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Galland J, Jaffrelot M, Sanges S, Fournier JP, Jouquan J, Chiniara G, Rivière É. [Introduction to debriefing for internists: how to transform real or simulated clinical situations into learning moments]. Rev Med Interne 2020; 41:536-544. [PMID: 32359818 DOI: 10.1016/j.revmed.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/18/2020] [Accepted: 03/06/2020] [Indexed: 01/09/2023]
Abstract
Debriefing is a phase of synthesis and reflection that immediately follows a real-life or simulated situation. It is an essential educational step that forces the learners to reflect upon the thought processes that underlie their actions. Debriefing encourages a personal and collective reflection in order to remodel erroneous mental schemas and rectify actions done in context. Debriefing cannot be improvised; it requires a sound structure and regular practice in order to be truly effective. The debriefer must be considerate, choose appropriate learning objectives and dedicate ample time to the learners. Debriefing is focused on learning acquired in context-in other words, on the actions that were performed within a real-life or simulated clinical practice situation-and immediately follows the situation. After an initial phase of emotional release, the debriefer will help learners analyse their actions to identify their underlying rationale (contextualization), extract the overarching principles related to the lived situation in order to modify the rationale if needed (decontextualization) and assist the transfer of learning to real life (in the case of simulation) and to similar situations (recontextualization). A final summary of learning achieved during the training session concludes the debriefing. Debriefing is useful in any learning situation, including in internal medicine. Even if simulation is still underused in internal medicine, post-event debriefing can be implanted in our clinical services. Indeed, training our students and shaping them into healthcare professionals rest in no small part on hospital rotations where the intern is confronted with real-patient situations that are suitable to learning. Some in-hospital clinical encounters can be actively transformed into learning opportunities thanks to post-event debriefing, but can also passively morph into bad daily practice if no supporting action is implemented. Debriefing can thus provide an opportunity to develop non-technical skills in critical situations, or doctor-patient communication skills, within a team or between colleagues. These competencies are the hallmark of well-trained interns and are indispensable for the proper functioning of a care team. We will not develop the emotional and psychological management of debriefing in this article. We hope we will helpfully introduce as many of our colleagues as possible to the art of debriefing in most circumstances.
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Affiliation(s)
- J Galland
- Service de médecine interne, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, F-75010 Paris, France; Université de Paris, Faculté de médecine Paris Diderot, F-75010 Paris, France.
| | - M Jaffrelot
- Expert-consultant en simulation et santé, Professeur associé au département d'anesthésiologie et de soins intensifs, Université Laval, Québec, Canada
| | - S Sanges
- Centre de Simulation PRESAGE, Université de Lille, UFR Médecine, F-59000 Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France
| | - J P Fournier
- Centre de simulation médicale de Nice, Université de Nice Sofia Antipolis, F-06107 Nice, France
| | - J Jouquan
- Equipe d'accueil EA4686 "Ethique, professionnalisme et santé", Université de Bretagne occidentale, 29609 Brest, France
| | - G Chiniara
- Directeur du département d'anesthésiologie et de soins intensifs (Université Laval, Québec, Canada) et titulaire de la chaire de leadership en enseignement de la simulation des sciences de la santé Université Laval - Université Côte d'Azur, Université Laval, Québec City, Québec, Canada
| | - É Rivière
- Service de médecine interne et maladies infectieuses, CHU de Bordeaux, F-33600 Pessac, France; 1 rue Hoffman Martinot, Université de Bordeaux, et CHU de Bordeaux, F-33000 Bordeaux, France.
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Galland J, Martis N, Levraut M, Hani H, Baumann C, Fournier JP, Braun M. Impact of Simulation-Based Learning on National Ranking Medical Examination Results in France. ACTA ACUST UNITED AC 2020; 15:259-265. [DOI: 10.1097/sih.0000000000000431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Faudeux C, Tran A, Dupont A, Desmontils J, Montaudié I, Bréaud J, Braun M, Fournier JP, Bérard E, Berlengi N, Schweitzer C, Haas H, Caci H, Gatin A, Giovannini-Chami L. Development of Reliable and Validated Tools to Evaluate Technical Resuscitation Skills in a Pediatric Simulation Setting: Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics. J Pediatr 2017; 188:252-257.e6. [PMID: 28456389 DOI: 10.1016/j.jpeds.2017.03.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/08/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To develop a reliable and validated tool to evaluate technical resuscitation skills in a pediatric simulation setting. STUDY DESIGN Four Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics (RESCAPE) evaluation tools were created, following international guidelines: intraosseous needle insertion, bag mask ventilation, endotracheal intubation, and cardiac massage. We applied a modified Delphi methodology evaluation to binary rating items. Reliability was assessed comparing the ratings of 2 observers (1 in real time and 1 after a video-recorded review). The tools were assessed for content, construct, and criterion validity, and for sensitivity to change. RESULTS Inter-rater reliability, evaluated with Cohen kappa coefficients, was perfect or near-perfect (>0.8) for 92.5% of items and each Cronbach alpha coefficient was ≥0.91. Principal component analyses showed that all 4 tools were unidimensional. Significant increases in median scores with increasing levels of medical expertise were demonstrated for RESCAPE-intraosseous needle insertion (P = .0002), RESCAPE-bag mask ventilation (P = .0002), RESCAPE-endotracheal intubation (P = .0001), and RESCAPE-cardiac massage (P = .0037). Significantly increased median scores over time were also demonstrated during a simulation-based educational program. CONCLUSIONS RESCAPE tools are reliable and validated tools for the evaluation of technical resuscitation skills in pediatric settings during simulation-based educational programs. They might also be used for medical practice performance evaluations.
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Affiliation(s)
- Camille Faudeux
- Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France; Pediatric Nephrology Department, CHU de Nice, Nice, France
| | - Antoine Tran
- Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France; Medical Simulation Center, Faculty of Medicine of Nice, Université de Nice Sophia-Antipolis, Nice, France
| | - Audrey Dupont
- Medical Simulation Center, Faculty of Medicine of Nice, Université de Nice Sophia-Antipolis, Nice, France; Pediatric Intensive Care Unit, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Jonathan Desmontils
- Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Isabelle Montaudié
- Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Jean Bréaud
- Medical Simulation Center, Faculty of Medicine of Nice, Université de Nice Sophia-Antipolis, Nice, France; Université de Nice-Sophia Antipolis, Nice, France
| | - Marc Braun
- University Centre for Education by Medical Simulation (CUESIM)-The Virtual Hospital of Lorraine of the Faculty of Medicine of Nancy, France; Université de Nancy, Nancy, France
| | - Jean-Paul Fournier
- Medical Simulation Center, Faculty of Medicine of Nice, Université de Nice Sophia-Antipolis, Nice, France; Université de Nice-Sophia Antipolis, Nice, France
| | - Etienne Bérard
- Pediatric Nephrology Department, CHU de Nice, Nice, France; Université de Nice-Sophia Antipolis, Nice, France
| | - Noémie Berlengi
- Pediatric Emergency Department, Hôpital d'enfants de Nancy, Nancy, France
| | - Cyril Schweitzer
- Université de Nancy, Nancy, France; Pediatric Emergency Department, Hôpital d'enfants de Nancy, Nancy, France
| | - Hervé Haas
- Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Hervé Caci
- Pediatric Outpatient Unit, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Amélie Gatin
- University Centre for Education by Medical Simulation (CUESIM)-The Virtual Hospital of Lorraine of the Faculty of Medicine of Nancy, France; Pediatric Emergency Department, Hôpital d'enfants de Nancy, Nancy, France
| | - Lisa Giovannini-Chami
- Medical Simulation Center, Faculty of Medicine of Nice, Université de Nice Sophia-Antipolis, Nice, France; Pediatric Intensive Care Unit, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France; Université de Nice-Sophia Antipolis, Nice, France; Pediatric Pulmonology and Allergology Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.
