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Biomedical subjects

F Guillemin

Publications and source records attributed to F Guillemin.

At least 73 records · Page 4Linked to original sources
PubMed2001

Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature.

OBJECTIVE: To determine the prevalence rates of morbidity in the general population through bibliographic research. METHODS: Articles relating to impairment, disability, handicap, quality of life and their prevalence in the general population, published between January 1990 and March 1998, were selected on the MEDLINE database. FINDINGS: The 20 articles retained out of 433 used 41 different indicators. Indicators of impairment, disability, handicap and low quality of life showed prevalence rates of 0.1-92%, 3.6-66%, 0.6-56% and 1.8-26% respectively, depending on age and the accuracy of indicators. The heterogeneity of the conceptual framework and insufficient recognition of the importance of indicator accuracy, the age factor and the socioeconomic characteristics of the studied populations impede reliable international comparison. CONCLUSION: Further standardization of indicators is therefore required. The revision of the International Classification of Impairments, Disabilities and Handicaps may make it possible to resolve some of the difficulties encountered.

Adolescent↗
PubMed2000

Enhancement of meta-tetrahydroxyphenylchlorin-sensitized photodynamic treatment on human tumor xenografts using a water-soluble vitamin E analogue, Trolox.

Photodynamic therapy (PDT) using meta-tetrahydroxyphenylchlorin (mTHPC) performed on HT29 human colon adenocarcinoma xenografts in nude mice was shown to be enhanced by Trolox, a water-soluble vitamin E analogue. Trolox, injected i.p. at 250 mg/kg body weight 90 min before PDT, delayed tumor doubling time from 13 (PDT only) to 19 days. Enhancement of the tumoricidal effect of PDT by Trolox required the presence of the drug at the photochemical stage since its injection after irradiation is ineffective. HPLC measurements indicated that 1 hr after injection the Trolox concentration in plasma was as high as 0.8 mM. In vivo measurements of mTHPC fluorescence in mice treated by PDT with or without Trolox injection showed that Trolox did not protect mTHPC from photodegradation. Laser flash photolysis studies performed in solution demonstrated that Trolox reduces triplet mTHPC efficiently (reaction rate constant 2 x 10(7) M(-1) * sec(-1)) leading to the formation of radical products. Kinetic considerations suggest that the Trolox-mediated radical pathway can work in relay with singlet oxygen in hypoxic conditions, providing a possible explanation for the observed enhancement of mTHPC-sensitized PDT by Trolox.

Animals↗
PubMed2000

Determination of intracellular organelles implicated in daunorubicin cytoplasmic sequestration in multidrug-resistant MCF-7 cells using fluorescence microscopy image analysis.

BACKGROUND: Anthracycline resistance is known to be mediated by P-glycoprotein (P-gp) or multidrug-resistance related protein (MRP) as well as intracellular sequestration of drugs. METHODS: The resistance phenotype of doxorubicin-selected MCF-7(DXR) human breast adenocarcinoma cell line was characterized by cellular and nuclear daunorubicin efflux, P-gp and MRP expression and apoptosis induction. Daunorubicin sequestration was investigated through organelle markers (lysosomes, endoplasmic reticulum and Golgi apparatus) and daunorubicin co-localization by dual-color image analysis fluorescence microscopy using high numerical aperture objective lenses to achieve the smallest field depth and the best lateral resolution. Signal to noise and specificity ratios were optimized for daunorubicin and organelle fluorescent probes labeling. RESULTS: An original image analysis procedure was developed to investigate daunorubicin and organelles co-localization. The reliability of the image analysis was controlled through chromatic shift and intensity linearity measurement using calibrated microbeads. The main contribution (65%) of Golgi vesicles in daunorubicin sequestration was demonstrated. Although no rational relationship could be established between daunorubicin sequestration and apoptosis induction, no apoptosis was observed in MCF-7(DXR) cells. CONCLUSIONS: In addition to P-glycoprotein mediated drug efflux and without MRP overexpression, MCF-7(DXR) daunorubicin resistance phenotype involves drug sequestration within intracellular vesicles identified as Golgi vesicles and resistance to apoptosis induction.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2000

Selection of quality-of-life measures for a prevention trial: a psychometric analysis.

