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Biomedical subjects

J Faivre

Publications and source records attributed to J Faivre.

At least 217 records · Page 12Linked to original sources
PubMed1992

Epidemiology, management, and prognosis of malignant large bowel polyps within a defined population.

The population based registry of digestive tract tumours established for the department of Côte d'Or, France (population 480,000) was used to study the epidemiology and management of malignant large bowel polyps. In a 10 year period (1976-85), 146 cases were recorded in the area. Age standardised incidence rates were 2.7 per 100,000 for men and 1.4 per 100,000 for women. Although incidence rates increased significantly during the study period, large bowel cancer diagnosed as a malignant polyp remained relatively rare (6.2% of all registered large bowel cancers). Two malignant polyps (1.4%) were less than 1 cm in diameter, 34 (23.3%) were more than 30 mm. Sixty patients were treated by endoscopic polypectomy, four by contact radiotherapy, 21 by surgical local excision, 58 by colectomy (10 preceded by polypectomy), and three by colotomy. Operative mortality was 8.2% after intra-abdominal surgery, 4.8% after local surgical excision, and 0% after polypectomy (p less than 0.05). All deaths occurred in patients over 65 years. The five year cumulative recurrence rates were 8.9% after surgical excision and 11.3% after endoscopic polypectomy (NS). The corresponding five year net survival rates were 86.1% and 95.9%. Endoscopic excision alone can be considered a sufficient treatment for adenomas with malignant change unless there is evidence of incomplete resection or a high risk of lymph node metastases.

Aged↗
PubMed1992

[Digestive cancers in France. Comparison of the incidence in 7 departments and estimation of incidence in the entire country of France].

Estimation of differences in the incidence of digestive cancers in France was made from incidence data coming from 7 French departments covered by population-based registries. For some localizations, such as cancer of the pancreas, incidence variations could be explained by differences in recording techniques. But geographic variations clearly appeared for digestive tract cancers: the incidence of esophageal cancer is 4 to 5 fold less in the departments of Tarn and Haute-Garonne than in the department of Calvados. Conversely, the incidence of colorectal cancer is lower in the department of Calvados than in the others. For the entire country, the estimated number of digestive cancers is 46,300 cases per year. This number represents a third of all cancers in males and a fourth in females. Colorectal cancer (25,700 cases per year) is the most frequent of all cancers in both sexes. Cancer of the stomach (8,200 cases per year) is the second digestive cancer, equal to esophageal cancer in males. The heavy burden of digestive cancers in public health is emphasized by our results. These results should lead our country to intensify research in the direction of primary and secondary prevention.

Adult↗
PubMed1992

[Role of deep temporal lift in the surgical treatment of face aging].

This is a new technique which is completely different from superficial temporal facelift also referred to as the mannequin facelift, which is associated with well known failures and sequelae. The principle of the deep temporal facelift is to approach the deep surface of the musculoaponeurotic plane by remaining in contact with the bone and to attach the ascension of this plane by means of sutures anchored to the temporalis mucsle and fibrin glue. This operation is technically possible due to the use of the dissectable space described by Rouvière between the galea and the temporalis muscle. This virtual, detachable space can only be easily defined by the use of hydrodissection. It is an avascular space with the exception of an unnamed vein located at the external agnle of the orbit. There is no resection of the scalp, no modification of the hairline and no modification of the sideburns. The frontal branch of the facial nerve constitutes the anatomical danger. It is situated anterior to the superficial temporoparietal aponeurosis which prolongs the galea. The two danger zones are the zygomatic arch which is crossed by the frontal nerve trunk and a quadrilateral area between the hairline and the tail of the eyebrow and a vertical line 1.5 cm lateral to the lateral canthus of the eye. The frontal nerve does not constitute any risk during deep temporal facelift, as this procedure remains about 1.5 cm away from the zygomatic arch. The nerve is obviously more superficial in the quadrilateral area. To avoid damaging it, the dissection must be performed under direct vision using a cold light, remaining in contact with the temporalis aponeurosis and avoiding any untimely instrumental manoeuvre between a subaponeurotic metallic instrument and the stretched skin. This technique causes minimal discomfort to the patient. It can be performed under local or general anaesthesia. The hospital stay is brief and the postoperative course is extremely straightforward with a very limited risk of bruising. The deep temporal facelift can be combined with the subpalpebral facelift in order to act on the upper 2/3 of the face. Its essential indications are: drooping of the tail of the eyebrow, drooping of the external canthus of the eye, erows feet.