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Feigerlova E, Oussalah A, Fournier JP, Antonelli A, Hadjadj S, Marechaud R, Guéant JL, Roblot P, Braun M. Predictors of High Motivation Score for Performing Research Initiation Fellowship, Master 1, Research Master 2, and PhD Curricula During Medical Studies: A Strobe-Compliant Article. Medicine (Baltimore) 2016; 95:e2633. [PMID: 26844478 PMCID: PMC4748895 DOI: 10.1097/md.0000000000002633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/31/2015] [Accepted: 01/06/2016] [Indexed: 11/26/2022] Open
Abstract
Translational research plays a crucial role in bridging the gap between fundamental and clinical research. The importance of integrating research training into medical education has been emphasized. Predictive factors that help to identify the most motivated medical students to perform academic research are unknown. In a cross-sectional study on a representative sample of 315 medical students, residents and attending physicians, using a comprehensive structured questionnaire we assessed motivations and obstacles to perform academic research curricula (ie, research initiation fellowship, Master 1, Research Master 2, and PhD). Independent predictive factors associated with high "motivation score" (top quartile on motivation score ranging from 0 to 10) to enroll in academic research curricula were derived using multivariate logistic regression analysis. Independent predictors of high motivation score for performing Master 1 curriculum were: "considering that the integration of translational research in medical curriculum is essential" (OR, 3.79; 95% CI, 1.49-9.59; P = 0.005) and "knowledge of at least 2 research units within the university" (OR, 3.60; 95% CI, 2.01-6.47; P < 0.0001). Independent predictors of high motivation score for performing Research Master 2 curriculum were: "attending physician" (OR, 4.60; 95% CI, 1.86-11.37; P = 0.001); "considering that the integration of translational research in medical curriculum is essential" (OR, 4.12; 95% CI, 1.51-11.23; P = 0.006); "knowledge of at least 2 research units within the university" (OR, 3.51; 95% CI, 1.91-6.46; P = 0.0001); and "male gender" (OR, 1.82; 95% CI, 1.02-3.25; P = 0.04). Independent predictors of high motivation score for performing PhD curriculum were: "considering that the integration of translational research in medical curriculum is essential" (OR, 5.94; 95% CI, 2.33-15.19; P = 0.0002) and "knowledge of at least 2 research units within the university" (OR, 2.63; 95% CI, 1.46-4.77; P = 0.001). This is the first study that has identified factors determining motivations and barriers to carry out academic research curricula among undergraduate and postgraduate medical students. Improving these 2 areas will certainly have an impact on a better involvement of the next generation of physicians in translational medicine.
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Affiliation(s)
- Eva Feigerlova
- From the University of Poitiers, UFR Médecine Pharmacie (EF, SH, RM, PR); Department of Endocrinology, University Hospital of Poitiers, Poitiers, (EF, SH, RM); Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France (AO, J-LG); INSERM, U954, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France (AO, J-LG); Medical Simulation Centre, Faculty of Medicine of Nice, University of Nice-Sophia-Antipolis, Nice (J-PF); Direction du Numérique, Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy (AA); Department of Internal Medicine and Infectious Diseases, University Hospital of Poitiers, University of Poitiers, Poitiers (PR); Department of Neuroradiology, University Hospital of Nancy, Nancy, France (MB); and Faculty of Medicine of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France ; University Centre for Education by Medical Simulation (CUESIM) - The Virtual Hospital of Lorraine of the Faculty of Medicine of Nancy; INSERM U947, IADI - Diagnostic and Interventional Adaptive Imaging, Vandoeuvre-lès-Nancy, France (MB)
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Oussalah A, Fournier JP, Guéant JL, Braun M. Information-seeking behavior during residency is associated with quality of theoretical learning, academic career achievements, and evidence-based medical practice: a strobe-compliant article. Medicine (Baltimore) 2015; 94:e535. [PMID: 25674756 PMCID: PMC4602751 DOI: 10.1097/md.0000000000000535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Data regarding knowledge acquisition during residency training are sparse. Predictors of theoretical learning quality, academic career achievements and evidence-based medical practice during residency are unknown. We performed a cross-sectional study on residents and attending physicians across several residency programs in 2 French faculties of medicine. We comprehensively evaluated the information-seeking behavior (I-SB) during residency using a standardized questionnaire and looked for independent predictors of theoretical learning quality, academic career achievements, and evidence-based medical practice among I-SB components using multivariate logistic regression analysis. Between February 2013 and May 2013, 338 fellows and attending physicians were included in the study. Textbooks and international medical journals were reported to be used on a regular basis by 24% and 57% of the respondents, respectively. Among the respondents, 47% refer systematically (4.4%) or frequently (42.6%) to published guidelines from scientific societies upon their publication. The median self-reported theoretical learning quality score was 5/10 (interquartile range, 3-6; range, 1-10). A high theoretical learning quality score (upper quartile) was independently and strongly associated with the following I-SB components: systematic reading of clinical guidelines upon their publication (odds ratio [OR], 5.55; 95% confidence interval [CI], 1.77-17.44); having access to a library that offers the leading textbooks of the specialty in the medical department (OR, 2.45, 95% CI, 1.33-4.52); knowledge of the specialty leading textbooks (OR, 2.12; 95% CI, 1.09-4.10); and PubMed search skill score ≥5/10 (OR, 1.94; 95% CI, 1.01-3.73). Research Master (M2) and/or PhD thesis enrolment were independently and strongly associated with the following predictors: PubMed search skill score ≥5/10 (OR, 4.10; 95% CI, 1.46-11.53); knowledge of the leading medical journals of the specialty (OR, 3.33; 95% CI, 1.32-8.38); attending national and international academic conferences and meetings (OR, 2.43; 95% CI, 1.09-5.43); and using academic theoretical learning supports several times a week (OR, 2.23; 95% CI, 1.11- 4.49). This study showed weaknesses in the theoretical learning framework during residency. I-SB was independently associated with quality of academic theoretical learning, academic career achievements, and the use of evidence-based medicine in everyday clinical practice. STUDY REGISTRATION CNIL No.1797639.
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Affiliation(s)
- Abderrahim Oussalah
- From the Faculty of Medicine of Nancy, University of Lorraine, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy; and Inserm U954, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Vandoeuvre-lès-Nancy (AO, JLG); Medical Simulation Centre, Faculty of Medicine of Nice, University of Nice-Sophia-Antipolis, Nice (JPF); Faculty of Medicine of Nancy, University of Lorraine; University Centre for Education by Medical Simulation (CUESIM)-The Virtual Hospital of Lorraine of the Faculty of Medicine of Nancy; Inserm U947, IADI-Diagnostic and Interventional Adaptive Imaging; and Department of Neuroradiology, University Hospital of Nancy, Nancy (MB), France
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La Ruche G, Souarès Y, Armengaud A, Peloux-Petiot F, Delaunay P, Desprès P, Lenglet A, Jourdain F, Leparc-Goffart I, Charlet F, Ollier L, Mantey K, Mollet T, Fournier JP, Torrents R, Leitmeyer K, Hilairet P, Zeller H, Van Bortel W, Dejour-Salamanca D, Grandadam M, Gastellu-Etchegorry M. First two autochthonous dengue virus infections in metropolitan France, September 2010. Euro Surveill 2010; 15:19676. [PMID: 20929659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
In September 2010, two cases of autochthonous dengue fever were diagnosed in metropolitan France for the first time. The cases occurring in Nice, southeast France, where Aedes albopictus is established, are evidence of dengue virus circulation in this area. This local transmission of dengue calls for further enhanced surveillance, active case finding and vector control measures to reduce the spread of the virus and the risk of an epidemic.
