoylated plasminogen streptokinase activator complex (APSAC) (30 U) at home and 43 received placebo at home. Patients receiving placebo at home were reevaluated on arrival in a coronary care unit and received APSAC (30 U) if indicated. The main results were that (1) diagnostic accuracy was good--all patients had an acute coronary syndrome and 97 of 100 patients had myocardial infarction; (2) time gain was approximately 60 minutes; (3) coronary patency rate was 72%; (4) ejection fraction was higher in the prehospital group (56.7%) than in the control group (53.4%), but the difference was not significant; (5) there was no rhythmic or bleeding complication related to the prehospital treatment; (6) 5 patients died from cardiogenic shock--2 between home and hospital and 3 in the hospital (3 received thrombolytic treatment at home and 2 received placebo at home and APSAC in the hospital); and (7) prehospital administration of APSAC did not induce a delay in arrival to the coronary care unit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