[Attempt of correlation between the data on atmospheric pollution in Bordeaux and school absenteeism of children due to broncho-respiratory causes].
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Biomedical subjects
Publications and source records attributed to M Bernadou.
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The study deals with the infectious diseases department of the university hospital of Bordeaux where most of the AIDS patients in south western France are admitted. In 1986, the department counted 64 admissions (and readmissions) from 35 AIDS patients and 1376 admissions (and readmissions) from 707 other patients. Taking into account admissions of AIDS patients into other hospital departments, the average cost of a hospital day of an AIDS patient was estimated at 1815 French francs in 1986. The length of stay, per AIDS patient and per year, was of 31.5 days in Bordeaux (1986), as compared to 18 days in San Francisco, USA (1984) and 33 days in the Massachusetts, USA (1984). In Bordeaux, the length of stay for other patients in the same department was 17 days. The consumption of diagnostic-related biological exams of AIDS patients in Bordeaux was twofold that of other patients. Per capita, overall hospital costs incurred by AIDS patients increased by 56 percent, as compared to other patients. For the time being, there is no need to build a new department, the existing facilities being sufficient to cope with the AIDS epidemic. If a new department has to be established, the hospital cost of AIDS patients would of course be much higher.
The different pulmonary function tests which enable the diagnosis of asthma and its functional criterium, reversible bronchial obstruction, are reviewed. It is our opinion that in epidemiology where the diagnosis should be made "on the spot" in a simple, rapid and non-aggressive manner, the most appropriate tests are the following: the FEV1 or other forced expiration parameters, to which could be added the measurements of closing volume, the slope of phase III, and/or flow-volume curves using two gas mixtures. The modifiers of bronchomotricity could confirm the reversible nature of the bronchial obstruction.
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The author proposes a study of the medico-social consequences of asthma. Having shown the impossibility of a monolithic conception of asthma, he shows how much it is conditioned in the child by his social and family surroundings. Different levels of consequences are considered: restraints linked to the therapeutics of a chronic disease, effect on physical activity and leisure, importance of the repercussions on school life (absenteeism and slowness). In conclusion, the author stresses both the importance of these consequences on the personal and professional future of the child and the need to define high risk groups corresponding to criteria based on seriousness and social environment for whom the prevention of these repercussions must have priority.
The first results of a survey involving 1950 children from 6 to 12 years old living in Bordeaux are presented here. For 280 of them, who had attacks of asthma or showed other closely related signs, a questionnaire was filled out by the parents. On this basis, the main features of the disease, as well as the ORL bronchial and allergological course, were specified for a representative epidemiological population (with a distinction between actual asthma and disappeared asthma, distribution according to sex and age of the first attack). A functional examination by flow-volume curve for 111 of the children showed, using maximal flow measurement (particularly V 50 and V 25), the existence of modifications of the bronchial paths that were not detected by classical spirometric parameters.
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