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Biomedical subjects

C Ferron

Publications and source records attributed to C Ferron.

At least 19 recordsLinked to original sources
PubMed2006

Reconstruction of circumferential pharyngolaryngectomy using a 'horseshoe-shaped' pectoralis major myocutaneous flap.

Eighteen patients underwent a circumferential pharyngolaryngectomy reconstruction post pharyngolaryngectomy. All tumours showed pharyngo-oesophageal junction invasion or circular involvement of the hypopharynx, requiring total, circumferential pharyngolaryngectomy. A pectoralis major myocutaneous flap was directly sutured to the pre-vertebral fascia. A Montgomery salivary bypass tube was introduced into the oesophagus, and a nasogastric tube was placed within it. No post-operative complications occurred for 14 patients and only minor ones for the other four. Average post-operative stay was 12 days. For 15 patients, feeding returned to normal throughout the follow-up period. No fistulae were noted and neopharyngeal stenosis occurred in three patients (16 per cent). Thirteen had complete resection with normal margins. Thirteen were still alive after one to three years of follow up. The local recurrence rate was 16 per cent. The use of a pectoralis major myocutaneous flap with Spriano's technique provides a simple, reliable method for circumferential hypopharyngeal resection. It has been applied to a wide range of patients, especially elderly ones and those with poor general status, as well as to cases in which widespread involvement was detected during surgery.

Aged↗
PubMed2006

[Interstitial brachytherapy of peri-orificial skin carcinomas on the face].

Purpose. - To analyse outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. Patients and methods. - We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas (BCCs), 9 squamous cell carcinomas (SCCs)) of the nose, periorbital areas and ears from 40 previously untreated patients (group 1) and 57 patients who had undergone surgery (group 2). The average dose was 55 Gy [50-65] in group 1 and 52 Gy [50-60] in group 2 (mean implantation times: 79 and 74 hours respectively). We calculated survival rates and assessed functional and cosmetic results de visu. Results. - Median age was 71 years [17-97]. There were 29 T1, 8 T2, 1 T3 and 2 Tx tumors in group 1. Tumors were<2 cm in group 2. Local control was 92.5% in group 1 and 88% in group 2 (median follow-up: 55 months [6-132]). Five-year disease-free survival was better in group 1 (91% [75-97]) than in group 2 (80% [62-90]), P=0.23. Of the 34 patients whose results were re-assessed, eight presented pruritus or epiphora. One group 2 patient had an impaired eyelid aperture. Cosmetic results were better in group 1 than in group 2, with respectively 72% (8/11) vs 52% (12/23) of good results and 28 (3/11) vs. 43% (10/23) of fair results. Conclusion. - Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.

Adolescent↗
PubMed2006

[Evaluation of pulmonary function in the elderly. Intergroupe Pneumo Gériatrie SPLF-SFGG].

Aging is associated with a progressive decrease in lung function. As a consequence of aging, individual's reserve is diminished, but this decrease is heterogeneous between individual subjects. Many factors are involved in the overall decline in lung function. The prevalence of asthma in the elderly is estimated between 6 and 10%. Mortality due to COPD is increasing, especially among older subjects. Older subjects are at an increased risk of developing chronic diseases such as Parkinson's disease, which can have consequences for lung function. Under-nutrition is also common in the elderly and can produce sarcopenia and skeletal muscle dysfunction. The presentation of respiratory disorders may differ in the elderly, especially because of a lack of perception of symptoms such as dyspnea. The impact of bronchodilatators or corticosteroids on respiratory function has not been studied in the elderly. Drugs usually used for the treatment of hypertension or arrhythmias, which are often observed with aging, can have pulmonary toxicity. There is no difference between functional evaluation in younger and older subjects but it is more difficult to find predicted values for older patients. Performing pulmonary function tests in older patients is often difficult because of a higher prevalence of cognitive impairment and/or poor coordination. When assessing pulmonary function in the elderly, the choice of tests will be depend on the circumstances, with the use of voluntary manoeuvres dependent on the condition of the patient.

