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Biomedical subjects

J F Tessier

Publications and source records attributed to J F Tessier.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Survey on cases of primary tuberculosis in the department of Gironde].

French official statistics do not mention primary tuberculosis and data on its prevalence are rare, despite the fact that the annual number of cases of primary tuberculosis is a clear indicator of the progression or regression of what remains an endemic disease in Europe. In order to collate information on the subject, a questionnaire was sent to 132 doctors practising in Gironde. These included pulmonologists, pediatricians and child health doctors. One hundred and one questionnaires were returned, listing a total of 18 cases of primary tuberculosis for the first half of 1997. Children were more often affected by the disease and presented a latent form. In 61% of cases, patients infected had not previously received BCG vaccination and in 56% of cases the infectious patient was identified. Furthermore, 4 of the non-vaccinated patients had been in close contact with an infectious patient and 3 patients among these should have been vaccinated since they were living in community structures. The 2 symptomatic cases reported occurred in non-vaccinated adults. This study was of limited-scope and duration but provides interesting information on the population affected by primary tuberculosis. These results underline the necessity of maintaining a high level of BCG vaccination amongst children and adults in community structures if we wish to lower the prevalence of the disease in France.

Adolescent↗
PubMed1998

[Comparison of cases of isolated pulmonary tuberculosis with cases of other localizations of tuberculosis in the course of an active surveillance (Gironde, 1995-1996)].

PURPOSE: Data collected during the years 1995 and 1996 in the course of an epidemiological survey of tuberculosis in Gironde allowed comparison of pulmonary tuberculosis with extrapulmonary localizations, evaluation of the importance of each localization and highlighting of potential risk factors. METHODS: Patients living in Gironde who had evidence of either clinical, radiological or bacteriological expression of tuberculosis were included in the survey. Statistical comparisons were done using either Pearson's Chi 2 or Fisher's exact test. RESULTS: The survey included 292 cases subdivided into 183 cases of pulmonary tuberculosis (63%) and 109 cases in which another localization had been diagnosed (37%). Extrapulmonary localizations that were the most often encountered either alone or in association with pulmonary localization were the following: lymphadenopathy (32%), pleural (28%), genito-urinary (12%) and osteo-articular localizations (7%). The survey showed that patients in whom tuberculosis localization was extra-pulmonary were more frequently under 20 years of age or over 60 years of age (P < 0.04). These patients also presented more often with HIV-infection (P < 0.02). CONCLUSION: Extrapulmonary localizations of tuberculosis should be systematically investigated in young and elderly patients as well as in HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Educational diagnosis in asthma. Descriptive results of a questionnaire survey].

The object of this work was to carry out an audit on an asthmatic's knowledge of their disease and of the risk factors, their usual therapy and of therapy for acute exacerbations as well as their need for information and education. The study was carried out by a survey of 327 adult asthmatics who were in consultation with specialist physicians in thoracic medicine. The information was gathered using an anonymous questionnaire completed by a nurse. The doctors looking after these patients had given their opinion on the severity of their asthma and the educational needs of their patients. The population studied had an average of 47 +/- 17 years. Forty seven per cent of the subjects were masculine. The general level of education was high. Seventy five per cent of the patients were from an urban environment. The duration of the asthma was on an average of 19 years. Half of these patients had already been in hospital for a serious attack. One third of the patients were considered by their doctors as having severe asthma. The patients were good at distinguishing the level of severity of their acute exacerbations and adapted their therapy on their own initiative in appropriate fashion based on the degree of severity of their disease. The enquiry revealed that patients take some liberties around the basic treatment that they had been prescribed. It also showed some defects or errors in their knowledge of the disease and the appropriate approach vis-à-vis the disease. One noted for example that one third of the asthmatics had already stopped the treatment before the date fixed by their doctor. In a general, patients who were surveyed were interested in their health problems with their health and hoped to be better informed both on asthma and its treatment. This study was biased towards an interest in the understanding of the education in order to manage the asthmatic population better.

Adolescent↗
PubMed1997

[Epidemiologic aspects of respiratory aging: contribution of the PAQUID survey].

