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Biomedical subjects

D Brille

Publications and source records attributed to D Brille.

32 records · Page 2Linked to original sources
PubMedDate not supplied

[Thr prognostic value of chronic cough, sputum and spirometry assessed by 10-year mortality among 1487 working men (author's transl].

The aim of the present study is to find out whether or not the diagnosis of chronic bronchitis at an early stage of the disease makes it possible to forecast an excess of mortality within 10 years, among 1487 men examined in 1960/61 while they were at work and aged at the time between 30 and 59 years. After having shown the prognostic value of chronic phlegm and spirographic measurements (VC, FEV1.0, FEV1.0/VC), we tried to state precisely their prognostic value by controlling the tobacco consumption and the socio-occupational class, which are bound to them and are themselves prognostic. FEV 1.0 is the most discriminant variable; its reduction is prognostic as young as 35. Survival-rates decrease regularly with the reduction of FEV1.0; this prognostic role seems to remain in all sociooccupational classes and for smokers as well as for non-smokers; it is more evident for the men who had chronic phlegm than in those who did not have such a symptom. It has been impossible to draw clear conclusions about the prognostic value of phlegm on these points because of interaction existing between phlegm and age.

Adult↗
PubMedDate not supplied

[A control trial of home I.P.P.B. therapy in patients with chronic obstructive respiratory insufficiency. Protocol and state of the study (author's transl)].

Because a previous retrospective study did not allow any conclusion as to the efficacy of home IPPB therapy in patients with chronic airflow obstruction, a control trial has been started. The protocol includes definition of patients, modalities of treatment, criteria for evaluation. Among criteria for a patient to enter the trial is a chronic hypercapnia (with PaCO2 greater than or equal to 48 mmHg) observed over a preliminary period of 4 months. At the end of this period patients are allocated at random into two groups with and without IPPB at home (at least 1 to 2 hours daily through a mouthpiece); medical prescriptions are same in the 2 groups so as surveillance which is planned for 2 years. Evaluation should be based upon 5 predetermined criteria. This trial is in progress.

Activities of Daily Living↗
PubMedDate not supplied

[I.P.P.B. therapy at home in chronic respiratory insufficiency in France. I. Survey method. Description of the prescribers. 1960-1977 prescription evolution (author's transl)].

In order to assess the usage of IPPB therapy at home in chronic respiratory insufficiency in France, a mail survey has been conducted among 2,062 chest physicians and physicians involved in intensive care. The response rate was 57%. Among those caring for chronic respiratory insufficient patients, 296, i.e. 38%, have prescribed IPPB to 3,778 patients from 1960 till 1977. A study among a sample of the non-spontaneous-responders allows the estimation of about 400 physicians who prescribed IPPB on the whole for France at this time. Those who prescribed, worked more often in hospital though 4% had only a private practice. Those involved in intensive care prescribed more often than the chest physicians (47% versus 37%). The development of this therapy was different according to the different regions in France. But, in a general way, the prescription of IPPB at home particularly spread out since 1975, 65% of all the prescriptions have been done in 1975, 76, 77.

France↗
PubMedDate not supplied

[IPPB therapy at home in chronic respiratory insufficiency in France. II. Indications. Technics and surveillance (author's transl)].

A survey has been conducted among French chest physicians and physicians involved in intensive care. 296 physicians have prescribed IPPB at home to 3 778 patients with chronic respiratory insufficiency between 1960 and 1977. Acute respiratory failure was the first criteria considered in the indications (57% of the patients); hypercapnia, hypoxemia and right heart failure episode frequency were the other criteria of severity the most often taken into account. Since 1960, the indications among those with airflow obstruction have decreased, whereas they have increased for those with restrictive insufficiencies, expressing the questions raised about the efficacy of IPPB in these two types. 18% of the patients have had IPPB through tracheostomy canula. 70% of the patients have used a pressure cycling respirator and 30% a volume or flow cycling respiratory. This second type was quite always used in the case of IPPB through canula. Oxygen was added for half of the patients. The physicians have regularly followed the patients. Great importance was accorded to home care surveillance.

France↗
PubMedDate not supplied

[Twelve year FEV1 changes and smoking habits among 556 workers in the Paris-area (author's transl)].

The aim of the study was to analyse the effects of smoking, in particular to show its causal role in the development of airflow obstruction, and to look at changes in smoking habits. The study was conducted among 556 men, aged 30 to 54 in 1960, surveyed twice, in 1960 and 1972. The hypothesis of tobacco as a causal factor of airflow obstruction is strengthened, following this study, by three results: 1) FEV1 slope was related to tobacco consumption, even after adjustement for FEV1 level (42 ml/yrs for non-smokers, 51 ml/yrs for heavy smokers); 2) FEV1 loss with age increased with the amount of tobacco consumption: one pack a day smoked for 25 years was equivalent to an aging of 5 years; 3) FEV1 loss decelerated if the subject gave up smoking, thus preventing any further risk. What appeared to be a spontaneous regulation in smoking habits was observed. The men who stopped smoking were those with low respiratory status. In this population, men who were ex-smokers in 1960 and maintained this status until 1972 had a FEV1 slope similar to that of the non-smokers.

Adult↗
PubMedDate not supplied

[Spirographic reference values. Mathematical models and practical use (author's transl)].

Various models predicting VC and FEV1 from age and height have been compared by both theoretical and practical approaches on several subgroups of a working population examined in 1960 and 1972. The models in which spirographic values are proportional to the cube of the height give a significantly worse fit of the data. All the other models give similar predicted values in practical terms, but cutoff points depend on the distributions of VC and FEV1 given age and height. Results show that these distributions are closer to a normal than to a lognormal distribution. The use of reference values and classical cutoffs is then discussed. Rather than using a single cutoff point, a more quantitative way is proposed to describe the subjects' functional status, for example by situating him in the percentile of the reference population. In screening, cutoff points cannot be choosen without specifying first the decision considered and the population concerned.

Adult↗