Aged↗
PubMed2004

[How to develop health education within general medicine and pharmaceutical practice? Implementation methods used in an experiment with pregnant women, adolescents and elderly people].

Through the impetus of the National Institute of Prevention and Health Education (INPES) and the National Funding Agency for Social Security (CNAMTS), five different health education interventions were designed and implemented by 61 general practitioners and pharmacists in 5 pilot locations in France. The projects involved 185 senior citizens, adolescents and pregnant women. The strategic development of these projects required training the participating health professionals for a period of one year within the framework of a structured programme. The educational interventions were subsequently designed to specifically meet health education criteria and standards, namely, incorporating a broad as well as individualised approach to the patient and including active participation in the learning process. The programme elements are not oriented towards a thematic approach, nor around a specific health topic, but rather they focus on the individual as belonging to part of a given population group. It is therefore a population oriented health education approach.

Adolescent↗
PubMed2002

Serum pentosidine as an indicator of Alzheimer's disease.

Pentosidine, an advanced glycation end product (AGE), was assayed by HPLC in serum proteins from patients with Alzheimer type dementia (AD), patients with diabetes mellitus (D), and healthy (C) age-matched old subjects (mean age from each group = 84 years). Serum pentosidine was significantly different between the three groups despite similar renal function (serum creatinine < 160 micromol/L). In all groups of patients, pentosidine was independent of glycated hemoglobin (HbA1C) and the early glycation marker fructosamine and appeared to be an independent marker, mainly bound to serum albumin. Pentosidine could be an important factor useful for the diagnosis of Alzheimer's disease.

Aged↗
PubMed2000

[Hypernatremia in the aged: clinical characteristics].

OBJECTIVE: Hypernatremia in young adults is a rare condition, sometimes occurring after gastrointestinal diseases, osmotic diuresis or diabetes insipidus. The clinical characteristics and prognosis of hypernatremia in geriatric patients would be different. Each case must be examined separately. PATIENTS AND METHODS: We conducted a prospective uncontrolled study among patients over 70 with sodium levels equal to or greater than 150 mmol/l (at admission or during the hospitalization). RESULTS: Hypernatremia was found in 77 patients. Mean age was 84.1 +/- 6.7 years. The mean peak serum sodium level was 157.3 +/- 7.4 mmol (two-thirds ranged from 150 to 160). Hypernatremia onset was produced by a wide range of symptoms: 48% had a febrile illness, 470% were on diuretics, 15% had had a stroke, but only 9% were suffering from diarrhea or vomiting. Most of the patients had disabling chronic illnesses (62% loss of two or more ADL of Katz), severe dementia (84% level = 6 on the Reisberg global deterioration scale). In spite of fluid replacement and follow-up treatment, outcome was poor: 62% of the patients died within three months. CONCLUSION: Besides digestive and renal losses, hypernatremia in elderly patients is increased by fluid supply disorders consecutive to hypodipsia contracted at the same time as disability and dementia. Hypodipsia is a sign of poor prognosis. Prevention must be undertaken early, emphasizing the importance of identifying dehydration early among elderly people with chronic disabling illnesses.

Adult↗
PubMed1999

Alternative methods in the investigation of adolescents' sexual life.

