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Biomedical subjects

A Morabia

Publications and source records attributed to A Morabia.

At least 37 records · Page 2Linked to original sources
PubMed2001

Contribution of body composition to nutritional assessment at hospital admission in 995 patients: a controlled population study.

Body weight, weight changes and BMI are easily obtainable indicators of nutritional status, but they do not provide information on the amount of fat-free and fat masses. The purpose of the present study was to determine if fat-free mass (FFM) and fat mass were depleted in patients with normal BMI or serum albumin at hospital admission. A group of 995 consecutive patients were evaluated for malnutrition by BMI, serum albumin, and 50 kHz bioelectrical impedance analysis and compared with 995 healthy adults, matched for age and height, and then compared with FFM and fat mass percentiles previously determined in 5225 healthy adults. A BMI of <or=20 kg/m2 was noted in 17.3 % of patients and serum albumin of <or=35 g/l was found in 14.9 % of patients. In contrast, 31 % of all patients were below the tenth percentile for FFM, compared with 10.1 % of controls (chi2, P=0.0001), while 73 % of patients with BMI <or=20 kg/m2 and 31 % of patients with BMI 20-24.9 kg/m2 fell below the tenth percentile for FFM. Furthermore, the FFM was lower in patients than controls and the differences with age in FFM (lower) and fat mass (higher) were greater in patients than in controls. BMI and albumin significantly underestimated the prevalence of malnutrition in patients at hospital admission compared with body composition measurements. Optimal nutritional assessment should therefore include objective measurement of FFM and fat mass.

Adipose Tissue↗
PubMed2001

Can the declining prevalence of left-handedness with age be due to smoking?

The objective of this study was to assess whether smoking habits can explain the decline in left-handedness prevalence with age. Subjects participating in a population-based survey (n = 3,071) in Geneva, Switzerland, completed a questionnaire on innate hand preference, current hand preference for writing and smoking habits. The prevalence of innate left-handedness in the Geneva population was 9.4% in men and 7.4% in women. There was no association between smoking and left-handedness. It is concluded that smoking is not associated with hand preference and is an unlikely cause of overmortality in left-handed subjects.

Adult↗
PubMed2001

Diet and socioeconomic position: does the use of different indicators matter?

OBJECTIVES: To describe the association of diet and socioeconomic position and to assess whether two different indicators, education and occupation, independently contribute in determining diet. METHODS: A community-based random sample of men and women residents of Geneva canton, aged 35 to 74, participated in a survey of cardiovascular risk factors conducted annually since 1993. Lifetime occupational and educational history and a semi-quantitative food frequency questionnaire were obtained from 2929 men and 2767 women. RESULTS: Subjects from lower education and/or occupation consumed less fish and vegetables but more fried foods, pasta and potatoes, table sugar and beer. Iron, calcium, vitamin A and vitamin D intake were lower in the lower educational and occupational groups. Both indicators significantly contributed to determining a less healthy dietary pattern for those from low social class. The effects of education and occupation on dietary habits were usually additive and synergistic for some food groups. CONCLUSION: Assessing both education and occupation, improves the description of social class inequalities in dietary habits, as they act, most of the time, as independent factors.

Adult↗
PubMed2001

Epidemiology of herpes simplex virus in children by detection of specific antibodies in saliva.

OBJECTIVES: To facilitate the study of the prevalence of herpes simplex virus (HSV) infection and its determinants in children, we developed a noninvasive saliva test. METHODS: A capture enzyme-linked immunosorbent assay (ELISA) for the detection of IgG to HSV in saliva was developed, validated against a commercial serum ELISA in 110 children and 187 adults and used in a cross-sectional population-based study including 2,048 children ages 1 to 17 years, recruited in day-care centers and schools of Geneva, Switzerland. Demographic and socioeconomic determinants of HSV prevalence were studied. RESULTS: The sensitivity and specificity of the saliva assay were 94.1 and 95.5%, respectively, compared with the commercial serum ELISA. Participation in the cross-sectional study was 86.6%. The overall prevalence of anti-HSV IgG was 23.91%. It increased with age up to 7 years, reaching a plateau at 35% without evidence for day-care or school transmission. The main determinants of prevalence were region of national origin and parents' professional category. CONCLUSIONS: This new saliva-based assay proved its feasibility in the first population-based study of HSV prevalence in children that uses saliva, confirmed its validity by identifying determinants of prevalence consistent with previous reports and yielded new information, such as the lack of influence of day-care attendance, in the population studied.

