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Biomedical subjects

M Gauthier

Publications and source records attributed to M Gauthier.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Reason for admission and cause of death in a multidisciplinary pediatric intensive care unit].

In contrast with neonatal intensive care services, paediatric intensive care units are relatively new; thus, it is not surprising that their clientele has not been well described in the medical literature. In order to better define it, we did a retrospective analysis of 4646 consecutive admissions of children aged between a week and 18 years to a multidisciplinary paediatric intensive care unit over a period of five years (1979-83). This unit belongs to a 700-bed paediatric hospital delivering medical as well as surgical tertiary care. Of the 4646 admissions, 2527 (54.3 per cent) were surgical and 2119 (45.6 per cent) medical. There were multiple diagnoses on admission. Among the most frequent diagnoses were major trauma (9.6 per cent of total), intoxications (4.6 per cent) and congenital cardiopathies in the postoperative phase of a corrective or palliative surgery (tetralogy of Fallot (2.8 per cent), ASD (2.7 per cent), etc.) The global mortality rate was 5.8 per cent (268/4646). Severe infections and cardiopathies, mostly congenital, were responsible for almost half the deaths (24.2 per cent each). This description of patients and problems encountered in a paediatric intensive care unit should facilitate planning for personnel training and can be used to establish guidelines for reducing mortality.

Adolescent↗
PubMed1986

Group A streptococcal supraglottitis.

We describe four children with severe supraglottic infections caused by group A beta-hemolytic streptococci. In each case the clinical presentation suggested Hemophilus influenzae epiglottitis. In only one patient was there significant involvement of the epiglottis, whereas all had striking inflammation of the aryepiglottic folds. Group A beta-hemolytic streptococcus was isolated in blood cultures in two patients and from the supraglottic area and trachea in two others. Fever persisted for 6 to 22 days, and tracheal intubation was necessary for 2 to 16 days, despite appropriate antibiotic therapy. The evolution of streptococcal supraglottitis may be protracted, and it must be managed accordingly.

Child↗
PubMed1986

[Anatomico-functional approach to the mechanisms of memory: analysis by deoxyglucose of the limbic activation induced by electric stimulation of the mouse entorhinal cortex].

Previous behavioral studies using post-training electrical stimulation of the brain have suggested that the lateral entorhinal cortex (LEC) is involved in mnemonic processes. In an attempt to characterize in vivo the neural pathways activated by LEC stimulation, regional patterns of uptake of 14C-2-deoxy-D-glucose (2-DG) were assessed in BALB/c mouse brain. The animals were implanted with a bipolar electrode in the LEC and a catheter in the jugular vein. In addition, four animals received an electrolytic lesion of the perforant path (PP) in order to disconnect the LEC from the hippocampus. The LEC was stimulated at subconvulsive intensity for 5 min. before and 30 min. after an injection of 2-DG. Stimulation of the LEC produced significant increases in 2-DG radioactivity in the hippocampus (dentate gyrus, CA3, CA1), subiculum and pre-subiculum. Demonstrable labelling was found in brain areas, beyond the hippocampal formation: piriform cortex, amygdala, cingulate cortex, Diagonal Band of Broca, the medial and lateral septal nuclei and the medial forebrain bundle. After PP lesion, the metabolic activity disappeared ipsilaterally in subiculum, dorsal part of the hippocampus, in some thalamic nuclei and in mammillary bodies, but all other extra-hippocampal labelling was unchanged. These data considered along with our previous behavioral results, suggest that LEC stimulation may act on mnemonic processes by the recruitment of cortical and subcortical extra-hippocampal structures (e.g. amygdala and cingulate cortex) directly or indirectly connected to the entorhinal cortex.

Animals↗
PubMed1985

Lesion of the temporo-ammonic perforant path facilitates self-stimulation of the lateral entorhinal cortex in mice.

The effect of a lesion of the perforant path (PP) on self-stimulation (SS) of the lateral entorhinal cortex (LEC) was tested in mice between 8 and 21 days after surgery. The current intensities tested ranged between 0 and 80 microA (peak to peak 100 Hz sine-wave). The PP lesion led to a two-fold increase in SS rates at intensities above 30 microA without affecting the baseline SS rates (0 microA) and SS threshold (30 microA). The lesion also led to a significant increase in LEC after-discharge (AD) threshold and eliminated behavioral convulsions during SS testing. The suppression of AD by i.p. Na phenobarbital injection (10 mg/kg) led to a similar increase in SS rates in sham-lesioned mice; there was no difference in PP-lesioned animals. These results might be interpreted as evidence in favor of an independence of the neuronal processes mediating entorhinal and hippocampal reward-related behaviors.

Animals↗
PubMed1985

[Orbital apex syndrome in a child with Wegener's granulomatosis].

The authors report the case of a 10 year-old child presenting with orbital apex syndrome as the initial manifestation of Wegener's granulomatosis. Orbital apex syndrome is characterized by complete or partial paralysis of the third, fourth and sixth cranial nerves with involvement of the trigeminal nerve's ophthalmic branch. The different mechanisms responsible for ocular complications in Wegener's granulomatosis and the usefulness of computer assisted tomography in this clinical situation are discussed.

Child↗
PubMed1984

Late post-learning effect of entorhinal cortex electrical stimulation persists despite destruction of the perforant path.

