Biomedical subjects

M C Nuttens

Publications and source records attributed to M C Nuttens.

26 records · Page 2Linked to original sources

PubMed1990

[Primary results of the MONICA project].

The MONICA project is an international study coordinated by the WHO, designed to explain the important variations of coronary mortality observed in the industrialised countries over the last 20 years. Thirty-nine centres in 27 countries are participating in the project which, over a 10 year period will, in geographically determined zones; a) record the numbers of acute myocardial infarcts and coronary deaths, b) analyse the treatment of acute cardiac events, and c) evaluate the cardiovascular risk factors and preventive measures in the general population. The MONICA-France project comprises three registers (Bas-Rhin, Haute-Garonne and the urban community of Lille), and a coordinating centre. The preliminary results confirm the wide geographic variability of coronary mortality with a prevalence slightly higher in Alsace and the North than in the South-West of France. The approximative frequency of coronary events in France is estimated at 112,000 infarcts and over 175,000 acute coronary episodes and deaths. Information is provided about the severity of the principal coronary risk factors and the conditions of their treatment in the register zones. A study of the accessibility of emergency treatment of acute infarction in the Bas-Rhin area, has demonstrated the key role of the general practitioner as the first contact but confirmed the long delay to hospital admission which nullified the potential benefits of thrombolysis in a high proportion of cases. However, the significant decrease in hospital mortality of acute infarction observed over a 3 year period in the three register zones, is probably related to the number of patients thrombolysed in that time.

Adult↗

PubMed1990

[Validity of death certificates in the study of ischemic heart diseases].

Mortality rates for ischaemic heart disease, as estimated from death certificates, show highly significant differences between countries. In order to study the validity of mortality rates for ischaemic heart disease, the authors, involved in the MONICA project, have compared the results obtained from the conventional death certificate code with the data collected in a complementary enquiry conducted for all deaths possibly due to ischaemic heart disease. Three hundred and thirty patients, aged from 25 to 64 years, belonging to the urban community of Lille, and who died between October 1 and December 31, 1984, were included in this study. The sensitivity of the death certificate for the diagnosis of ischaemic heart disease was 77.9 percent and its specificity was 95.9 percent. The concordance rate between death certificate and complementary enquiry was not modified by age, sex, socio-professional category, family situation, place of death and doctor who signed the certificate. The complementary study proved impossible in 31.8 percent of the cases, usually because the doctor who signed the death certificate was not fully conversant with the patient's condition. Our results therefore confirm that death certificates are valid to study mortality from ischaemic heart disease.

Adult↗

PubMed1990

Between-register and within-register variability in event-finding and rates in the MONICA-France Project.

The 1985 and 1986 coronary event data from the three French MONICA Registers in Haute-Garonne (Toulouse), Bas-Rhin (Strasbourg) and the Urban Community of Lille (UCL) are used to compare the sources of information, the distribution of events in different diagnostic categories, and their possible effects on event rates. All three registers follow the MONICA protocol, and use the "cold pursuit" method, with data abstracted retrospectively from medical files or from the doctors establishing the causes of death. The health system and medical background are similar in the three centers. The distribution of the sources of information (in-hospital and out-of-hospital) and the distribution of events by diagnostic categories are different among centres. The possible effects of these differences on rates of definite myocardial infarction or possible coronary death are estimated between registers and within registers during a 2-year period. Cross-sectional comparisons are questionable, and possible false trends in event rates require special attention.

Adult↗

PubMed1990

Comparison of dietary patterns between population samples in the three French MONICA nutritional surveys.

A nutritional survey was carried out from 1985 to 1987 in three French areas covered by the ischaemic heart disease registers: Bas-Rhin (BR), Haute-Garonne (HG) and the Urban Community of Lille (UCL). 1,128 men aged 45-64 were included in a survey, using the 3-day record method. The results, after adjustment for age, socio-economic status, residence and prescribed diet, showed differences, sometimes significant, between the three samples. Fat represented 37% of the total energy intake in BR, 36% in UCL, and 34% in HG. The P:S ratio ranged from 0.50 in HG, to 0.47 in BR, and 0.40 in UCL. These differences were due to a higher intake of vegetable fat and a lower intake of animal fat in HG. In spite of a very important alcohol intake, with no big differences between the centres (33 to 36 g/day), we noticed that HG drank mainly wine, whereas BR and UCL drank wine and beer in about the same proportions.