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Affiliation(s)
- G La Ruche
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France.
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La Ruche G, Souarès Y, Armengaud A, Peloux-Petiot F, Delaunay P, Desprès P, Lenglet A, Jourdain F, Leparc-Goffart I, Charlet F, Ollier L, Mantey K, Mollet T, Fournier JP, Torrents R, Leitmeyer K, Hilairet P, Zeller H, Van Bortel W, Dejour-Salamanca D, Grandadam M, Gastellu-Etchegorry M. First two autochthonous dengue virus infections in metropolitan France, September 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.39.19676-en] [Citation(s) in RCA: 271] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In September 2010, two cases of autochthonous dengue fever were diagnosed in metropolitan France for the first time. The cases occurring in Nice, south-east France, where Aedes albopictus is established, are evidence of dengue virus circulation in this area. This local transmission of dengue calls for further enhanced surveillance, active case finding and vector control measures to reduce the spread of the virus and the risk of an epidemic.
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Affiliation(s)
- G La Ruche
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
| | - Y Souarès
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
| | - A Armengaud
- Regional office of the French Institute for Public Health Surveillance (Cire Sud), Marseille, France
| | - F Peloux-Petiot
- Regional Health Agency of Provence-Alpes-Côte d’Azur, Marseille and Nice, France
| | - P Delaunay
- Entomology-Parasitology, Virology and Emergency Medicine and Internal Medicine Departments, University Hospital of Nice, Nice, France
| | - P Desprès
- Institut Pasteur, National Reference Centre for arboviruses, Paris, France
| | - A Lenglet
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - F Jourdain
- Directorate General for Health, Ministry of Health, Paris, France
| | - I Leparc-Goffart
- Institut de recherche biomédicale des armées, National Reference Centre for arboviruses associated laboratory, Marseille, France
| | - F Charlet
- Regional Health Agency of Provence-Alpes-Côte d’Azur, Marseille and Nice, France
| | - L Ollier
- Entomology-Parasitology, Virology and Emergency Medicine and Internal Medicine Departments, University Hospital of Nice, Nice, France
| | - K Mantey
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - T Mollet
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J P Fournier
- Entomology-Parasitology, Virology and Emergency Medicine and Internal Medicine Departments, University Hospital of Nice, Nice, France
| | - R Torrents
- Regional office of the French Institute for Public Health Surveillance (Cire Sud), Marseille, France
| | - K Leitmeyer
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - P Hilairet
- Entomology-Parasitology, Virology and Emergency Medicine and Internal Medicine Departments, University Hospital of Nice, Nice, France
| | - H Zeller
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - W Van Bortel
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - D Dejour-Salamanca
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
| | - M Grandadam
- Institut Pasteur, National Reference Centre for arboviruses, Paris, France
| | - M Gastellu-Etchegorry
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
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Fournier JP, Thiercelin D, Pulcini C, Alunni-Perret V, Gilbert E, Minguet JM, Bertrand F. Évaluation du raisonnement clinique en médecine d’urgence :
les tests de concordance des scripts décèlent mieux l’expérience
clinique que les questions à choix multiples à contexte riche. ACTA ACUST UNITED AC 2008. [DOI: 10.1051/pmed:2006020] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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De Champlain AF, Melnick D, Scoles P, Subhiyah R, Holtzman K, Swanson D, Angelucci K, McGrenra C, Fournier JP, Benchimol D, Rampal P, Staccini P, Braun M, Kohler C, Guidet B, Claudepierre P, Prével M, Goldberg J. Assessing medical students' clinical sciences knowledge in France: a collaboration between the NBME and a consortium of French medical schools. Acad Med 2003; 78:509-517. [PMID: 12742789 DOI: 10.1097/00001888-200305000-00016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE The French government, as part of medical education reforms, has affirmed that an examination program for national residency selection will be implemented by 2004. The purpose of this study was to develop a French multiple-choice (MC) examination using the National Board of Medical Examiners' (NBME) expertise and materials. METHOD The Evaluation Standardisée du Second Cycle (ESSC), a four-hour clinical sciences examination, was administered in January 2002 to 285 medical students at four university test sites in France. The ESSC had 200 translated and adapted MC items selected from the Comprehensive Clinical Sciences Examination (CCSE), an NBME subject test. RESULTS Less than 10% of the ESSC items were rejected as inappropriate to French practice. Also, the distributions of ESSC item characteristics were similar to those reported with the CCSE. The ESSC also appeared to be very well targeted to examinees' proficiencies and yielded a reliability coefficient of.91. However, because of a higher word count, the ESSC did show evidence of speededness. Regarding overall performance, the mean proficiency estimate for French examinees was about 0.4 SD below that of a CCSE population. CONCLUSIONS This study provides strong evidence for the usefulness of the model adopted in this first collaborative effort between the NBME and a consortium of French medical schools. Overall, the performance of French students was comparable to that of CCSE students, which was encouraging given the differences in motivation and the speeded nature of the French test. A second phase with the participation of larger numbers of French medical schools and students is being planned.
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Fournier JP, De Champlain AF, Benchimol D, Staccini P, Subhiyah R, Braun M, Kohler C, Guidet B, Claudepierre P, Prevel M, Scoles P, Holtzman K, Swanson D, Angelucci K, McGrenra C, Goldberg J, Rampal P, Melnick D. [Transposition of an American-designed comprehensive medical student examination within the framework of the forthcoming French nationwide comprehensive examination. A preliminary study]. Ann Med Interne (Paris) 2003; 154:148-56. [PMID: 12910041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Medical training is undergoing extensive revision in France. A nationwide comprehensive clinical competency examination will be administered for the first time in 2004, relying exclusively on essay-questions. Unfortunately, these questions have psychometric shortcomings, particularly their typically low reliability. High score reliability is mandatory in a high-stakes context. The National Board of Medical Examiners-designed multiple choice-questions (MCQ) are well adapted to assess clinical competency with a high reliability score. The purpose of this study was to test the hypothesis that French medical students could take an American-designed and French-adapted comprehensive clinical knowledge examination with this MCQ format. Two hundred and eighty five French students, from four Medical Schools across France, took an examination composed of 200 MCQs under standardized conditions. Their scores were compared with those of American students. This examination was found assess French students' clinical knowledge with a high level of reliability. French students' scores were slightly lower than those of American students, mostly due to a lack of familiarity with this particular item format, and a lower motivational level. Another study is being designed, with a larger group, to address some of the shortcomings of the initial study. If these preliminary results are replicated, the MCQ format might be a more defendable and sensible alternative to the proposed essay questions.
