Medical information delivered to patients: discrepancies concerning roles as perceived by physicians and nurses set against patient satisfaction.

Objective: To assess and to compare roles as perceived by physicians and nurses regarding medical information delivered to patients and to set this against patients' opinions on the quality of the medical information delivered to them.

Methods: A questionnaire administered to 302 physicians (MDs) and 533 nurses (NUs), and an inpatient satisfaction survey administered to 1246 patients the day before discharge, as a part of a quality improvement program on patient information in a university hospital.

Results: MDs and NUs reported that diagnosis and prognosis announcements were made by MDs alone.

[Information for the patient in hospitals: the implicit shared role among professionals].

Objective: Perceived practices declared by physicians were assessed in order to determine the role of the different professionals in patient medical information, the communication methods and traceability practices used in patient files. Method Data were collected using an anonymous questionnaire sent by mail in April 2003 to the 794 physicians of the University Hospital of Nantes (France).

Results: The participation rate was of 38% (302 responses) and differed according to the medical categories: university professors (44%), young seniors (50%), hospital practitioners (43%) and practitioners under contract (21%).

[Inflammatory pseudo-tumors of the liver. Apropos of 2 cases].

Inflammatory pseudotumors of the liver (IPTL) are a reaction pathology of most often mysterious etiology. This is an ill-known clinicopathological entity, of which 13 cases only have been reported. The authors report about 2 cases for which an infectious or parasitic etiology can be suggested.

[Gastric fundus necrosis following acute gastric dilatation].

Total gastrectomy with immediate re-establishment of digestive continuity successfully treated a patient with gastric fundus necrosis due to acute dilatation of stomach. The very particular circumstances of onset of this major complication are outlined, diagnosis being dependent on radiological and endoscopic findings. In cases with necrosis of the fundus the extensive nature of the ischemic lesions as shown by results of histopathology strongly suggests the need for total gastrectomy in these patients.

[Bilateral adrenal pheochromocytoma associated with pregnancy. Simultaneous cesarean section and adrenalectomy].

An-25-year-old primigravida with bilateral phaeochromocytomas was managed from 6 weeks' gestation until 2 years following combined caesarean section and removal of adrenal tumours. Preoperative alpha-blockade was achieved by oral prazosin without deleterious effects. Intraoperative management comprised neuroleptanalgesia, arterial and pulmonary pressures monitoring, adequate heart loading with fluid replacement and sodium nitroprusside.

[Postoperative respiratory complications of myotonia dystrophica (Steinert's disease)].

Respiratory difficulties have long been recognized to be a major risk in patients with myotonia dystrophica, but postoperative pulmonary complications have only rarely been considered. Two cases of postoperative pulmonary complications which led to the patients's death stressed the severity and difficulty of treatment of these complications. A third case of postoperative respiratory failure revealed the underlying disease.

[Development of blood sugar and insulinemia in the first 12 postoperative hours. Effects of glucose and insulin intake].

Serum levels of glucose and insulin are studied during 12 hours in the early post-operative period after intra-abdominal surgery. Five groups of non diabetic patients are perfused with incremental doses of glucose, G. I: no glucose, G.

[Comparison of the hemodynamic effects of fazadinium, pancuronium and alcuronium in coronary insufficiency (30 cases)].

Cardiovascular effects of neuromuscular blocking agents mainly guide the choice of these relaxants in patients with cardiovascular disease. The purpose of this study was to compare the hemodynamic effects of fazadinium (1 mg . kg-1), pancuronium (0,08 mg .

Comparison of effects of balanced anaesthesia and neuroleptanalgesia on postoperative cardiovascular function in patients with coronary artery disease.

Patients with chronic ischaemic heart disease and a history of myocardial infarction or who present with exertional or spontaneous angina suffer a decrease in left ventricular pump function during recovery from anaesthesia and in the period immediately after operation. This decrease is reflected in an increase in pulmonary capillary wedge pressure and in a decrease in stroke volume and cardiac output. Two groups of 10 such patients, clinically and haemodynamically comparable in the preoperative period, were studied: 10 patients received balanced anaesthesia, and 10 neuroleptanalgesia.

[Hemodynamic effects of a new antidepolarizing agent: fazadinium bromide].

Studies concerning the hemodynamic effects of this new antidepolarizing agent are scarce and difficult to interpret because of drug interactions, and of an accentuation of vagal tonus related to the use of morphinomimetic analgesics. For a better approach of the effects proper to fazadinium, we have tried to perform a study freed, to a maximum, from any drug interference. We studied the hemodynamic effects to a single dose of 1 mg.