176
|
Bertrand JC, Bonin P, Goutx M, Gauthier M, Mille G. The potential application of biosurfactants in combatting hydrocarbon pollution in marine environments. Res Microbiol 1994; 145:53-6. [PMID: 8090987 DOI: 10.1016/0923-2508(94)90070-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
177
|
Hoffmann L, Manuel AA, Peter M, Walker E, Gauthier M, Shukla A, Barbiellini B, Massidda S, Adam G, Adam S, Hardy WN, Liang R. Study of the chain related Fermi surface in (R)Ba2Cu3O7- delta. PHYSICAL REVIEW LETTERS 1993; 71:4047-4050. [PMID: 10055140 DOI: 10.1103/physrevlett.71.4047] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|
178
|
Proulx F, Lacroix J, Farrell CA, Gauthier M. Convulsions and hypertension in children: differentiating cause from effect. Crit Care Med 1993; 21:1541-6. [PMID: 8403965 DOI: 10.1097/00003246-199310000-00024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine if the magnitude of blood pressure (BP) increase could differentiate convulsion caused by a hypertensive crisis from a primary convulsive disorder, which itself increases BP. DESIGN Retrospective analysis. SETTING Admission to a pediatric intensive care unit (ICU) within a tertiary care center. PATIENTS All children with hypertensive crisis admitted to the pediatric ICU from 1976 to 1990 were studied. Thirty-eight episodes occurred in 36 patients. The charts of children admitted for status epilepticus from 1976 to 1986 were also reviewed. One hundred and fifty-three episodes occurred in 145 patients. MEASUREMENTS AND MAIN RESULTS BP values at entry to the pediatric ICU in patients with hypertensive crisis were compared with the highest BP values obtained within an hour after cessation of convulsion in 120 patients admitted for status epilepticus. The Z scores for BP, adjusted for age and sex, were compared. The BP values for children in hypertensive crisis with or without convulsions were by far greater than the BP values observed in patients in status epilepticus (p < .0001). For a patient in the postictal phase, a BP > or = 4.0 SD above the mean for age and sex predicted with 78% probability the presence of a hypertensive crisis requiring emergency treatment. If the BP was < 4 SD below the mean, the possibility of a hypertensive crisis was excluded (negative-predictive value 100%). CONCLUSIONS Children with hypertensive crisis, as well as children with status epilepticus, can present with a high BP. In a postictal patient, the magnitude of BP increase is a useful clinical parameter to exclude a hypertensive crisis that requires specific treatment of the BP.
Collapse
|
179
|
San-Miguel A, Polian A, Gauthier M, Itié JP. ZnTe at high pressure: X-ray-absorption spectroscopy and x-ray-diffraction studies. PHYSICAL REVIEW. B, CONDENSED MATTER 1993; 48:8683-8693. [PMID: 10007082 DOI: 10.1103/physrevb.48.8683] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
|
180
|
|
181
|
Dunn C, Gauthier M, Gaudreault P. Coma in a neonate following single intranasal dose of xylometazoline. Eur J Pediatr 1993; 152:541. [PMID: 7687548 DOI: 10.1007/bf01955075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
182
|
Hemmings G, Salevsky FC, Sloan PA, Angle M, Ralley FE, Chartrand D, Weeks S, Moore A, Gauthier M, Catchlove R. Anaesthetists and the right to die. Can J Anaesth 1993; 40:78-9. [PMID: 8425249 DOI: 10.1007/bf03009325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
|
183
|
González J, Fernández BJ, Besson JM, Gauthier M, Polian A. High-pressure behavior of Raman modes in CuGaS2. PHYSICAL REVIEW. B, CONDENSED MATTER 1992; 46:15092-15101. [PMID: 10003623 DOI: 10.1103/physrevb.46.15092] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
|
184
|
Bado A, Moizo L, Laigneau JP, Gauthier M, Dubrasquet M, Lewin MJ. Possible mediation by luminal somatostatin of bombesin-induced satiety in the cat. Am J Physiol Regul Integr Comp Physiol 1992; 263:R84-8. [PMID: 1353312 DOI: 10.1152/ajpregu.1992.263.1.r84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intravenous bombesin produced a dose-related stimulation of luminal gastric somatostatin output and a concomitant dose-dependent inhibition of food intake in the gastric fistula cat. Maximal food intake inhibition was observed at 1,280 pmol.kg-1.h-1 and corresponded to 65 +/- 7% (P less than 0.01). These effects of bombesin were dose dependently abolished by the specific bombesin-receptor antagonist, [Leu13-psi(CH2NH)-Leu14]bombesin. Furthermore, intragastric administration of somatostatin-14, at doses corresponding to those found in the gastric lumen in response to intravenously administered bombesin, significantly inhibited the first 30 min of food intake. This administration had however no effect on total (daily) food intake. We therefore suggest that luminal gastric somatostatin could at least account for bombesin-induced short-term satiety.
