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Biomedical subjects

J Lellouch

Publications and source records attributed to J Lellouch.

121 records · Page 7Linked to original sources

[Twelve year FEV1 changes and smoking habits among 556 workers in the Paris-area (author's transl)].

The aim of the study was to analyse the effects of smoking, in particular to show its causal role in the development of airflow obstruction, and to look at changes in smoking habits. The study was conducted among 556 men, aged 30 to 54 in 1960, surveyed twice, in 1960 and 1972. The hypothesis of tobacco as a causal factor of airflow obstruction is strengthened, following this study, by three results: 1) FEV1 slope was related to tobacco consumption, even after adjustement for FEV1 level (42 ml/yrs for non-smokers, 51 ml/yrs for heavy smokers); 2) FEV1 loss with age increased with the amount of tobacco consumption: one pack a day smoked for 25 years was equivalent to an aging of 5 years; 3) FEV1 loss decelerated if the subject gave up smoking, thus preventing any further risk. What appeared to be a spontaneous regulation in smoking habits was observed. The men who stopped smoking were those with low respiratory status. In this population, men who were ex-smokers in 1960 and maintained this status until 1972 had a FEV1 slope similar to that of the non-smokers.

Adult↗

[Principles of therapeutic trials (author's transl)].

Therapeutic trials aim at comparing the effectiveness of two therapeutic attitudes. The problems involved are considered: comparability requirements of the groups, assured by randomization, which raises ethical questions. The need of a "sufficient" number of subjects, often imposing cooperative trials, is then discussed. Finally, it is necessary to define the disease and patients, the therapeutic possibilities, and judgement criteria.

Clinical Trials as Topic↗

[Serum urate and gout in 4663 young male workers (author's transl)].

Serum urate levels and history of gout were observed from 4663 men aged 20-44 who were employed by a Parisian government agency. Serum urate levels, mean value 62,8 mg/l (374 mu mol/l), did not vary with age but were strongly correlated with weight. For constant weight, urate levels decreased with age. By our definition: typical history of gout and either efficacity of colchicine during an attack or serum urate level over 70 mg/l (417 mu mol/l) at examination, there were 57 cases of gout, giving a prevalence of 1,1% among men 35-39 and 2,0% among men 40-44 years old. Using the definition by the New York criteria which do not include serum urate level, there were 51 cases of gout, giving a prevalence of 1,5% in the 35-44 year age group. This is about 3 times the prevalence found by O'Sullivan, using the same criteria, in an American town. the higher serum urate levels in the present study may account for much of this difference. The incidence of new cases of gout was estimated to be 1,6% over 5 years for men 40-44 years old. The site was the great toe in 57% of gouty men with only one attack and in 92% of those with more than one attack. It was not related to the amount of standing or activity at work. Comparison with a study made 7 years earlier showed an augmentation in serum urate values and probably in prevalence of gout. These results are discussed in terms of dietary modification over this time period.

Adult↗

[Spirographic reference values. Mathematical models and practical use (author's transl)].

Various models predicting VC and FEV1 from age and height have been compared by both theoretical and practical approaches on several subgroups of a working population examined in 1960 and 1972. The models in which spirographic values are proportional to the cube of the height give a significantly worse fit of the data. All the other models give similar predicted values in practical terms, but cutoff points depend on the distributions of VC and FEV1 given age and height. Results show that these distributions are closer to a normal than to a lognormal distribution. The use of reference values and classical cutoffs is then discussed. Rather than using a single cutoff point, a more quantitative way is proposed to describe the subjects' functional status, for example by situating him in the percentile of the reference population. In screening, cutoff points cannot be choosen without specifying first the decision considered and the population concerned.

Adult↗

Cross-national epidemiology of major depression and bipolar disorder.

OBJECTIVE: To estimate the rates and patterns of major depression and bipolar disorder based on cross-national epidemiologic surveys. DESIGN AND SETTING: Population-based epidemiologic studies using similar methods from 10 countries: the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand. PARTICIPANTS: Approximately 38000 community subjects. OUTCOME MEASURES: Rates, demographics, and age at onset of major depression and bipolar disorder. Symptom profiles, comorbidity, and marital status with major depression. RESULTS: The lifetime rates for major depression vary widely across countries, ranging from 1.5 cases per 100 adults in the sample in Taiwan to 19.0 cases per 100 adults in Beirut. The annual rates ranged from 0.8 cases per 100 adults in Taiwan to 5.8 cases per 100 adults in New Zealand. The mean age at onset shows less variation (range, 24.8-34.8 years). In every country, the rates of major depression were higher for women than men. By contrast, the lifetime rates of bipolar disorder are more consistent across countries (0.3/100 in Taiwan to 1.5/100 in New Zealand); the sex ratios are nearly equal; and the age at first onset is earlier (average, 6 years) than the onset of major depression. Insomnia and loss of energy occurred in most persons with major depression at each site. Persons with major depression were also at increased risk for comorbidity with substance abuse and anxiety disorders at all sites. Persons who were separated or divorced had significantly higher rates of major depression than married persons in most of the countries, and the risk was somewhat greater for divorced or separated men than women in most countries. CONCLUSIONS: There are striking similarities across countries in patterns of major depression and of bipolar disorder. The differences in rates for major depression across countries suggest that cultural differences or different risk factors affect the expression of the disorder.

Adolescent↗