Eyelids↗
PubMed1992

[Cost of a mass screening program for colorectal cancer using the occult blood test].

The Cancer Registry of Burgundy, France, set up a controlled study involving 91,000 people aged 45 to 74 to ascertain the cost-effectiveness of mass screening for colorectal cancer with the Hemoccult test. The aim of this study was to estimate the cost of the first part of the screening campaign, which took place in 1988 and 1989. The overall cost of the campaign was 2,275,589 FF. The cost for the GPs' instruction course was 3.9 percent and the press campaign, 8.4 percent of total costs. The cost related to the distribution or prescription of tests by the GPs was 60.3 percent of the total cost of the campaign. The average cost per test was 39.8 FF when it was distributed by the GPs. The average cost per test was 116.4 FF when bought individually in drugstores or pharmacies. The average cost per test was 70.1 FF when mailing was used. The average cost per test for the analysis was 12.7 FF that is to say 13.7 percent of the total cost. The cost of scientific follow-up and analysis was 13.8 percent. The cost for one person completing the test averaged 92.7 FF. The preliminary results of the cost-effectiveness analysis make it possible to estimate the cost of the mass screening campaign for colorectal cancer. Better cost/effectiveness ratios have already been made according to these results.

Aged↗
PubMed1992

[Multiple colorectal cancers. A population based study].

Data from the Registry of Digestive Cancers in the Côte-d'Or (France) concerning 2,174 colorectal cancers diagnosed between January 1, 1976 and December 31, 1985, and followed through December 31, 1987 enabled us to study the risk of a second synchronous or metachronous intestinal cancer occurring in a given population. Several simultaneous cancers were seen in 59 patients i.e. 2.8 per cent of cases. Diagnosis was made during the initial diagnostic phase in only 32 per cent of cases. Simultaneous cancers occurred preferably on the same colonic segment (kappa = 0.4) and the distribution of the principal tumour did not differ from that of the cancers occurring alone. When polyps were associated with the cancer, the risk of discovering a second synchronous lesion was multiplied by 3.8. Survival in single or multiple synchronous lesions was identical for the same cancer stage. Twenty cases of second metachronous cancers occurred during follow-up of a first colorectal cancer, the relative risk (RR) compared to the Côte-d'Or population was 1.4 (NS). The risk was significantly high for Dukes' stage A tumours (RR = 2.9; P less than 0.01), with an exophytic appearance (RR = 2.1; P less than 0.05) or with adenomatous remnants (RR = 3.4; P less than 0.01). These data suggest that complete examination of the colon should be performed when the diagnostic of colorectal cancer is made to look for an associated cancer or polyps. Follow-up surveillance should address mainly patients with Dukes' stage A or Dukes' stage B carcinoma with an exophytic appearance or adenomatous remnants.

Actuarial Analysis↗
PubMed1991

The triple facelift. Current approach.

The combination of deep temporal facelift, subpalpebral facelift, and cervicofacial facelift constitutes the triple facelift. It exerts vertical traction with anchorage to solid anatomical landmarks, which permits perfect correction of ptosis. In addition, since this traction affects the upper two thirds of the face, the malar detachment of the cervicofacial facelift is considerably reduced or even nonexistent. Only the cervical phase is retained to reestablish the cervicomental angle. This technique, therefore, has the advantage of improving the quality of the result and reducing the postoperative course.

Facial Muscles↗
PubMed1991

[Appendectomy, cholecystectomy, cholelithiasis and colorectal cancer. A retrospective case control study at the Côte-d'Or].