Collapse
|
185
|
Blandin P, Massidda S, Barbiellini B, Jarlborg T, Lerch P, Manuel AA, Hoffmann L, Gauthier M, Sadowski W, Walker E, Peter M, Yu J, Freeman AJ. Two-photon momentum density in La2-xSrxCuO4 and Nd2-xCexCuO4. PHYSICAL REVIEW. B, CONDENSED MATTER 1992; 46:390-397. [PMID: 10002223 DOI: 10.1103/physrevb.46.390] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
|
186
|
Tucci M, Lacroix J, Farrell CA, Gauthier M, Héon E. Hypertensive iridocyclitis associated with meningococcal infection. Crit Care Med 1992; 20:906-7. [PMID: 1597052 DOI: 10.1097/00003246-199206000-00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
187
|
Kazi A, Gauthier M, Lebel MH, Farrell CA, Lacroix J. Uvulitis and supraglottitis: early manifestations of Kawasaki disease. J Pediatr 1992; 120:564-7. [PMID: 1552395 DOI: 10.1016/s0022-3476(05)82484-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Two children with Kawasaki disease initially had upper respiratory tract manifestations. The first was admitted with a diagnosis of uvulitis; in the second the clinical picture was characterized by supraglottic involvement, confirmed by direct laryngoscopic examination.
Collapse
|
188
|
Lacroix J, Farrell C, Gaudreault P, Gauthier M, Lapierre G. Intoxication orale au cannabis chez sept enfants. ACTA ACUST UNITED AC 1992. [DOI: 10.1016/s1164-6756(05)80004-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
189
|
Lacroix J, Nadeau D, Laberge S, Gauthier M, Lapierre G, Farrell CA. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit Care Med 1992; 20:35-42. [PMID: 1729041 DOI: 10.1097/00003246-199201000-00013] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine the frequency of upper gastrointestinal (GI) bleeding in pediatric ICUs. DESIGN Prospective, descriptive study. SETTING Pediatric ICU in a university hospital. PATIENTS All children admitted to a pediatric ICU over a 55-wk period. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Upper GI bleeding was considered to be present if there was an episode of hematemesis or if any amount of blood was seen in drainage from a nasogastric tube. Sixty-three (6.4%) upper GI bleeds were detected among 984 patients: 5.2% in 698 patients who did not receive upper GI bleeding prophylaxis, and 9.4% in 286 patients who did receive some prophylaxis. Density was defined as the number of events/1000 days.patient. The mean density was 10.8 GI bleeding episodes/1000 days.patient in a pediatric ICU. A multivariate analysis detected four independent risk factors or risk markers for upper GI bleeding: high Pediatric Risk of Mortality score, coagulopathy, pneumonia, and multitrauma. Age, sex, hepatic and respiratory failures were identified as confounding variables. An upper GI bleeding episode was defined as being clinically important if hypotension, death, or transfusion occurred within 24 hrs after the bleeding. There were four clinically important GI bleeding episodes. All were caused, at least in part, by a coagulopathy. The GI bleeding was associated with a need for transfusion in four children, and with hypotension in two. CONCLUSIONS The frequency of upper GI bleeding is substantial, but the rate of occurrence of clinically important upper GI bleeding is low, even in a pediatric ICU where most patients do not receive any prophylaxis.