PURPOSE: To describe two methodological approaches to surveying adolescents' sexual life which were combined within a national survey. METHODS: The questionnaire was designed during a 5-day workshop. Ten adolescents played the roles of imaginary adolescents involved in different situations related to sexual life. The information obtained through the analysis of these role-plays was used to establish the sequence of the questions, their content, and wording. The questionnaire was computerized so that it could be completed by the adolescents using laptop computers. Its arborescent structure, leading each respondent from one module to another, made possible the adjustment of the questions to each respondent's stage of development and type of sexual experience. RESULTS: A total of 4283 teenagers (2075 girls and 2208 boys, and 4 refusals) 16-20 years were included. Only 7.6% did not fill in the whole questionnaire. By the age of 18 years, more than 50% of boys and girls were sexually active. Half of sexually active teenagers have discussed contraception issue before engaging in their first intercourse, but much fewer (14-35%) have discussed issues related to HIV transmission. During their first sexual intercourse, the majority of the respondents used a condom (girls, 63%; boys, 58%) or condom plus oral contraception (girls, 11%; boys, 17%). CONCLUSION: Youth participation and role-play decrease the conceptual biases often associated with professionals' perceptions and bring tools enabling a better exploration of circumstances and negotiations surrounding the sexual encounter. The computerized questionnaire increases confidentiality, attractiveness, easy data collection, and, above all, adjustment of the questions to the respondent's level of experience. These methods could be more systematically used in surveys targeting sensitive issues related to adolescents' health.

Adolescent↗
PubMed1999

Sport activity in adolescence: associations with health perceptions and experimental behaviours.

Despite the relevance of this research topic from a public health perspective, there is currently a lack of objective data on European adolescents' sport activity, notably the associations between their sport habits and their health attitudes and behaviours, which may have important consequences both in terms of somatic (cardiovascular) health and mental health. The objective of the present study was to determine the direction and strength of the associations between the frequency of sport and health variables; in particular, perceptions of health, self image, substance use and experimental behaviours. Data were collected as part of the 1993 Swiss Multicentric Adolescent Survey on Health. In this survey, anonymous self-administered questionnaires were distributed to a national representative sample of 10,000 in-school adolescents (15-20 years of age). Univariate analyses explored the relationships between the level of sport activity and health variables; then logistic regression analyses examined the strength of these relationships. According to the results, half of the sample do sports more than twice a week, boys more often as part of a sports club. Differences between non-athletic and athletic adolescents describe the latter as having less somatic complaints, more confidence in their future health, a better body image, a lesser tendency to attempt suicide, a higher frequency of use of the car seat belt, and a lower use of tobacco, wine and marijuana. Links between the frequency of sport activity and the locus of control related to health, general satisfaction with life or sexual behaviours are less strong. It must be noticed that the cross-sectional data collection precludes the establishment of a causal relationship between exercise and health behaviours. However, the existing links underline the coexistence of positive health characteristics and sport activity, suggesting that an incitement to get involved in physical activity may be a necessary component of a comprehensive prevention approach among adolescents.

Adolescent↗
PubMed1998

Eating disorders among female adolescents in Switzerland: prevalence and associations with mental and behavioral disorders.

OBJECTIVES: To measure the prevalence of eating disorders in a national representative sample of adolescent girls and association of eating disorders with other behavioral/mental problems in Switzerland. METHODS: As part of a national health survey, a subsample of 1,084 15 to 20-year-old female students attending school aged filled in a self-administered anonymous questionnaire focusing on eating behavior and body image. Factor analysis made on these specific questions reveals two major dimensions: weight and image concern (WIC) and problematic eating conduct (PEC). The correlates of these two dimensions were measured using bivariate analyses. RESULTS: Among girls, 62% say they want to lose weight, 36% feel too fat, 37% report fasting episodes, 18.9% fear not to be able to stop eating, 9.1% engage in binge eating at least once a week (1.9% daily), 1.6% self-induced vomit at least once a week (0.2% daily). Girls who exhibit high WIC (N = 198) or high PEC (N = 75) scores report significantly more mood problems (p < .05), suicidal conducts (p < .05), or violent and aggressive behaviors (p < .05). No association is found with substance use. Associations with acting-out behavior are stronger among high PEC subjects, whereas those with mood disorders are stronger among high WIC subjects. CONCLUSION: A large proportion of adolescent girls show concerns regarding their weight and body image whereas a less important proportion exhibit dysfunctional eating behavior. The results confirm the associations between eating disorder and mood, suicide, and conduct problems but infirm the association with substance use. Girls who exhibit problematic conducts appear to require more attention from health resources.

