PubMed Health⌕ Search

Biomedical subjects

R Cloutier

Publications and source records attributed to R Cloutier.

At least 37 records · Page 2Linked to original sources
PubMed1992

[The evolution of child custody after the separation of the parents].

Following the separation of spouses, a family undergoes a reorganization process where the choice of a formula for child custody represents a major step, which child's living environment will depend on. Despite the importance of this form of custody, it seems, in the context of the crisis following separation, that decisions surrounding that choice are often taken haphazardly, without much consideration of various alternatives. On a different note, the family's profile at the time of the separation is bound to change following the pace of the child's and the parent's development. What may seem a relevant formula for a three year-old child may not necessarily be the case when the child turns eight. This article looks at the extent to which the child custody formula evolves to adjust itself to the changing needs of children and parents. Research focused on a sampling of 112 families separated for an average of four and a quarter years, with children aged 10 (N = 49) or adolescents of 15 years of age (N = 63). Data was compiled through a telephone questionnaire filled out by the parent who was the most committed to the child's custody. The description of the two categories of change (minor and major) was made according to the original child custody formula, the time lapse since the separation, the child's age and parental re-composition. Results point to three main trends: a) child custody arrangements do not evolve much over time; b) when there are changes, these are especially motivated by the needs of the parents; and c) the changes mainly result in reducing the frequency of contacts between the child and the parent without custody.

Adolescent↗
PubMed1989

[Isolated rectal ectasia: a rare cause of chronic constipation. Apropos of 2 cases].

We present two patients with intractable constipation, in which investigation revealed a huge rectal ectasia without apparent other anomaly. Findings at operation are similar to those observed in the focal ectasia of the terminal bowel that we have already described in some cases of low anal deformities. As long as the physiopathology of this anomaly is not elucidated, complete amputation of the rectum seems to be the treatment of choice.

Adolescent↗
PubMed1989

[Congenital diaphragmatic hernia. Therapeutic re-evaluation].

Twenty-eight patients with "High-Risk" diaphragmatic hernia were treated without postoperative ipsilateral chest drains. Overall survival was 71%. This study suggests that, in cases of complete absence of the diaphragm, the use of a mesh pervious to air is as noxious postoperatively as an underwater chest drain. This idea is supported by experiments in cats with a left pneumonectomy, in which part of the diaphragm was replaced either by a macroporous mesh or by a microporous prosthesis impervious to air at normal pressures. Moreover, barotrauma may occur preoperatively and when assisted ventilation is required, inspiratory pressure must be strictly limited.

Animals↗
PubMed1989

[Education instead of coercion].

By educating the public, nurses can play an important role in the prevention of HIV transmission. This education should focus on three areas: primary prevention by educating people who are, or are going to be sexually active; HIV screening; and tracing sexual contacts.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Observer variation in assessing spinal curvature and skeletal development in adolescent idiopathic scoliosis.

Accurate measurements of spinal curvature and skeletal development are crucial in planning treatment and assessing curve progression in adolescent idiopathic scoliosis (AIS). An inter-rater agreement trial was undertaken to estimate the reliability of measuring these spinal parameters. Two orthopaedic surgeons and two trained technicians from a scoliosis clinic independently read 30 anteroposterior roentgenograms of AIS patients. Skeletal maturity was assessed using the six-point Risser sign scale, and spinal curvature was measured using the method of Cobb. Excellent agreement was observed in evaluating Risser signs (Kappa = 0.8) and primary Cobb angles (intra-class correlation coefficient, Rho = 0.98). The standard deviation of inter-observer error in measuring primary Cobb angles was 2.5 degrees, and the intra-reader error, based on one observer's reassessments of 15 films, was 1.9 degrees. Inter-rater agreement for assessing secondary Cobb angles was much lower (Rho = 0.52) because small curves (less than 20 degrees) were often not noticed. Differences in agreement between surgeons and technicians were relatively minor. These results indicate that personnel trained at this clinic are able to assess these spinal parameters reliably.

Adolescent↗
PubMed1988

[Taking responsibility and communication : the keys to adolescence.].

The following article focuses on parent-adolescent communication from a perspective of the progressive entrance into adulthood of 12-18 year-olds. The notion of responsibleness is presented here as the learning process towards self-management. The hypothesis of the existence of synchronism between the adolescents' search for autonomy and their parents' delegation of decision-making is drawn and tested using recent results obtained from a sample of Quebec families. The importance of quality communication in parent-adolescent adaptation is discussed in relation with the room given to teens in decisions that concern them. The authors finally suggest that this type of communication is fundamental to the mental health of youth within the family unit.

English Abstract↗
PubMed1987

Pulmonary barotrauma in congenital diaphragmatic hernia: experimental study in lambs.