Collapse
|
190
|
|
191
|
Furfaro S, Gauthier M, Lacroix J, Nadeau D, Lafleur L, Mathews S. Arterial catheter-related infections in children. A 1-year cohort analysis. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1991; 145:1037-43. [PMID: 1877564 DOI: 10.1001/archpedi.1991.02160090089031] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To determine the incidence of infection secondary to arterial catheterization in children as well as the risk markers, we prospectively evaluated, during a 1-year period, all arterial catheters installed in children admitted to the pediatric intensive care unit. A total of 340 cannulas were placed in 310 children aged 80 +/- 4 months (mean +/- SEM) for a period of 64 +/- 4 hours. Most catheters were inserted percutaneously (99%) in the radial artery (86.5%). Ninety-two percent (313/340) of the catheters were sterile (group 1), 5% (17/340) were contaminated (less than 10 colony-forming units on semiquantitative culture) (group 2), and 3% (10/340) were considered either locally infected (ie, greater than or equal to 10 colony-forming units) (eight of 10) or associated with a possible catheter-related sepsis (two of 10) (group 3, or infected group). The incidence of local inflammation at the insertion site was higher in group 2 than in group 1 (18% vs 2.9%) but not statistically different between groups 3 and 1 (10% vs 2.9%). The duration of arterial catheterization was longer in group 3 than in group 1 (125 +/- 31 vs 61 +/- 4 hours). The risk of infection was nonexistent in the first 48 hours of catheterization. Thereafter it was calculated as being 6.2% (10/161), but it correlated poorly with the duration of arterial catheterization. These results confirm the very low incidence of infection related to arterial catheterization in children. Thus, routine catheter reinsertion is, in our opinion, unjustified.
Collapse
|
192
|
Lacroix J, Gauthier M. Attitude of pediatric intensivists toward prophylaxis of upper gastrointestinal bleeding. Crit Care Med 1990; 18:1192-3. [PMID: 2209060 DOI: 10.1097/00003246-199010000-00041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
193
|
Gauthier M. [Drowning in children]. LA REVUE DU PRATICIEN 1990; 40:812-6. [PMID: 2320908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Drowning is one of the most common causes of death in children. Near-drowning is even more frequent: near-drowning/drowning ratio is approximately 9-10/1. The age-groups between 1 and 3 years and 15 and 25 years are most likely to be at risk for submersion accidents. The majority of drowning accidents in children occur in swimming pools and bathtubs. The awake or stuporous victim has an excellent prognosis. In comatose patients, the prognosis is directly proportional to the severity of coma. Treatment is mostly supportive. Despite optimal care, it is not infrequent for a near-drowning accident to end in death or severe neurological handicap. Prevention must be a priority for the medical profession.
