Biomedical subjects

F Guillemin

Publications and source records attributed to F Guillemin.

225 records · Page 13Linked to original sources

PubMedDate not supplied

Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over.

Although weight, lean mass, fat mass and muscular strength are often found to be intercorrelated, the respective role of each parameter in bone mineral density (BMD) remains unknown in older women. The aim of the present study was to investigate the relationship between body weight and composition and quadriceps strength on femoral neck and lumbar spine BMD in healthy postmenopausal women. The relationship between isokinetic quadriceps strength measured by Biodex and BMD measured by dual energy X-ray absorptiometry was studied in 56 women aged 60-81 (70.5 +/- 6.2) years in multiple regression models adjusted for age, body composition and menopausal treatment. Weight and age were associated with femoral neck BMD (33 and 10% of variance accounted for, respectively) and lumbar spine BMD (23 and 8% of its variance). When body weight and quadriceps strength were excluded from the model, lean mass and age were associated with femoral neck BMD (29 and 14% of variance explained, respectively) and lumbar spine BMD (28 and 11% of variance explained, respectively). When quadriceps strength was entered into the model, it was strongly associated with femoral neck BMD (30% of variance accounted for), in addition to lean mass (9%) and age (7%), whereas it was not associated with lumbar spine BMD. In conclusion, lean mass explains a great part of the strong association between body weight and femoral neck and lumbar spine BMD. Quadriceps strength explains a great part of the association between lean mass and BMD at the femoral neck site but not at the lumbar spine site. These results suggest a site-specific effect of muscular strength on bone and a potential role of the age-related decline of muscle strength in age-related bone loss in postmenopausal women.

Age Factors↗

PubMedDate not supplied

Biliary lesions during radiofrequency ablation in liver. Study on the pig.

BACKGROUND: Radiofrequency (RF) is a method of in situ destruction of liver tumor. Biliary complications are bile ducts stenosis or biliary abcess. The aim of this work was to study consequences of liver RF on bile ducts. METHODS: A porcine model of biliary lesions was created using radiofrequency ablation liver. Twenty-two pigs were used for the study. The RF RITA 1500 generator (RITA Medical Systems, Mountain View, Calif., USA) was used for all experiments. The needle was positioned under sonographic control in liver parenchyma beside bile ducts. Two lesions were performed in left liver. Four groups of 5 pigs were treated. The pigs were sacrificed 1 or 3 weeks after the procedure. Pringle maneuver was utilized in half of the RF procedures. An ex vivo cholangiogram was obtained by direct injection into the main bile duct. Samples of RF lesions of liver parenchyma near and at a distance from the RF lesions were taken for pathological studies. RESULTS: Radiological lesions were biliary stenosis, with or without upstream bile duct dilatation, or complete interruption of the bile duct, or extravasation of the radiological contrast agent. Histological lesions of bile ducts were observed near RF lesions and at distance of the RF lesions when a Pringle maneuver was used or when the liver was removed after 3 weeks. CONCLUSIONS: RF ablation in contact of the intrahepatic bile duct induced biliary lesions. Therefore, it is required to stay away from the bile duct or to protect it when performing RF ablation.

Animals↗

PubMedDate not supplied

Validity and discriminant ability of the HAQ Functional Index in early rheumatoid arthritis.

A sensitive and valid instrument is needed in the earliest stages of rheumatoid arthritis (RA) for the measurement of functional disability. A French version of the Health Assessment Questionnaire Functional Disability Index (HAQ) has been developed, validated in an early RA sample (i.e. with disease duration less than 5 yr; n = 50), and compared with longstanding RA (n = 32) and control subjects (n = 59). Five factors provided by principal components analysis accounted for 75% of the variability of the HAQ score (construct validity). It appeared to be significantly correlated with clinical and radiological variables and to be reproducible (r intraclass = 0.964). It proved to be discriminant in groups with various levels of disability (HAQ score = 1.332 in early RA, 1.745 in longstanding RA, and 0.152 in controls; p less than 10(-5). Finally, the validity of the original scoring method of the HAQ, as compared with other scoring methods, was confirmed.

Activities of Daily Living↗

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↗

PubMedDate not supplied

[Cost of medical imaging practices in acute abdominal syndromes].

OBJECTIVES: To describe the costs of medical imaging practices in the diagnosis management of acute abdominal pain (AAP). METHODS: Medical imaging techniques until decision for treatment were prospectively recorded in patients presenting with AAP. Direct costs used hospital analytic accountability. Time of human resources involved was also surveyed prospectively. RESULTS: In 122 adult patients (2.3 examinations on average) before treatment decision making, the more frequent practices were: initial plain abdomen x-ray followed by tomodensitometry (36.8%), by echography or endoscopy (17.2%), plain abdomen solely (19.6%) or initial abdominal tomodensitometry (12.3%). Direct costs ranged from 977 to 1073 FF for practices with initial plain abdomen x-ray, and from 996 to 1150 FF with initial tomodensitometry. It ranged from 808 to 880 FF when the treatment decision was surgery, and 300 FF higher when it was medical. CONCLUSION: Differences in costs assessed for practices were very narrow. Such information should be taken into account to determine cost-effective strategies, and to built up reference guidelines.

Abdomen, Acute↗

PubMedDate not supplied

Longitudinal study of rheumatoid arthritis patients discloses sustained elevated serum levels of soluble CD106 (V-CAM).