BACKGROUND: Respiratory ageing raises for the epidemiologists many questions still unsolved by clinical and physiological approaches: prevalence of chronic respiratory diseases, consequences on autonomy, risk factors. This paper aims to provide some responses based on a wide sample of elderly people: the PAQUID cohort. METHOD: PAQUID is a cohort of 3777 dwellers representative of the population aged 65 and over in two administrative areas of south-western France. The study is based on general variables as well as specific variables identifying dyspnea, asthma, chronic bronchitis and their risk factors. Disability was measured using specific scales. Mortality is registered during the follow-up. RESULTS: Twenty-five percent of subjects had a dyspnea for minor efforts (level 3 and over). There was a significant relationship between dyspnea and disability levels for basic and instrumental activities of daily living. Mortality rate was significantly associated to dyspnea level of the subjects at inclusion in the cohort, especially in men, even taking into account other mortality related risk factors (sex, smoking, occupation). 6.1% of the subjects reported symptoms of asthma. But only 2.5% reported symptoms in the twelve last months. The follow-up has shown new asthma cases among symptom-free subjects at the beginning of the survey. Previous occupation especially agricultural (pesticides exposition), and industrial activity, smoking and allergy may be considered as the main respiratory risk factors. CONCLUSION: These data provide more knowledge of some aspects of respiratory ageing. The results allowed to evaluate associated morbidity, to determine risk factors and to measure its impact on disability and mortality. Such information may be useful for prevention of respiratory related disability.

Age Factors↗
PubMed1996

Prevalence of self-reported asthma symptoms in a French elderly sample.

The aim of this study was to estimate the prevalence of reported asthma symptoms in French elderly people according to age, sex and principal lifetime occupation. PAQUID (Personnes Agées QUID) is a cohort of 3777 subjects, aged 65 years and over, living at home in the south-west of France. The aim of PAQUID is to study factors of cerebral and functional ageing. This cross-sectional study took place during the third year of the PAQUID follow-up, and concerned 2406 subjects (63.7% of the initial sample). Two questions were introduced into the PAQUID general questionnaire: "have you ever had asthma?' (cumulative asthma), and "did you have at least one asthma attack in the last 12 months?' (current asthma). Of 2355 subjects, 144 (6.1%) reported asthma history at some point in their life. For 58 (40.3%) subjects, it was in the previous 12 months. In men, the prevalence rate was 7.3% for cumulative asthma and 2.8% for current asthma. In women, rates were 5.2% and 2.2%, respectively. The rates were lower at advanced ages (> 85 years) for both males and females. They were particularly high in former farm workers; 13% reported cumulative asthma and 11% reported at least one asthma attack in the previous 12 months. Farmers appear to have a higher risk of both cumulative [odds ratio (OR): 2.30; 95% confidence interval (CI): 1.00-5.47] and current asthma (OR: 5.35; 95% CI: 1.33-21.50) compared to white collar workers, despite adjustments on age, sex and smoking history. The risk was also significant for manual workers, but only for cumulative asthma.

Age Factors↗
PubMed1996

European medical schools and tobacco.

Following a survey in 19 European countries of the habits, attitudes and knowledge of medical students regarding tobacco, World Health Organisation European Office and the International Union against Tuberculosis and Lung Disease jointly circulated to the Deans of all European medical schools a summary of the results, including figures for mortality for smoking-related diseases in their countries and a brief questionnaire concerning faculty action on the tobacco problem. The response rate was just over 50%, higher in Northern Europe (66%) than in Southern (35%) or Eastern (38%). Only 8% of faculties had a specific teaching module on tobacco. In most it was either systematically (35%) or unsystematically (55%) integrated in other teaching. Teaching hospitals, teaching areas and faculty meetings were said to be smokefree by over 90%; figures were lower for other areas. Seventy-seven per cent of Deans intended to discuss our approach with their teaching staff; 72% gave the name of a staff member with a particular tobacco interest.

Attitude to Health↗
PubMed1996

[Attitudes of French cardiologists towards smoking].

The object of this study was to evaluate the attitudes and opinions of French cardiologists towards smoking. A postal enquiry was performed with the aid of the French Society of Cardiology and the French Federation of Cardiology in 1993 using a questionnaire developed by the World Health Organisation and the International Union against Tuberculosis and Respiratory Diseases (IUATRD). Seven hundred and thirty cardiologists replied (34% of the study population). The average age was 47 +/- 9 years; 84% were male. The prevalence of smoking was 27% (14% daily smokers and 13% occasional smokers); 47% were former smokers and 26% had never smoked. The proportion of physicians who had never smoked was higher in the younger age groups (29 to 45 years) than in the older age groups (33% versus 21% in the over 45). Forty-two per cent of daily smokers had tried seriously to stop smoking at least once but only 16% hoped to stop smoking in the following 5 years. Young cardiologists were more aware of the cardiovascular and respiratory diseases related to tobacco consumption. Only 64% of cardiologists (54% of daily smokers) systematically warned a smoker if the patient had no tobacco-related illness or did not ask about smoking systematically. Forty-seven per cent of those who replied stated that they were underinformed about the methods of helping patients to stop smoking. The authors conclude that fewer French cardiologists smoke than their general practitioner counterparts (14% of daily smokers versus 21%). They have a better understanding of the respiratory and cardiovascular risks of tobacco consumption but seem to be insufficiently prepared to help their patients to stop smoking. In addition, their personal behaviour with regards to smoking influences their attitude towards patients who smoke.

