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101.
Benjamin Bouyer Manon Bachy Redoine Zahi Camille Thévenin-Lemoine Pierre Mary Raphaël Vialle 《European spine journal》2014,23(1):163-171
Background
We present the results of a prospective series of 60 patients treated for neuromuscular spinal deformities with an original spinopelvic construct using two sacral screws and two iliac screws. Clinical and radiological results obtained with this new surgical technique were studied and discussed according to the epidemiological data and relevant literature.Methods
From January 2008 to June 2010, the clinical data of every patient who underwent spinopelvic fixation for treatment of a neuromuscular spinal deformity were recorded prospectively.Results
Sixty patients were operated on during the study period. Spinal correction and fusion was performed by posterior approach. In six patients with a residual spinopelvic imbalance more than 15° on lateral preoperative bending films, an anterior release of the thoracolumbar junction was performed on the same day, before posterior correction. Preoperative pelvic obliquity (PO) ranged from 4° to 44° (mean 21.6°). Postoperative pelvic obliquity ranged from 0° to 14 (mean 4.6°). No significant loss of correction was noted at the last follow-up. One patient died 3 months after the initial procedure due to respiratory compromise. 11 patients had early postoperative infections of the posterior approach.Conclusions
Despite a high rate of infectious complications, optimal correction of pelvic obliquity requires extension of spinal instrumentation to the pelvis. Spinopelvic fixation remains a difficult challenge in neurological patients with hypotrophy. We think that pelvic fixation with the “T construct” did provide effective and improved spinal stabilization in these patients, while reducing the need for a postoperative cast or brace. As a result, patients had a favourable postoperative course with early mobilization and return to a comfortable sitting position. 相似文献102.
103.
Camille Cohier Lucie Chevillard Patricia Risède Olivier Roussel Bruno Mégarbane 《Toxicology letters》2014
Respiratory depression has been attributed to buprenorphine (BUP) misuse or combination with benzodiazepines. BUP/naloxone (NLX) has been marketed as maintenance treatment, aiming at preventing opiate addicts from self-injecting crushed pills. However, to date, BUP/NLX benefits in comparison to BUP alone remain debated. We investigated the plethysmography effects of BUP/NLX in comparison to BUP/solvent administered by intravenous route in naive and BUP-tolerant Sprague-Dawley rats, and in combination with diazepam (DZP) or its solvent. In naive rats, BUP/NLX in comparison to BUP significantly increased respiratory frequency (f, P < 0.05) without altering minute volume (VE). In combination to DZP, BUP/NLX significantly increased expiratory time (P < 0.01) and decreased f (P < 0.01), tidal volume (VT, P < 0.001), and VE (P < 0.001) while BUP only decreased VT (P < 0.5). In BUP-tolerant rats, no significant differences in respiratory effects were observed between BUP/NLX and BUP. In contrast, in combination to DZP, BUP/NLX did not significantly alter the plethysmography parameters, while BUP increased inspiratory time (P < 0.001) and decreased f (P < 0.01) and VE (P < 0.001). In conclusion, differences in respiratory effects between BUP/NLX and BUP are only significant in combination with DZP, with increased depression in naive rats but reduced depression in BUP-tolerant rats. However, BUP/NLX benefits in humans remain to be determined. 相似文献
104.
Sarra Smati MD Blandine Tramunt MD Matthieu Wargny MD Cyrielle Caussy MD Bénédicte Gaborit MD Camille Vatier MD Bruno Vergès MD Deborah Ancelle MD Coralie Amadou MD Leila A. Bachir MD Olivier Bourron MD Christine Coffin-Boutreux MD Sara Barraud MD Anne Dorange MD Bénédicte Fremy MD Jean-François Gautier MD Natacha Germain MD Etienne Larger MD Stéphanie Laugier-Robiolle MD Laurent Meyer MD Arnaud Monier MD Isabelle Moura MD Louis Potier MD Nadia Sabbah MD Dominique Seret-Bégué MD Patrice Winiszewski MD Matthieu Pichelin PharmD Pierre-Jean Saulnier MD Samy Hadjadj MD Bertrand Cariou MD Pierre Gourdy MD for the CORONADO investigators 《Diabetes, obesity & metabolism》2021,23(2):391-403
105.
