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Biomedical subjects

B Henry

Publications and source records attributed to B Henry.

At least 55 records · Page 3Linked to original sources
PubMed1997

Accuracy and safety of laparoscopic lymphadenectomy: an experimental prospective randomized study.

INTRODUCTION: The goal of this study was to investigate the accuracy and safety of bilateral pelvic and paraaortic lymphadenectomy performed via transperitoneal laparoscopy (LS) compared to laparotomy (LT) in a porcine model. MATERIALS AND METHODS: Fifteen adult, female hogs underwent LS and 15 underwent LT. A complete pelvic and paraaortic lymphadenectomy was performed in each animal by an experienced surgeon. Lymph nodes were counted by a pathologist in each case. Operative times were reviewed and included all procedures performed. The intraoperative complications were noted. Four weeks after the lymphadenectomy, the animals underwent exploratory laparotomy, and intraperitoneal adhesions were quantified. RESULTS: Thirty animals were evaluable. The average total number of lymph nodes retrieved by LS was 16.9 +/- 3.8, which was not statistically (P = 0.77) different from 16.5 +/- 4.9 nodes in LT. The average operating time in LT was 60 +/- 16 min compared with 128 +/- 24 min in LS. Twenty-eight animals were evaluable for adhesion formation. The average adhesion scores observed in anterior abdominal wall (P = 0.0006), paraaortic (P = 0.0005), right (P = 0.015), and left (P = 0.0324) iliac areas after LS were uniformly lower than after LT. DISCUSSION: This study indicates that laparoscopic pelvic and paraaortic lymphadenectomy is a safe and effective procedure. The node yield is similar for both approaches. The transperitoneal laparoscopy pelvic and paraaortic lymphadenectomy may not induce the degree of adhesion formation associated with laparotomy.

Animals↗
PubMed1996

Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ).

Quality of life may be considerably reduced in patients who are suffering from chronic lower limb venous insufficiency, although existing generic quality of life instruments (NHP, SF-36 or SIP) cannot completely identify their specific complaints. The Chronic Venous Insufficiency Questionnaire (CIVIQ) has been developed by iterative process. First, a pilot group of 20 patients was used to identify a number of important features of quality of life affected by venous insufficiency, other than physical symptoms of discomfort. A second study involving 2,001 subjects was used to reduce the number of items. Subjects were asked to score both the severity of their problems and the importance they attributed to each problem on a 5-point Likert scale. The importance items found in patients with venous insufficiency were subjected to factorial analyses (PCA, PAF). The final version is a 20-item self-administered questionnaire which explores four dimensions: psychological, physical and social functioning and pain. Internal consistency of the questionnaire was validated for each dimension (Cronbach's alpha > 0.820 for three out of four factors). Reproducibility was confirmed in a 60 patient test-retest study. Pearson's correlation coefficients for both the four dimension subscales and for the global score at 2-week intervals were greater than 0.940. Finally, the questionnaire was tested in a randomized clinical trial of 934 patients in order to assess responsiveness and the convergent validity of the instrument, together with the patient's own quality of life. This study demonstrated that convergence was valid: Pearson's correlation coefficients between clinical score differences and quality of life score differences were small (from 0.199-0.564) but were statistically different from 0 (p < 0.001). Standardized response mean (SRM) and effect size (ES) were calculated to assess sensitivity to change. SRM and ES both demonstrated considerable responsiveness to change (> 0.80). Reliability, face, content, construct validity and responsiveness were also determined for this specific quality of life questionnaire relating to venous insufficiency. Results suggest that this questionnaire may be used with confidence to assess quality of life in clinical trials on chronic venous insufficiency.

Factor Analysis, Statistical↗
PubMed1996

Potential of opioid antagonists in the treatment of levodopa-induced dyskinesias in Parkinson's disease.

Current treatments for Parkinson's disease (PD) rely on dopamine-replacing strategies, and centre around dopamine precursors (e.g. levodopa) or directly acting dopamine agonists. With long-term therapy these agents lose much of their clinical utility due to the appearance of adverse effects such as dyskinesias and/or a wearing off of efficacy. Although dyskinesias in Huntington's disease, hemiballism and experimental animals are thought to be associated with reductions in amino acid transmission within the lateral and medial segments of the globus pallidus, the neural mechanisms underlying treatment-related dyskinesias in PD are poorly understood. Recent evidence suggests that, within these regions of the brain, the opioid peptides enkephalin and dynorphin, acting at delta and kappa opioid receptors, respectively, can reduce the release of amino acid transmitters. Furthermore, the synthesis of these peptides appears to be enhanced in neurons projecting to the pallidal complex in animal models of PD following repeated treatment with dopamine-replacing agents that also cause dyskinetic adverse effects (e.g. levodopa and apomorphine). In contrast, dopamine receptor agonists such as bromocriptine and lisuride do not cause dyskinetic adverse effects following long-term treatment, and do not elevate peptide synthesis when given de novo. These data, together with recent data on the behavioural effects of opioid antagonists in a rodent model of levodopa-induced dyskinesia in PD, suggest the possibility that antagonists of opioid receptors may prove useful as adjuncts to levodopa. By limiting the severity of dyskinetic adverse effects, these drugs may help extend the time for which the antiparkinsonian effects of such compounds can be usefully exploited.

