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Biomedical subjects

B Huet

Publications and source records attributed to B Huet.

At least 19 recordsLinked to original sources
PubMed2001

[Cause of non-pertinent hospital stays: interobserver concordance using the French version of the Appropriateness Evaluation Protocol].

BACKGROUND: The modified French version of the Appropriateness Evaluation Protocol (AEPf) has been validated. Inappropriate days according to simple medical and technical criteria are identified with this tool. The aim of this study is to highlight the interest of investigating the reasons for inappropriate days and to assess the inter-observers reliability of the questionnaire developed for this purpose. METHODS: This questionnaire collects on one hand the needs of patients - distinguishing health care and accommodation needs - and on the other hand the reasons for inappropriate hospital days. The data were collected from January to September 1998 in nine voluntary medical and surgical departments. For each day of study randomly selected, each inappropriate hospital day according to AEPf has been included. Data were collected by two health professionals (a nurse and a physician), using a concurrent design. RESULTS: The reliability of the over-ride option of the appropriateness assessment of the 345 hospital days was good (overall Kappa coefficient: 0.66; 95% CI: 0.55-0.78). The comparison of the two expert judgments on health care needs fulfilled during the hospital day was acceptable; the Kappa coefficient was 0.62 (95% CI: 0.52-0.72). The reliability of expert assessment on patient accommodation needs (home, housing facilities or hospital) was good (Kappa coefficient: 0.67; 95% CI: 0.60-0.75). When hospital was not the accommodation the most adapted for patient, the reliability of the reasons for inappropriate days was high (Kappa coefficient: 0.75; 95% CI: 0.61-0.80). Kappa coefficients were different between hospitals, indicating a center effect. CONCLUSION: This instrument has been found to be reliable and should be used in complement of the first part of the AEPf which assess the prevalence of inappropriate days. It might help to detect dysfunctions within or outside the hospital and thus be used for evaluation or planning of health care.

Adult↗
PubMed2001

Meta-modelling: the appropriate solution for a family of applications.

The aim of this paper is to present an appropriate framework able to generate models and to implement them, in the objective of computerizing a family of medico-technical reports. The accelerated rate of technical development makes it necessary to design computerized applications independently of data-processing technology. This apparent paradox is a quite real challenge which needs research and development software environments to support frameworks. In this article, we present a meta-model (i.e. a generic structure - supported by the Méta-Gen software tool) ) which is able to generate various models of medico-technical reports. These models in turn are able to generate various types of instances. This meta-model is a "Meta-medical record", it is constituted of basic concepts : " User Semantic Group " to which are attached a set of " sentence-type ", a set of several corpus of variables with a set of graphs ("navigators"). Five models (echocardiography for hospital "A", echocardiography for hospital "B", gastroscopy, fibercoloscopy A.E.P.). were already generated from this "Meta-Medical Record". A beginning of implementation in echocardiography report is presented here. The advantages are a very thorough personalization of the document for the user, and a greater independence of the design diagram from the technological platform.

Echocardiography↗
PubMed2000

[Assessment of the management of arterial hypertension in a population of (type 2) diabetic patients undergoing hospitalization. Diabetes and prognostic factors in the control of arterial hypertension].

The control of hypertension in diabetic hypertensive patients prevents micro and macroangiopathy complications. Our prospective study was designed to evaluate the level of treatment of hypertension in type II diabetic patients at the time of referral to our endocrinology unit and after a mean follow-up of 9.2 months. Five hundred and sixty four patients (sex ratio: 1.15, mean age of 56 +/- 13, mean BMI of 28 +/- 15, mean duration of diabetes of 11.3 +/- 9.9) were referred to our unit. Among these, 42% had an antihypertensive drug (58% under monotherapy, 42% under combinations) and 92% had a documented history of CHD. Glycemic and blood pressure controls were stable during follow-up. HbA1c remained unchanged (8.95% at admission, 8.8% at 9 months) BP decreased from 143/84 +/- 26/13 mmHg to 142/82 +/- 23/13 mmHg. Fifty six percent reached a BP goal of 140/90 mmHg whereas 42% achieved a BP goal of 130/85 mmHg at 9 months compared to respectively 56% and 39% at admission. A multivariate logistic regression analysis showed that initial value of SBP (p < 0.0001), age (p < 0.0001), BMI (p = 0.006), HbA1c (p = 0.018) were independent factors of non control of hypertension. In conclusion, follow-up of hypertension diabetic patients would be focussed on identified and modifiable factors.