Several studies have shown that there might be a relationship between previous history of appendectomy or cholecystectomy and the subsequent risk of colorectal cancer. In order to investigate these hypotheses, a case-control study was set up to compare the history of appendectomy and cholecystectomy as well as the presence of cholelithiasis in patients with colorectal carcinoma vs patients with gastric carcinoma. The study was performed in the 727 patients included in the Registry of Digestive Cancers of the Côte d'Or and treated at the Dijon University Hospital during the period 1981-1987. These patients were well matched to those of the whole registry population for sex, age, stage, and residence distributions. In females, in comparison to the gastric cancer patients, a personal history of appendectomy was more commonly observed in case of right colonic cancer (odds ratio: 3.5; P less than 0.01) and a personal history of cholecystectomy in case of left colonic cancer, in particular when considering only those earlier than 10 years (odds ratio: 3.2; P less than 0.05). In contrast, the risk of rectal cancer was lower in case of a cholecystectomy performed more than 10 years earlier (odds ratio: 0.2; NS) and in case of cholelithiasis (odds ratio: 0.4; P less than 0.05). In males, there was no difference between cases and controls as for the proportion of appendectomies, cholecystectomies or cholelithiasis. These observations are consistent with the hypothesis that the appendix as a lymphoid organ plays a protective role in colon carcinogenesis, in particular in women.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Participation in mass screening for colorectal cancer: results of screening and rescreening from the Burgundy study.

A controlled study was made in Burgundy (France) to assess the acceptability and efficiency of colorectal cancer screening using the Hemoccult test. A total of 91,000 people aged 45 to 74 years were included. The first screening campaign was made from January to July 1988 or 1989, and rescreening occurred from January to July 1990. During the first 4 months of the campaign, the General Practitioners (GPs) offered the test to their patients. It was then mailed to all subjects who had not completed it with a recall letter, if necessary, one month later. The overall compliance rate was 54.0% in the first campaign and 55.5% in the second campaign. A total of 63.7% subjects had completed at least one screening test over the two screening campaigns. Compliance was lower among men than women; compliance rate was also lower in the youngest and oldest age group than in the intermediate age groups. During the second screening campaign, the participation rate was 83.6% among participants in the first screening campaign and 20.9% among non-participants. Compliance during the medical offer phase was higher (81.4% during the first campaign, 82.9% during the second campaign) than during the postal offer phase (respectively, 33.8% and 28.5%). It was easier for GPs to propose the test when they had to offer it than when they had to prescribe it. These results suggest that a satisfactory participation rate can be obtained in France if GPs are actively involved in the screening programme. The final objective is to find a 25% difference in 5-year mortality by large bowel cancer between the screened and the test population.

Age Factors↗
PubMed1991

[Incidence, diagnosis, treatment and prognosis of cancer of the pancreas: development in Côte-d'Or from 1976 to 1985].

The aim of this study was to analyze the epidemiological aspects of pancreatic cancers and their time trends in the Côte-d'Or population between 1976 and 1985. Over a period of ten years, 444 cases were diagnosed. The incidence rates standardized according to the world reference population were 8.2/100,000 in males and 3.8/100,000 in females. The Côte-d'Or is an intermediate risk area for pancreatic cancer. This cancer was slightly more common in urban than in rural areas (NS). The initially urban predominance of pancreatic cancer in males was no longer present 10 years later. Between 1976 and 1985, incidence of pancreatic cancer decreased by a mean of 4.7% per year in males (NS) and 0.5% per year in females (NS). A high proportion of the cancers (73.9%) were located in the head of the pancreas; among histologically confirmed cases, 69.7% were adenocarcinomas. Criteria for diagnosis evolved throughout the 10 years. The rate of histological confirmation increased annually by a mean of 3.0% (P less than 0.001). The relative importance among diagnostic procedures of direct biliary and pancreatic examinations decreased (P less than 0.05) whereas that of ultrasonography and radioscan increased (P less than 0.001). The overall surgical rate was 64.4% and the rate of curative surgery was 4.4%. The operability rate increased annually by a mean of 2.0% (NS). The overall survival rate was 13.2% after 1 year, 4.5% after 3 years and 3.2% after 5 years. Prognosis depended neither on age nor on sex or cancer location. The 5-year survival rate was 38.5% in the limited group of patients (n = 13) who underwent surgery for cure, and 0.0% in patients with palliative treatment. These data emphasize the severity of pancreatic cancers and the absence of any therapeutical improvement between 1976 and 1985 in spite of the evolution in diagnostic procedures.

