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Biomedical subjects

J Faivre

Publications and source records attributed to J Faivre.

At least 235 records · Page 13Linked to original sources
PubMed1990

[Treatment and prognosis of stomach cancers in the population of the Cote d'Or's District (1976-1985)].

The present study on treatment and prognosis of gastric cancers is based on the data of the digestive tract cancer registry set up for the French department of Côte-d'Or. During the 1976-1985 period, 784 cases of gastric cancer were diagnosed. Resection for cure was performed in 41.3% of gastric cancers and that proportion remained the same during the course of the study period. Operative mortality was 18.5% after resection for cure and 26.7% after palliative surgery. The overall survival rate was 31.7% at 1 year, 17.0% at 3 years, and 13.0% at 5 years. Ten different criteria (personal data, histologic and therapeutic parameters) were studied in relation to survival. With the univariate analysis, the survival rates were related to age, duration of the symptoms, history of previous gastric ulcer, tumour location, stage of diagnosis and treatment. Only 4 aspects were of good prognosis according to the multivariate analysis (Cox model): extension limited to the gastric wall, resection for cure, duration of the symptoms and location to the antrum or the angulus. These results underline the fact that the prognosis of gastric cancer in a well-defined population remains poor. Because of its severity, gastric cancer still represents a major cancer problem.

Aged↗
PubMed1990

[Descriptive epidemiology of cancer of the pancreas].

Cancer of the pancreas is a relatively common malignancy in France, where it represents 10% of all digestive tract cancers. Over the world, there is little variation in incidence rates; Europe, North America, South America, Oceania and parts of Asia represent high risk areas. The regions with the lowest incidence rates are India, mid-western countries and Africa. In most countries, pancreatic cancer incidence rates increased between 1950 and 1965; however little change in incidence has been observed over the past 20 years. Pancreatic cancer occurs more frequently in males than in females in all age groups. No consistent differences have been identified in urban/rural distribution or in socioeconomic status. Studies of migrant populations and some religious groups indicate that environmental factors are of overwhelming importance in determining the incidence of pancreatic cancer in a given population. In the same areas, difference in incidence has been reported among various ethnic groups: in the United States the rate is higher in Blacks than in Whites, in New Zealand in Maoris and Polynesians than in Whites, in Israel in Jews than in non-Jews. This data leads us to the conclusion that diet is of importance in pancreatic cancer etiology. No premalignant lesion has been clearly identified. Particular attention has been paid to diabetes mellitus and chronic pancreatitis, but a firm conclusion cannot be drawn. Some potentially valuable clues for clarifying the etiology of pancreatic cancer have been found by way of descriptive epidemiology. In view of the severe prognosis of the disease, there is an urgent need for further aetiological studies in order to develop effective methods of prevention.

Adult↗
PubMed1990

[Preliminary results of a mass screening program for colorectal cancer].

The Digestive Tumours Registry of Burgundy set up a study to assess acceptability and results of colorectal cancers screening using the Hemoccult test. A total of 95,000 people, aged 45 to 74, were included, 55,000 in 1988 and 40,000 in 1989. The aim of this paper is to report the results of the first screening process in the population tested from January to July 1988, i.e. 27,421 subjects. Information on colorectal cancer was mailed to all homes in the screening areas and a news campaign was organized. During the first 4 months, the general practitioners (GPs) either prescribed the test which was then reimbursed (Autun area), or gave it free to their patients (other areas). After that phase, the test was mailed to all subjects who had not consulted their GP, and a second letter was sent 1 month later when the test had not been sent back. A total of 14,603 subjects performed the Hemoccult test (53.3 percent). Acceptability was higher in those areas there the test was initially given free by the GPs (57.3 percent) than in those where it was prescribed (40.0 percent). Acceptability was higher in women (55.8 percent) than in men (50.6 percent). A total of 57.8 percent of the performed tests were done during the medical offer phase, 29.1 percent after mailing and 13.1 percent after the recall letter. There was a positive test in 340 subjects (2.3 percent) and 288 (84.7 percent) had colonic investigations, a colonoscopy in 99 percent of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1989

A comparison of two diet history questionnaires that measure usual food intake.