Collapse
|
194
|
Mitchell G, Larochelle J, Lambert M, Michaud J, Grenier A, Ogier H, Gauthier M, Lacroix J, Vanasse M, Larbrisseau A. Neurologic crises in hereditary tyrosinemia. N Engl J Med 1990; 322:432-7. [PMID: 2153931 DOI: 10.1056/nejm199002153220704] [Citation(s) in RCA: 172] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hereditary tyrosinemia results from an inborn error in the final step of tyrosine metabolism. The disease is known to cause acute and chronic liver failure, renal Fanconi's syndrome, and hepatocellular carcinoma. Neurologic manifestations have been reported but not emphasized as a common problem. In this paper, we describe neurologic crises that occurred among children identified as having tyrosinemia on neonatal screening since 1970. Of the 48 children with tyrosinemia, 20 (42 percent) had neurologic crises that began at a mean age of one year and led to 104 hospital admissions. These abrupt episodes of peripheral neuropathy were characterized by severe pain with extensor hypertonia (in 75 percent), vomiting or paralytic ileus (69 percent), muscle weakness (29 percent), and self-mutilation (8 percent). Eight children required mechanical ventilation because of paralysis, and 14 of the 20 children have died. Between crises, most survivors regained normal function. We found no reliable biochemical marker for the crises (those we evaluated included blood levels of tyrosine, succinylacetone, and hepatic aminotransferases). Urinary excretion of delta-aminolevulinic acid, a neurotoxic intermediate of porphyrin biosynthesis, was elevated during crises but also during the asymptomatic periods. Electrophysiologic studies in seven patients and neuromuscular biopsies in three patients showed axonal degeneration and secondary demyelination. We conclude that episodes of acute, severe peripheral neuropathy are common in hereditary tyrosinemia and resemble the crises of the neuropathic porphyrias.
Collapse
|
195
|
Gauthier M. Aligning the backroom with the boardroom at Blue Cross/Blue Shield. CHIEF INFORMATION OFFICER JOURNAL 1989; 1:41-3. [PMID: 10303432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
A recent survey of Blue Cross/Blue Shield organizations reveals fundamental differences in the attitudes and objectives of top management and information executives. Both groups learned valuable lessons for improving I/S effectiveness.
Collapse
|
196
|
Lebel MH, Gauthier M, Lacroix J, Rousseau E, Buithieu M. Respiratory failure and mechanical ventilation in severe bronchiolitis. Arch Dis Child 1989; 64:1431-7. [PMID: 2684031 PMCID: PMC1792760 DOI: 10.1136/adc.64.10.1431] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A retrospective review of children who needed mechanical ventilation for severe bronchiolitis identified 62 cases over a 10 year period. The mean age at initiation of ventilation was 73 days (range: 14-201). Compared with a group of 150 children in hospital for bronchiolitis but not transferred to the intensive care unit, these 62 cases were significantly younger (73.0 compared with 166.3 days), and smaller (4.5 compared with 6.8 kg), and significantly more had been born prematurely (40% compared with 16%). Taken independently, age, weight, and prematurity were significantly associated with the need for artificial ventilation, weight being the most important factor. Using stepwise logistic regression, prematurity in itself added to the quality of the prediction but age did not. The mean duration of mechanical ventilation was 105 hours (range 2-381). Duration of ventilation was significantly longer in children with a low gestational age at birth and a positive familial history of atopy. There were no deaths, and no patient developed pneumothorax or pneumomediastinum. Mechanical ventilation is well tolerated and safe in acute bronchiolitis.
Collapse
|
197
|
Blanchard H, Bensoussan AL, Weber A, Gauthier M, Lacroix J, Charest J, Laberge JM, Guttman FM, Brandt ML, Adelson J. Pediatric liver transplantation: the Montreal experience. J Pediatr Surg 1989; 24:1009-12. [PMID: 2809945 DOI: 10.1016/s0022-3468(89)80204-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The introduction of cyclosporine A in 1980 greatly improved the survival of children with end-stage liver disease undergoing orthotopic liver transplantation. The average 1-year survival rate following hepatic transplantation increased from 30% in 1963 to 70% in 1980. This report summarizes the initial experience of two pediatric hospitals in Montreal--Hôpital Ste-Justine and Montreal Children's Hospital. Since December 1985, 13 orthotopic liver transplantations have been performed in 11 patients: six females and five males. The median age was 18 months (range, 13 months to 17 years) and the median weight was 10 kg (range, 8.5 to 38 kg). The indications for transplantation were biliary atresia (5 patients), tyrosinemia (2 patients), biliary hypoplasia (1 patient), Amerindian cirrhosis (1 patient), Crigler-Najjar syndrome, type I (1 patient), and fulminant non-A, non-B hepatitis with grade IV encephalopathy (1 patient). Immunosuppression was ensured by cyclosporine A, azathioprine, and steroids. The function of 11 grafts was immediate following revascularization of the grafts. One graft had delayed function due to preservation injury, and one had primary nonfunction. Surgical complications included bile peritonitis (1), ruptured aneurysm of an aortic conduit (1), and thrombosis of the hepatic artery necessitating retransplantation (2). Three of our patients died, one from postoperative cerebral edema, one of primary nonfunction of the graft, and one of ruptured aneurysm of an aortic conduit. Our overall survival rate was 72% with a follow-up of 3 to 32 months. Pediatric liver transplantation can now provide successful treatment and cure of liver diseases considered, until recently, dismal and hopeless.
