Biomedical subjects

F Empereur

Publications and source records attributed to F Empereur.

8 recordsLinked to original sources

PubMed2003

Factors associated with the consumption of psychotropic drugs in a cohort of men and women aged 50 and over.

OBJECTIVES: The use of psychotropic drugs has increased continuously over recent years in industrialized countries. In Europe, France has the highest consumption of such drugs. The aim of this study was to identify the sociodemographic and medical factors associated with the use of psychotropic agents. METHODS: Data, collected as part of the SUVIMAX (SUpplementation en VItamines et sels Mineraux AntioXydants) prevention trial, from a self- administered questionnaire involving 7299 subjects aged 45-60 years, were subjected to logistic regression analysis. RESULTS: A total of 467 subjects used psychotropic drugs (8.4% of the women, 4.6% of the men). Use of psychotropic drugs increased in subjects of both sexes with past history of depression, perception of poor health and use of other drug treatments. Widowhood in men [odds ratio (OR) = 3.4; 95% CI = 1.6-7.3] and divorce in women (OR = 2; 95% CI = 1.2-3.2) were also associated with an increased use of psychotropic drugs. Interaction was demonstrated between educational level and occupational satisfaction in men (OR = 2.9; 95% CI = 1.5-5.8) and between perception of health status and use of other types of medication in women (OR = 6.5; 95% CI = 4.6-9.5). CONCLUSION: The results of our study are consistent with those of others in demonstrating that specific socio-occupational factors in men and specific medical factors in women influence extent of use of psychotropic drugs.

Age Factors↗

PubMed2002

Factors determining inpatient satisfaction with care.

The objective of the study was to identify factors associated with satisfaction among inpatients receiving medical and surgical care for cardiovascular, respiratory, urinary and locomotor system diseases. Two weeks after discharge, 533 patients completed a Patient Judgments Hospital Quality questionnaire covering seven dimensions of satisfaction (admission, nursing and daily care, medical care, information, hospital environment and ancillary staff, overall quality of care and services, recommendations/intentions). Patient satisfaction and complaints were treated as dependent variables in multivariate ordinal polychotomous and dichotomous logistic stepwise regressions, respectively. Patient sociodemographic, health and stay characteristics as well as organization/ activity of service were used as independent variables. The two strongest predictors of satisfaction for all dimensions were older age and better self-perceived health status at admission. Men tended to be more satisfied than women. Other predictors specific for certain dimensions of satisfaction were: married, Karnofsky index more than 70, critical/serious self-reported condition at admission, emergency admission, choice of hospital by her/himself, stay in a medical service, stay in a private room, length of stay less than one week, stay in a service with a mean length of stay longer than one week. The factors associated with inpatient satisfaction elucidated in this study may be helpful in interpreting patient satisfaction scores when comparing hospitals, services or time periods, in targeting patient groups at risk of worse experiences and in focusing care quality programs.

Adolescent↗

PubMed2002

[A new locking nail for proximal humerus fractures: the Telegraph nail, technique and preliminary results].

We present a new nail, the telegraph nail, designed for the treatment of proximal fractures of the humerus. This nail has a new locking system providing a self-stabilization of the cancelous screws inserted in small fragments. We discuss the surgical technique and present preliminary results. The anterolateral approach and nail insertion through the medial and well vascularized part of the cuff is described for simple fractures. With the cup and ball technique, this nail can also be used for complex fractures of the proximal humerus with three or four fragments and major displacement. With this method, the nail is inserted before reduction and locked in the distal humerus before fixation of the head and tuberosities around the head once the targeting device removed. We report results for the first 64 nails inserted in our unit during the first year (1998-1999). Outcome was assessed at 11 months mean follow-up using the Constant score. Outcome was favorable, including in patients with complex fractures involving 3 or 4 separate displaced fragments. Besides providing an anatomically stable reconstruction, the telegraph nail has the advantage of allowing early mobilization of the shoulder joint. This method is a useful alternative to prosthetic reconstruction for traumatic fractures of the proximal humerus.

Adolescent↗

PubMed2002

[Satisfaction of patients hospitalized in Ho Chi Minh City, Vietnam].

This study aims to describe the level of satisfaction of patients and their families, according to the type of hospital and the sociodemographic characteristics of patients hospitalised within Ho Chi Minh City (HCMC), Vietnam. The study is supported by a sample of 538 patients and their families from all of the hospitals in HCMC to whom an evaluation questionnaire was given to be filled out on the day of their release. The average age is 39, and 64.4% are women. The scores measuring the level of satisfaction vary from 57.7 to 90.7 points (on a scale of 0 to 100). The section under the heading "treatment provided by the doctors" received the highest scores (90.7/100). Dissatisfaction was primarily associated with factors such as the amount of time spent waiting, the behaviour of the hospital staff, cleanliness, the cafeteria and parking for motorbikes. Almost 100% of the patients spoke about their experiences during their stay in the hospital, and 50.2% had some negative opinions (1.042 complaints registered). The older patients, having a lower level of education and living either in other cities or in the rural region of HCMC, tented to be more satisfied than the younger patients, possessing higher levels of education and generally residing in the sub-urban or urban regions of HCMC. The patients who judged their condition to be very serious and their problems bad enough to justify hospitalisation, and who also felt that their health and condition had improved at the time of release compared to the time of admission were more satisfied than the other patients. Patients hospitalised who had an individual private room in a specialised hospital tended to be more satisfied that those who had a room sharing many beds for several patients in either a general hospital or in the emergency area of a specialised hospital. The authors observed no correlation between the level of satisfaction and the patient's gender. The results of this study have highlighed that certain domains, notably hat of the hospital's environment, should be reviewed and examined by health care administrators and managers in order to ensure the quality of the patient's care and coverage.