Animals↗
PubMed1996

A cost-utility analysis of second-line chemotherapy in metastatic breast cancer. Docetaxel versus paclitaxel versus vinorelbine.

The aim of this study was to determine the incremental effectiveness, the incremental health-related quality of life (differences in quality-adjusted progression-free survival between treatments), the incremental cost and the incremental cost-effectiveness and cost-utility ratios, for docetaxel, paclitaxel and vinorelbine, when these drugs were used as second-line treatment in patients with metastatic breast cancer. In the absence of comparative direct evidence of the relative efficacy of docetaxel, paclitaxel and vinorelbine in this setting, a model was designed to determine the effects of the 3 interventions on health outcome and cost. A Markov process model, based on 53 disease states, was thus constructed to evaluate the socioeconomics of the 3 treatment regimens. The model allows assessments from the start of second-line chemotherapy until death. Costs were evaluated from the combined view of the healthcare system and the patient. Direct nonmedical and indirect costs were excluded. Consumption per episode of care was estimated by retrospective analysis of 153 medical reports from 5 different hospitals. Hospital costs were allocated values from the national accounting costs by diagnosis-related group (DRG). The content of the health states was based on the multiattribute health states classification system (MASH). Preference values were assigned by application of a standard reference lottery using 20 oncological nurses as proxies for the patients. The health-related quality-of-life score was used as a quality adjustment weighting factor to calculate quality-adjusted progression-free survival associated with the 3 different regimens. Docetaxel reduces the time spent in progression, decreases the number of complications due to progressive disease and thereby provides better quality of life. It provides a benefit of 57 disease- and discomfort-free days compared with vinorelbine and 22 days compared with paclitaxel. Docetaxel may be thought of as self-financing as a result of savings in hospital admissions, providing net savings of 6800 French francs (FF; 1993 values) compared with expenditure associated with vinorelbine treatment and FF700 compared with the equivalent figures for paclitaxel.

Antineoplastic Agents↗
PubMed1996

Countries where anesthesia is administered by nurses.

Nurse anesthetists make significant contributions to healthcare worldwide. A little known fact is that, in many countries of the world, nearly all anesthesia is provided by nurses. This international survey, in five languages, was done to provide information about nurse anesthesia care delivered in countries in the regions of the world designated by the World Health Organization. Phase I, reported here, of a three-phase project, determined that nurses administer anesthesia in at least 107 of the world's nearly 200 countries. They administer anesthesia in developed, developing, and least developed countries, as well as in all regions of the world. A goal of disseminating data in this article is to further validate these 1992-1994 study findings. Readers are encouraged to contact the authors with follow-up information. Support for the study was provided by the American Association of Nurse Anesthetists, Council on Recertification of Nurse Anesthetists, and the International Federation of Nurse Anesthetists.

Anesthesiology↗
PubMed1995

Temperamental origins of child and adolescent behavior problems: from age three to age fifteen.

We assessed relations between early temperament and behavior problems across 12 years in an unselected sample of over 800 children. Temperament measures were drawn from behavior ratings made by examiners who observed children at ages 3, 5, 7, and 9. Factor analyses revealed 3 dimensions at each age: Lack of Control, Approach, and Sluggishness. Temperament dimensions at ages 3 and 5 were correlated in theoretically coherent ways with behavior problems that were independently evaluated by parents and teachers at ages 9 and 11, and by parents at ages 13 and 15. Lack of Control was more strongly associated with later externalizing behavior problems than with internalizing problems; Approach was associated with fewer internalizing problems among boys; and Sluggishness was weakly associated with both anxiety and inattention, especially among girls. Lack of Control and Sluggishness were also associated with fewer adolescent competencies. These results suggest that early temperament may have predictive specificity for the development of later psychopathology.

Adolescent↗
PubMed1995

A case-control study of wood dust exposure, mutagen sensitivity, and lung cancer risk.

The associations between lung cancer risk, mutagen sensitivity (a marker of cancer susceptibility), and a putative lung carcinogen, wood dust, were assessed in a hospital-based case-control study. There were 113 African -American and 67 Mexican-American cases with newly diagnosed, previously untreated lung cancer and 270 controls, frequency-matched on age, ethnicity, and sex. Mutagen sensitivity ( 1 chromatid break/cell after short-term bleomycin treatment) was associated with statistically significant elevated risk for lung cancer [odds ration (OR) = 4.3; 95% confidence intervals (CI) = 2.3-7.9]. Wood dust exposure was also a significant predictor of risk (overall OR = 3.5; CI = 1.4-8.6) after controlling for smoking and mutagen sensitivity. When stratified by ethnicity, wood dust exposure was s significant risk factor for African-Americans (OR = 5.5; CI = 1.6-18.9) but not for Mexican-Americans (OR = 2.0; CI = 0.5-8.1). The ORs were 3.8 and 4.8 for non-small cell lung cancer in Mexican-Americans (CI = 1.2-18.5). Stratified analysis suggested evidence of strong interactions between wood dust exposure and both mutagen sensitivity and smoking in lung cancer risk.

