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Biomedical subjects

J Belmin

Publications and source records attributed to J Belmin.

At least 55 records · Page 3Linked to original sources
PubMed1993

Reliability of sampling urine from disposable diapers in elderly incontinent women.

OBJECTIVE: To assess the reliability for biochemical and microbiological analysis of urine collection from disposable diapers in elderly women with severe urinary incontinence. DESIGN: Cross-sectional comparison of two methods of collection. PATIENTS AND MEASUREMENTS: Urine was sampled from 52 women inpatients (aged 68-98 years) in a geriatric hospital ward by pressing a diaper which the patient had worn for 3 hours. Just after this collection, another sample was obtained by retrograde catheterization. Both samples were analyzed for sodium, potassium, chloride, proteins, urea, creatinine, calcium, and phosphate and for cell counts, the presence of bacteria, and bacteria culture. RESULTS: For all the biochemical parameters, the urinary concentrations obtained by the two methods were strongly and significantly correlated. The following differences (mean and range, in mmol/L) were found between the values obtained by the two methods: sodium: 6.05 (-26 to 27), potassium: (-16 to 14), chloride: -1.13 (-24 to 23), urea: 6.85 (-33 to 37), creatinine: 0.24 (-0.95 to 1.45), calcium: -0.22 (-1.27 to 1.70), and phosphate: 2.17 (-2.5 to 13.4). For diagnosis of urinary tract infection, agreement between the two methods was good (kappa = 0.84), and bacteriological agreement was obtained in 25 out of 28 cases (89%). However, for diagnosis of microscopic hematuria, agreement was poor (kappa = 0.50), probably due to the overestimation of the true urinary red cell count in the samples collected by catheterization. CONCLUSION: For routine microbiological and biochemical analysis, urine extraction from disposable diapers is a simple and reasonably reliable method of sampling urine from elderly women with severe incontinence.

Aged↗
PubMed1993

Age-related changes in endothelial permeability and distribution volume of albumin in rat aorta.

Age-related changes in macromolecular transport across the arterial wall were investigated in 10-, 20-, and 30-mo-old WAG/Rij rats. Animals were injected with 125I- and 131I-labeled albumin, 90 and 5 min before they were killed, respectively. The transmural distribution of relative concentration of tracers in the aortic wall was obtained using en face serial sectioning technique. The apparent endothelial permeability to albumin calculated from the distribution of 5-min 131I-labeled albumin concentrations was significantly enhanced in 20- and 30-mo-old rats compared with 10-mo-old rats. The apparent distribution volume of albumin within the media, estimated as the mean medial 125I-labeled albumin concentration, was not significantly changed in 20-mo-old rats but was significantly decreased in the 30-mo-old animals. These age-related changes in the macromolecular transport suggest that the entry of plasma macromolecules in the aged arterial wall might be enhanced, whereas the efflux through the media may be impeded, possibly contributing to their trapping in the subendothelium.

Aging↗
PubMed1992

Effect of two French nurses' strikes on mortality in a geriatric hospital.

PURPOSE: To study the influence of the 1988 French nurses' strikes on mortality in a geriatric hospital. MATERIALS AND METHODS: Two nurses' strikes affected the Charles Foix Hospital near Paris from June 29 to July 31 and from September 17 to October 22, 1988. Mortality was studied in nine geriatric wards of this hospital, including two rehabilitation units comprising 187 beds, and seven long-term care units comprising 1,132 beds. Monthly mortality rates were calculated from the hospital's administrative registers and expressed as deaths per 1,000 patient-days. These rates were calculated in each of the aforementioned nine units for the 36 months preceding the first strike (control period) and for the 12 months following it (study period). RESULTS: Over the control period, monthly mortality was significantly higher in rehabilitation units than in long-term care units (2.46 +/- 1.21 versus 0.83 +/- 0.47, p less than 0.001), but mortality rates among rehabilitation units, as well as among long-term care units, were comparable. Also, during the control period, large seasonal fluctuations in monthly mortality rates were observed in both rehabilitation units and long-term care units (peak in winter and nadir in summer). These rates tended to decrease from year to year in rehabilitation units but not in long-term care units. A statistical model based on time-series analysis of the control period data was used to calculate the expected monthly mortality rates for the study period in rehabilitation units and in long-term care units, respectively. Three of the 12 actual monthly mortality rates exceeded the upper limit of the 95% confidence interval of the 12 expected monthly mortality rates, in the units where the more severe care disruption occurred. A detailed analysis of discharge summaries of these units failed to identify a possible link between some of these deaths and a possible absence of care. CONCLUSIONS: The nurses' strikes did not induce a clear-cut increase in mortality in this population of elderly patients. However, we cannot exclude the possibility that these strikes had some negative effects on health. Our results fail to provide answers to the difficult ethical problems created by such stoppages.