Age Factors↗
PubMed1999

[Reliability and validity of the French version of the first part of the Appropriateness Evaluation Protocol (AEPf): pertinent criteria of hospitalization stay].

BACKGROUND: The Appropriateness Evaluation Protocol (AEP) is a tool used to identify hospitalization days that are appropriate with respect to simple technical criteria, and the reasons for hospitalization days that do not meet these criteria. The goal of the study was to validate the clinical criteria of AEPf, required for identifying the reasons which explain these inappropriate hospital days. METHODS: The validity of a French version of criteria of appropriateness (AEPf) was assessed in a sample of 502 hospital days in medical and surgical wards of six French teaching hospitals. The reliability of the AEPf-based conclusions was studied by the measure of the concordance between two independent measures of AEPf for the same hospital day. Validity of AEPf was studied by the measure of the concordance between AEPf-based conclusions and the judgments of physicians using implicit criteria to assess the necessity of the hospital day studied. The degree of concordance was estimated by the Kappa coefficient. RESULTS: AEPf reproducibility was high (Kappa coefficient: 0.81; 95% confidence interval (95% CI): 0.76-0.87). Validity was also high (Kappa coefficient: 0.61; 95% CI: 0.53-0.68). CONCLUSION: The French version of the AEP was thus shown to be both reliable and valid to identify hospitalisation days appropriate with respect to hospital's technical equipment and specific resources. However, the reproducibility of the assessment of reasons for hospital days that did not meet AEP criteria will require a validation.

Chi-Square Distribution↗
PubMed1998

Hospital information system: reusability, designing, modelling, recommendations for implementing.

The aims of this paper are to precise some essential conditions for building reuse models for hospital information systems (HIS) and to present an application for hospital clinical laboratories. Reusability is a general trend in software, however reuse can involve a more or less part of design, classes, programs; consequently, a project involving reusability must be precisely defined. In the introduction it is seen trends in software, the stakes of reuse models for HIS and the special use case constituted with a HIS. The main three parts of this paper are: 1) Designing a reuse model (which objects are common to several information systems?) 2) A reuse model for hospital clinical laboratories (a genspec object model is presented for all laboratories: biochemistry, bacteriology, parasitology, pharmacology, ...) 3) Recommendations for generating plug-compatible software components (a reuse model can be implemented as a framework, concrete factors that increase reusability are presented). In conclusion reusability is a subtle exercise of which project must be previously and carefully defined.

Clinical Laboratory Information Systems↗
PubMed1996

Relationship between insulin sensitivity, hyperinsulinemia, and insulin-mediated sympathetic activation in normotensive and hypertensive subjects.

The adrenergic response to high physiological hyperinsulinemia was studied in 39 hypertensive subjects (28 men and 11 women) and 25 normal volunteers (15 men and 10 women), using the euglycemic clamp technique. Control studies using 0.45% saline infusions (sham studies) were also performed. Before and during the clamp procedure, plasma norepinephrine (NE) and epinephrine (E) were measured using a high performance liquid chromatographic method (HPLC). The association between the increment in NE and E levels and insulin sensitivity, steady-state insulin level during the clamps, waist to hip ratio (WHR), baseline NE levels and gender was studied. NE levels increased during the hyperinsulinemic period (mean increase 46 +/- 6 pmol P < .001 upsilon baseline and P < .01 upsilon sham studies). E levels did not differ between the insulin clamps and the sham studies. Insulin sensitivity was not significantly associated with the increment in NE. Hypertensive subjects had a higher NE increase than the normotensive individuals (55 +/- 7 upsilon 30 +/- 10 pmol, P = .03), but also had higher insulin levels during the clamps (839 +/- 43 upsilon 522 +/- 38 pmol, P < .001). Insulin levels accounted for most of the differences in NE increase between the normotensive and hypertensive groups. Gender, adiposity and WHR were also associated with NE increment. We conclude that the insulin mediated sympathetic activation is not affected in the presence of decreased insulin sensitivity for glucose utilization. The greater degree of sympathetic activation observed in hypertensive subjects is a function of the level of insulinemia obtained during the clamps.