Adolescent↗
PubMed2001

Influence of occupational exposure to latex on the prevalence of sensitization and allergy to latex in a Swiss hospital.

BACKGROUND: Replacement of powdered latex gloves has been recommended in order to prevent the development of latex allergy in health care workers. The conclusion that occupational exposure to latex gloves represents a risk factor for latex allergy is mainly based on studies without exposure controls. Atopy is also thought to be a risk factor for the development of latex allergy. OBJECTIVE: To determine the prevalence of atopy, sensitization to latex, and symptoms following latex exposure in professionally exposed and nonexposed hospital personnel by means of a cross-sectional study. METHODS: Six hundred randomly sampled individuals working in medicine and surgery departments and in surgery theaters and 300 sex- and age-matched individuals classified as administrative personnel were selected from the employee data base of the Geneva University Hospital. A questionnaire about exposure to latex and symptoms following this exposure was sent to all individuals. Skin prick test reactions and serum IgE to latex as well as standard environmental allergens were determined in both groups. RESULTS: Respiratory and skin (local) symptoms but not objective tests of latex sensitization (positive skin prick test and specific IgE to latex) were significantly associated with occupational exposure to latex (p < 0.001). Only among atopics subjects was 15 years or more of occupational exposure associated with a significantly higher prevalence of local symptoms than among those who were exposed from 1 to 9 years (odds ratio: 3.2; 95% confidence interval: 1.6-6.5). Atopy was significantly associated with sensitization to latex (odds ratio: 10.3; 95% confidence interval: 4.0-26.6) but not with local symptoms. Tests of latex sensitization were both frequently positive, less frequently negative, resulting in low kappa values. CONCLUSION: These results support the current preventive health care recommendation to replace powdered latex gloves. In atopics, increasing years of occupational exposure increase the risk of developing latex allergy. In contrast to questionnaires about local symptoms, skin prick tests and specific serum IgE to latex are of limited value in epidemiologic studies of latex allergy.

Adult↗
PubMed2001

A comparison of knowledge and attitudes about diet and health among 35- to 75-year-old adults in the United States and Geneva, Switzerland.

OBJECTIVES: This study compared responses of US and Geneva residents to items on analogous questionnaires concerning knowledge and attitudes about diet and health. METHODS: Comparable data were available from 2 population-based sample surveys: the Cancer Control Supplement of the 1987 National Health Interview Survey and the 1994 Bus Santé 2000 in Geneva, Switzerland. Samples included 10,366 US respondents and 698 Geneva respondents, aged 35 to 74 years. The analysis involved descriptive statistics, contingency tables, and linear regression models. RESULTS: In both the United States and Geneva, health consciousness was greater among women and more highly educated persons than among other groups. Compared with Americans, Genevans assigned more importance to avoiding salt, sugar, and overweight (odds ratio = 1.6, 2.9, and 5.9, respectively) and less importance to lowering cholesterol (odds ratio = 0.6). Genevans were more likely to recognize the relatively high fiber content of lettuce, carrots, and apples. Recognition of low-fat foods was slightly better in the United States. CONCLUSIONS: Knowledge and attitudes differed despite high general diet and health awareness in both populations. Identifying why generally similar dietary guidance messages are embraced to different extents across cultures may facilitate global implementation.

Adult↗
PubMed2000

Incidence of status epilepticus in French-speaking Switzerland: (EPISTAR).