Quality-of-life (QoL) outcomes have become increasingly important in the evaluation of health interventions. The objective of the present study was to determine which of three generic QoL instruments was most suitable for use in an 8-year nutritional primary prevention trial. We compared the Duke Health Profile, the Nottingham Health Profile, and the Short Form Health Survey Questionnaire (SF36). We conducted the comparison in two stages: (1) a statistical analysis of data from a pilot study (n = 963) comparing the psychometric properties of the three instruments; and (2) an assessment of the practicality of the tools. With regard to psychometric properties, convergent validity was comparable for the three scales, and the correlation with Global Health Assessment ranged from 0.24 to 0.72. Discriminant validity was best for the SF36, with a difference between scores in healthy subjects and those with chronic disease in the range of 4.4 to 15.8 (scores could range from 0 to 100, where 100 indicates perfect health). Reproducibility was good for all three instruments, with a test-retest intraclass correlation coefficient of over 0.60 for most dimensions. DHP and SF36 performed best in terms of responsiveness. We judged the practicality of the three tools as satisfactory. We chose the SF36 for its high responsiveness. We also selected the Duke Health Profile for its practicality and favorable psychometric properties.

Cardiovascular Diseases↗
PubMed2000

Biosynthesis and photodynamic efficacy of protoporphyrin IX (PpIX) generated by 5-aminolevulinic acid (ALA) or its hexylester (hALA) in rat bladder carcinoma cells.

Hexylester of 5-aminolevulinic acid (hALA) has been considered as an alternative to 5-aminolevulinic acid (ALA) for the treatment of malignancies of different origin. The present study addresses the ALA and hALA-induced PpIX pharmacokinetic profile using rat bladder carcinoma cells (AY27). The total PpIX content measured spectrofluorimetrically after extraction procedure at the end of 2 h incubation was at least 1.5-fold greater with hALA compared to ALA despite the difference in concentration of several orders between the two compounds (1 or 5 mM ALA and 5 or 10 x 10(-3) mM hALA). Considerable PpIX efflux was detected in the extracellular medium at the end of the incubation. With 5 mM ALA and 10 x 10(-3) mM hALA, PpIX build-up was continued beyond the incubation period pointing out to enzyme saturation in the biosynthetic pathway or/and the constitution of ALA reserve. Red laser light (lambda=630 nm) irradiation of AY27 cells after 2 h incubation with increasing ALA or hALA concentrations resulted in a nearly equal photocytotoxicity.

Aminolevulinic Acid↗
PubMed2000

Endoscopic ultraviolet-induced autofluorescence spectroscopy of the esophagus: tissue characterization and potential for early cancer diagnosis.

BACKGROUND AND STUDY AIMS: Endoscopic identification of dysplasia and early carcinoma of the esophagus is difficult and is currently done through random pinch biopsies. This study assesses the potential of ultraviolet-induced autofluorescence spectroscopy for early diagnosis with special focus on Barrett's esophagus. PATIENTS AND METHODS: Measurements were performed on 24 patients using 330 nm light excitation. The determination of the spectral distribution typical of each histological tissue type was done using three fluorescence intensity ratios: RI = I390nm/I450nm; R2 = I550nm/I450nm; R3 - I390nm/I550nm. RESULTS: The spectral distribution of normal esophageal mucosa and specialized columnar Barrett's mucosa were similar. A strong modification of the spectral distribution was observed for high grade dysplasia and intramucosal carcinoma. Statistical analysis indicated that the spectral shape modification associated with neoplastic transformation was greater than intra- and interpatient spectral variations. These results allow the determination of discriminating criteria based on ratios R1 and R3. Using ratio R3, the spectroscopy-based diagnosis differentiated neoplastic tissue from normal esophageal mucosa and specialized columnar Barrett's mucosa with a sensitivity and specificity of 86% and 95 %, respectively. CONCLUSIONS: The use of ultraviolet autofluorescence spectroscopy should improve the diagnostic yield of standard endoscopy in patients with Barrett's esophagus.

Adult↗
PubMed2000

Drug consumption in the first years of rheumatoid arthritis in France, The Netherlands, and Norway. A longitudinal study in the early nineties.

OBJECTIVE: To analyse drug consumption in the first years of rheumatoid arthritis (RA) in France, the Netherlands, and Norway, in a longitudinal study between 1991 and 1993. PATIENTS AND METHODS: The EURIDISS cohort followed up over three years included 695 RA subjects with less than 5 years disease duration. Clinical and biological parameters, drug consumption according to ATC classification, and use of local treatment were recorded. RESULTS: In the Netherlands consumption of second-line treatment occurred early on, and remained constant over time. In France, it was consumed by half of the subjects and decreased during follow-up (p<0.001). In Norway, 50% of the subjects were on second-line treatment at the outset. NSAIDs rather than corticoids were the most widely consumed. Patients underwent frequently local treatments with decrease frequency of infiltrations over time (p<0.001). CONCLUSION: Second-line treatments were used in the first years of disease development, following varying sequences in the different countries.