In an appetitive learning task in mice, stimulation of the lateral entorhinal cortex (LEC) 30 min after training produced an improvement in retention 24 h later, as well as faster extinction of conditioning. This effect persisted in animals with bilateral lesions of the perforant path. In addition, the threshold for hippocampal after-discharges produced by LEC stimulation was raised significantly in perforant-path lesioned animals. The results indicate a functional dissociation between hippocampal and cortical mechanisms involved in memory consolidation.

Animals↗
PubMed1984

Dissociation of limbic structures by pharmacological effects of diazepam on electrical self-stimulation in the mouse.

The effect of diazepam was tested on self-stimulation (SS) in 21 mice implanted with a bipolar electrode in the lateral hypothalamus (LH), the dorsolateral hippocampus (HPC) or the lateral entorhinal cortex (LEC). Diazepam, injected i.p. in doses of 0.5, 1 and 2 mg/kg, significantly increased SS rates with electrodes in LH while 4 and 8 mg/kg of diazepam had no significant effect. At low doses, similar increases were seen in mice with LEC electrodes but high doses produced a significant suppression. HPC animals showed an almost total suppression of SS beginning at 2 mg/kg of diazepam; lower doses had no significant effect. The results indicate that entorhinal and hippocampal SS are at least partly independent phenomena; in addition, the suppression of SS by moderate doses of diazepam remains specific to the HPC among the brain structures studied to date.

Animals↗
PubMed1984

[Continuous phentolamine perfusion in the treatment of severe arterial hypertension associated with neuroblastoma].

Treatment of severe arterial hypertension associated with neuroblastoma is not well discussed in the literature. A six-month-old boy was referred for evaluation of an abdominal mass which proved to be neuroblastoma stage IV. Arterial hypertension of 26/16 kPa (190/110 mmHg) was also found. Because of the degree of malignancy and the risk of intra-tumoral haemorrhage, urgent management of the hypertension was required before proceeding to surgery. Phentolamine, a short-acting alpha-blocking agent, was administered as a continuous infusion of a 0.01 per cent solution, at a rate of 1 to 4 microgram X kg-1 X min-1 titrated according to the arterial blood pressure (BP), central venous pressure and urinary output. BP was rapidly controlled and the child went to surgery within 48 hours. The operation was uneventful but only 80 per cent of the tumour could be resected. Phentolamine was discontinued intraoperatively but was reinstituted postoperatively when hypertension recurred. With the return of normal intestinal function five days after surgery, phenoxybenzamine was begun p.o. and phentolamine was tapered over 24 hours and discontinued. A continuous infusion of phentolamine provided satisfactory control pre- and post-operatively with no significant hypotension. We consider this technique to be potentially very useful in the management of severe arterial hypertension associated with neuroblastoma, as it permits early surgical intervention under optimal conditions.

Abdominal Neoplasms↗
PubMed1984

Stimulant medications in adults with attention deficit disorder.

The long-term prospective studies done in the last two decades on children suffering from attention deficit disorder with hyperactivity (ADD-H) give evidence of persistent disability in a majority of them when they reach adulthood. The literature on the use of stimulant medication in adults suffering from attention deficit disorder, residual type (ADD-R), is critically reviewed. After optimistic case reports two controlled double-blind studies have recently showed contradictory results. Some adults appear clearly to be helped by stimulant medication, but more investigations, especially with children diagnosed in childhood and followed-up, are needed before any firm conclusion can be made about the usefulness or non-usefulness of stimulants in ADD-R. There, as it is the case in childhood, medication might be insufficient by itself and might have to be associated with other forms of treatment.

Adolescent↗
PubMed1984

Countertransference and supervision: a discussion of some dynamics from the point of view of the supervisee.

Although the important role of supervision in the training of psychotherapists is generally well recognized, it does remain a neglected topic in daily psychiatric practice. An overview of the abundant literature written on the subject shows the paucity of papers that take the perspective of the supervisee and subjectively describe the experience. A common difficulty of the supervisory process appears to be the management of the therapist's feelings both in his relationship with the patient and with the supervisor. This problem is approached from the point of view of the supervisee, using a group perspective. A clinical vignette, from a supervised individual psychotherapy process illustrates how supervision is a mourning process where frustrations and losses abound. The difficult task of working through these conflictual feelings is fundamental for the supervisee if he wants to learn from the experience. Within this painful process (and to avoid it) many defensive mechanisms are often used and are described by the author along with some of their possible psychodynamics.

Adult↗
PubMed1984

[Differentiation of the effects of diazepam on self-stimulation behavior as a function of the structure of the stimulated brain].

The effect of diazepam was tested on self-stimulation in 21 mice with a bipolar electrode in lateral hypothalamus (HL), dorsolateral hippocampus (HPC) or lateral entorninal cortex (CEL). Diazepam at 0.5, 1 and 2 mg/kg significantly increased self-stimulation rates in HL while 4 and 8 mg/kg had no significant effect. Similar increases were seen in CEL mice but high doses produced a significant suppression. HPC animals showed a drastic suppression of self-stimulation beginning at 2 mg/kg of diazepam, lower doses having no significant effect. The results demonstrate that entorhinal and hippocampal self-stimulation involve at least partly independent neuronal mechanisms and point to a possible inhibitory influence of HPC and CEL.

Animals↗