BACKGROUND: To determine the incidence, risk factors, and case fatality rate of status epilepticus (SE) in the French-speaking part of Switzerland. METHODS: Between October 1, 1997 and September 30, 1998 all cases of SE referred to all the hospitals in the six cantons of the French-speaking part of Switzerland were identified by physicians working in emergency rooms, intensive care units, and electroencephalography departments; neurologists; and pediatricians from all hospitals in the area. Each case was validated and classified according to seizure type and etiology. RESULTS: Over 1 year, 172 cases were identified, of whom 74 had a history of epilepsy (42.4%). The crude and standardized annual incidence rate were 9.9/100,000 (95% CI, 8.4 to 11.4) and 10.3/100,000 (95% CI, 8.7 to 11.9). The incidence rate was higher among children < 1 year of age and adults > 65 years, and among men than women. There were 108 cases of acute symptomatic SE (incidence: 6.2 per 1000), 49 cases of remote symptomatic SE, and 15 cases of unknown etiology. Case fatality rate was 7.6%. CONCLUSIONS: The standardized incidence rate of SE in the French-speaking part of Switzerland was lower than that reported in Rochester, MN (18.3/100,000) and in the white population of Richmond, VA (20/100,000). The discrepancy may stem from the lack of a homogeneous, rigorous, and pragmatic definition of SE and the efficient management of acute repetitive seizures in this area.

Adolescent↗
PubMed2000

Breast cancer and active and passive smoking: the role of the N-acetyltransferase 2 genotype.

The association of breast cancer with passive and active smoking was investigated in slow and fast acetylators of aromatic amines in a Geneva, Switzerland, study in 1996-1997. A slow acetylator was homozygous for one, or heterozygous for two, of three N-acetyltransferase 2 (NAT2) polymorphisms determined on buccal cell DNA from 177 breast cancer cases and 170 age-matched, population controls. The reference group consisted of women never regularly exposed to active or passive smoke. Among premenopausal women, the odds ratios were homogeneous in slow and fast acetylators: 3.2 (95% confidence interval (CI): 1.2, 8.7) for passive smoking and 2.9 (95% CI: 1.1, 7.5) for active smoking. Among postmenopausal women, the odds ratios for fast acetylators were 11.6 (95% CI: 2.2, 62.2) for passive and 8.2 (95% CI: 1.4, 46.0) for active smoking; the corresponding effects were also apparent but less strong in slow acetylators. After the nonexposed and the passive smokers were grouped in a single reference category, active smoking was associated with postmenopausal breast cancer in slow acetylators (odds ratio (OR) = 2.5, 95% CI: 1.0, 6.2) but not in fast acetylators (OR = 1.3, 95% CI: 0.5, 3.3). Thus, the associations of both passive and active smoking with breast cancer appear stronger in fast than in slow NAT2 genotypes. Separating passive smokers from the nonexposed impacts on the inference about a possible NAT2-smoking interaction.

Acetylation↗
PubMed2000

Efficacy of a liquid-based thin layer method for cervical cancer screening in a population with a low incidence of cervical cancer.

The performance of the ThinPrep(R) Pap Testtrade mark (TP) (Cytyc Corp., Boxborough, MA) for detection of cervical cancer precursors in a population with a low incidence of disease was evaluated. This prospective trial compared results obtained with TP to those obtained with the standard cytologic smear in women from the general community who were being screened for cervical cancer from January 1, 1995-December 31, 1997 by physicians in private practice (n x 130, 381 conventional examinations and 39,864 TP examinations). In the TP series there was a significant increase in the proportion of "satisfactory" examinations (91.9% TP vs. 72.2% conventional) and positive diagnoses (5.5% TP vs 2.4% conventional, odds ratio x 2.21; 95% confidence interval (CI), 2.08-2.34). The likelihood of detecting a high-grade squamous intraepithelial lesion (HSIL) by TP was significantly greater than in controls (odds ratio x 1.86; 95% CI, 1.68-2.06). Detection of low-grade squamous intraepithelial lesions (LSIL), or atypical squamous cells of undetermined significance (ASCUS), was significantly greater in the TP series than in controls (LSIL odds ratio x 3.41; 95% CI, 3.07-3.79; ASCUS odds ratio x 1.68; 95% CI, 1.56-1.82). A histologic lesion was confirmed in 141 (93%) of the biopsies for HSIL (130 HSIL or greater, 10 LSIL, 1 SIL not otherwise specified). In conclusion, both diagnostic sensitivity and sample adequacy were significantly improved using the ThinPrep(R) Pap test under routine conditions in an outpatient population with a low incidence of cervical cancer.

Adult↗
PubMed2000

Reproductive factors and incidence of breast cancer: an international ecological study.