Adrenal Cortex Hormones↗
PubMed2000

Occupational exposure to blood: search for a relation between personality and behavior.

OBJECTIVE: To describe the behavior of French nurses after occupational exposure to blood (OEB); to study the reasons for not reporting an OEB to the occupational medicine service or the hospital authorities, and to explore the links between personality traits and both the risk of having an OEB and the likelihood of reporting it. DESIGN: A descriptive and correlational study using a cross-sectional survey for data collection. SETTING: Six nursing schools (four initial training institutes and two specialty training schools, one for surgical nurses and one for nurse anesthetists) and six hospitals in Lorraine. PARTICIPANTS: 942 nurses and 459 nursing students were approached, and 964 (69%) replied to the questionnaire. METHODS: The participants received an anonymous two-part questionnaire. The first part explored the knowledge of the risk and Standard Precautions and collected details of the history of OEB. Reporting of OEB to the occupational medicine service or the hospital authorities and the nature of serological monitoring after OEB also were explored. The second part was composed of the Zuckerman sensation-seeking scale, exploring four areas: disinhibition, danger- and adventure-seeking, seeking new experiences, and susceptibility to boredom. RESULTS: 947 nurses were vaccinated against hepatitis B, but only 528 (56%) had checked that they were effectively immunized. Only 166 respondents (17%) stated they routinely used gloves during all procedures in which they were exposed to blood. There were 505 recorded OEB during the study period (0.24 per person per year). The most frequently reported OEB were those involving hollow needles (57%). Approximately one half (48.5%) of all OEB were reported. "Good local antisepsis immediately after the accident" was the reason most often given to justify nonreporting. Only 57% of OEB victims sought to determine the serological status of the source patient for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus immediately after accident. Only 40% and 31% of OEB victims checked their own HIV and HCV serostatus 3 and 6 months after OEB, respectively. Few staff adopted safer-sex measures after OEB, and some continued to donate blood in subsequent months. Logistic regression identified two variables significantly and independently linked to the risk of having at least one OEB in the 27 months preceding the date on which the questionnaire was completed: having a permanent position and having a higher degree of disinhibition. Taking into account the number of OEB during this period (Poisson regression), four variables were significantly and independently linked to the risk of having a larger number of OEB: having a permanent position; having a higher degree of disinhibition; being more susceptible to boredom; and having less nursing experience. In logistic regression, three variables emerged as being significantly and independently linked to reporting all OEB: younger age; having had at least one percutaneous injury (excluding splashes); and having lower susceptibility to boredom. CONCLUSION: Nursing personnel continue to ignore or be unaware of many factors surrounding OEB, meaning that information and counseling must continue unabated. Knowledge of the risk, of the benefit of respecting Standard Precautions, and of the importance of notification and serological follow-up is still inadequate. Finally, certain personality traits, such as a high level of disinhibition and susceptibility to boredom, appear to be linked to the risk of OEB. Subjects strongly susceptible to boredom are less likely to report such accidents.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Functional disability and quality-of-life assessment in clinical practice.

Functional disability and quality of life in rheumatoid arthritis (RA) are key outcomes that determine patients' demand for care, and influence their compliance and satisfaction with treatment. In the past decade, there has been a shift from physician-focused assessment toward methods based on the postulate that patients can better report their perceptions of health impairment. There are several disease-specific and generic instruments available that have proven valuable in outcome testing in RA. While there are several obvious advantages to patient self-assessment, clinicians may be reluctant to adopt these measurements. Functional assessment testing will be easier to implement if physicians have access to computer resources for quantitation of disease outcomes and if normative data can be provided to make interpretation clear. Despite current limited access to computer resources and normative data, functional disability and quality of life assessment of RA should be encouraged in clinical practice because it fosters better patient-physician relations and provides much needed long-term outcome information on drug therapy beyond clinical trials.

Arthritis, Rheumatoid↗
PubMed2000

Determination of the maximal carcinoma/normal skin ratio after HpD or m-THPC administration in Hairless mice (SKH-1) by fluorescence spectroscopy.

