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Biomedical subjects

C Thilly

Publications and source records attributed to C Thilly.

13 recordsLinked to original sources

[The economics of health planning or social medicine revisited? 1. The conceptual framework].

Born in the nineteenth century, social medicine has already evolved through several steps. Indeed, having started as a community approach of the most deprived population groups, it has been progressively reoriented through the study of the most rational ways to give medical care to large target groups. Recently it has studied the impact of individual life health status and quality of life. The laws of functioning applicable to these approaches are those coming from liberal and planified economical theories while health planning has developed more and more sophisticated and convincing methodologies.

Health Planning↗

The Belgian Heart Disease Prevention Project: 10-year mortality follow-up.

The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference in risk profile change was greatest at two years, intermediate at four years and minimal at six years. Total and cause-specific mortality rates were systematically followed from the 6th to the 10th year. Follow-up at 10 years was 99.3% complete. The differences between intervention and control groups in total, coronary and cardiovascular mortality reduced from the 6th to the 10th year. The results suggest that changes in risk profile are rapidly followed by changes in cardiovascular mortality, but this applies in both directions. Thus risk reduction should be maintained in order to achieve a long-lasting preventive effect.

Adult↗

Belgian heart disease prevention project: incidence and mortality results.

Results are presented from the Belgian Heart Disease Prevention Project, part of the WHO European Collaborative Trial in the Multifactorial Prevention of Coronary Heart Disease (CHD). 19 409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038). Coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5% (p = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).

Adult↗

[The Belgian Heart Disease Prevention Project (author's transl)].

The Belgian Heart Disease Prevention Project is a controlled multifactorial preventive trial. It is basal on the well-documented epidemiologic notion of major coronary risk-factors: hypercholesterolemia, hypertension, smoking and obesity. This Project has been executed in industries, in males aged 40-59 yrs at the base-line screening. It is part of the WHO European Collaborative Trial including the United-Kingdom, Italy, Poland and Spain. This trial should verify a double work-hypothesis: 1 degree it is possible to modify significantly the coronary risk profile in middle-aged males through a comprehensive intervention program, 2 degrees this modification should, in turn, significantly reduce total mortality as compared to a control group. The authors discuss the pros and cons of a preventive trial in industry and review the numerous problems raised by the difficulties in modifying well-established life-styles as well as those related to the follow-up morbidity and mortality. Final screening took place in 1979-80 and results regarding incidence should be available by 1981.

Adult↗

The Belgian heart disease prevention project. Modification of the coronary risk profile in an industrial population.

The Belgian Heart Disease Prevention Project is a controlled, multifactorial prevention trial involving 19,390 males aged 40-59 years employed by 30 Belgian industries. These industries were paired and randomized into a control or intervention unit. In each intervention factory, the subjects from the two highest deciles of a coronary risk-score distribution curve were given individual advice twice a year. A health education campaign was also organized in each intervention factory. In the control group, 10% of randomly chosen subjects had the same baseline examination as the whole of the intervention group. After 2 years, high-risk subjects and random samples of the control and intervention group were compared regarding the coronary risk profile by means of a multiple logistic function (MLF). In the intervention high-risk group, the MLF showed a decrease of 20%, and in the control group there was an increment of 12.5% (p less than 0.001). Comparing the random samples an increment of 25% was found in the control group vs a drop of 2.26 in the intervention group (p less than 0.001). The coronary risk profile can be altered in a middle-aged male working population through mass media health education supplemented by face-to-face counseling in high-risk subjects.

Adult↗

Regional differences in risk factor distributions, food habits and coronary heart disease mortality and morbidity in Belgium.

Belgium can be divided in 4 major geographical areas: two Dutch speaking areas in the north (Campine and Flanders), a French speaking area in the south (Wallonia) and the Brussels area in between. Significant differences in mean serum cholesterol levels were observed with the lowest level in Campine, intermediate in Flanders and Brussels, and the highest level in Wallonia. Similar differences were observed in the prevalence of CHD and mortality from CHD is also higher in the French speaking part of the country. A survey of food habits since 1959 shows a higher butter and lower soft margarine consumption in the south. However, differences in smoking habits and personality traits also exist.

Adult↗

[Evaluation of technics used to define type 'A' pattern, in the Belgian Prevention Project of cardiovascular diseases (author's transl)].

In order to define the Rosenman and Friedman type A pattern three technics where used: the Bortner scale, the Jenkins Acitivity Survey (J.A.S.) and the interview. These are part of the base-line data recorded during the screening of a belgian male population aged 40 to 59 at entry of a controlled trial for the multifactorial prevention of cardiovascular diseases. The J.A.S. and the Bortner scale are evaluated in relation to the interview. Extremes of type A and B are less prevalent in our study compared to the Western Collaborative Group Study. Both the J.A.S. and the Bortner scale are very satisfactory in predicting type A and B pattern. The Bortner scale predicts the pattern in 78% of the subjects, by the method of weighted scores. The validation of this classification method, on a second sample, gives an accurate classification in 75% of the subjects. The J.A.S. predicts, the pattern in relation to the interview in 78% of the subjects; again the validation of the classification method, on a second sample, gives a correct classification in 70% of the subjects.

Behavior↗