Ecological studies can help in understanding the relation of reproductive history of breast cancer. We analyzed data from 9416 women, comprising the control groups of seven countries (Australia, People's Republic of China, Colombia, (former) German Democratic Republic, Israel, Philippines, and Thailand) from the WHO international, multi-center case-control study of female cancers. Positive correlations with country-specific breast cancer incidence were observed for (median) duration of reproductive life (r > or = 0.95, p < 0.005), age at menopause (r > or = 0.84, p < 0.025) and delay to first birth (r > or = 0.59, p < 0.22) (when People's Republic of China was omitted, r > or = 0.85, p < 0.07). The association of age at first birth with breast cancer incidence was weakly positive in the whole sample (age-adjusted r = 0.18, p = 0.73), but weakly negative in the age groups 15-29 and 30-39 years and weakly positive in the age groups 40-49 and 50-64 years. A strong inverse correlation was observed between age at menarche and breast cancer incidence (r < or = -0.84, p < 0.03). These international ecological correlations agree with the associations previously reported for single populations, between higher incidence of breast cancer and younger age at menarche, older age at menopause, longer duration of reproductive life, and (possibly) longer delay to first birth. In contrast, age at first birth is only weakly related to breast cancer incidence across populations, indicating that this variable represents different constructs when measured ecologically versus individually.

Adolescent↗
PubMed2000

Treatment efficacy is not an index of pain intensity.

PURPOSE: To determine if the efficacy of pain treatment assessed by the patient is a valid indicator to evaluate pain management. METHODS: Three hundred and ninety one adult patients were investigated on the day of surgery and on the two following days after intraperitoneal or orthopedic surgery. Pain scores and efficacy of pain treatment were evaluated using ungraduated visual analog scales (VAS). According to the evolution of pain between two consecutive days, patients were classified as having "worse pain", "same pain" or "lower pain". RESULTS: During the first time interval, pain treatment was considered effective by 42% of patients with worse pain, compared with 55% with less pain (OR= 1.9, 95% CI=1.1-3.7) and to 58% of patients with the same pain (OR =2.0, 95%CI=1.2-3.0). During the second time interval, these proportions were: 46% (worse pain), 63% (lower pain vs worse: OR= 1.8, 95%CI= 1.0-3.2) and 66% (same pain vs worse: OR=2.1, 95%CI=1.1-4.1). Using pain evolution as a"gold standard", patient assessment of pain treatment efficacy had sensitivity of 0.55 and specificity 0.5 during the first time interval, and of 0.63 and 0.43 during the second time interval. CONCLUSION: Patient evaluation of the efficacy of pain treatment can mislead the clinician about the severity of pain. Patients tend to be satisfied with pain treatment, even when pain is not relieved. The relation of intensity of pain to patient perception of treatment efficacy is weak.

Adolescent↗
PubMed2000

Reference values of fat-free and fat masses by bioelectrical impedance analysis in 3393 healthy subjects.

Determination of fat-free mass (FFM) and fat mass (FM) is of considerable interest in the evaluation of nutritional status. In recent years, bioelectrical impedance analysis (BIA) has emerged as a simple, reproducible method used for the evaluation of FFM and FM, but the lack of reference values reduces its utility to evaluate nutritional status. The aim of this study was to determine reference values for FFM, FM, and %FM by BIA in a white population of healthy subjects, to observe the changes in these values with age, and to develop percentile distributions for these parameters. Whole-body resistance of 1838 healthy white men and 1555 women, aged 15-64 y, was determined by using four skin electrodes on the right hand and foot. FFM and FM were calculated according to formulas validated for the subject groups and analyzed for age decades. This is the first study to present BIA-determined age- and sex-specific percentiles for FFM, FM, and %FM for healthy subjects, aged 15-64 y. Mean FM and %FM increased progressively in men and after age 45 y in women. The results suggest that any weight gain noted with age is due to a gain in FM. In conclusion, the data presented as percentiles can serve as reference to evaluate the normality of body composition of healthy and ill subject groups at a given age.

Adipose Tissue↗
PubMed2000

The differential effect of education and occupation on body mass and overweight in a sample of working people of the general population.