The two major steps in our study on the treatment of skin carcinomas by photochemotherapy (PCT) were the development of a skin tumor model in Hairless mice by a chemical carcinogenesis and the use of fluorescence spectroscopy, a semi-quantitative and non-invasive method, in order to determine the time after i.p. injection of photosensitizer when the tumor/normal skin ratio was the highest. A three-step carcinogenesis protocol provided mice bearing carcinomas and these were used to determine the tumor/normal skin ratios of two photosensitizers by fluorescence spectroscopy. Hematoporphyrin derivative (HpD) (5 mg/kg body weight) and m-tetra(hydroxyphenyl) chlorine (m-THPC) (0.3 mg/kg body weight) were injected i.p., and fluorescence was measured at 1, 4, 8, 12, 24, 48, 72 and 96 h after injection. The best carcinoma/normal skin ratio would be 3.2+/-1.4 for HpD and 2.7+/-2.1 for m-THPC, respectively. The delays required to reach these ratios were 72 h for HpD and 24 h for m-THPC. These results have to be considered with caution due to the high SEs and they must be confirmed by organic extraction. Photodynamic therapy with the same doses of HpD and m-THPC used in this pharmacokinetic study has to be carried out in order to compare the toxicities of the two photosensitizers and to determine which one is the best for this type of tumor.

Animals↗
PubMed2000

Self-administered questionnaire compared with interview to assess past-year physical activity.

PURPOSE: The Modifiable Activity Questionnaire (MAQ) is a physical activity questionnaire shown to be both valid and reliable and was initially designed to be interviewer-administered. After translation and adaptation into French, the objective of the study was to compare past-year physical activity data obtained by self-administration of this questionnaire and by interviewer-administration. METHODS: 84 subjects (22 men, 62 women, age 36-63 yr) enrolled in an ongoing prospective study in France (the SUpplementation en VItamines et Minéraux AntioXydants or SU.VI.MAX study) completed both versions of the questionnaire in a randomized order with a mean (SD) delay of 7.9 (5.8) d between the two modes. Past-year leisure and occupational physical activity were expressed as both h x wk(-1) and MET-h x wk(-1) of activity, and television watching was expressed as h x d(-1). Analysis of variance on ranks was used to compare activity variables obtained by self-administration and interview. Agreement was assessed by nonparametric intraclass correlation coefficients. RESULTS: A significant effect of the mode of administration was found only for past-year leisure physical activity with lower values reported in self-administered conditions compared with interview. However, a high level of concordance between the two modes of administration was observed for all variables as shown by the intraclass correlation coefficients: 0.90 for leisure physical activity (h x wk(-1)), 0.82 for occupational activity (h x wk(-1)), 0.83 for total (leisure and occupational combined) physical activity (h x wk(-1)), and 0.97 for television viewing (h x d(-1)). CONCLUSIONS: The agreement between the two modes of administration of the questionnaire suggests that the self-administered version of the MAQ is a valuable tool to assess past-year physical activity and inactivity in self-administered conditions. This instrument could be used in large-scale population studies investigating the relationships between physical activity and health outcomes.

Adult↗
PubMed2000

A computer-assisted assessment of lifetime physical activity: reliability and validity of the QUANTAP software.

BACKGROUND: This study investigated the reliability and the validity of the QUANTAP (QUANTification de l'Activité Physique) interview-administered survey, a new computer-assisted tool designed to determine physical activity over a lifetime. METHODS: The tool was used to assess lifetime exercise habits in four dimensions (sport at school, leisure sport, occupation, daily activities) in 419 men and women aged 13-90 years. Physical activity indicators (time spent and energy expenditure) were calculated for 20-year periods. The inter-observer and intra-observer reliability of the tool was studied in two subgroups of 30 subjects. RESULTS: Intraclass correlation coefficients for intra-observer and inter-observer reliability varied from 0.56 to 0.96 and from 0.42 to 0.99 respectively according to the dimensions and indicators considered. Energy expenditure was not statistically significantly different from recommended nutritional intake in either males or females. Percent body fat at the time of the survey correlated with leisure sport (particularly in recent periods of practice): age-adjusted correlation coefficients varied from - 0.23 to - 0.45 among males, and from - 0.19 to - 0.31 among females. CONCLUSION: The results indicate that QUANTAP is reliable and valid to assess lifetime physical activity. It therefore provides a tool with which the long-term effects of physical activity on current health may be studied.

Activities of Daily Living↗
PubMed2000

Compliance with drug therapy in rheumatoid arthritis. A longitudinal European study.

OBJECTIVE: To delineate compliance with drug therapy in rheumatoid arthritis patients, determine specific characteristics of compliant and noncompliant patients, and look for changes in compliance over time. PATIENTS AND METHODS: A prospective European cohort study (EURIDISS) recruited 556 patients in four countries over three years. Compliance with drug dosages and dosing times was evaluated yearly using a questionnaire. RESULTS: Of the 556 patients, 429 (77.2%) were on drug therapy at all three evaluation time points. Use of steroids, nonsteroidal anti-inflammatory drugs, and second-line drugs varied significantly across countries. The compliance behavior was stable over time in 59.5% of them (35.7% of patients were consistently compliant and 23.8% consistently noncompliant); it was independent of disease duration and from the clinical features of the disease. Older patients and women were more likely to be compliant (odds ratios, 2.5 and 2, respectively). CONCLUSION: Compliance with drug therapy can be measured using two simple questions. Compliance is more closely dependent on individual behavior than on responses to specific features of rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed2000

[Quality of life assessment one year after total hip or knee arthroplasty].

