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Biomedical subjects

P Clement

Publications and source records attributed to P Clement.

11 recordsLinked to original sources
PubMed1992

Fiberoptic examination of the nasal cavity and nasopharynx in children.

In this prospective study, a flexible fiberoptic nasolaryngoscope with color video camera was used to examine the nasal cavity and nasopharynx in 180 pediatric patients. The relative size of the adenoid tissue was judged by endoscopy, which lead to a classification into 3 types according to the distance from the vomer to the adenoid tissue. The condition of the nasopharyngeal orifice of the Eustachian tube was also described and differentiated into 3 types relating to the condition of adenoid tissue. Assessment was performed by correlating these measurements with the tympanogram, lateral X-ray and clinical complaints. The authors conclude that: (1) fiberoptic examination allows direct visualization of the size and condition of the adenoid tissue, as well as of the condition of the nasopharyngeal orifice of the Eustachian tube. (2) The size of the adenoid tissue correlates very well with the nasal obstruction complaints as well as with the type of tympanogram. (3) The condition of the nasopharyngeal orifice of the Eustachian tube significantly corresponds with the type of tympanogram. (4) For the indication of adenoidectomy, fiberscopy gives more accurate information than standard X-ray. (5) With a correct choice of premedication and local anesthesia, it is a minor invasive technique which is very well tolerated by children. It is possible in all cases, provided it is performed by a skilled endoscopist and preceded by careful explanation to the child. (6) Finally, thanks to the possibility of direct visualization of the fiberscopic image via a monitor, it allows a better explanation of the indication for adenoidectomy to the child's parents.

Acoustic Impedance Tests↗
PubMed1992

Dose-response relations of doxacurium and its reversal with neostigmine in young adults and healthy elderly patients.

Dose-response relationships for doxacurium and neostigmine were established in 24 young (18-40 yr) and 24 elderly (70-85 yr) patients, ASA physical status I or II, anesthetized with thiopental, fentanyl, nitrous oxide, and isoflurane. Mechanomyographic response of the adductor pollicis muscle to the train-of-four stimulation of the ulnar nerve was recorded. Doxacurium (5, 10, 15, or 20 micrograms/kg IV) was administered by random allocation. After maximal blockade, and additional dose, for a total of 30 micrograms/kg, was administered. When first twitch height recovered to 25%, incremental doses of 5 micrograms/kg were administered for maintenance of relaxation. Neostigmine (5, 10, 20, or 40 micrograms/kg) was injected at 25% first twitch recovery, and neuromuscular monitoring was continued for 10 min. The doses of doxacurium (+/- SEM) required to produce a 50%, 90%, and 95% depression of twitch tension in the young patients were, respectively, 13.3 +/- 1.6, 23.6 +/- 2.8, and 28.6 +/- 3.4 micrograms/kg, not statistically different from corresponding values in the elderly, 11.8 +/- 1.3, 21.2 +/- 2.3, and 25.9 +/- 2.9 micrograms/kg, respectively. Time to 25% recovery after 30 micrograms/kg was 80.2 +/- 12.2 min in the young versus 133.0 +/- 17.1 min in the elderly (P less than 0.05). Neostigmine-assisted recovery was not significantly different in both groups. The estimated doses of neostigmine to obtain 70% train-of-four recovery after 10 min were 53.6 +/- 7.5 micrograms/kg in the young and 41.6 +/- 5.8 micrograms/kg in the elderly (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Crossroads in ambulatory surgery.

In its short history, same-day surgery has encountered several major decision points or crossroads: during its inception, and when facing the decision to expand to meet the needs of radiology, cardiology, and neurology. Changes in surgery toward less invasive procedures, such as laparoscopic, laser, and stapling procedures influence institutions to make major decisions involving same-day surgery. Perioperative nurses in ambulatory services are being compelled to look at efficiencies regarding patient contact and interaction. Major decisions regarding these nursing approaches must be made, just as major decisions have been required in ambulatory services in the past.

Ambulatory Surgical Procedures↗
PubMed1992

Twenty-three hour recovery: observation versus hospitalization.

In the wake of the rapidly changing health care delivery environment, it is becoming essential to health care organizations that unique, innovative methods of managing resources be implemented. Further, such developments must be achieved within the confines of those requirements and revisions occurring within the reimbursement structures of Medicare and Medicaid as well as other third-party payors in keeping with the delivery of quality patient care. The evaluation of patients in an outpatient environment for a period of time before a final decision regarding disposition is made creates the "observation concept." This article discusses the significance of 23-hour observation units for ambulatory surgery patients.

Adult↗
PubMed1991

[Statistical value of the various mathematical models in rhinomanometry].

By means of rhinomanometry, analogue physiological transnasal pressure and corresponding flow signals are simultaneously recorded during quiet nasal breathing. In order to describe the sigmoid shaped pressure/flow curves or relationship, several mathematical models have been developed. In this study, the authors wanted to demonstrate which model best describes the curvilinearity of the pressure/flow curves. By their approach, they found that polynomial models like delta p = K0 + K1V + K2V2 as well as the Broms' polar coordinate model best fit the recorded pressure/flow data. Since the parameters and exponents of such a model characterize the degree of laminar and turbulent behaviour of transnasal flow, a diagnostic potential may be offered in the future, to qualify and quantify the phenomenon of nasal obstruction.

Humans↗
PubMed1991

Optimal sample frequency in computerized rhinomanometry. Development and method.

The authors studied the pressure/flow signals generated during active anterior rhinomanometry of 25 subjects, presenting a normal transnasal breathing. By means of a Fourier transformation, the frequency content of these signals was analyzed. This investigation demonstrated clearly that signals with a frequency of more than 50 Hz no longer yield any further information about the transnasal ventilation.

Adult↗
PubMed1991

Fiberoptic examination of the nasal cavity and nasopharynx in children.

A flexible fiberoptic nasolaryngoscope with color video camera was used to study the nasal cavity and nasopharynx in 243 pediatric patients. The size of the adenoid tissue was judged by endoscopy and classified into three types according to the distance from the vomer to the adenoid tissue. The condition of the nasopharyngeal orifice of the Eustachian tube was also classified into three types relating to the condition of adenoid tissue. Assessment was performed by correlating these measurements with the type of tympanogram, lateral X-ray and clinical complaints. The authors conclude that: (1) Fiberoptic examination allows direct visualization of the size and condition of the adenoid tissue, as well as of the condition of the nasopharyngeal orifice of the Eustachian tube. (2) The size of the adenoid tissue correlates very well with the nasal obstruction complaint as well as with the type of tympanogram. (3) The condition of the nasopharyngeal orifice of the Eustachian tube significantly corresponds with the type of tympanogram. (4) For the indication of adenoidectomy, fiberscopy gives more accurate information than standard X-ray. (5) With a correct choice of premedication and local anesthesia, it is a minor invasive technique which is very well tolerated by children. It is possible in all cases provided it is performed by a skilled endoscopist and preceded by careful explanation to the child. (6) Finally, thanks to the possibility of direct visualization of the fiberscopic image via a monitor, it allows a better explanation of the indication for adenoidectomy to the child's parents.

Acoustic Impedance Tests↗
PubMed1978

Giant intralobar sequestration.

A case of intralobar sequestration is reported in a 20-year-old male who had recurrent localized infections since age 5. The prolonged course without diagnosis, the very large size of the lesion, and the demonstration of an anomalous artery from the abdomen on the plain chest film represented unusual features. Classification, clinical presentation, and diagnostic and therapeutic approaches are emphasized.

Adult↗