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Biomedical subjects

R Grenier

Publications and source records attributed to R Grenier.

At least 19 recordsLinked to original sources
PubMed1996

[Computerization and nursing: in search of an ideal!].

The computerized systems that are currently available are frequently incompatible with the specific information needs of nursing practice (Grassert, 1990). It is not currently possible to analyze the computerization requirements of nursing practice, since we do not know towards what ideal situation the process of computerizing nursing should be evolving. This makes it impossible to measure the gap between the status quo and the ideal situation. This methodological study described the desired situation by identifying 43 criteria for ideal management procedures and the handling of data needed in nursing practice. Criteria were validated using the DELPHI technique on a non-probablist sampling of 22 nurses who had developed some expertise in computerization in nursing. The study paves the way for conducting a needs assessment, then measuring the capacity of current systems to meet specific needs in terms of management and handling of nursing data.

Attitude of Health Personnel↗
PubMed1994

A randomized, double-blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness.

OBJECTIVE: Our purpose was to assess the potential benefit of therapy with conjugated estrogens therapy on skin thickness in postmenopausal women. STUDY DESIGN: Sixty postmenopausal women were randomly allocated to receive conjugated estrogens or placebo treatment for 12 months. Neither participants nor investigators were aware of the group allocation. Skin thickness was measured by ultrasonography at baseline and after 6 to 12 months of treatment. Histologic changes were evaluated by skin biopsy at baseline and after 12 months' treatment. Quality of life and adverse events were recorded at each visit and at the end of treatment. RESULTS: Treatment with conjugated estrogens for 12 months significantly increases, at the level of the right great trochanter, the thickness of the skin (p < 0.01), as assessed by ultrasonography, and of the dermis (p < 0.05), as assessed by skin biopsy. No statistically significant difference was observed in the control population. Quality of life was reported to be improved (p < 0.05) in women treated with estrogen compared with those in the placebo group. CONCLUSION: The results may help postmenopausal women to better appraise the benefits of estrogen replacement therapy, and they provide further evidence of the potential of conjugated estrogens in preventing skin aging.

Aged↗
PubMed1992

Patient-controlled analgesia: a double-blind study in burn patients.

A double-blind controlled study was performed to assess the efficacy and safety of patient-controlled analgesia in burn patients. This method was compared with conventional analgesic therapy consisting of intermittent intravenous morphine injections. Twenty-four adult patients hospitalised for burn injuries participated in the study. The McGill Pain Questionnaire, visual analogue scales and verbal-numeric scales were administered at regular intervals to measure various components of the patients' pain experience, degree of pain relief, anxiety levels, adverse side effects and overall treatment efficacy. Although statistical significance was found in only one measure, the results suggested better pain control in patients who were administered morphine by patient-controlled analgesia as compared with intermittent injections. Analysis of the side effects showed no difference between the groups. The amount of morphine administered over the trial period was also similar for the two groups but considerable interpatient variability was seen. Although further research is needed to determine the conditions for optimal use of patient-controlled analgesia, it is concluded that it is a safe, effective and improved method for controlling pain in selected burn patients.

Adolescent↗
PubMed1990

Attenuation of mild hyperandrogenic activity in postpubertal acne by a triphasic oral contraceptive containing low doses of ethynyl estradiol and d,l-norgestrel.

