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P Chastonay

Publications and source records attributed to P Chastonay.

At least 19 recordsLinked to original sources
PubMed2001

[Coronary artery bypass by mini-thoracotomy: noticeable benefits with clinical experience of the treatment team].

AIM OF THE STUDY: Minimally invasive coronary artery bypass surgery is fundamentally different as compared to open sternal approach under cardiopulmonary bypass. Modifications of the surgical, anesthesiologic and post-operative techniques are necessary before evaluation of its real benefit. We analyze the potential effect of a learning period on the short term results of this technique. METHODS: From July 1997 to February 1999, 20 patients were operated using this method. We compare the results of the first 10 patients (group 1: 8M/2F, 59.6 +/- 13.8 years) to those of the last 10 patients (group 2: 8M/2F; age = 63.2 +/- 6.1 years). DISCUSSION: Progress between the two groups is striking. Left anterior descending coronary clamping time could be reduced from 28.5 +/- 2.4 min. in group 1 to 22.2 +/- 1.8 min. in group 2 (p < 0.05), and operative time was reduced from 125 +/- 4 min. to 97 +/- 5 min. (p < 0.005). The post-operative atrial fibrillation rate diminished from 4/10 in group 1 to 1/10 in group 2.3/10 patients in group 1 suffered a post-operative pneumonia whereas none in group 2 had pulmonary complication. The stay in the intensive care unit could be reduced from 2.3 +/- 0.3 days to 1.4 +/- 0.2 days (p < 0.05) and the total post-operative stay diminished from 8.5 +/- 0.9 days to 4.7 +/- 0.5 days (p < 0.005). CONCLUSION: There are evidence for a learning period in minimally invasive cardiac surgery. Short term benefits of this technique are then evident as demonstrated by a reduction in the ICU stay and the hospital stay.

Adult↗
PubMed1999

[Malignant hyperthermia].

Malignant hyperthermia is a serious anesthetic complication, presenting with various manifestations, with high mortality and morbidity. There are several incomplete and abortive forms, and the clinicians must be aware of the possibility of malignant hyperthermia, and recognize the first signs of the hyperthermic crisis hyperthermia, hypermetabolism and muscular rigidity. Screening is performed by in vitro contracture testing on a muscular biopsy. Treatment is based on discontinuation of triggering agents and dantrolene administration, as well as supportive care. Cellular investigations demonstrate that the malignant hyperthermia crisis presents as an intracellular flooding with calcium, leading to an abnormal muscular contracture. Several mutations in particular involving the ryanodine receptor gene have been linked to malignant hyperthermia.

Biopsy↗
PubMed1997

[Educational strategies and tools in a public health program at the University of Geneva].

In the Swiss context, the newly developed MPH programme at the University of Geneva is experimental in educational matters. Indeed the programme is fully learner-centered and community-oriented. Throughout the curriculum students plan, implement and evaluate intervention programmes or/and research projects related to health problems of the communities they are in charge of. In this article, we describe the educational strategies and tools used in this MPH curriculum (professional profile, mind-mapping procedures, field-work either on research projects or on intervention programmes, group work and evaluation procedures). These strategies and tools might assist some educational experimentation in MPH programmes in search of public health relevance and pedagogic efficacy.

Certification↗
PubMed1996

[Eating behavior of 12-16-year olds of French-speaking Valais: cross-sectional survey among 962 secondary students].

Eating habits that are potentially harmful are picked up during the teens. The aim of the study is to identify the main eating habits of 12-16 year-old teenagers of central Valais in order to plan better targeted health promotion interventions. The study design is cross sectional. An anonymous questionnaire was taken by a sample of 962 teenagers. Some results: 25.2% did not have breakfast every day, 37.0% did not eat neither fruit nor vegetable the day before, 58.2% had a soda drink the day before, 5.5% of the 12 of the 16 year-old ones and 51.2% year old ones drink some alcohol over the weekends. Possible health promotion interventions are listed.

Adolescent↗
PubMed1991

The construction of a 'topic tree': a way of familiarizing a teaching staff to problem-oriented learning in a master's programme in public health.

At the planning stage of a community-oriented and problem-based learning master's programme in public health it is indispensable to build a network of teachers, experts in specific fields, willing to guide the students in acquiring new competencies and ready to facilitate the experimental learning process. We discuss in this paper the construction and the utilisation of the 'topic tree'. In addition we show how the teaching staff get acquainted with that educational methodology by experimenting with it themselves (prior to the students). About 10 experts, each one a specialist in a given field, have conceptualized their approach in building a topic tree (concept tree); such a tree makes it possible to schematize the topics to be understood in order to solve a given problem and the relationship existing between actions to be undertaken. The experiment, meant to initiate the teaching staff in experimental learning procedures, was appreciated by all the experts, who considered it a creative and stimulating method. It also permitted the construction of a bibliography including key documents concerning each identified priority health problem. We discuss the utility and the relevance of our approach in the perspective of initiating teachers in experiential learning based on problem-solving.

Algorithms↗
PubMed1989

[Late disseminated tuberculosis. Anatomo-clinical correlations in 40 cases].

Late disseminated tuberculosis has a diversity of clinical presentations and is difficult to diagnose. This disease has a growing importance in industrialised countries and we decided to study forty cases correlating autopsy findings with the clinical date. This diffuse form of miliary tuberculosis occurs long after the primary infection. It is a disease of the elderly (72.5% greater than 65, 32.5% greater than 80). It represented 42.5% of serious tuberculous cases observed at autopsy over the same period. At the top of the list of clinical presentations is fever (57.5%) followed by loss of weight (42.5%) and respiratory symptoms (32.5%). The diagnosis of tuberculosis was only considered in 37.5% of cases (15/40), however the pulmonary radiograph suggested the diagnosis in the majority of cases. In 62.5% of cases (25/40) tuberculous disease was not recognised in the clinic, the presenting symptomatology was attributed in nearly half the cases to neoplastic disease. Autopsy showed that the primary disease was caseous tuberculosis in 25% of cases and in 25% there was a cancer. Our observations underline the diagnostic challenge of late disseminated tuberculosis in clinical practice and also discern the particular clinical characteristics and anatomo-pathological features.

Adult↗
PubMed1988

[Tuberculosis simulating cancer. An autopsy study of 12 cases presenting diagnostic difficulties in clinical practice].

Tuberculosis may simulate cancer. We report on twelve cases with the clinical diagnosis of cancer in which autopsy revealed tuberculosis. Weight loss and fever were the most common symptoms. Chest x-ray abnormalities were seen in 50% of cases. A debilitating disease other than tuberculosis was present in 6 cases. Miliary disseminated tuberculosis was the most common form encountered at autopsy. Physicians should be aware that the clinical findings of tuberculosis may suggest malignancy.

Aged↗
PubMed1987

[Extensive active tuberculosis at autopsy: retrospective study of a collection of adult autopsies (1961-1985)].

While over the past decades tuberculous morbidity and mortality have steadily declined in Switzerland, tuberculosis has not been eradicated. The present study investigates tuberculosis in an autopsy material. From 1961 to 1985 severe active tuberculosis was seen in 1.9% of autopsies performed; pulmonary tuberculosis accounted for 54% and miliary tuberculosis 35.3%. The majority of cases of severe active tuberculosis were seen in the elderly. Clinically undiagnosed cases made up 44% of the cases. A constant decrease in severe active tuberculosis has been seen over the years, but clinically undiagnosed cases are on the increase.

Adult↗