Blood Glucose↗
PubMed1995

The presence and role of transmembrane transforming growth factor-alpha in cultures of rat liver epithelial cells.

We assessed the presence and the role of membrane TGF-alpha in two rat liver epithelial cell lines, either parental or transfected with c-fos proto-oncogene. c-fos overexpressing cells had more TGF-alpha-like activity in their membranes. When TGF-alpha was removed by elastase or neutralized, the growth rates of both cell lines were markedly reduced, but to a higher extent for parental cells. If membrane TGF-alpha seemed to play a key contribution in normal cell growth, both cell lines were unable to react to the addition of soluble TGF-alpha, showing that these two forms of growth factors are not equivalent.

Animals↗
PubMed1995

Hospital information systems modeling and simulation: the right method for the right objective.

The aim of this paper is to present an "instruction for use" on the information systems modeling and simulation methods in the case of a Hospital Information System. Firstly, a right modeling is defined as the right modeling method for the right objective and secondly, it exposes a short state of the art on these methods, the objectives of modeling and simulation for the Information System of a hospital and the application of the right method for the right objective. Finally it insists on the concrete aspects of how to realize modeling and simulation and the advantages of such an approach.

Computer Simulation↗
PubMed1989

[Morphology of the tibial tuberosity].

The influence of anterior projection of the tibial tuberosity in the pathogenesis of anterior knee pain syndromes has been given relatively little attention. This point has been investigated by performing a morphological study of 77 knee-joints with a standard radiological method. The knees fell into two groups: one of them included typical patellar syndromes, the other group included knees presenting with some other conditions, mostly meniscal. A subjective evaluation of the shape of the tuberosity was made and correlated with clinical status. An objective rating was attempted by measuring the anterior projection of the tuberosity, in order to eliminate the influence of skeletal size, it was expressed as a ratio between two values. Subjective evaluation of the shapes of the tuberosities was found unreliable. The individual values for the calculated index of anterior projection were found to be scattered for every morphological type. It appeared difficult to conclude that there is a definite proven relationship between hypoplasia of the tuberosity and overloading of the femoro-patellar joint. Evaluation of the anterior projection of the tuberosity should take into account the position of the tuberosity in the coronal plane.

Adolescent↗
PubMed1986

[Codus: a coding system for ultrasonic examinations].

A semeiologic and anatomic code for ultrasound imaging data has been in use for 3 years. A simple index, it allows coding under specific headings of almost all ultrasound record sheets and can be modified as a function of the requirement of different departments. It is also perfectly well adapted for inclusion in a data-processing system.

Abstracting and Indexing↗
PubMed1985

[Influence of diazepam premedication on upper digestive fiberscopy. 81 cases].

Upper gastrointestinal endoscopy is routinely used to follow up patients with digestive disease. The influence of premedication with diazepam on the procedure and on patients' acceptance of a second endoscopy was evaluated in a double-blind trial conducted on 81 patients randomized to 3 types of intravenous premedication: placebo (group A, 29 patients), diazepam 5 mg (group B, 27 patients) and diazepam 10 mg (group C, 25 patients). Endoscopy was performed under unfavourable conditions (refusal or agitation) in 12, 4 and 1 patients respectively of groups A, B and C (P less than 0.02). Out of 65 patients questioned one month later, 1 (group A) sternly refused a second endoscopy, 10 accepted unreservedly (O in group A, 4 in group B, 6 in group C; P less than 0.05 between A and C) and 54 accepted reluctantly. To find out whether diazepam was beneficial by impairing memory, a memory score on duration of the procedure was established; there were no significant differences between the three groups (P less than 0.001), but they did not correlate with the patients' acceptance of a second endoscopy. It is concluded that premedication with diazepam 10 mg i.v. makes upper gastrointestinal endoscopy easier to perform and facilitates acceptance of a repeat endoscopy 1 month later. This effect is probably independent of the impairment in memory induced by diazepam.