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Vandenbos F, Basar A, Tempesta S, Fournier JP, Bertrand F, Vanesland L, Oualid H, Dunais B, Dellamonica P, Roger PM. Relevance and complications of intravenous infusion at the emergency unit at Nice university hospital. J Infect 2003; 46:173-6. [PMID: 12643866 DOI: 10.1053/jinf.2002.1101] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Insertion of peripheral venous catheters (PVCs) is current practice within the hospital environment and particularly in the emergency department (ED). This simple yet invasive technique may result in venous thrombosis, infection or mechanical complications. We conducted a prospective study at the Nice University Hospital ED in order to determine the frequency, relevance and complications of peripheral venous cannulation. PATIENTS AND METHODS Fourteen 24 h periods were surveyed over the months of May and June 2000, during which 2515 patients over 16 years of age attended the unit. Demographic and medical data were recorded for every patient who received a PVC. These patients were followed at 12 h intervals until the catheter was removed. Reasons for PVC, time left in place, and eventual complications were recorded. Justification for PVC was evaluated upon arrival at the ED, upon exiting the ED and in some cases within the hospital ward. RESULTS Six hundred and thirty of 2515 patients (25%) received a PVC (290 women (46%) and 340 men (54%); meanage 58 years). Indication for the PVC was considered unjustified in 24.8% of cases upon arrival at the ED, and 33.8% upon leaving the ED. Upon admission in a hospital ward after passing through the ED, out of 318 patients, the PVC was left in place for no reason in 63 (20%). Overall, 390 PVCs were followed until the time of their removal. Mean duration of IV infusion was 28 h. Among these 390 patients, 62 (15.9%) developed complications, of which 54 (13.6%) had thrombophlebitis and 9 (2.3%) developed local infection. Mean duration of PVC left in place for patients with complications was 50 h vs 25 h for patients with no complications (P<0.001). CONCLUSION Insertion of a PVC is common practice especially in EDs. The excessive use of this procedure leads to extra cost and iatrogenic complications. A renewed definition of its indication and raised awareness among hospital staff concerning the risks involved with this standard procedure should result in less use of PVC and fewer complications.
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Affiliation(s)
- F Vandenbos
- Service de Maladies Infectieuses et Tropicales, Hôpital de l'Archet 1 CHU de Nice, 151 Rte St Antoine de Ginestière, BP, 3079-06202, Nice cedex 3, France.
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12
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Roger PM, Martin C, Taurel M, Fournier JP, Nicole I, Carles M, Mondain V, Fontas E, Bertrand F, Pradier C, Vandenbos F, Dellamonica P. [Motives for the prescription of antibiotics in the emergency department of the University Hospital Center in Nice. A prospective study]. Presse Med 2002; 31:58-63. [PMID: 11850986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES Since April 1999, we have set-up an infectious disease consultation in the emergency unit of the University Hospital in Nice. Unjustified antiobiotherapy is often initiated. We therefore conducted a survey to study the motives and validity of antibiotic prescriptions. METHOD This prospective study was conducted in two phases. The first consisted in asking the emergency physicians prescribing antibiotics to fill-in a questionnaire giving information on the diagnosis established and the antiobiotherapy proposed. In the second phase, the diagnoses and corresponding treatments were submitted to 4 experts who assessed the acceptability of the diagnoses and the antibiotics prescribed. The experts only had access to the clinical and para-clinical data available. Moreover, their therapeutic judgement was based on previously published consensuses. RESULTS The 6-month survey collected 117 questionnaires that could be analysed. The rate of error in diagnosis was of 33% (39/117). Thoracic x-rays could not be interpreted in 11% of cases. In single variant analysis, factors of erroneous diagnosis were due to its interpretation by an internist, the diagnostic category of "broncho-pulmonary infections" and the lack of documentation. In multi variant analysis, only the lack of documentation was related to erroneous diagnosis (OR = 5.5; IC 95% (2.03; 15.30), p < 0.0002). The rate of antibiotherapy not adapted to the diagnosis made by the physician was of 32% (37/117). In 24 cases the modalities of the prescription were incorrect and in 13 cases the prescription was unjustified. Only the status of the prescriber (internist) was statistically associated with an antibiotherapy not adapted to the diagnosis (OR = 2.2; IC 95% (0.93; 5.26), p < 0.05). CONCLUSION Unjustified antibiotherapy in an emergency unit is generally due to erroneous diagnosis of infection. The lack of documentation and inexperience of the prescribers appear to be the two elements contributing to unjustified antibiotherapy.
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Affiliation(s)
- P M Roger
- Service des Maladies Infectieuses et Tropicales, Hôpital de l'Archet 1, Centre Hospitalo-Universitaire de Nice, BP3079, F06202 Nice.
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13
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Maziade M, Roy MA, Rouillard E, Bissonnette L, Fournier JP, Roy A, Garneau Y, Montgrain N, Potvin A, Cliche D, Dion C, Wallot H, Fournier A, Nicole L, Lavallée JC, Mérette C. A search for specific and common susceptibility loci for schizophrenia and bipolar disorder: a linkage study in 13 target chromosomes. Mol Psychiatry 2001; 6:684-93. [PMID: 11673797 DOI: 10.1038/sj.mp.4000915] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2000] [Revised: 02/23/2001] [Accepted: 02/26/2001] [Indexed: 11/08/2022]
Abstract
We report the first stage of a genome scan of schizophrenia (SZ) and bipolar disorder (BP) covering 18 candidate chromosomal areas. In addition to testing susceptibility loci that are specific to each disorder, we tested the hypothesis that some susceptibility loci might be common to both disorders. A total of 480 individuals from 21 multigenerational pedigrees of Eastern Québec were evaluated by means of a consensus best-estimate diagnosis made blind to diagnoses in relatives and were genotyped with 220 microsatellite markers. Two-point and multipoint model-based linkage analyses were performed and mod scores (Z, for max Z(max)) are reported. The strongest linkage signals were detected at D18S1145 (in 18q12; Z = 4.03) for BP, and at D6S334 (in 6p 22-24; Z(het) = 3.47; alpha = 0.66) for SZ. Three other chromosomal areas (3q, 10p, and 21q) yielded linkage signals. Chromosomes 3p, 4p, 5p, 5q, 6q, 8p, 9q, 11q, 11p, 12q, 13q, 18p and 22q showed no evidence of linkage. The 18q12 results met the Lander and Kruglyak (1995) criterion for a genome-wide significant linkage and suggested that this susceptibility region may be shared by SZ and BP. The 6p finding provided confirmatory evidence of linkage for SZ. Our results suggest that both specific and common susceptibility loci must be searched for SZ and BP.
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Affiliation(s)
- M Maziade
- Centre de Recherche Université Laval Robert-Giffard, 2601, chemin de la Canardière, Beauport (Québec) G1J 2G3, Canada.
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14
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Roger PM, Eberhartd P, Sola L, Cottalorda C, Caramella A, Tamisier R, Alluni V, Fournier JP, Bertrand F, Dellamonica P. [Evaluation of a hospitalization unit opened during the winter influenza epidemic of 1999-2000]. Rev Med Interne 2001; 22:433-9. [PMID: 11402514 DOI: 10.1016/s0248-8663(01)00368-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Last winter, a great many patients with influenza-like infection were admitted to our hospital, leading us to open a specific unit for 6 weeks. We report the evaluation of medical care given to these patients. METHODS Useful data for evaluating care to patients presenting respiratory infections were determined beforehand by the retrospective analysis of patients' charts. RESULTS Fifty-seven out of 185 admitted patients (31%) had infectious respiratory symptoms. The mean age was 81 years. Six cases of influenza virus infection, 43 cases of viral bronchitis, six cases of bacterial pneumonia, one superinfected asthma and one septic shock were diagnosed. All patients presented with cardiac and/or chronic pulmonary diseases. Influenza vaccination had been performed in 28 patients (49%). Before hospitalisation, 30 patients (52%) had received antibiotics, and 17 (30%) a steroid therapy. In contrast, only 12 patients (21%) have received anti-infective agents during the hospitalisation. Twenty-five patients were able to go back home and a nursing home was required for 27 patients (47%); five patients died. Tools for improving this specific department in a public hospital are discussed. CONCLUSION Vaccinations in the elderly appear to be poorly utilized; meanwhile, antibiotic treatments, as well as steroid therapy, are overused. Managing epidemic infections requires attention from the public hospital system.