Collapse
|
198
|
Lacroix J, Infante-Rivard C, Jenicek M, Gauthier M. Prophylaxis of upper gastrointestinal bleeding in intensive care units: a meta-analysis. Crit Care Med 1989; 17:862-9. [PMID: 2670450 DOI: 10.1097/00003246-198909000-00003] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A meta-analysis was performed of 15 randomized studies on the prophylaxis with cimetidine and/or ant-acids of upper GI bleeding acquired in the ICU. There were eight comparisons of a group receiving cimetidine with a control group, nine comparisons of a group receiving antacids with a control group, and ten comparisons of a group receiving cimetidine with a group receiving antacids. The incidence of upper GI bleeding ranged from 3.4% to 52.7% among 866 control patients who received either a placebo or no prophylaxis. In five of eight comparisons, cimetidine was significantly more effective than no treatment or a placebo to prevent occult and overt upper GI bleeding; the typical odds ratio was 0.32 (95% confidence interval 0.21 to 0.49). In six of nine comparisons, antacids were significantly more effective than no treatment or a placebo; the typical odds ratio was 0.12 (0.08 to 0.19). Finally, antacids were significantly more effective than cimetidine in two of ten comparisons; the typical odds ratio was 1.61 (0.97 to 2.65). However, weaknesses in the study designs, heterogeneity of treatment effects, the lack of strength of the accumulated evidence, and the fact that no utility has been shown in terms of reducing morbidity (shock, need for transfusion) or mortality, prevent any definitive conclusion in regard to compulsory use of upper GI bleeding prophylaxis for ICU patients.
Collapse
|
199
|
Gauthier M, Polian A, Besson JM, Chevy A. Optical properties of gallium selenide under high pressure. PHYSICAL REVIEW. B, CONDENSED MATTER 1989; 40:3837-3854. [PMID: 9992353 DOI: 10.1103/physrevb.40.3837] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
|
200
|
Lacroix J, Gaudreault P, Gauthier M. Admission to a pediatric intensive care unit for poisoning: a review of 105 cases. Crit Care Med 1989; 17:748-50. [PMID: 2486553 DOI: 10.1097/00003246-198908000-00005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We reviewed all patients treated for intoxication in the pediatric ICU (PICU) of the Sainte-Justine Hospital over a 3-yr period. Poisoning (105 patients) constituted 3.1% of PICU admissions. Most involved children less than 3 (42%) yr or greater than 12 (33%) yr. Products most commonly ingested included tricyclic antidepressants (22%), benzodiazepines (15%), theophylline (10%), ethanol (10%), hallucinogens (8%), salicylates (8%), narcotics (8%), antihistamines (7%), and carbamazepine (5%). Three children became comatose after ingesting about 1 g of hashish. Multiple drug ingestions were frequent (22%), particularly in suicide attempts (11/23). Treatment was, in general, interventionist and nonspecific; aggressive measures for poisoning were required in only two patients who were hemodialyzed. Two patients stayed in the PICU greater than 2 days. All patients survived with no sequelae, except for one patient who required an intestinal resection. Poisoning in children is a common occurrence leading to PICU admission; however, the medical prognosis is usually excellent.
Collapse
|