PubMed Health⌕ Search

Biomedical subjects

M Gehri

Publications and source records attributed to M Gehri.

16 recordsLinked to original sources
PubMed2005

[Recognition of cardiorespiratory distress and failure in children].

Every pediatrician and general practitioner can face children with life-threatening conditions in their private practice. Recognition of symptoms of respiratory failure and shock is essential to initiate therapy promptly in order to prevent the development of cardiopulmonary failure. This article provides clinical information on detecting critical respiratory and cardiac conditions, anticipating cardiac arrest in children, establishing priorities in care, and transferring to an emergency center.

Child↗
PubMed2005

[Acute dyspnea in children].

Respiratory disease and acute respiratory difficulties are life threatening problems frequently met in paediatric medicine. Since parents often call their doctor first, telephone triage is important in the correct management of children with respiratory distress. On arrival in the office or the emergency department, a child with dyspnea should rapidly be assessed for signs of severity and respiratory compromise. Oxygenation and early initiation of specific treatment are priorities in the management. Only a simple and rigorous clinical process, based on the essential, will reach all these objectives without delay. As soon as the child's situation is stabilised, the doctor decides what are the appropriate modalities for transfer. This article aims at reviewing these different issues.

Acute Disease↗
PubMed2004

The oxygen concentrator: an appropriate technology for treating hypoxaemic children in developing countries.

The World Health Organization (WHO) recommends supplying oxygen in developing countries by concentrators because cylinders pose considerable logistic and financial problems. This technology was employed to treat children in a hospital in Ndioum, Senegal, who met the WHO oxygenation criteria. There were clear clinical and financial benefits, but neither the nurses' knowledge of the various techniques of oxygen supply nor the maintenance service were satisfactory. The use of concentrators should be encouraged in developing countries. A strategy including technical training, maintenance and monitoring should be adopted. Corrective actions were undertaken in Ndioum, and several concentrators are now being used on a regular basis.

Child, Preschool↗
PubMed2001

Epidemiological and economical impact of tuberculosis in an adolescent girl in Lausanne (Switzerland).

UNLABELLED: Patients with pulmonary tuberculosis (TB) can infect people in their environment but children and adolescents are rarely contagious. A recent case of an adolescent girl in Lausanne, however, proved to be infectious and required extensive contact tracing. SUBJECTS AND METHODOLOGY: The source case was a 15-years-old adolescent girl of African origin. Upon her arrival in Switzerland in 1994 the tuberculin skin test was 14 mm. The patient did not receive preventive treatment. She developed smear-positive pulmonary tuberculosis in May 1999. Contact tracing identified contacts in the surrounding population. The contact persons were divided into 3 groups according to their proximity. The first group consisted of close family and friends, the second of classmates and teachers and the third of more distant contacts. Costs were also evaluated. RESULTS: Of the 53 people examined, 24 (45%) were infected and required treatment. Eight out of 9 cases (88%) were infected in the first group (including another case of culture-positive pulmonary tuberculosis). Fourteen out of 33 cases (42%) in the second group and 2 of 11 (18%) to the third group. Passing from one proximity group to the next decreased the relative risk of infection 4 fold. The costs of contact tracing and treatment are estimated at over CHF 24,000. CONCLUSIONS: (1) Pulmonary TB can be contagious even in adolescents. (2) Subdividing contacts into proximity groups allows for better targeting of the people to be screened. (3) Contact tracing and the high costs involved could have been avoided if the patient had received preventive chemotherapy upon her arrival in Switzerland.

Adolescent↗
PubMed2000

[Carbon monoxide poisoning in children: never trivialize].

The risks linked to tissular hypoxemia after carbon monoxide (CO) poisoning are well known. Unawareness of CO exposure and of its complex pathophysiology may delay appropriate treatment and lead to long term neuropsychological sequelae. We report two cases of children treated in our institution and review the main issues regarding the optimal management. A high index of suspicion for carbon monoxide poisoning when dealing with an unclear neurological clinical presentation is mandatory. Classical therapy with normobaric 100% oxygen has to be instaured immediately. Hyperbaric oxygen therapy must be considered when anamnestic symptoms or clinical signs suggest neurological involvement even when carboxyhemoglobin values are low or already normalized.

Age Factors↗
PubMed1999

[Migrant populations at the Hôpital de l'Enfance of Lausanne (HEL): evaluation inquiry, taking care and contribution of cultural mediators-translators].

The number of patients belonging to migrant populations who consult Lausanne's Hôpital de l'Enfance (HEL) has increased massively in an exponential manner. HEL is a facility dedicated to children with a vocation of public health and training in a university setting and it has to make a point of developing an adequate and pertinent health care system for these populations. In order to do this, a study was undertaken in the form of a prospective survey including over a thousand ambulatory patients. Administrative data (origin, date of migration, nature of the permit and legal situation), social data (home language, professional situation, number of siblings), medical (diagnosis) and psychosomatic data (sleep, enuresis) was recorded as well as data testing the level of understanding between carrier and patient. The study allowed us to define priorities of intervention: introduction of a service of translators--cultural mediators trained by the association "Appartenances" (as well as on going follow-up and assessment of this service), training of health care workers in the fields of cultural mediation and the different aspects of migrant population medicine and, finally, the creation of a steering group within the Institution. Having allowed rapid and spectacular improvement in the quality of the service provided by the HEL, this process is also included in the will to improve health care given to migrant populations at local and national levels in accordance with the priorities defined by the WHO in this domain. It is this experience which is reported in this paper.

Child↗
PubMed1999

Home and hospital treatment of acute seizures in children with nasal midazolam.

Rectal diazepam is widely used in the treatment of acute seizures in children but has some disadvantages. Nasal/sublingual midazolam administration has been recently investigated for this purpose but never at home or in a general paediatric hospital. The aim of this open study was to determine the efficacy, the tolerance and the applicability of nasal midazolam during acute seizures in children both in hospital and at home. We included known epileptic children for treatment at home and all children with acute seizures in the hospital. In all, 26 children were enrolled, 11 at home and 17 in the hospital (including two treated in both locations); only one had simple febrile seizure. They had a total of 125 seizures; 122 seizures (98%) stopped within 10 minutes (average 3.6 minutes). Two patients in the hospital did not respond and in three, seizures recurred within 3 hours. None had serious adverse effects. Parents had no difficulties administering the drug at home. Most of those who were using rectal diazepam found that nasal midazolam was easier to use and that postictal recovery was faster. Among 15 children who received the drug under electroencephalogram monitoring (six without clinical seizures), the paroxysmal activity disappeared in ten and decreased in three. Nasal midazolam is efficient in the treatment of acute seizures. It appears to be safe and most useful outside the hospital in severe epilepsies, particularly in older children because it is easy for parents to use. These data should be confirmed in a larger sample of children. Its usefulness in febrile convulsions also remains to be evaluated.

Acute Disease↗