OBJECTIVE: To appreciate the evolution of serum angiogenic and/or adhesion molecules levels during a long term follow-up of rheumatoid arthritis (RA) patients. METHODS: Serum levels of 5 soluble adhesion/angiogenesis glycoproteins (VEGF, CD31, CD54, CD62E, CD106) were measured in Elisa in samples collected over 6 years in a cohort of 43 RA patients with monitored clinical parameters of disease activity and severity. RESULTS: RA patients had significantly higher levels (p < 0.0001) of sCD106 (VCAM-1) than control subjects. Conversely, the levels of soluble VEGF, CD31, CD54 and CD62E were normal or lower than normal. No statistically significant time effect was noted. No effect either was noted as related to the therapeutic agents taken by the patients. CONCLUSION: The sustained elevated serum levels of sCD106 observed here imply that this molecule might be related to the chronicity and progression of RA.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Is quality of life affected by season and weather conditions in ankylosing spondylitis?

OBJECTIVE: To examine the links between the quality of life (QOL) and season and weather conditions in ankylosing spondylitis (AS) patients. METHODS: A cohort of 146 AS patients (67% males), with a mean age of 47.3 years and a mean disease duration of 12.8 years, answered a self-administered questionnaire, the AS-AIMS2 validated for AS, 4 times over a period of one year in a postal survey. Clinical measures were assessed in a subsample of the cohort. Meterological data including daily temperature, hygrometry, wind speed and atmospheric pressure were collected over the same period. RESULTS: In this cohort, 106 patients completed the follow-up. A higher lumbar spine flexibility (Schober index) was associated with a higher climatic temperature and lower wind speed. Physical QOL improved in the summer, as did Social Interaction in the summer and fall, while Role QOL decreased in winter. A lower perceived QOL was significantly associated with a higher temperature and wind speed over the past 4 weeks, and with a higher hygrometry and atmospheric pressure over the past 2 days prior to completion of the questionnaire. CONCLUSION: This study provides some support to the popular belief and frequent patient complaints of a link between health status and perceived quality of life, as assessed by a specific questionnaire, with season and weather conditions.

Adolescent↗

PubMedDate not supplied

The French version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report the results of the cross-cultural adaptation and validation into the French language of two health status instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health related quality of life instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. Five hundred children were enrolled including 306 patients with JIA classified into systemic (23%), polyarticular (22%), extended oligoarticular (25%), and persistent oligoarticular (30%) subtypes, and 194 healthy children. Both instruments were reliable with intra-class correlation (ICC) coefficients for the test-retest procedure of 0.91 for the CHAQ, and 0.87 and 0.89 for the physical and psychosocial summary scores of CHQ, respectively. Agreement between parents and children evaluated for the CHAQ was high with an ICC of 0.89 for the disability index; weighted kappa coefficients for the 8 domains ranged from 0.61 to 0.72. Convergent validity was demonstrated by significant correlations with the JIA core set of variables (physician and parent global assessment, scores for active joints and joints with limited range of motion, erythrocyte sedimentation rate) for both instruments. Both CHAQ and CHQ discriminated between healthy and JIA children, but only the disease specific CHAQ questionnaire discriminated clearly between the 4 JIA subtypes. In conclusion, the French versions of the CHAQ and the CHQ are reliable, and valid health assessment questionnaires to be used in children suffering from JIA.

Adolescent↗

PubMedDate not supplied

[Prognostic factors of pregnancy and delivery complications in Senegalese adolescents and their newborn].

Developing countries exhibit the highest adolescent fertility rate in the world. Undesirable outcome frequency during adolescents' pregnancy and delivery is debated. The aim of this study is to determine the incidence of these events and the factors predicting their occurrence among pregnant Senegalese adolescents and their newborn. The study was conducted between August 1st, 1999 and July 31st, 2000 in a national sample of 435 women attending prenatal clinics after a 20-week gestation. The data were collected by interviews: sociodemographic characteristics, obstetrical antecedents, current pregnancy history before inclusion in the study; the clinical characteristics were determined at inclusion. Then pregnancy and delivery complication occurrences were observed for mothers and their newborn during follow-up. Logistic regression analyses were performed to determine the factors associated with each complication, controlling the effects of other sociodemographic and clinical factors. The most frequent pregnancy complications were pregnancy-induced hypertension and toxaemia (17.5%). Anemia occurred in 25% of the women. At delivery, at least one of dystocia, eclampsia, or placenta haemorrhage complications occurred in 46% of women. The caesarian rate was 20% and the mortality rate was 71%. When planned, caesarian interventions lowered mortality. Forty percent of the newborns presented a neonatal distress while 17.9% of them weighed less than 2,500 g. The pregnancy-induced hypertension and toxaemia incidence rates were higher when the weight at onset of pregnancy was unknown (OR = 3.7 [1.9-7.5] for hypertension and 3.1 [1.3-7.6] for toxaemia). When a woman with a narrow pelvis was less than 1.50 m tall, the delivery was more frequently assisted by forceps and extracting action in breech delivery. Dystocia, eclampsia, placenta haemorrhage and premature delivery were associated with high mortality. Overall, complications were not more frequent in the youngest (16 years and below), as suggested in previous studies. Those results suggest that undesirable events occur frequently during adolescents' pregnancy and delivery, and in their newborn, while attendance in prenatal clinics is adequate. The prognostic factors of these complications are identified. These complications can be avoided by improving ante- and perinatal care quality.

Adolescent↗