Diazepam↗
PubMed1985

[Computerized report of anesthesia in real time].

The computerized report of anesthesia (C.R.A.) is an equivalent of the document filled out by the anesthesiologist, linked to a multicriteria research program giving the opportunity to study connections between different performances of anesthesia. To obtain these results, the authors are introducing a microcomputerized system in real time, including a microcomputer (capacity 64 kO), a visual display monitor (80 column format), two floppy disks controllers and a printer. Through a "menu", there is an access to the following functions: identity, patient story, drug prescriptions, anesthetics used, chronology of administration, monitoring of parameters, incidents/accidents, multicriteria research, editing of the C.R.A. The operational realisation shows that this computerized system offers storage capacity and allows a retrospective analysis of anesthesia. As it is inexpensive and easy to use, it may become a very important device in every-day practice.

Anesthesia, General↗
PubMed1982

An automaton computer program for a microcomputerized real-time (thesaurus based) abstract medical record.

A study of the key wordings used by the doctors in medical records in ICU preceded this implementation; they constitute a thesaurus (2700 strings) organized in 2 trees. These strings are proposed along the dialogue which occurs between the microcomputer and the user; on these bases, several graphs allows movement in the tree by minimization of the pathway. The use of the thesaurus with the corresponding graphs necessitates only one automaton program. This medical data microcomputerized system is transparent for the user, thanks to a multilayered software. In the external layer the microcomputer provides access to the system by one of the following function keys: creation of a medical record, additional information on a medical record already known, research of a medical record, listing of the open medical records, printing of a medical record. Each one of these function keys provides access to the following 5 chapters: identity, antecedents, reasons for admission, evolution, destiny; these chapters use parameterized procedures. This software is implemented on a low-cost microcomputer fitted with a dual drive disk (170 kilobytes each) and a printer (90 characters/s).

Computers↗
PubMed1982

Design and feasibility of a flexible computerized system for the clinical laboratory, based on the IEEE 488 standardized interface.

Our target is to build a flexible computerized system based on an informational study of the clinical laboratory, which would leave the laboratory staff free to use equipment or modules from different manufacturers interchangeably. This applies to hardware and software. To fulfil this objective, it is necessary that automatic analyzers, microcomputers and minicomputers, have built-in standardized hardware and software interfaces. Technical specifications of the IEEE 488 standardized interface, recommended by the authors, are presented here; this interface is already widely used in instrument interfacing with low-cost microcomputers are minicomputers but has not yet been used for clinical laboratory automatic analyzers. A design for a flexible laboratory based on this interface is presented, with a discussion of the feasibility of such a project.

Autoanalysis↗
PubMed1982

Medical and administrative information modelling of a hospital university centre pneumology department.

Instead of a technology-oriented approach of a hospital information system (HIS), the authors present a structure oriented approach built on three elements: objects, events and operations which allow one to model a static and dynamic schema of an information system (IS). Objects of the static schema lead to a relational model. Events expose various states of Information System; operations allow one to build a dynamic schema. Such a schema is interesting for IS description in order to enhance the analytical capability of the designer, to define IS solutions and to limit the risks of errors. It allows the clinician better management of information relative to patients, especially thanks to the dynamical schema which enables one at any moment to know the patient's state. Finally, it has to free clinicians from managing information and allow them to give an always more important consideration to human relationships in medicine.

Hospital Departments↗