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M Poupard

Publications and source records attributed to M Poupard.

4 recordsLinked to original sources
PubMed2003

[Prevalence and incidence of dementia among the very old. Review of the literature].

BACKGROUND: The increasing number of elderly and very old people observed in France for more than 20 years raises the problem of an expected increase in the prevalence and incidence of dementia in this population. Prevalence and incidence estimates for persons older than 85 years are incomplete and discordant. This information is crucial for organizing future health and social care. OBJECTIVE: Review of literature of prevalence and incidence of dementia for people older than 85 and their link to aging. METHODS: A Medline search has led to a selection of 50 articles. RESULTS: Some studies conclude that there is an exponential relationship of incidence with age; some, a decrease of dementia in the oldest old population. Prevalence estimates in these studies fluctuate between 15 and 40% and incidence between 60 and 100 person-years. CONCLUSION: The variation of prevalence and incidence estimates for 85 and over are partly due to methodological differences and limitations between studies. Further research is needed to include larger samples of persons aged 85 and over and to confirm results where clinical and public health consequences are major issues.

Age Factors↗
PubMed1994

[Emergency cesarean section: role of locoregional anesthesia].

Emergency cesarean section is sometimes required for acute fetal distress but also for some maternal vital emergencies. In spite of its maternal (Mendelson's syndrome, difficult intubation) and fetal (neonatal depression) risks, general anaesthesia was classically used. The arguments in favor of regional anaesthesia techniques for emergency cesarean section and the respective advantages of spinal and epidural anaesthesia are developed in this text. The already functioning epidural catheter can be used to rapidly convert analgesia for labor to anaesthesia for cesarean section: this situation is probably the simplest to manage but requires that parturients at risk for cesarean section were recognized in early labor, especially all the parturients with a suspected difficult airway. In case of patchy or unilateral analgesia, it is particularly important to resite the catheter to avoid the need for emergency general anaesthesia to solve an inadequate epidural anaesthesia for cesarean section. Spinal anaesthesia is the technique of choice for its rapidity of action but its hemodynamic risks need a prior careful evaluation of maternal hemodynamics. General anaesthesia will be always indispensable in some cases; therefore, every anaesthetist should maintain sufficient experience and skills in the management of some of its complications, especially intubation difficulties.

Adult↗
PubMedDate not supplied

Survey of regional anesthetic practice among French residents at time of certification.

BACKGROUND AND OBJECTIVES: A survey of anesthesia practice was conducted among French residents in anesthesia at the end of their training. This study was performed mainly to evaluate the residents' experience in peripheral nerve blocks. METHODS: Two short clinical cases were proposed to all French residents during a telephone interview immediately before their certification. The first described the case of a young asthmatic patient admitted for an elbow fracture. The second described an elderly woman with severe aortic stenosis admitted for a supracondylar fracture of the femur. A questionnaire had been prepared and was filled in during the interview. Each resident was asked to answer according to the actual choice he or she would have made. For both cases, when general anesthesia was chosen first, the next question was to discuss which regional anesthesia would be used if general anesthesia had to be discarded. In that way, the practical knowledge about most common peripheral nerve blocks learned during residency was investigated. RESULTS: Of 77 residents registered as being at the end of their residency, 8 were on either sabbatical or maternity leave. Regional anesthesia was the first choice in 78% and 57% of cases for the first and second clinical cases, respectively. The regional anesthetic techniques chosen were axillary block (66%), interscalene block (31%), and intravenous regional anesthesia (3%) for case 1 and combined lumbar plexus and sciatic block (36%), epidural anesthesia (30%), single-shot spinal anesthesia (18%), and continuous spinal anesthesia (16%) for case 2. Throughout the residency of the group, 32 +/- 2 axillary blocks, 12 +/- 2 interscalene blocks (axillary vs interscalene, P < .0001), 21 +/- 3 femoral blocks, and 10 +/- 2 sciatic blocks (femoral vs sciatic, P < .0001) had been performed (mean +/- SEM). They had also performed 2.5 +/- 0.5 continuous spinal anesthesias and 17 +/- 3 intravenous regional anesthesias respectively. Upper extremity blocks were more often used during residency than lower extremity blocks (44 +/- 3 vs 31 +/- 4, P < .01). A peripheral nerve stimulator was routinely used by 83% of residents. CONCLUSION: French residents in anesthesiology at time of certification are better trained for peripheral nerve blocks of the upper extremity than for those of the lower extremity. Axillary plexus and femoral nerve block are the most widely used blocks, probably reflecting the techniques the most mastered among teachers. Finally, the extensive use of a peripheral nerve stimulator by residents is probably the result of the widespread use of this device by teachers in France.

Adult↗