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Affiliation(s)
- P M Roger
- Service des maladies infectieuses et tropicales, hôpital de l'Archet, route Saint-Antoine de Ginestière, BP 3079, 06202 Nice, France.
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15
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Mahagne MH, Darcourt J, Migneco O, Fournier JP, Thiercelin D, Ducoeur S, Bertrand F, Bussière F, Chatel M, Baron JC. Early (99m)Tc-ethylcysteinate dimer brain SPECT patterns in the acute phase of stroke as predictors of neurological recovery. Cerebrovasc Dis 2000; 10:364-73. [PMID: 10971022 DOI: 10.1159/000016092] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Accurate prediction of outcome in acute stroke would help in identifying subgroups of patients for therapeutic trials and intravenous thrombolysis. The purpose of this study was to prospectively test the hypothesis that brain SPECT, with (99m)Tc-L, L-ethylcysteinate dimer (ECD), a tracer sensitive to cell function, performed in the first hours after stroke onset, adds predictive power to concomitant neurological evaluation. METHODS Twenty-four patients with a first-ever middle cerebral artery stroke were prospectively studied with ECD-SPECT within 12 h after stroke onset. Neurological evaluation was performed using Orgogozo's scale at admission and 3 months later in order to calculate the percent Martinez-Vila evolution indices (EI%). Semiquantitative visual analysis of SPECT images was performed in 6 cortical regions relevant for carotid artery territory. Both the extent and the intensity of cortical reduced ECD uptake were calculated, leading to an 'ischemia' score, corresponding to the sum of regions of interest (ROI) where ECD uptake was between 40 and 80% of the contralateral healthy hemisphere, and an 'irreversibly damaged tissue' (IDT) score, corresponding to an uptake below 40%, and a total score (ischemia + IDT). Each patient was assigned to one of three patterns: (1) pattern I with severe ECD cortical uptake reduction defined by at least one ROI with uptake under 40%, (2) pattern II with moderate ECD cortical uptake reduction (40-80%) only and (3) pattern III with normal ECD uptake. RESULTS There were 11 patients (46%) with pattern I ECD-SPECT. This group had almost invariably (10/11 patients) a poor outcome. The 12 patients (50%) classified in pattern II had a variable clinical outcome, ranging from improvement to deterioration. The single patient with a normal SPECT (pattern III) had a full clinical recovery. Both total score and IDT score were strongly significantly correlated with neurological recovery EI% (respectively p = 0.006 and 0.004). Their predictive value was significantly higher than, and independent of, day 0 neurological evaluation. No patient had an increased ECD uptake. CONCLUSION Our results show that the degree of ECD cortical uptake reduction, measured on early brain SPECT, is a strong predictor of neurological recovery. ECD-SPECT data have a higher predictive value than day 0 neurological evaluation. The apparently better predictive value of ECD over hexamethylpropyleneamine oxime may reflect this tracer's brain retention mechanisms which are weighted more towards cell function than towards perfusion. ECD-SPECT is easily obtainable and may help in selecting out from therapy those patients who are likely to have either very good or very poor spontaneous outcome, and thus improve the assessment of acute stroke and the choice of therapeutic strategy.
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Affiliation(s)
- M H Mahagne
- Emergency Department, University of Nice, France
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Abstract
This article presents a review of 16 instruments measuring behavioral disturbance of persons with schizophrenia as perceived by their family members. Information about the domain, the types of rating scales, and the psychometric properties of these instruments are provided. Future directions in the study of behavioral disturbance are proposed.
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Affiliation(s)
- H L Provencher
- Faculty of Nursing, Laval University, Centre de Recherche, Université Laval-Robert Giffard, Québec, Canada. helene.provencher@@fsi.ulaval.ca
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Provencher HL, Fournier JP, Perreault M, Vezina J. The caregiver's perception of behavioral disturbance in relatives with schizophrenia: a stress-coping approach. Community Ment Health J 2000; 36:293-306. [PMID: 10933245 DOI: 10.1023/a:1001961331890] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This article suggests some theoretical orientations in studying behavioral disturbance from a stress-coping perspective. First, an overview of Lazarus and Folkman's cognitive theory of stress is presented. Secondly, some linkages are proposed between the rating scales used to measure behavioral disturbance and the concepts of this theory. Future research directions are then suggested to further explore the affective, cognitive and behavioral responses related to the management of disturbing behaviors.
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Affiliation(s)
- H L Provencher
- Faculty of Nursing, Laval University, Centre de Recherche, Université Laval-Robert Giffard, Québec, Canada.
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18
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Roy MA, Lanctôt G, Mérette C, Cliche D, Fournier JP, Boutin P, Rodrigue C, Charron L, Turgeon M, Hamel M, Montgrain N, Nicole L, Pirès A, Wallot H, Ponton AM, Garneau Y, Dion C, Lavallée JC, Potvin A, Szatmari P, Maziade M. Clinical and methodological factors related to reliability of the best-estimate diagnostic procedure. Am J Psychiatry 1997; 154:1726-33. [PMID: 9396953 DOI: 10.1176/ajp.154.12.1726] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The reliability and accuracy of the best-estimate diagnostic procedure were examined, and factors associated with reliability were determined. METHOD The subjects were 134 members of large multigenerational pedigrees densely affected by bipolar disorders or schizophrenia. Three best-estimate diagnoses were derived: first, by a research psychiatrist and research assistant unblind to the relatives' diagnoses; second, by two blind independent psychiatrists; third, by a panel of four blind psychiatrists. The subjects were characterized on several clinical and methodological variables, which were used to compare the agreements of two types of best-estimate diagnoses with the disagreements. RESULTS There was satisfactory agreement between the unblind and blind consensus best-estimate diagnoses and between the two blind independent psychiatrists. Latent class analyses revealed that limited sensitivity was the main source of imperfect reliability. Confusability analyses revealed that the most problematic diagnostic distinctions involved schizoaffective disorder, which was confused with schizophrenia, bipolar I disorder, and schizophreniform disorder. Blindness significantly affected diagnostic outcome in latent class analyses. Moreover, for diagnostic disagreements, unblind diagnoses had greater continuity with the most predominant diagnosis in the pedigree than did blind diagnoses. Diagnostic disagreements were associated with the presence of mixed affective and psychotic symptoms, less diagnostic certainty, and shorter duration of illness. CONCLUSIONS These results suggest that it is possible to identify cases that are more likely to lead to diagnostic disagreements in family and epidemiological studies and that blind diagnoses may help to prevent false positive diagnoses, which may be particularly detrimental to genetic linkage analyses.
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Affiliation(s)
- M A Roy
- Centre de recherche Université Laval Robert-Giffard, Beauport, Québec, Canada.
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19
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Pugliese P, Martini-Wehrlen S, Roger PM, Fouché R, Pradier C, Carlès M, Marty P, Fournier JP, Mousnier A, Dellamonica P. [Malaria attacks after returning from endemic areas. Failure or inadequate chemoprophylaxis?]. Presse Med 1997; 26:1378-80. [PMID: 9404345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Determine the causes of malaria attacks in subjects who have returned from endemic areas by assessing prescriptions for chemical prophylaxis and compliance. PATIENTS AND METHODS All patients who developed a paroxysmal episode of malaria diagnosed at the University of Nice hospital in 1995 answered specific questions concerning their anti-malaria prophylaxis. RESULTS Thirty-three patients were hospitalized for paroxysmal episodes of malaria in 1995. In 32 cases (97%) the attack resulted from either the lack of any prophylaxis (17 cases, 52%), inadequate prescription (11 cases, 12%) or poor compliance (4 cases, 12%). The prescribed chemical prophylaxis was not adapted to the chloroquinone-resistant area in 8 cases (24%) and medical recommendations concerning administration rules were inadequate in 3 cases (9%). Only one patient developed a paroxysmal episode despite correct compliance to a chloroquine-resistant zone-adapted well-conducted prescription. The cost of poor prophylaxis in terms of human suffering and financial cost was high for this preventable disease. Four patients had to be hospitalized in the intensive care unit and one died during hospitalization. The cumulative cost of hospitalization for these 33 cases was evaluated at 660,000 FF. CONCLUSION Preventive measures for malaria must include better information for physicians on changing recommendations for chemical prophylaxis as well as better information for travelers provided by all those involved in organizing travel to endemic areas.