This study was conducted during the preparation of a case-control study on patients with adenomatous polyps or cancer of the large bowel. It was done to compare two dietary history methods for assessing individual current dietary intakes. Subjects were interviewed concerning their food consumption by meal in one of the questionnaires and by broad food groups in the other questionnaire. Two groups of 20 volunteers, comparable according to sex and age, were interviewed by a dietitian who used one of the questionnaires. Data on diets obtained with the questionnaire were compared with those of a 14-day dietary record. The subjects were informed of the importance of the validation procedure. Whatever the type of questionnaire, mean daily intakes of nutrients and foods were rather similar for the questionnaires and for the 14-day records. Thus, there were more significant correlations between the questionnaire by meal and the record than between the questionnaire by food group and the record. When using tertiles, it appears that the questionnaire by meal was better at classifying individuals with regard to their food intake than the questionnaire by food groups. Although extrapolating these results to a patient population is not straightforward, it seemed likely that interviewing patients on diet without using a pattern of meals would prove even less reliable than for healthy subjects. The questionnaire by meal was preferred to the questionnaire by food groups for the ongoing case-control study. Further studies are needed to know whether these results could be extrapolated to studies on past diet and to non-Latin populations.

Adult↗
PubMed1989

Epidemiological evidence for distinguishing subsites of colorectal cancer.

The registry of digestive tract tumours established for the department of Cote d'Or (France) was used to study the epidemiological characteristics of large bowel cancer subsites for the period 1976-1983. Age standardised incidence rates for colon cancers were 18.9/100,000 for men and 14.2/100,000 for women. The corresponding rates for rectal cancers were 18.4/100,000 and 10.2/100,000. The sex ratio for right colon cancer (caecum, ascending colon, hepatic flexure, transverse, splenic flexure) was close to 1 and did not change with advancing age, while that for the left colon (sigmoid, descending colon) showed a male excess after 65. For rectal cancer (rectosigmoid junction, rectal ampulla) the male predominance was more marked and occurred earlier, after 55 years of age. There was no significant variation in incidence between rural and urban areas for the different sublocalisations. In males the risk was high in the highest social classes for left colon cancer (p less than 0.01), and among farmers for rectal cancer (p less than 0.01). The risk of left colon cancer in males increased with the comfort of housing (p less than 0.01), but this marker of social class had little influence on incidence for the other localisations in males, or for any localisation in females. No significant variation was found with education. The incidence of colon cancer tended to increase over the 8 years of study. The variations were significant for left colon cancer. For rectal subsites cancer incidence decreased in women (p less than 0.05). The observed differences suggest differences in the aetiological factors within large bowel cancers. Therefore right colon cancer, left colon cancer and rectal cancer should be considered separately in epidemiological analytical investigations.

Aged↗
PubMed1989

[Trends in the incidence of colorectal cancer at the Department of Côte-d'Or between 1976 and 1985].

Colorectal cancer is the leading cause of cancer morbidity in France when both sexes are considered together. There are few available data on time trends, although such data would prove both necessary for planning screening programs and usefull to construct hypotheses on etiological factors. Data from the Registre des Tumeurs Digestives de Côte d'Or permitted to establish time trends for the different locations of colorectal cancer during the 1976-1985 period. Changes in incidence rates as based on the world reference population were studied using a log linear model as well as the Armitage test. Overall colon cancer rates have increased in both sexes. The mean annual increase of left colonic cancer was 3.1 p. 100 in men (p less than 0.05) and 4.0 p. 100 in women (NS), whereas rectal cancer decreased by 2.4 p. 100 in men and 3.3 p. 100 in women (NS). In men, left colonic cancer rates increased mainly in rural areas (+ 7.3 p. 100; p less than 0.05) whereas it increased mainly in urban areas in women (+ 6.0 p. 100; NS). In both sexes, the left colonic cancer increase was particularly noticeable in the 45-64 age group, which could indicate that the observed trend is likely to become more important in the next years. As for rectal cancer, the decrease was most important in the 65-74 age groups. That inversed trend for colon and rectum cancer has already been observed in other countries including the USA and Canada. As the trends we observed for right colon, left colon and rectal cancer differ, colorectal cancer etiology should be studied separately.

Aged↗
PubMed1989

[Neonatal Proteus mirabilis septicemia and cerebral abscess. Value of the assay of antibiotics in the puncture fluid].