Kathleen M. Adelgais J. Matthew Sholl Rachael Alter Kristin Lauria Gurley Camille Broadwater-Hollifield Peter Taillac 《Prehospital emergency care》2019,23(2):167-178
Background: Individual states, regions, and local emergency medical service (EMS) agencies are responsible for the development and implementation of prehospital patient care protocols. Many states lack model prehospital guidelines for managing common conditions. Recently developed national evidence-based guidelines (EBGs) may address this gap. Barriers to statewide dissemination and implementation of model guidelines have not been studied. The objective of this study was to examine barriers and enablers to dissemination and implementation of an evidence-based guideline for traumatic pain management across 5 states. Methods: This study used mixed methods to evaluate the statewide dissemination and implementation of a prehospital EBG. The guideline provided pain assessment tools, recommended opiate medication dosing, and indications and contraindications for analgesia. Participating states were provided an implementation toolkit, standardized training materials, and a state-specific implementation plan. Outcomes were assessed via an electronic self-assessment tool in which states reported barriers and enablers to dissemination and implementation and information about changes in pain management practices in their states after implementation of the EBG. Results: Of the 5 participating states, 3 reported dissemination of the guideline, one through a state model guideline process and 2 through regional EMS systems. Two states did not disseminate or implement the guideline. Of these, one state chose to utilize a locally developed guideline, and the other state did not perform guideline dissemination at the state level. Barriers to state implementation were the lack of authority at the state level to mandate protocols, technical challenges with learning management systems, and inability to track and monitor training and implementation at the agency level. Enablers included having a state/regional EMS office champion and the availability of an implementation toolkit. No participating states demonstrated an increase in opioid delivery to patients during the study period. Conclusion: Statewide dissemination and implementation of an EBG is complex with many challenges. Future efforts should consider the advantages of having statewide model or mandatory guidelines and the value of local champions and be aware of the challenges of a statewide learning management system and of tracking the success of implementation efforts. 相似文献
106.
107.
Camille Stengel 《Health, risk & society》2014,16(1):36-50
In this article, I examine the ways in which risk is constructed and managed by those involved in the pregnancy and childbirth of women who use drugs, including the women themselves. I discuss how constructions of risk influence maternal care outcomes and the understanding of choice, often in the form of stigmatisation. In this article, I draw on data from a qualitative research study that I conducted in 2011 in a western Canada city in which I interviewed 13 pregnant and parenting women who had used drugs during their pregnancy. In this article, I show how the everyday risk construction of pregnancy, labour and delivery is compounded significantly by drug use and the stigmatisation associated with this perceived risk-taking behaviour. The participants in the study often internalised this understanding of risk and this manifested itself in delays in accessing maternal health and social care services. The women in the study had different understandings of risk and these were structured by the women’s own understanding of general risk factors during their pregnancy, as well as their experiences of the constructions of risk and risk management by health and social care professionals. While structural life chances can constrain women’s feelings of self-efficacy, services that promote clients’ ability to make choices can facilitate reduced stigmatisation and facilitate the development of more compassionate and autonomous approaches to risk management. 相似文献
108.
Ewan K. Cobran Anthony K. Wutoh Euni Lee Folakemi T. Odedina Camille Ragin William Aiken Paul A. Godley 《Journal of immigrant and minority health / Center for Minority Public Health》2014,16(3):394-400
Cancer fatalism is believed to be a major barrier for cancer screening in Black males. Therefore, the purpose of this study was to compare perceptions of prostate cancer (CaP) fatalism and predictors of CaP screening with Prostate Specific Antigen (PSA) testing between U.S.-born and Caribbean-born Black males. The Powe Fatalism Inventory and the Personal Integrative Model of CaP Disparity Survey were used to collect the following data from males in South Florida. Multivariate logistic regression models were constructed to examine the statistically significant predictors of CaP screening. A total of 211 U.S.-born and Caribbean-born Black males between ages 39–75 were recruited. Nativity was not a significant predictor of CaP screening with PSA testing within the last year (Odds ratio [OR] = 0.80, 95 % confidence interval [CI] = 0.26, 2.48, p = 0.70). Overall, higher levels of CaP fatalism were not a significant predictor of CaP screening with PSA testing within the last year (OR = 1.37, 95 % CI = 0.48, 3.91, p = 0.56). The study results suggest that nativity did not influence CaP screening with PSA testing. However, further studies are needed to evaluate the association between CaP screening behavior and levels of CaP fatalism. 相似文献
109.
110.