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Affiliation(s)
- P Pugliese
- Service de Maladies infectieuses et tropicales, Hôpital de l'Archet, Nice
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20
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Abstract
Schizophrenia is a devastating illness for the affected individuals and their families. Health care providers and researchers are also challenged by the clinical heterogeneity of this disorder. The goal of the present paper is to offer an updated overview of the aetiology, definition, clinical manifestations and pharmacological and psychosocial treatments of schizophrenia. Finally, some future directions for psychiatric nursing will be suggested in light of the existing knowledge of schizophrenia.
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21
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Maziade M, Bissonnette L, Rouillard E, Martinez M, Turgeon M, Charron L, Pouliot V, Boutin P, Cliche D, Dion C, Fournier JP, Garneau Y, Lavallée JC, Montgrain N, Nicole L, Pirès A, Ponton AM, Potvin A, Wallot H, Roy MA, Mérette C. 6p24-22 region and major psychoses in the Eastern Quebec population. Le Groupe IREP. Am J Med Genet 1997; 74:311-8. [PMID: 9184316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Recent reports of a linkage trend in 6p24-22 for schizophrenia (SZ), in different samples, were tempered by the concurrent evidence of negative reports in other samples. In the studies showing positive results, different definitions of affection and a wide spectrum of diagnoses were used. Our objectives were not only to test for linkage at 6p24-22 in the Eastern Quebec population, but also to test whether this putative vulnerability locus was either selectively linked to schizophrenia (SZ), or to bipolar disorder (BP), or to both major psychoses. Parametric and nonparametric linkage analyses with 12 microsatellite markers in 6p24-p22 were performed on a sample of 18 large multigenerational pedigrees (N = 354) either affected by SZ, or by BP, or equally affected by both major psychoses (i.e., mixed pedigrees). Three affection definitions were usually tested in our program: one on schizophrenia (SZ), one on bipolar disorder (BP), and one that comprised SZ and BP under the hypothesis of a susceptibility locus common to both in major psychoses (common locus, CL). The results of parametric analyses did not support a major gene hypothesis. However, in one large mixed pedigree (#151), we observed with the common locus phenotype (CL) lod scores of 2.49 and 2.15, respectively, at the D6S296 and D6S277 loci under a dominant model. Our data suggest the presence of a potential vulnerability locus at 6p24-22 that could be related to both schizophrenia and bipolar affective disorder. These results may be seen as congruent with former studies that used schizoaffective as well as schizophrenia diagnoses as entry criteria for the affected families, and used an affection definition that comprised affective psychoses as well as schizophrenia.
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Affiliation(s)
- M Maziade
- Centre de Recherche Université Laval Robert-Giffard, Beauport, Quebec,Canada
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22
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Maziade M, Raymond V, Cliche D, Fournier JP, Caron C, Garneau Y, Nicole L, Marcotte P, Couture C, Simard C. Linkage results on 11Q21-22 in Eastern Quebec pedigrees densely affected by schizophrenia. Am J Med Genet 1995; 60:522-8. [PMID: 8825888 DOI: 10.1002/ajmg.1320600607] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The 11q21-22 region is of interest for schizophrenia because several candidate genes are located in this section of the genome. The 11q21-22 region, including DRD2, was surveyed by linkage analysis in a sample (N = 242) made of four large multigenerational pedigrees densely affected by schizophrenia (SZ) and eight others by bipolar disorder (BP). These pedigrees were ascertained in a large area of Eastern Quebec and Northern New Brunswick and are still being extended. Family members were administered a "consensus best-estimate diagnosis procedure" (DSM-III-R criteria) blind to probands and relatives' diagnosis and to pedigree assignment (SZ or BP). For linkage analysis, 11 microsatellite polymorphism (CA repeat) markers, located at 11q21-22, and comprising DRD2, were genotyped. Results show no evidence of a major gene for schizophrenia. However, a maximum lod score of 3.41 at the D11S35 locus was observed in an affected-only analysis of one large SZ family, pedigree 255. Whether or not the positive linkage trend in pedigree 255 reflects a true linkage for a small proportion of SZ needs to be confirmed through the extension of this kindred and through replication.
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Affiliation(s)
- M Maziade
- Centre de Recherche Université Laval Robert-Giffard, de la Canardière, Beauport, Québec, Canada
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23
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Maziade M, Roy MA, Martinez M, Cliche D, Fournier JP, Garneau Y, Nicole L, Montgrain N, Dion C, Ponton AM. Negative, psychoticism, and disorganized dimensions in patients with familial schizophrenia or bipolar disorder: continuity and discontinuity between the major psychoses. Am J Psychiatry 1995; 152:1458-63. [PMID: 7573584 DOI: 10.1176/ajp.152.10.1458] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study aimed to answer the following questions: 1) Can we reliably measure the psychopathologic dimensions of schizophrenia by using a lifetime frame and by rating acute and interepisode periods separately? 2) Can we reproduce in subjects with familial schizophrenia the characteristic three-factor structure of schizophrenic symptoms that has been found previously in general groups of schizophrenic patients? 3) Is the factor structure also present in familial bipolar disorder? METHOD Lifetime measures of psychotic symptoms were taken through a slightly modified version of the Comprehensive Assessment of Symptoms and History for 138 patients with highly familial DSM-III-R schizophrenia (N = 51), bipolar disorder (N = 44), or spectrum disorders (N = 43). Symptoms were rated separately in the acute episodes and in the stabilized interepisode intervals across the patients' lives. RESULTS A satisfactory level of reliability was obtained. In this highly familial study group, the positive/negative factorial distinction was replicated, as was a three-factor model similar to that observed in prior general groups of schizophrenic patients. These factors were also present in bipolar affective disorder. The negative, psychoticism, and disorganized factor model applied more to the acute phase of illness than to the stabilized state. CONCLUSIONS These findings offer an empirical basis for testing biological or genetic variables in relation to negative/positive symptom dimensions, rather than diagnoses. Observations of a shared structure for schizophrenia and bipolar disorder suggest some continuity in the causes of these disorders.
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Affiliation(s)
- M Maziade
- Centre de recherche, Université Laval Robert-Giffard, Québec, Canada
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24
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Bertrand F, Le Pileur P, Fournier JP, Martinez P, Mahagne MH, Ducoeur S, Lefebvre M, Oualid H. [The value of suspecting cervicofacial and thoracic purpura following an episode of unconsciousness]. Presse Med 1993; 22:1794. [PMID: 8115327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Fournier JP, Gagnon F. [A crisis intervention service in an outpatient psychiatric clinic of a general hospital: function and clientele]. Can J Psychiatry 1993; 38:96-100. [PMID: 8467450 DOI: 10.1177/070674379303800205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The authors describe an external crisis intervention service in a general hospital. This service is intended for a clientele presenting acute mental health problems, referred, in the majority of cases, from the emergency department. They present demographic data, diagnostic data, data on the factors precipitating the crises and data which can be used to qualify and quantify the clientele. In addition, they describe the therapeutic approach and the treatment philosophy, the number of follow-up sessions, and the guidance provided to the clientele after follow-up. Finally, the authors suggest prerequisites considered essential to the effective operation of a crisis intervention module in an external psychiatric clinic.