PURPOSE: To assess whether two indicators of social class, education and occupation, have independent and/or synergistic effects in determining the body mass and overweight. METHODS: Body mass index (BMI), education, and occupation were assessed in a survey of 1767 men and 1268 women from a representative sample of currently working people of the general population of Geneva, Switzerland. Education and occupation were categorized as low, medium, and high. Overweight was defined as BMI > or = 25 kg/m(2). RESULTS: The prevalence of overweight was 52.1% in men and 28.7% in women. Men with overweight were more likely to have low education while women with overweight had lower education and lower occupation. Education and occupation were inversely related to BMI in both genders and, in women, had a synergistic effect (p-value for the interaction = 0.03). CONCLUSIONS: Education and occupation have independent and, in women, synergistic effects on BMI. The two indicators may express different mechanisms through which low social class is related to high body mass.

Adult↗
PubMed2000

Dietary patterns in six european populations: results from EURALIM, a collaborative European data harmonization and information campaign.

OBJECTIVE: To determine and describe the extent to which European dietary data collected in disparate surveys can be meaningfully compared. DESIGN: Seven independent population-based surveys from six European countries were initially included. Differences in study designs and methodological approaches were examined. Risk factor data for 31,289 adults aged 40-59 y were harmonized and pooled in a common, centralized database. RESULTS: Direct comparisons of dietary measures across studies were not deemed appropriate due to methodological heterogeneity. Nonetheless, comparisons of intra-population contrasts by gender across sites were considered valid. Women consumed fruit and vegetables more often than men. Age-standardized gender differences in the prevalence of low fruit and vegetable consumption ranged from 7 to 18% and 5 to 15%, respectively. Data on energy intake showed good agreement across study populations. The proportion of total energy from macronutrients was similar for women and men. Gender differences for relative intakes of saturated fatty acids (percentage energy) were small and only in France were they significant. Dietary fibre density was significantly higher in women than in men. Overall, the participating Southern European populations from Italy and Spain exhibited more healthful food composition patterns. CONCLUSIONS: Contrasts in dietary patterns by gender across populations may provide the basis for health promotion campaigns. The most favourable patterns observed may serve as attainable goals for other populations. An international risk factor surveillance programme based upon locally run, good quality studies has the potential to provide the needed data. SPONSORSHIP: European Community (DG V), project 96CVVF3-446-0; Swiss Federal Office for Education and Science, OFES 96.0089.

Adult↗
PubMed2000

Smoking, dietary calcium and vitamin D deficiency in women: a population-based study.

OBJECTIVE: To determine differences in dietary calcium and vitamin D intakes between female never, former and current smokers. DESIGN: Population-based survey using a validated food frequency questionnaire. SETTING: The Bus Santé 2000, epidemiologic observatory of Geneva, Switzerland. SUBJECTS: 2319 women resident in Geneva, Switzerland between 1993 and 1997. RESULTS: Daily calcium intake was 798 mg among current heavy smokers (>/=20 cigarettes/day), 882 mg among current moderate smokers (1-19 cigarettes/day) and 945 mg among never smokers (P=0.0001). There was a difference of almost 50 mg/day in median calcium intake from cheese (P=0.04), which corresponded to about one-third of the total difference in calcium intake between heavy smokers and never smokers. Of the current heavy smokers, 21% did not eat yogurt compared to 10% of never smokers (P=0.001). Among yogurt eaters, heavy smokers consumed 90 mg/day of calcium from yogurt vs 115 mg/day in never smokers (P=0.003). Smokers ate more butter and cream (P=0.02) or milk (P=0.06) than never smokers, but these were minor sources of calcium. Fish was the main cause of higher intake of vitamin D in never smokers (0.81 microg/day) compared with heavy smokers (0.53 microg/day) and moderate smokers (0.70 microg/day). The diet of ex-smokers after 5 y or more of smoking cessation tended to resemble that of never smokers for calcium (about 900 mg/day) and vitamin D (about 2.55 microg/day). CONCLUSION: Female current smokers have lower dietary intakes of calcium and vitamin D than never smokers. SPONSORSHIP: This study was funded by the Swiss National Fund for Scientific Research (grants 32.31.326.91, 32-37986.93 and 32-49847.96).

Adult↗