Adult↗
PubMed1991

[Colorectal hyperplasic polyps in the population of Côte-d'Or, between 1976 and 1985].

The data of the polyp registry of the Côte d'Or was used to study the characteristics of hyperplasic polyps detected in a well defined-population. In the 1976-1985 10-yr period, 1,222 hyperplasic polyps were resected in 874 Côte d'Or residents. They represented 17% of all polyps. The incidence rate standardized according to the world reference population was 21.9/100,000 in males and 8.1/100,000 in female. The male predominance was observed in all age groups. The incidence of hyperplasic polyps increased by a mean of 19.8% per year in males and 26.6% in females (P less than 0.001). Hyperplasic polyps were discovered twice as often in patients living in an urban area than in patients living in a rural area (P less than 0.001). Hyperplasic polyps were smaller than 5 mm in 91.4% of cases and were located in the rectum in 59.4% of the cases. They were associated with an adenoma in 21.0% of the cases. In the case of a rectal hyperplasic polyp, 10.5% of the patients had an adenoma in the left colon and 2.8% in the right colon. A rectal hyperplasic polyp cannot be considered as a marker of the presence of a large bowel adenoma. The relationship between hyperplasic polyp and colorectal cancer needs to be established.

Adenoma↗
PubMed1991

[Postoperative mortality for colorectal cancer in the Côte-d'Or (France) from 1976 to 1985].

Postoperative mortality from colorectal cancers in the resident population of the department of Côte-d'Or was studied for the 1976-1985 period through the data collected by the Registry of Digestive Tumors of the Côte-d'Or (France). The overall postoperative mortality was 14.7 percent for colonic cancers and 11.2 percent for rectal cancers. After surgery with curative intent (n = 1,411), the corresponding figures were 10.3 percent and 6.8 percent, respectively. In patients operated with curative intent, postoperative mortality was slightly less in females than in males (NS), and in patients less than 65 than in older patients (P less than 0.001). It was higher when cancer was discovered through an acute event (20.0 percent) than in the other patients (7.7 percent; P less than 0.001). Stage at diagnosis, gross macroscopical appearance, and tumour size had no influence on postoperative mortality for colonic cancers. For rectal cancers, postoperative mortality was lower in tumors less than 3 cm in diameter (1.3 percent) than in larger tumors (7.5 percent; P less than 0.05). Postoperative mortality decreased by a mean of 9.7 percent per year between 1976 and 1985 (P less than 0.001). This trend was more pronounced after curative surgery: 10.9 percent (P less than 0.001) than after palliative surgery: 5.5 percent (P less than 0.05). After curative surgery, postoperative mortality decreased more in men (annual variation: 13.9 percent; P less than 0.001) than in women (6.3 percent; NS), before age 75 (20.2 percent; P less than 0.001) than in older patients (5.6 percent; NS), and for colonic cancers (13.1 percent; P less than 0.001) than for rectal cancers (9.1 percent; NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Aldehyde dehydrogenase activity in xenografted human brain tumor in nude mice. Preliminary results in human glioma biopsies.

ALDH activity measured fluorimetrically using a high concentration of aliphatic aldehyde as substrate was studied in human glioblastomas grafted in nude mice. Compared with normal brain, ALDH activity is significantly increased in malignant glioma tissue, especially in the cytosolic subcellular fraction. Correlatively, in comparison with normal brain tissue, MDA levels were significantly reduced in whole homogenates and in cytosolic fractions of xenografted glioblastoma tissue. Preliminary results concerning human malignant glioma biopsies are in good agreement with our experimental data. In view of previous works, these results suggest a relationship between alterations in ALDH iso-enzymes activities and cytosolic aldehyde concentrations with respect to normal or tumoral cell growth.

Aldehyde Dehydrogenase↗