Aged↗
PubMed1990

[Antihypertensive agents in elderly patients].

Arterial hypertension is common in elderly people, and the risk of cardiovascular complications due to that disease is reduced by antihypertensive treatments in these as in younger hypertensive patients. However, some points must be borne in mind when treating and following up elderly subjects with hypertension. Old age alters the metabolism and effects of antihypertensive agents. Concomitant pathologies are frequent and may preclude the use of some of these agents, while other medicines taken by the patient interreact with them. Several complications of antihypertensive therapy particularly threaten elderly hypertensive drugs patients. The complications depend on the antihypertensive drugs used and include malaise, excessive fall in blood pressure, postural hypotension, water and electrolyte disorders, renal impairment and neuropsychological disturbances. Because of these iatrogenic effects, which may have more serious consequences in elderly therapy must be handled with care. Close supervision enables these undesirable effects to be detected early on and corrected before more serious complications develop.

Acute Kidney Injury↗
PubMed1990

[Measurement of water, DNA and collagen in different parts of the aorta in rats. Effect of hypertension].

Renovascular hypertension was induced in two-week rats (group HR, n = 6) and their aortas were studied 8 weeks later and compared with those from normotensive rats (group NR, n = 6). Total water content, DNA (fluorometric method) and collagen (calculated from hydroxyproline concentrations) concentrations were measured in the media of the arch, the descending thoracic aorta and the abdominal aorta. Water content and DNA content did not significantly change in the different parts of the aorta. The collagen content significantly decreased from the arch to the abdominal aorta, in NR as well as in HR group (p less than 0.01). Hypertension did not affect water content, DNA neither collagen content in the abdominal aorta. In the arch and in the descending thoracic aorta, hypertension was associated with an increase in collagen content (p less than 0.001), whereas the water and DNA contents did not significantly change. These results suggest that hypertension induced an increased collagen synthesis only in the thoracic aorta, this being more important in the arch than in the descending thoracic aorta. Responses to hypertension are different in thoracic and in abdominal part of rat aorta.

Animals↗
PubMedDate not supplied

Reduction of transmural 125I-albumin concentration in rat aortic media by chronic hypertension.

Relative 125I-albumin concentration was measured in vivo in the aortic media of sham-operated (n = 10) and hypertensive (two-kidney, one clip) rats, untreated (n = 8) or treated (n = 10) by an angiotensin converting enzyme inhibitor (CEI, Trandolapril). Blood pressure was acutely lowered to a normal level at the time of the experiment in hypertensive rats (n = 7) to separate the direct effect of increased pressure from the effect of pressure-induced structural changes. Relative tissue concentration profiles of labeled albumin across the media were obtained using a serial frozen-sectioning technique. In hypertensive rats, the mean medial albumin concentration decreased by 35% in the ascending arch and 32% in the descending arch (p less than 0.01). When blood pressure was acutely lowered in hypertensive animals, this value decreased further by 56% in the ascending arch, 48% in the descending arch (p less than 0.01), and 22% in the thoracic aorta (p less than 0.05) as compared with controls. The medial thickness in hypertensive rats was significantly increased (more in the ascending arch than in the rest of the aorta). Four-week CEI treatment reversed hypertension and medial thickening, but the mean medial albumin concentration remained significantly lower in the arch (by 36% in the ascending part and 40% in the descending part, p less than 0.01). The collagen content in the thoracic aorta was significantly increased in hypertensive rats (by 40%, p less than 0.01) and remained increased (by 29%, p less than 0.01) after CEI treatment. These results suggested that the hypertension-induced structural changes might reduce the medial distribution volume for albumin, whereas elevated blood pressure per se tended to enhance albumin concentration within the media. However, the net result of chronic hypertension was a reduction of the mean medial albumin concentration. The aortic arch appeared to be more affected than the rest of the aorta. Fiber content, more than medial thickness, might be responsible for the observed differences in albumin concentration. Lowering of blood pressure seemed to be insufficient to restore normal albumin concentration profiles and perhaps those of other macromolecules. This finding may be relevant in evaluating some of the complications associated with hypertension.

Albumins↗