Adult↗
PubMed1994

Upregulation of the 2-5A synthetase/RNase L antiviral pathway associated with chronic fatigue syndrome.

Levels of 2',5'-oligoadenylate (2-5A) synthetase, bioactive 2-5A, and RNase L were measured in extracts of peripheral blood mononuclear cells (PBMCs) from 15 individuals with chronic fatigue syndrome (CFS) before and during therapy with the biological response modifier poly(I).poly(C12U) and were compared with levels in healthy controls. Patients differed significantly from controls in having a lower mean basal level of latent 2-5A synthetase (P < .0001), a higher pretreatment level of bioactive 2-5A (P = .002), and a higher level of pretherapy RNase L activity (P < .0001). PBMC extracts from 10 persons with CFS had a mean basal level of activated 2-5A synthetase higher than the corresponding control value (P = .009). All seven pretherapy PBMC extracts tested were positive for the replication of human herpesvirus 6 (HHV-6). Therapy with poly(I).poly(C12U) resulted in a significant decrease in HHV-6 activity (P < .01) and in downregulation of the 2-5A synthetase/RNase L pathway in temporal association with clinical and neuropsychological improvement. The upregulated 2-5A pathway in CFS before therapy is consistent with an activated immune state and a role for persistent viral infection in the pathogenesis of CFS. The response to therapy suggests direct or indirect antiviral activity of poly(I).poly(C12U) in this situation.

2',5'-Oligoadenylate Synthetase↗
PubMed1994

Chemonucleolysis versus surgical discectomy for sciatica secondary to lumbar disc herniation. A cost and quality-of-life evaluation.

The objective of this study was to evaluate and compare the cost and effects on quality of life [using quality-adjusted life years (QALYs)] of 2 treatments for sciatica secondary to lumbar disc herniation: chemonucleolysis and surgical discectomy. The design involved a combination of decision analysis and Rosser index, with assessment of probabilities from long term clinical series. Utility was based on patients' subjective assessment using a simplified self-administered Health Measurement Questionnaire (HMQ). 146 patients from 7 hospitals were enrolled, 2 to 3 months after chemonucleolysis or surgery. The end-points used were cost and QALYs for each intervention, every year for years 1 to 7. At the time of analysis (1990), the total cost of surgical discectomy was FF15,400, compared with FF8000 for chemonucleolysis. After 1 year, and including the costs of reoperation for failure and relapse and long term medical costs for the non-reoperated unsatisfactory results, discectomy costs were almost 40% higher than those of chemonucleolysis. Ratios remain unchanged after 7 years. QALY results reveal an additional benefit of 52 days of good health associated with chemonucleolysis.

Cost-Benefit Analysis↗
PubMed1994

Management and leadership by nurses.

Good management and leadership by nurses is essential for the achievement of health for all. Well-prepared nurses are required locally and nationally who can identify problems and needs, work on interdisciplinary teams to formulate development plans for human resources, improve working conditions, and raise the quality of care at reasonable cost.

Education, Nursing, Continuing↗
PubMed1994

Semi-automatic external defibrillation.

Malignant arrhythmia, which is responsible for most of the out-of-hospital cardiac arrests, is ventricular fibrillation (VF). The best treatment of VF is a controlled electric shock on the chest administered in a short delay. The emergency medical technicians (EMTs) qualified to carry out this treatment in Belgium and in districts often succeed in arriving on the spot 8 minutes earlier than the people of the Service Mobile d'Urgence et de Réanimation (SMUR). The delegation of defibrillation to ambulance crew members however implies a specific teaching, training and a medical control. The Brussels experience shows that semi-automatic external defibrillation by EMT-Ds (SAED) is feasible when criteria for applying SAED in the pre-hospital phase are applicable.

Aged↗
PubMed1993

The importance of conduct problems and depressive symptoms in predicting adolescent substance use.

The current study assessed the relative importance of conduct problems and depressive symptoms, measured at two ages (11 and 15), for predicting substance use at age 15 in an unselected birth cohort of New Zealand adolescents. Among males, when the relative predictive utility of both conduct problems and depressive symptoms was assessed, only pre-adolescent depressive symptoms were found to predict multiple drug use 4 years later. No predictive relation was found between early symptomatology and later substance use among females. The strongest association between predictors and substance use emerged between age 15 multiple drug use and concurrent conduct problems for both males and females. Finally, both conduct problems and depressive symptoms at age 15 were also found to be associated with concurrent "self-medication" among females.

Adolescent↗
PubMed1993

Effects of argon laser light, alternate source light, and cyanoacrylate fuming on DNA typing of human bloodstains.

Restriction fragment length polymorphism (RFLP) profile results were obtained from deoxyribonucleic acid (DNA) isolated from human bloodstains that had been subjected to cyanoacrylate ester ("superglue") fuming, argon ion laser light and alternate light sources. All RFLP profile results obtained from treated samples were consistent with the DNA pattern from untreated bloodstains.

Argon↗