Adult↗
PubMed1996

Determinants of chronic bronchitis prevalence in an elderly sample from south-west of France.

This paper attempts to estimate by means of a cross-sectional study in subjects aged 65 yrs and over the determinants of the prevalence of chronic bronchitis according to age, gender, smoking history, educational level, former occupation and associated morbidity. Data were examined from the third year of a cohort (Personnes àgêes QUID (PAQUID)) and concerned 2,406 subjects. Identification of chronic bronchitis was based on a direct question asking for the presence of phlegm on most days during at least 3 months per year for at least the two previous years. Of the sample, 13% reported chronic bronchitis (20% of males, and 8% of females). A multivariate analysis was performed and showed that chronic bronchitis was linked to sex, smoking history and professional category. Independent of these factors, asthma history and digitalic drug therapy were also closely associated to chronic bronchitis. These results underline the long-term effect of smoking and occupation on chronic bronchitis, and also illustrate the strong association with asthma and cardiac morbidity over 65 yrs of age.

Age Factors↗
PubMed1995

Attitudes and opinions of French cardiologists towards smoking.

To assess attitudes and opinions of French cardiologists towards tobacco, a postal survey was performed in 1993 of all members of the French Society of Cardiology using a questionnaire designed by the World Health Organisation (WHO) and the International Union against tuberculosis and lung diseases (IUATLD) for health professionals. 730 cardiologists responded to the mailing. The mean age of them was 47 + or - 9 years, 84% were males. The prevalence of smoking was 27% (14% daily smokers and 13% occasionally smokers). There were more never smokers in age group < 45 than in those aged 45 and more (33% vs 21%). Of daily smokers, 42% claimed to have made a serious attempt to stop smoking, but only 16% expected to have stopped within five years of the survey. French cardiologists aged 29-45 years had a better knowledge of tobacco related respiratory and cardiovascular diseases than those over 45 years old. Only 64% (54% of daily smokers) would counsel a patient to stop smoking if he did not have a smoking related illness and did not himself raise the question. 53% thought they had sufficient knowledge to advise their patients on stopping smoking. The results compared to those of the French general practitioners survey, showed a lower prevalence of daily smokers. French cardiologists especially those aged 29-45, have a better knowledge of the risk of cardiovascular diseases. But only 64% of them would advise any smoker patients. These results also demonstrated the influence of personal smoking on the attitude of cardiologists towards smoker patients.

Adult↗
PubMed1994

[Psycho-rehabilitation of patients with dementia].

Rehabilitation techniques for dementia are reviewed, followed by a discussion of their limitations with regard to application and evaluation. It is concluded that, although these techniques may be imperfect, empiric and of variable effect, they are necessary for the support of these patients and their families, particularly since no effective drug yet exists for treating dementia.

Aged↗
PubMed1994

Tobacco consumption and cognitive impairment in elderly people. A population-based study.

We examined the relationship between tobacco consumption and Alzheimer's disease (AD), cognitive deficit, and memory performances in elderly community residents of southwestern France. Subjects were considered to have a cognitive deficit if they scored under 24 on the French version of the Mini-Mental State Examination, and poor memory performances if they scored under 8 on the Benton Visual Retention Test. Among the 3770 subjects who gave information about their smoking habits, only 356 (9.5%) were current smokers, 998 (26.5%) were past smokers, and 2416 (64%) were never smokers. Current smokers (odds ratio (OR) = 0.52, P < 0.001) and past smokers (OR = 0.54, P < 0.001) had a lower risk of cognitive deficit than did never smokers. However, this significant relationship disappeared after adjustment for potential confounding factors such as occupational category (OR = 0.91 (not significant) for current smokers and OR = 0.87 (not significant) for past smokers). Similar results were obtained for the risk of AD and of poor memory performances. The apparent protective effect of smoking habits on cognitive abilities could be due to a confounding effect of occupational category.

Aged↗
PubMed1994

Medical education on tobacco: implications of a worldwide survey. Tobacco and Health Committee of the International Union against Tuberculosis and Lung Disease (IUATLD).

This report considers the implications for medical education of a global survey of the knowledge, behaviour and attitudes of medical students regarding tobacco. This was conducted in 42 countries derived from all continents. A total of 9326 students (44% women) from 51 medical schools replied anonymously to a multiple choice questionnaire administered in the local language. Student smoking rates varied greatly between countries/regions: daily smoking in men from 2% (Australia) to 48% (one centre in the former USSR); in women from nil in some Asian medical schools to 22% in one European. Though there was some variation between countries and medical schools, there was widespread ignorance of the causal role of smoking in specific diseases; notably coronary artery disease, peripheral vascular disease, emphysema, bladder cancer and neonatal mortality. There were widespread defects in knowledge and motivation regarding counselling patients to quit smoking, with a common failure to appreciate a doctor's responsibilities in prevention. Very few students knew the value of tobacco taxation in reducing consumption. Following our survey we were asked to advise the World Health Organization on a summary of the desirable tobacco content of medical curricula, which has now been issued. The International Union against Tuberculosis and Lung Disease, in cooperation with the European Region of WHO, has circulated the Deans of all European medical schools with a summary of the deficiencies revealed by the European component of the survey, together with a questionnaire on proposed action. A similar initiative is being considered in cooperation with the Western Pacific Region of WHO.