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Affiliation(s)
- J P Fournier
- Centre hospitalier de l'Université Laval, Ste-Foy, Québec
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26
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Maziade M, Debraekeleer M, Genest P, Cliche D, Fournier JP, Garneau Y, Shriqui C, Roy MA, Nicole L, Raymond V. A balanced 2:18 translocation and familial schizophrenia: falling short of an association. Arch Gen Psychiatry 1993; 50:73-5. [PMID: 8422227 DOI: 10.1001/archpsyc.1993.01820130079017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Petitou M, Coudert C, Level M, Lormeau JC, Zuber M, Simenel C, Fournier JP, Choay J. Selectively O-acylated glycosaminoglycan derivatives. Carbohydr Res 1992. [DOI: 10.1016/0008-6215(92)85010-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Maziade M, Roy MA, Fournier JP, Cliche D, Mérette C, Caron C, Garneau Y, Montgrain N, Shriqui C, Dion C. Reliability of best-estimate diagnosis in genetic linkage studies of major psychoses: results from the Quebec pedigree studies. Am J Psychiatry 1992; 149:1674-86. [PMID: 1443244 DOI: 10.1176/ajp.149.12.1674] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Diagnostic classification and reliability are critical in genetic linkage studies of schizophrenia and bipolar disorder. To establish an optimal diagnostic procedure, the authors drew 13 methodological elements from 38 major linkage studies and workshop reports. They determined reliability for a consensus best-estimate diagnostic method based on these 13 features. METHOD Each of 59 subjects from several large multiplex pedigrees, densely affected by either schizophrenia or bipolar disorder, received a best-estimate diagnosis from unblind diagnosticians in the field and also from a panel of four research psychiatrists who were blind to the proband's and relatives' clinical status. The best estimate was based on personal diagnostic interviews, all available medical records, and family history data. RESULTS The diagnostic concordance between the field team and the blind psychiatric board yielded 78% to 90% agreement for the whole sample (kappa = 0.83-0.88) and 71% to 87% agreement for the subjects given field diagnoses (kappa = 0.76-0.83). The diagnoses made by the unblind field diagnosticians were biased toward a greater severity (or certainty) level in the diagnostic hierarchy (schizophrenic or bipolar) and more consistency with the most prevalent diagnosis affecting the pedigree. CONCLUSION Since several previous linkage studies used diagnoses made by diagnosticians who were not blind to the status of the probands and the relatives or did not use a consensus best-estimate diagnosis, further reliability studies of different aspects of the best-estimate method and of its effect on linkage studies are needed. Such research is imperative given the serious impact of diagnostic misclassifications on genetic linkage results.
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Affiliation(s)
- M Maziade
- Centre de recherche Université Laval Robert-Giffard, Beauport, PQ, Canada
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29
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Bertrand F, Fournier JP, Martinez P, Mahagne MH, Chichmanian RM, Ducoeur S, Lefebvre M, Avril E. [Acute rhabdomyolysis during treatment with simvastatin (Zocor)]. Therapie 1992; 47:442. [PMID: 1299994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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30
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Fournier JP, Schneider S, Martinez P, Mahagne MH, Ducoeur S, Haffner M, Thiercelin D, Chichmanian RM, Bertrand F. [Hypoglycemic coma in a patient treated with glipizide and fluconazole: a possible interaction?]. Therapie 1992; 47:446-7. [PMID: 1299999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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31
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Ferrari E, Taillan B, Fournier JP, Ferrari P, Bayle J, Morand P. [Acute pulmonary embolism with negative D-dimers]. Presse Med 1992; 21:581-2. [PMID: 1533924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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32
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Bernardin G, Fournier JP, Quaranta JF, Marty P, Dellamonica P, Mattei M. [Acute respiratory distress syndrome with fatal outcome after exsanguinotransfusion in pernicious malaria attack]. Presse Med 1989; 18:1394-5. [PMID: 2529517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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33
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Ferrari E, Fournier JP, Gibelin P, Drici MD, Morand P. [Is treatment with molar lactate in flecainide poisoning safe?]. Presse Med 1989; 18:1395. [PMID: 2529518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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34
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Bernard E, Carles M, Toussaint-Gari M, Fournier JP, Dellamonica P. [Value of fluconazole in the treatment of systemic yeast infection]. Pathol Biol (Paris) 1989; 37:690-3. [PMID: 2552380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
20 patients (18 men, 2 women), 10 of whom were HIV +, were given Fluconazole (F) for either systemic candidiasis (13 cases), histoplasmosis (1), or cryptococcosis (6). The localization of the Candida infections (12 C. albicans, 1 C. tropicalis), were: septicemic (2), urinary (7), bronchial (2), esophageal (5), uveal (1), soft tissue (2), and 1 undetermined localization but a positive serology (1). On day (d) 1, Candidiasis patients were given an initial dose of 400 mg (for septicemia) or 200 mg (other localizations) of FIV or PO, then 200 or 100 mg per d. The length of treatment lasted from 28 to 70 d. Evolution was favorable in all the patients. 4 relapses occurred after the end of treatment: at 10 d, a septicemic candidiasis (C. tropicalis) in 1 patient who had prosthetic endocarditis; and at 1 month, digestive candidiasis in 3 HIV + patients. For the patient, infected by Histoplasma capsulatum, despite a clinical improvement, urine were still positive at day 75. The patients with cryptococcosis (5 meningitidis in the AIDS patients) and renal (1) (kidney transplant) were given on the average 400 mg a d, IV or PO (mean length 8 weeks). Only 5 patients were evaluable. For 2 of the meningitis patients with other localizations, standard treatment was instituted due to the persistence of positive cultures. For the 2 other patients, the cerebrospinal fluid (1) and the urine (1) were sterilized by the 3d week. But they relapsed 1 month after the treatment stopped. For the 18 patients evaluable, clinical and biological tolerance was good except for 1 patient with transaminases rise for which fluconazole was probably the cause.
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Affiliation(s)
- E Bernard
- Maladies Infectieuses et Tropicales, Hôpital de l'Archet, Nice
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35
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Fournier JP, Barbieri N. [Suicide: an update]. Union Med Can 1989; 118:106-9. [PMID: 2667246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors relate etiological and epidemiological data on suicide. They also discuss cognitive and psychodynamic as well as biological factors involved. In the second part, they described different ways of predicting and dealing with suicide. They propose the use of a scale as a useful way for the assessment of suicide risk.
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36
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Bernard E, Roger PM, Carles D, Bonaldi V, Fournier JP, Dellamonica P. Diarrhea and Campylobacter infections in patients infected with the human immunodeficiency virus. J Infect Dis 1989; 159:143-4. [PMID: 2909632 DOI: 10.1093/infdis/159.1.143] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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37
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Vinti H, Chichmanian RM, Fournier JP, Pesce A, Taillan B, Fuzibet JG, Cassuto JP, Dujardin P. [Systemic complications of beta-blocking eyedrops. Apropos of 6 cases]. Rev Med Interne 1989; 10:41-4. [PMID: 2566193 DOI: 10.1016/s0248-8663(89)80112-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Six cases of systemic reactions to topical treatment with beta-blocking eyedrops are reported, bradycardia and faintness due to an overdosage of ophthalmic timolol; decompensated heart failure one month after the prescription of carteolol eyedrops: bronchospasm after two weeks of treatment with metipranolol eyedrops; crippling Raynaud's phenomenon of otherwise unknown origin, which had begun with timolol eyedrops, continued with carteolol eyedrops and regressed after discontinuation of ophthalmic beta-blockers; aggravation of an anaphylactoid shock in a patient treated with ophthalmic timolol, and myocardial infarction possibly due to the abrupt withdrawal of timolol eyedrops. It cannot be overstressed that the rules governing the prescription of oral beta-blockers also apply to ophthalmic preparations of these drugs: respect of contra-indications, strict adherence to the dosage recommended, gradual drug withdrawal and regular supervision. Only controlled studies and long-term follow-up will be able to demonstrate differences in safety between the five beta-blockers commercialized as eyedrops in this country.