The authors describe a case of neonatal Proteus mirabilis septicemia accompanied by cerebral abscess formation despite the presence of therapeutically effective antibiotic levels utilised to treat the disorder. The occurrence of such brain abscesses during the course of effective antibiotic therapy raises the question of the mechanism behind their formation. Cerebritis may occur very early in the clinical course of the infection without being due to failure of antimicrobial therapy.

Anti-Bacterial Agents↗
PubMed1989

[Acceptability of the Hemoccult test in general medical practice. Results of a pilot study].

In view of preparing a controlled trial to assess the efficacy of screening for colorectal cancer by fecal occult blood testing in reducing cancer mortality, a pilot study was performed to evaluate the acceptability rate of the Hemoccult test in non selected subjects consulting in a general practice. 566 subjects aged 45 to 74 years from two small towns, Neuville-aux-Bois (Loiret) and Vicherey (Vosges) were included in the study. The screening test was proposed by GPs to 89.2% of their patients; of these, 5.6% refused the test and 9.4% did not return it. Of the tests carried out, 80.8% were performed spontaneously, and 19.2% after a recall letter. Acceptability depended neither on age or on sex. The patients' confidence in his GP was the most important acceptability factor (60%), followed by explanations the GP had provided, and ease of application. The results suggest that after receiving the correct information, a GP will succeed in prescribing the Hemoccult test to most high-risk subjects and that acceptability then proves excellent. Experience drawn from the pilot study has been very useful in conceiving the on-going controlled trial in Burgundy.

Aged↗
PubMed1988

Primary liver cancer in Côte d'Or (France).

The registry of digestive tract tumours established for the department of Cote d'Or (France) was used to study the incidence and some of the characteristics of primary liver cancer (PLC) in this area. The annual age-standardized incidence rate was 7.6/100,000 for males, and 1.8/100,000 for females. As compared to other areas the Cote d'Or is in the intermediate incidence areas. The risk of PLC was higher in urban than in rural areas in men (p less than 0.01). There was no significant variation in PLC incidence over the eight years of the study. Alfafoetoprotein levels over 200 ng/ml were observed in only 48.9% of the cases. Alfafoetoprotein measurement has to be complemented by other investigations in screening of high-risk patients. Liver cirrhosis was present in 70.9% of the cases in which the information was available. The male:female ratio in the non-cirrhotic group was 1.5:1, very different to the 8.8:1 in the cirrhotic group. Cirrhosis was associated with excessive alcohol consumption in 92% of cases. The prevalence of serological markers of hepatitis B virus infection was investigated in 91 patients. Hepatitis Bs-antigen was found in 8.8% and evidence of past or present infection in 28.2%. In view of the prevalence of chronic alcoholism in patients with cirrhosis it is suggested that alcohol leads to an increased risk of cirrhosis followed by an increased incidence of PLC. Further studies are needed to elucidate the eventual role of HBV infection and other suspected environmental factors in the aetiology of PLC.

Adolescent↗
PubMed1988

[Epidemiology of cancers of the small intestine. Evaluation of 10 years' registration at the Cote-d'Or department].

The registry of digestive tract tumours established for the department of Côte-d'Or was used to study the epidemiologic characteristics of cancer of the small intestine. Over a period of 10 years (1976-1985), 42 new cases were recorded. Age standardized incidence rates, based on world standard population, were 0.7/100,000 for males and 0.4/100,000 for females. As compared with the data from other cancer registries, the risk in Côte-d'Or is in the intermediate range. The mean age was 60.9 years for males and 73.3 years for females (P less than 0.05). Adenocarcinomas represented 40% of the cases, lymphomas 20%, carcinoid tumours 20%, sarcomas 17% and undifferentiated carcinomas 2%. The mean time between symptoms and diagnosis was 4.6 months. Lymph node involvement or metastatic disease were found in 3/4 of the cases at time of diagnosis (31/42). Patients were treated by surgery in 95% of the cases. Curative surgery was used in 23 cases (55%). The post-operative death rate was 13% after curative surgery and 37.5% after palliative surgery. The overall survival rates were 39.9% at 1 year, 19.5% at 3 years and 11.7% at 5 years. Prognosis depended on the stage of diagnosis and the finality of surgical treatment. These results indicate that cancers of the small intestine are rare and difficult to diagnose, explaining the delay in diagnosis and the poor prognosis.

Actuarial Analysis↗