Adolescent↗
PubMed1998

Suicide attempts among adolescents in Switzerland: prevalence, associated factors and comorbidity.

Switzerland has one of the highest rates of adolescent suicide in Europe, but the prevalence of suicidal thoughts and attempts is unknown. The objective of this paper is to assess the prevalence of suicidal ideation and behaviour among Swiss teenagers and to identify the factors associated with suicide attempts. A self-administered anonymous questionnaire was distributed to a representative sample of 9268 15- to 20-year-old adolescents attending school or college. Six items focused on suicidal ideation and conduct. Multivariate analyses were performed to identify the health variables associated with suicide attempts. About 55% of the adolescents had no suicidal concerns; 26% reported suicidal thoughts, 15% reported suicidal plans and 3% reported suicide attempts. Suicide attempters reported significantly more problems in four areas, namely health behaviour, life events, social relationships and mental health. In conclusion, many factors associated with suicide attempts represent detectable behaviours. Thus health professionals could use this knowledge to be more effective in suicide prevention among adolescents.

Adolescent↗
PubMed1997

Accuracy of an automatic and patient-triggered long-term solid memory ambulatory cardiac event recorder.

This study evaluated the R-Test Evolution, a new type of cardiac event recorder bearing both patient-triggered and automatic capabilities. Its 7-day automatic arrhythmia analysis showed promising clinical advantages, especially when investigating patients with unexplained rare events such as syncope, feeling of weakness or faintness, palpitations, stroke, or in patients inconsistent in their use of patient-triggered recordings.

Arrhythmias, Cardiac↗
PubMed1997

Health behaviours and psychosocial adjustment of migrant adolescents in Switzerland.

BACKGROUND: Except for that of skilled and professional personnel, labour migration has practically ceased in Europe since the mid-1970s, and many of those who migrated as single males now have families in host countries. In Switzerland, among school-attending adolescents both of whose parents were born outside the country, some three quarters are children of labour migrants. Our hypothesis is that these adolescents present particular adjustment difficulties attributable to low socio-economic status and double cultural affinity. OBJECTIVE: To compare Swiss and labour-migrant adolescents in attitudes towards health risks, psychological adjustment and family relationships. METHOD: As part of the Swiss Multicentric Adolescent Survey on Health, an anonymous self-administered questionnaire was distributed in school classes among a national representative sample of 9300 fifteen- to twenty-year-olds. The subsample of labour-migrant youth includes 1200 adolescents both of whose parents are from Italy, Spain, Portugal, Turkey or former Yugoslavia. RESULTS: Bivariate analyses show significant differences between Swiss and labour-migrant adolescents in health concepts and health behaviour (notably, sexual behaviour and substance use), general well-being and family relationships. Only alcohol consumption and drink-driving behaviour place migrant adolescents at a lower risk than their Swiss peers. When sociodemographic variables are controlled in multivariate analysis, less favourable perceptions of the future, more marks risk behaviours, symptoms of depression, and difficult relationships with parents all appear to be strongly associated with migrant status. CONCLUSION: The findings of this study reflect the negative effects of lack of social stability and of clear opportunities and positive perspectives on the health and psychosocial adjustment of migrant adolescents.

Acculturation↗
PubMed1997

[Suicidal behavior in adolescents in Switzerland: role of physicians].