The effect of a low dose triphasic oral contraceptive (OC) was evaluated during a 6-month treatment period in 41 patients (mean age, 25.4 +/- 0.7 yr) who had grade I-IV postpubertal acne and normal menses. The OC contained three dose levels of ethynyl estradiol and dl-norgestrel. Acne lesions were assessed, and serum androgen levels were measured during a control cycle and between days 17-21 of treatment cycles 1, 2, 3, and 6. Four patients dropped out after 3 months of treatment. Acne was significantly improved after the first OC cycle. After six cycles, the number of comedones had decreased by 79.6 +/- 3.2% (range, 50-100%) in 69.4% of the patients. Mean baseline levels of testosterone, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate were in the upper third of the normal range, with elevated individual values in 18.9%, 36.5%, and 26.8% of the women, respectively. Mean baseline levels of androstenedione, free testosterone (T), and 3 alpha-androstanediol glucuronide (3 alpha-diol-G) were above the normal range, with elevated individual values in 51.2%, 75.0%, and 85.4% of the patients, respectively. Sex hormone-binding globulin (SHBG) levels were below the normal range in 26.8% of the cases. At the end of the first OC cycle, there was a significant (P less than 0.01) decrease in all androgen precursors and a 2-fold increase in SHBG. Androstenedione and free T decreased into the normal range during OC intake. Serum 3 alpha-diol-G levels remained elevated, but had decreased by 34.5% at cycle 6 (P less than 0.05). These results show that the triphasic OC has significantly improved acne in postpubertal women for whom acne was the main manifestation of mild hyperandrogenic activity. The improvement in acne corresponded to a decrease in adrenal/ovarian androgens and free T, which led to a decreased metabolism to 3 alpha-diol-G, presumably by the sebaceous glands. The increase in SHBG is considered an estrogenic effect, and the triphasic formulation containing low dose dl-norgestrel is not androgenic but, rather, an estrogen-dominant formulation; as such, this product is recommended in women requiring contraception who also have idiopathic acne.

Acne Vulgaris↗
PubMed1984

Evaluation of a presurgical group program given at two different times.

This study was designed to test the outcomes of a preoperative teaching program for cholecystectomy patients and to determine the appropriate time to offer the program. The hypotheses were: (a) Patients in a preadmission program will recover better than those in a program given the eve of surgery, and (b) patients in the control group will have a poorer recovery than those in the two experimental groups. The outcomes measured were state-anxiety, ventilatory function, well-being, pain, functional ability, analgesics, and length of hospitalization. There were no significant differences between the three groups except in state-anxiety the eve of surgery which was higher in the control than in the two experimental groups. State-anxiety the eve of surgery and trait-anxiety were the most important variables affecting outcomes. There was a positive and significant linear relationship between pre- and postoperative state-anxiety.

Adolescent↗
PubMed1984

Lens opacities appearing during therapy with methoxsalen and long-wavelength ultraviolet radiation.

Therapy with methoxsalen and type A (long-wavelength) ultraviolet radiation (PUVA) has recently become a common method of treating psoriasis and other dermatologic conditions. This treatment could induce cataractous changes in the human lens through a reaction between the psoralen in the lens and either UVA or ambient light. In a 28-month-long prospective study of 78 patients treated with PUVA, small lens opacities appeared in 3 patients, aged 67, 48 and 32 years. The two younger patients had not worn their protective glasses for 24 hours after each treatment, as recommended. Therefore, although it cannot be concluded that PUVA therapy caused these opacities, eye protection during treatment and for 24 hours thereafter should be emphasized to the patients.

Adult↗
PubMed1982

[Comparative study of the performance of leather and plastic skate boots].

The authors have tried to demonstrate the influence of leather skate boots and plastic boots on the performance of Atome hockey players. Speed tests and joint flexibility tests by means of rotentgenograms showed that besides the speed tests where the leather boot appeared to perform a little better than the plastic boot, no significant difference could be found between both types of boots. It seems to be more a matter of individual choice and adaptation.

Equipment Design↗
PubMed1980

Clinical judgement versus arthrography for diagnosing knee lesions.

The authors carried out a retrospective, randomized study of 200 patients with a preoperative diagnosis of meniscal tear of the knee. Of 208 knees operated on, more than one lesion was found in 84 knees (40.4%). Arthrographic diagnosis was incomplete or incorrect in 103 (51.5%) of 200 knees. Chondromalacia of the patella was present in 55 knees (26.4%) and tears of the anterio cruciate ligament were present in 15 (20.8%) of the 72 athletes who formed part of the study population. With regard to the medial meniscus, arthrographic errors occurred in only 9%. For the lateral meniscus, the rate of accuracy of the radiologists' reports was 67% compared with 97% accuracy for clinical assessment. This study points out that clinical evaluation still remains the best means of diagnosing knee lesions.

Adolescent↗