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Affiliation(s)
- H Vinti
- Service de médecine interne I, hématologie, hôpital de Cimiez, Nice
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38
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Roger P, Monneret C, Fournier JP, Choay P, Gagnet R, Gosse C, Letourneux Y, Atassi G, Gouyette A. Rationale for the synthesis and preliminary biological evaluation of highly active new antitumor nitrosoureido sugars. J Med Chem 1989; 32:16-23. [PMID: 2909727 DOI: 10.1021/jm00121a005] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Various new nitrosoureido derivatives of di- or trideoxy sugars were synthesized. The influence of the hydroxyl substitution pattern, the configuration at the anomeric center, and the absolute configuration of the sugar moiety on the antitumor activity of a series of nitrosoureido derivatives of di- and trideoxy sugars was studied. All compounds showed a very significant activity in vivo against L1210 leukemia, B16 melanocarcinoma, and Lewis lung carcinoma. Methyl 3-[3-(2-chloroethyl)-3-nitrosoureido]-2,3-dideoxy-alpha-D-arabino- hexopyranoside, 24 (NSC 609224), was found to be the most active compound. When treated with 24 (NSC 609224) at 20 mg/kg on day 1, at least 90% of the L1210 leukemia and B16 melanocarcinoma bearing mice showed a survival of over 60 days for a LD50 value for this compound of 42 mg/kg.
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Affiliation(s)
- P Roger
- Département de Chimie Thérapeutique, Institut Choay, Montrouge, France
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39
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Atassi G, Dumont P, Gosse C, Fournier JP, Gouyette A, Roger P. Characterization of the anti-tumour activity against solid tumours of a new nitrosoureido sugar: Cy 233. Cancer Chemother Pharmacol 1989; 25:205-9. [PMID: 2598412 DOI: 10.1007/bf00689584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The anti-tumour properties of Cy 233, a new nitrosoureido sugar, were investigated in two murine solid tumours: B16 melanoma and subcutaneously implanted colon adenocarcinoma. Injected i.v., Cy 233 exerted a strong anti-tumour effect against the established B16 melanoma: long-term survivors were recorded with all schedules of treatment. The drug was even more effective against advanced colon 38 adenocarcinoma: it produced a high percentage of total tumour regression, regardless of the route of administration (i.p., i.v., p.o.). The marked in vivo activity of Cy 233 against advanced colon 38 adenocarcinoma, which is known to be resistant to such major anti-cancer drugs as BCNU and chlorozotocin, its water solubility and its stability in aqueous media are further elements warranting toxicological and clinical studies of this agent.
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Affiliation(s)
- G Atassi
- Institut Jules Bordet, Université Libre de Bruxelles, Belgium
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40
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Gosse C, Atassi G, Letourneux Y, Ardouin P, Gouyette A, Fournier JP, Roger P. Antitumour activity of a new water-soluble nitrosoureido sugar: CY233 (NSC 609224). Anticancer Res 1988; 8:1419-22. [PMID: 3218975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
L1210 leukemia was used to evaluate the antitumour activity in vivo of CY233 (NSC 609224) a new water-soluble nitrosoureido derivative of deoxysugar currently being studied in preclinical trials. The antitumour activity of CY233 is dose-dependent with the same large therapeutic index whatever the route of administration (I.P., I.V., per os). Thus starting from a single dose of 10 mg/kg (less than 25% of the LD50), 80% to 100% of mice survive at 120 days, whether the drug is being administered I.V., I.P. or P.O. These results clearly emphasize the very original and promising potentiality of CY233 among the series of alkylating agents, and more precisely nitrosoureas.
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Affiliation(s)
- C Gosse
- Pavillon de Recherche, Institut Gustave-Roussy, Villejuif, France
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41
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Taillan B, Vinti H, Fuzibet JG, Fournier JP, Montagne N, Dujardin P. [Non-traumatic rhabdomyolysis in Staphylococcus aureus septicemia]. Presse Med 1988; 17:1860-1. [PMID: 2973052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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42
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43
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Fournier JP, Bernardin G, Ferrari E, Paquis P, Corcelle P, Mattei M. [Threatening hyperkalemia caused by mannitol. A little-known side effect]. Presse Med 1988; 17:824. [PMID: 2968577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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44
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Bernardin G, Fournier JP, Corcelle P, Politano S, Bernard E, Dellamonica P, Mattei M. [Hemodynamic profile of septic shock in systemic tuberculosis of fulminating course]. Presse Med 1988; 17:486-7. [PMID: 2965353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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45
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Bernardin G, Fournier JP, Ferrari E, Corcelle P, Mattei M. [Septic shock and biventricular infarction: symptomatologic value of hemodynamics]. Presse Med 1987; 16:1868. [PMID: 2962132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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46
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47
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Blaive B, Bugnas B, Bonnaud F, Lemoigne F, Beziau H, Fournier JP. [Significance and evaluation of theophyllinemia in clinical medicine]. Allerg Immunol (Paris) 1986; 18:33-6. [PMID: 3331088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The theophyllinemia variations depend upon some factors: -observance of treatment, time of blood swab posology, laboratory technic, concomitant drugs, method of adaptation selected and the mean of administration. The theophylline title is a very important biologic parameter, necessary to the asthma treatment survey through such drug. Daily posology may be adapted to this titrate.
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Affiliation(s)
- B Blaive
- Service de pneumologie et réanimation respiratoire, Hôpital Pasteur, Nice
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48
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Dellamonica P, Fournier JP, Garraffo R, Lapalus P, Bernard E, Chichmanian RM, Marty P, Le Fichoux Y. [Monitoring of treatment involving 5-fluorocytosine]. Pathol Biol (Paris) 1985; 33:642-5. [PMID: 3911161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The occurrence of hematologic and neurologic complications probably caused by an overdose of 5-FC has prompted us to study 5-FC pharmacokinetics in 10 patients under a 5-FC and amphotericin B. On the basis of our findings we have determined the optimal dosage that achieves desired concentrations. In 5 cases this dosages was found to differ from that suggested by the manufacturer. 5-FC concentrations were however higher than predicted levels as a result of the association with amphotericin B. A subsequent modification of dosage was needed in 10 patients. 5 undesirable side effects were recorded: thrombopenia (1 case), neutropenia (1 case), diarrhea (2 cases), and isolated rise in transaminases. In 4 patients with high 5-FC concentrations, chromatograms showed a peak possibly formed by 5-FU, suggesting that 5-FC may be converted into 5-FU.
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49
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Fournier JP, Palmier B, Marsan P, Dorne R, Garrigue G. [Pulmonary fibrosis during treatment involving amiodarone]. Ann Fr Anesth Reanim 1984; 3:324. [PMID: 6476507 DOI: 10.1016/s0750-7658(84)80131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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50
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Corcelle P, Fournier JP, Mattei M, Duplay H. [Acute renal insufficiency caused by transfusion of hemolyzed blood]. Nouv Presse Med 1982; 11:1881-2. [PMID: 7110942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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