PURPOSE OF THE STUDY: The development of quality of life (QOL) instruments has made it possible to obtain an objective assessment of the impact of surgical procedures taking into consideration the physical, psychological and social aspects of the patient's everyday activities. The aim of this work was to evaluate the short-term and long-term course of QOL after total hip arthroplasty (THA) and total knee arthroplasty (TKA). MATERIALS AND METHODS: This study included a prospective multicentric cohort of patients with a first intention indication for degenerative bone and joint disease. Clinical assessment was obtained preoperatively and 6 weeks, 6 months and 12 months postoperatively. The Merle d'Aubigné and Harris scores were determined for THA and the Hospital Special Surgery score for TKA. Clinical data (pain, walking distance), and QOL scores [French version of the Nottingham Health Profile (NHP) and the French version of the Arthritis Impact Measurement Scale 2 (AIMS2)] were also obtained. RESULTS: One hundred twenty-three patients had a THA (mean age 62 years) and 60 had a TKA (mean age 68 years). Preoperative clinical features were those commonly found in these populations. For THA, the 6-week, 6-month and 1-year assessments showed an improvement (2.7 and 2.8 points on the 0 to 10 NHP). For TKA, improvement came later and was less significant with 0.8, 1.8 and 1.5 point improvements. The AIMS 2 did not appear to be perfectly adapted to measure this dimension. Improvement in pain came earlier and was greater for THA than for TKA on all measurement scales. For THA, psychological capacity improved by 0.7, 1.4 and 1.5 points on the 0 to 10 AIMS 2 at 6 weeks, 6 months and 12 months respectively. For TKA, improvement was to the same order with 1.1 and 1.2 point improvements at 6 weeks and 6 months respectively. DISCUSSION: These findings confirm the clear improvement in QOL after THA and TKA, mainly due to physical and psychological dimensions. The QOL measurements allow comparisons with other surgical procedures in other fields. They provide supplementary information, notably concerning pain and are particularly useful in orthopedic surgery. The questionnaires are generally well accepted by the patients, particularly short self-administered questionnaires. They provide useful information on the efficacy of THA and TKA in terms of human and social costs and open new perspectives for analysis of prognostic factors for optimal QOL of operated patients.

Activities of Daily Living↗
PubMed2000

A comparison of agreement and sensitivity to change between AIMS2 and a short form of AIMS2 (AIMS2-SF) in more than 1,000 rheumatoid arthritis patients.

OBJECTIVE: To examine the agreement between and compare the sensitivity to change of the Arthritis Impact Measurement Scale (AIMS2) and AIMS2 Short Form (AIMS2-SF) in a large sample of rheumatoid arthritis (RA) patients examined within the framework of a longitudinal observational study. METHODS: Data were collected from patients in a community based RA register by a postal survey in April 1994 (1,030 respondents) and again in 1996 (1,153 respondents), comprising AIMS2, Modified Health Assessment Questionnaire (MHAQ), Medical Outcome Survey SF-36, and other commonly used health status measures. The degree of agreement was examined by plotting differences between AIMS2 and AIMS2-SF against the mean of the 2 scores for the 5 main components. The upper and lower limits of agreement (mean diff. +/- 1.96 SD) were calculated and plotted. The intraclass correlation coefficients were computed by repeated measurement ANOVA. Validity was assessed on the basis of external indicators of health status, and responsiveness on the basis of standardized response means. RESULTS: The AIMS2 and AIMS2-SF showed substantial to near-perfect agreement. Best agreement was seen for the physical and affect components. Better agreement for the symptom component was obtained when replacing item 42 with item 38. Internal consistency was high in all components. The 2 forms correlated similarly with scores from other instruments within the same domains, showing similar construct validity. There was no difference in responsiveness between the 2 forms when using changes in patient assessed global disease activity as external indicator of change in health status, and responsiveness for the physical and symptom dimension was similar to other instruments (SF-36, MHAQ). CONCLUSION: The AIMS2-SF is amenable for use in large surveys with a modification of one item in the symptom scale.

Arthritis, Rheumatoid↗
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↗