Biomedical subjects

D Leibovici

Publications and source records attributed to D Leibovici.

41 records · Page 3Linked to original sources

PubMed1994

[Dynamics of asthma mortality in France: seasonal fluctuations and peak mortality in 1985-87].

In the face of an observed increase in asthma mortality since the end of the 70's an analysis of the time series of the deaths for the period 1979-89 was conducted; which shows a peaking of mortality between 1985 and 1987. A different seasonal component of asthma mortality has been identified for the age group 5-34 and over 34 group. For the later, mortality was found to peak during winter and dropping to the lowest point in summer, well synchronised with the mortality due to respiratory infection. For the former, mortality usually peaks during summer and troughs during the winter, independently of the mortality due to respiratory infection. A bimodal repartition of deaths was observed in the age group 5-34 with a main peak in summer (July) and a secondary peak in autumn (October). Modeling of the deaths series by season shows a dramatic rise in mortality during the years 1985, 1986 and 1987 affecting both age groups. During these 3 years, the global over-mortality is 21%. The increase has affected all the seasons allowing for seasonal variations of each age group. Factors responsible for the death seasonality in each age group are discussed. The temporary action of a non-specific factor was proposed to explain the cross-sectional character of the mortality crisis in the population; namely the influenza epidemics during the 1985 and 1986 winters.

Adolescent↗

PubMed1993

[Past and present asthma mortality: towards a shift in the secular trend?].

In recent years disconcerting observations have been published concerning changes in mortality from asthma in France and other countries. These conclusions are difficult to assess due to uncertainty regarding the underlying asthma mortality trends. We have attempted to address this question by constituting a statistical series of asthma deaths from 1925 to 1989. The 1925 to 1989 mortality trend is clearly decreasing. This decrease follows the same rhythm as the general mortality decline, since the proportion of asthma in total deaths remained between 3 to 4/1000. Three periods are emphasized: from 1925 to 1965 where the decreasing trend is interrupted by an important crisis in mortality, from 1965 to 1980 where the decrease is regular, and the last period since 1980 with an important crisis in 1985 and 1986; crisis applying to all genders and ages. The latest trend is uncertain. Careful epidemiologic surveillance will decide between a change in the secular trend or a transitory crisis and thus determine the cause(s). An effect due to the reinclusion by ICD 9 of a fluctuating component in asthma mortality cannot be excluded.

Abstracting and Indexing↗

PubMed1982

Insulin responsiveness of superficial forearm tissues in type 2 (non-insulin dependent) diabetes.

Forearm perfusion studies were carried out to determine the responsiveness to insulin of the superficial forearm tissues in non-obese Type 2 (non-insulin-dependent) diabetics, and the interrelationships among plasma concentrations of glucose, insulin and non-esterified fatty acids (NEFA), tissue uptake of glucose and insulin and tissue release of NEFA. It was found that: (1) in normal subjects, uptake of glucose was dependent on glucose concentration. It was also dependent on insulin concentration in the range of 0-30 mU/l, but not over a wider range of insulin concentration (less than 66 mU/l), indicating that the insulin effect was maximal at approximately 30 mU/l. In contrast, glucose uptake in diabetics was independent of glucose concentration but dependent on insulin uptake over an insulin concentration range up to 140 mU/l; glucose uptake reached the same levels as in control subjects but only at higher concentration and higher uptake of insulin. (2) Insulin uptake was directly dependent on insulin concentration and the regression coefficients were very similar in the two groups. (3) NEFA concentration fell to comparable levels in the two groups of subjects in response to insulin. It is concluded that in Type 2 diabetes: (1) the superficial forearm tissues show decreased responsiveness to the stimulatory effect of both hyperglycaemia and hyperinsulinaemia on glucose utilization but the NEFA-lowering effect of insulin is undiminished, and (2) tissue uptake of insulin is normal, despite the decrease in receptor capacity that has been demonstrated by others.

Adult↗

PubMed1980

Effect of age on glucose utilization and responsiveness to insulin in forearm muscle.

To determine the effect of age on responsiveness to insulin, 35 healthy subjects (age range, 22--73 years) were studied. A glucose-clamp technique was used to obtain a range of values for steady-state arterial glucose and arterial insulin concentrations; total body glucose utilization was estimated from the rate of glucose infusion needed to maintain the steady state; and the uptake of glucose and insulin by forearm muscle was determined by a forearm perfusion procedure. The results were examined by multiple regression analyses. The rate of glucose utilization by the whole body as well as by forearm muscle was dependent upon the insulin concentration. Age had no apparent effect on body glucose utilization, the uptake of glucose or insulin by muscle, or the steady-state insulin concentration in response to hyperglycemia. It is concluded that the abnormal glucose tolerance commonly associated with increased age is not due to a decrease in either insulin secretion or insulin stimulation of glucose uptake.

Adult↗

PubMedDate not supplied

The efficacy of integrating "smart simulated casualties" in hospital disaster drills.

INTRODUCTION: Full-scale disaster drills are complex, expensive, and may involve hundreds or thousands of people. However, even when carefully planned, they often fail to manifest the details of medical care given to the casualties during the drill. OBJECTIVE: To assess the feasibility of integrating physicians among the simulated casualties of a hospital disaster drill. METHODS: A total of 178 physicians graduating an Advanced Trauma Life Support (ATLS) course participated in eight hospital disaster drills during 1994 as "Smart Victims." The participants were given cards with descriptions of their injury and detailed instructions on how to manipulate their medical condition according to the medical care provided in the hospital. They also were given coded questionnaires to fill out during the process of the drill. Conclusions were drawn from analysis of the questionnaires and from a roundtable discussion following each drill. RESULTS: The "smart casualties" made comments on the following topics: 1) triage (over-triage in 9%, and under-triage in 4%); 2) treatment sites; 3) medical equipment usage (i.e., shortage of ventilators and splinting devices); 4) medical knowledge and care rendered by the hospital staff; 5) evacuation and escorting of the wounded; 6) management of patients with post-traumatic stress disorder; and 7) medical documentation. Their comments contributed valuable information on the quality of medical care and organization, and identified obstacles that otherwise would have been overlooked. The "smart casualties" were very cooperative and indicated that their participation in the drill contributed to their understanding of disaster situations in hospitals. CONCLUSION: Integrating physicians among the simulated casualties in a hospital disaster drill may contribute to achieving the objectives of hospital disaster drills and add to disaster management education of the simulated casualty physicians.

Adult↗