Adult↗

PubMed2001

No correlation between wine intolerance and histamine content of wine.

BACKGROUND: Histamine is thought to be the main cause of adverse reactions to wines. OBJECTIVE: The purpose of this study was to test the hypothesis that the level of histamine in wine affects the tolerance to wine in 16 subjects with wine intolerance. METHODS: We performed a study to examine the effects of wine histamine content in 16 adults with wine intolerance. Each subject underwent 2 double-blind provocation tests with wine: 1 with a wine poor in histamine (0.4 mg/L), and 1 with a wine rich in histamine (13.8 mg/L). Blood was collected for histamine and methylhistamine RIAs at 0, 10, 30, and 45 minutes after ingestion of the wine. Methylhistamine and methylimidazolacetic acid (gas chromatography and mass spectrometry) were measured in urine 5 hours before and 5 hours after ingestion. RESULTS: No significant differences in the occurrence of adverse reactions were noted after ingestion of either of the wines (McNemar test). At 10 minutes, a significant increase was observed in plasma histamine with histamine-poor wine. No significant changes (Wilcoxon test) were observed in the methylhistamine and methylimidazolacetic acid levels after ingestion of either histamine-poor or histamine-rich wine. CONCLUSION: This study demonstrates that there is no correlation between the histamine content of wine and wine intolerance. The increase of plasma histamine levels at 10 minutes with histamine-poor wine suggested the role of a histamine-releasing substance. The role of acetaldehyde is discussed.

Adult↗

PubMed2000

[Evaluation of professional practices].

Concepts and methods in professional practices evaluation are often confused. After a description of the classical conceptual framework, we present these methods in an approach in which practice is the principal result to be measured. Thus it makes it possible to apply the traditional epidemiological concepts to the evaluation of the professional practices with their three traditional fields: 1) In the descriptive approach, cross-sectional practice studies allow an observation and description of the usual behaviors, possibly compared to references. The methodological constraints are the same as which of descriptive epidemiological studies; 2) In the analytical approach, factors associated with practice - simple or conformed to criteria - are evidenced on a representative sample; 3) In the evaluative approach of practices improvement, the objectives are the assessment of formative, organizational or structural interventions, aiming at modifying practices. Three types of studies are to be used: quasi experimental in which clinical audit is the reference method in the field of medical care. The six main steps of clinical audit are described; experimental, based on the community randomized trial scheme, which have the advantage to provide results that can be immediately generalized; observational in which no control on the implementation of intervention is done. "Here and else" and "before and after" studies are used. To be effective for evaluation of professional practice, theses methods must come within the scope of a favorable institutional context.

Epidemiologic Methods↗

PubMed1998

Evaluating a computerized tool for coding patient information.

OBJECTIVE: Computerized tools may be useful in speeding up and facilitating the laborious task of coding patient information. This paper describes a method of objectively evaluating their efficiency. DESIGN: 38 study subjects were randomly assigned to a manual coding group or an automated coding group, with stratification according to two variables (used to coding yes/no, physician yes/no). Subjects then coded the same standardized set of diagnoses in a limited time. The numbers of exact codes retrieved were compared using a global analysis of variance model. RESULTS: The two groups were not significantly different with regard to the number of physicians (p = 0.74) and the number of usual coders (p = 0.52) they included. Significantly more exact codes were achieved in the group using automated coding than among the manual group (p = 0.04). Physicians were significantly more efficient at coding than non-physicians (p = 0.02). CONCLUSION: This study describes an objective means of evaluating the performance of an automated coding tool. It shows that better results were achieved with the computerised compared to the manual method, even when the superior abilities of physicians were taken into account.

Disease↗

PubMedDate not supplied

[Clinical research, evaluation of care and quality assurance].

This paper aims to clarify the concepts and terminology of clinical research, evaluation, and quality. Clinical research or clinical epidemiology aims to demonstrate the efficacy of medical care. The optimal methodology is a randomized, double-blind trial that allows a causal inference in respect of efficacy. This should be the first stage before generalization of all medical practice. Evaluation of quality of care aims to verify the effectiveness of medical care by comparing practice with references. The optimal methodology is clinical audit that allows fine-tuned diagnosis of the existence of deviant practices. The analysis of causes and correction of the care process are an integral part of the evaluation work. Thus quality assurance and quality management concepts and methods have been developed which tend to ensure solutions for better care and to maintain the level of quality of care to achieve patient satisfaction. Evaluation, clinical research and management quality could in fact be seen as the complementary facets of a comprehensive approach to quality of care.

Clinical Protocols↗