INTRODUCTION: In most industrialized countries, suicide represents the second leading cause of death among adolescents. Swiss teenagers exhibit one of the highest death rates by suicide in Europe; however, the prevalence of suicidal conducts (suicidal ideas, projects and attempts) in Switzerland is not known. OBJECTIVES: To assess the prevalence of suicidal conducts among Swiss adolescents and to compare these figures with available data from other countries. To establish how suicidal adolescents use health services in comparison with non-suicidal adolescents. METHODS: Bivariate analyses have been performed using data from the "SMASH" study (Swiss Multicenter Adolescent Survey on Health), a national survey on the health and lifestyles of 9,268 15 to 20 years in-school youth (3,993 girls et 5,275 boys). Within a self-administered anonymous questionnaire of 80 items, five specific questions focused on suicidal conducts and lead to the distribution of respondents in four groups: no suicidal concern, suicidal ideas, suicidal plans, suicide attempt. RESULTS: Regarding the last 12 months, 5,144 teenagers (55.5%) report no suicide preoccupation at all; 2,376 (25.6%) report suicide ideas only, 1,366 (14.7%) report suicidal projects and 274 (3%) report suicide attempts. Only 40% of respondents who report a suicide attempt have talked about it to someone in their circle of family or friends. Moreover, less than 20% have spoken of their suicide with a psychologist, and although they see physicians as often as the rest of the sample, only 10% have discussed their attempt with one of them. In comparison with those free of suicidal concerns, suicidal adolescents report significantly more health problems and concerns: they feel more often tired or depressed and use medication more often. They also seem to exhibit more deviant behaviors like alcohol and drug use or runaway. CONCLUSION: Suicidal conducts, especially suicide attempts are much more prevalent among Swiss adolescents, but a small minority is acknowledged and treated by the medical profession. Physicians should be aware of this pathology and better trained both in term of detection and treatment.

Adolescent↗
PubMed1997

[Sports activities of Swiss youths: practices, motivations and links to health].

BACKGROUND: Despite the relevance of this research topic from a public health perspective, there is currently a lack of objective data on the frequency and context of European adolescents' sport activity, their motivations to engage in sports, as well as the links between their sport habits and their health attitudes and behaviors. OBJECTIVES: 1) to describe the sport habits of adolescents in Switzerland and their motivations to get involved in a physical activity, 2) to define the sociodemographic profile of adolescents defined as athletic, 3) to determine the nature of the associations between the frequency of sport activity and health variables. METHOD: In the 1993 Swiss Multicentric Adolescent Survey on Health, anonymous self-administered questionnaires were distributed to a national representative sample of 10,000 in-school adolescents (15 to 20 years old). The answers were investigated by means of univariate analyses. RESULTS: Half of the sample do sports more than twice a week, boys more often as part of a sports club. Motivations depend on the gender, girls doing sports for self image and health motivations and boys for competition and relational reasons. Almost all the sociodemographic characteristics show statistically significant differences between "non athletic", "fairly athletic" and "athletic" adolescents, which suggests the influence of the sociocultural background on the perception of sport activity. These three groups also differ as regards their health behaviors, attitudes and perceptions; the most athletic adolescents generally give more positive answers in terms of prevention and perceived health. These findings have implications for health promotion, notably as regards the creation of the material conditions more likely to favor adolescents' involvement in physical activity.

Adolescent↗
PubMed1997

Body image in adolescence: cross-cultural research--results of the preliminary phase of a quantitative survey.

This preliminary phase of a quantitative research had two main objectives: to identify the emotional and relational components of body image in adolescents, and to determine whether the experience of body changes is dependent upon individuals' context. Two samples of adolescents, both 13 to 17 years of age, who were healthy, middle- or upper middle-class, and randomly chosen, participated in the study. Subjects were 80 French adolescents (40 boys and 40 girls) from a center for preventive medicine, and 60 American adolescents (30 boys and 30 girls), from a suburban high school. Thorough individual interviews were conducted with these adolescents on the basis of a precise interview guide in order to determine their perceptions, attitudes, and beliefs about body image. A thematic analysis of the content of these recorded interviews revealed the differences between adolescents from the two countries. I was found that the main cultural differences were based on the belief that the real body and the ideal body coincide, and on the way physical appearance is included in the diversity of relational experiences. Gender differences were shown to be centered more on the level of control of body changes and on self-assessment modes; the signs of a failing or troubled body image may find their origin on an individual level, in the particularities of the family and parental language about the body, and on a collective level in the social representation of the body. The consequences of these symbolic representations on the adolescents' body image and attitudes toward their own health, are presented and discussed.

Adolescent↗