A left diaphragmatic hernia was created surgically in 20 fetal lambs between 93 and 110 days of gestation. Ten animals were alive with defects at cesarean section near term (135 to 140 days). These animals and two controls were submitted to various transpulmonary pressure gradients (inspiratory pressure minus pleural pressure). Hemodynamic and ventilatory studies were performed after the correction of the hernia. Morphometric analysis of the lung was carried out in all cases. The results showed a highly significant linear correlation between the transpulmonary pressure gradient employed and the pulmonary interstitial emphysema found at morphometry. Our data suggest that using low ventilatory pressures and not draining the pleural cavity results in less trauma to both lungs and may prevent one of the components of the pulmonary hypertension so often seen in newborns with congenital diaphragmatic hernia.

Animals↗
PubMed1987

Focal ectasia of the terminal bowel accompanying low anal deformities.

Three patients were treated at birth for low anal deformities and developed intractable constipation, not imputable to usual causes of rectal inertia. Barium enema, done the first time at ten days of age in one case, revealed focal ectasia of the terminal bowel, with a peculiar "balloon-like" aspect of the rectum. Optimal treatment includes resection of the terminal bowel down to the dentate line. Incidence of this anomaly in association with low anal deformities has been 5% in our series.

Abnormalities, Multiple↗
PubMed1986

[Congenital diaphragmatic hernia: have the results truly changed?].

Between 1971 and 1985, 97 patients born with posterolateral diaphragmatic hernia (CDH) were treated in three different centers in Quebec and Montreal (Canada). A retrospective study of these cases shows that with appropriate measures the results can be much less gloomy than they used to be. The series is analysed in order to determine the effect of post-operative thoracic drainage, the effect of the high frequency low volume mechanical ventilation as well as the effect of the serious associated conditions present in a significant number of these patients. Our results indicate that the ipsilateral thoracic drainage has a clear deleterious effect when used systematically++. Out of 52 such patients, 17 survived (32.7%) and 35 died (67.3%); while out of 43 patients who received no thoracic drainage, 25 survived (58.1%) and 18 died (42.8%). This is statistically significant CHI2: (p less than 0.005). If the series is analysed after elimination of the cases with severe associated conditions and taking into account the advent of the high frequency low pressure mechanical ventilation, the figures are even more significant. Fifty-seven patients (57) fall in this category; 28 patients received an ipsilateral thoracic drainage and 29 did not. In the first group 11 survived (39.2%) and 17 died (60.7%) while in the no drainage group 22 survived (75.8%) and 7 died (24.1%). This is statistically significant (p less than 0.005). We believe that with simple measures, it is possible to prevent the return to fetal circulation in a significant number of patients born with CDH and to clearly increase to overall survival rate.

Drainage↗
PubMed1984

[Evaluation of dermatologic impairment in occupational health].

This paper presents a simple method for evaluating the extent of impairment in occupational dermatosis based on the portion (P) of the anatomic area involved (A) and the coefficient of physiologic disturbance (C). A percentage value is assigned to each anatomic area on the basis of its functional importance. The coefficient of physiologic disturbance is the average of four factors (stiffness, dehydration, thickening, and pruritus or pain). The formula (P X A). C gives the final percentage of impairment.

Dermatitis, Contact↗
PubMed1984

Friedreich's ataxia: malic enzyme activity in cellular fractions of cultured skin fibroblasts.

We have measured the activity of malic enzyme NADP+ dependent in the nuclear, mitochondrial, lysosomal and cytosolic fractions of cultured skin fibroblasts from twelve patients with Friedreich's ataxia and nine control subjects. Hexosaminidase, cytochrome-C-oxidase, lactate dehydrogenase and malic enzyme NAD+ dependent were used as marker enzymes. The activity of malic enzyme NADP+ dependent was not significantly reduced in the mitochondrial fraction of patients with Friedreich's ataxia as compared with controls. When corrected for possible contamination between mitochondrial and cytosolic fractions, malic enzyme NADP+ dependent activity was still not significantly reduced in patients with Friedreich's ataxia. Unless critical methodological differences were overlooked in this or previously published studies, we conclude that mitochondrial malic enzyme deficiency is not the primary genetic defect underlying Friedreich's ataxia.

Adolescent↗
PubMed1983

Reversion to fetal circulation in congenital diaphragmatic hernia: a preventable postoperative complication.

A review of 26 patients with congenital diaphragmatic hernia, diagnosed in the first 24 hours of life, supports the hypothesis that the postoperative fetal circulation syndrome is an iatrogenic complication, due to the rapid expansion of both lungs, when they are severely hypoplastic. This complication is preventable, when no aspiration of air from the chest cavity is done, and when no tube attached to an underwater seal is inserted. When assisted ventilation is necessary, small volumes at a rapid rate allows satisfactory gaseous exchanges, without pulmonary overinflation.

Female↗
PubMed1982

Reinforcement procedure in the treatment of reluctant speech.

The efficacy of a positive reinforcement contingency procedure was evaluated in the treatment of a 6-year old boy with reluctant speech. The intervention was conducted in the kindergarten classroom and the teacher served as therapist. Using an ABABB' single case experimental design, positive reinforcement was found to be effective for increasing the child's verbal responsiveness. At a 1-year follow-up, therapeutic benefits were maintained at an optimal level. The present results bring support to the use of reinforcement procedures in the case of reluctant speech.

Behavior Therapy↗