Curriculum↗
PubMed1994

Probing velocity: novel approach for assessment of inflamed periodontal attachment.

Little is known about the biophysical characteristics of the dento-gingival junction in response to the development or resolution of inflammation. The Toronto automated periodontal probe (TAPP) provides an estimate of the biophysical integrity of the dento-gingival junction by measuring intrapocket probing velocity. Presence or absence of a plateau in displacement versus time plots were used to perform dichotomous analyses as a function of established parameters of inflammation. Plateaus were operationally defined as a 3 standard deviation reduction in the slope of the displacement versus time plot (probing velocity) and hence the plateau represents an increased resistance of the probe tip at the dento-gingival junction. The aim of the study was to measure the relationship between post-treatment reductions of gingival inflammation and the probability of plateau formation as measured by the TAPP. Twenty-nine subjects exhibiting gingival inflammation were provided with periodontal therapy consisting of subgingival scaling and root planing. Over a 2-month sampling period, 6 sites from each subject were monitored and these sites exhibited wide variations of inflammation. Logistic regression revealed a significant relationship between the probability of plateau formation and treatment (P = 0.002), plaque index (P = 0.002), the increased severity levels of gingival index (P > 0.05), or bleeding index (P > 0.05). The probability of plateau formation decreased with higher levels of crevicular fluid flow but there was no dependence of plateau formation on probing depth (P > 0.55). These data indicate a direct relationship between improved measures of clinical health and increased resistance to probe penetration near the base of the pocket.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1994

Functional status of elderly people treated for asthma-related symptoms: a population based case-control study.

There are few data on the disability caused by asthma in elderly subjects. The aim of this survey was to assess the functional status of a population aged 65 years or more, being treated for asthma-related symptoms. A representative sample of 3,777 elderly people, living at home in the South-West of France, was surveyed using a standardized questionnaire on factors of ageing and their consequences. To assess the functional status, five scales were used: Activities of Daily Living (ADL); Instrumental Activities of Daily Living (IADL); Rosow and Breslau scale; Mobility; and a Subjective Health Scale. Patients treated for asthma-related symptoms were identified by means of their use of the anti-asthma drugs mentioned in the questionnaire. In a second stage, the presence of asthma-related symptoms was further established by enquiring from their general practitioners and by direct questioning of the patients. Among 135 subjects taking anti-asthma drugs, 83 (61%) had positive responses to specific questions, either from their doctors or from themselves, allowing them to be identified as "asthmatic". In comparison with a control group matched for age and sex (n = 166; two controls for each patient), asthmatic patients had a higher dependence in the IADL scale, a greater self-assessment of poor health, and a greater handicap in mobility. However, they had the same level of ADL disability as controls. Despite adjustment for residential area, depressive symptoms, Mini Mental Status (MMS) Exam score, visual and auditory impairment, and joint pain, patients treated for asthma still had a higher risk of disability in daily life, and a poorer subjective health than controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1993

The relationship between dyspnoea and main lifetime occupation in the elderly.

PAQUID is a prospective epidemiological study of mental and functional ageing. Based on the data collected during the baseline screening of this cohort, the present paper will examine the relationship between main lifetime occupation and the presence of dyspnoea in a representative sample of 3777 subjects aged > or = 65 years; living at home in the south-west of France. Subjects were considered dyspnoeic if they had a dyspnoea level 3, 4 or 5 according to the Fletcher classification. Occupational categories were determined according to the classification of the French 'Institut National de la Statistique et des Etudes Economiques,' and to the type of occupation for blue-collar workers. The proportion of dyspnoeic subjects varied significantly according to the occupational categories (from 13% for teachers to 37% for farm workers) and to the type of work (from 18% for printing workers to 41% for building workers). When age, sex, weight, smoking history, place of residence, educational level and some concurrent diseases were adjusted for, former farm workers (odds ratio [OR] = 3.3, 95% confidence interval [CI]: 2.0-5.6), farm managers (OR = 2.1, 95% CI: 1.3-3.5), domestic service employees (OR = 1.9, 95% CI: 1.2-3.6) and blue-collar workers (OR = 1.9, 95% CI: 1.3-3.0), had a higher risk of dyspnoea than subjects who used to have an intellectual occupation. The risk was not significant for other professional categories. These results demonstrate the important long-term effect of previous professional activities on respiratory health in the elderly.

Age Factors↗