Alcoholic Beverages↗

PubMed1990

Blood pressure and dietary intake in a French population sample from three regions.

In order to determine the possible relationship between nutritional factors and blood pressure (BP), a sample of 1128 men of the population living in the three French MONICA centres, Bas-Rhin (BR), Haute-Garonne (HG) and the Urban Community of Lille (UCL), was included in a nutritional survey. Of the sample, 16.2% were taking antihypertensive drugs and 34.1% of the remainder had high BP. Prevalence of high BP was greater in BR and UCL than in HG, the differences persisting after adjustment for body mass index (BMI) and age. BMI and geographic location were the best predictors of high systolic BP (SBP) and diastolic BP (DBP). Age was positively correlated with SBP, but not with DBP. Alcohol intake was the dietary component which had the most consistent relationship with SBP and DBP. However, greater intakes of total fat and of cholesterol were also associated with higher DBP and SBP respectively. A small but significant contribution of sodium chloride to SBP and DBP was also found, whereas no influence of the intake of calcium or of any diary product was observed.

Age Factors↗

PubMed1990

Acute coronary care and treatment of myocardial infarction in the three French MONICA registers.

The study evaluates and compares among the three French MONICA centres the access to emergency care, and the treatment administered to 1444 patients aged 25-64 years hospitalized for an acute coronary event. It was carried out in 1985 in Bas-Rhin (BR) on 596 subjects, in 1986 in Haute-Garonne (HG) on 450 subjects, and from October 1986 to July 1987 in the Urban Community of Lille (UCL) on 395 subjects. The time before receiving initial medical care could be analysed only in BR and HG: it is shorter in HG (p less than 0.001). Patients with a history of coronary disease are inclined to consult more quickly than patients with a first event (p less than 0.001). According to the three centres, 68.5 to 72.5% of the patients consult first a private practitioner, while 9 to 10.5% contact first a mobile team (mobile emergency care unit), and 6 to 15% go directly to hospital. Patients with a previous history tend more to call a mobile team directly, or to go to hospital directly than patients without a history (p less than 0.001). The analysis of the treatment was made only on patients classified in MONICA diagnostic category 1: the therapeutic schemes are similar in the three centres, although differences are noted in the frequency of prescription. The use of new medications and procedures seems to be best established in HG and in UCL than in BR, with the reservation that the three studies were not conducted at the same time.

Adult↗

PubMed1990

[Influence of pedagogy on vigilance in school age children].

The relationship between vigilance and pedagogy was studied in 3 middle classes of primary school (children aged between 8 and 9 yrs). Three different types of pedagogy, belonging to 3 major pedagogic currents were evaluated: the pedagogy of Maria Montessori, the traditional one and the so-called "open" pedagogy. The vigilance of children was tested with the psychometric test of Zazzo. The rate of performance of the test was significantly different according to the nature of pedagogy after adjustment of the only 2 confusing factors between the 3 schools: the age of the children and the degree of the mother. This difference was in favor of the pedagogy of Maria Montessori compared with the 2 others. It was observed on the results to the tests but also on learning.

Age Factors↗

PubMed1988

[Myocardial infarction in 3 French regions: comparison of incidence and mortality in 1985].

In 1985, the age-standardized (25-64) attack rate (per 100,000) for myocardial infarction, among men was 240 in the Bas-Rhin, 219 in the Haute-Garonne and 231 in the urban community of Lille and among women, respectively, 58, 28 and 51. The mortality rate for men (per 100,000) was 66 (Bas-Rhin), 57 (Haute-Garonne), 69 (Lille) and among women 18, 7 and 14. Among women, these differences are significant. A regional significant difference appears among men when cases with insufficient data are included. The sex ratio (men/women) was higher in the Haute-Garonne. 38% of death cases occurred within one hour, 76% within one day, and 89% in the first week after the first symptoms. The case fatality rate at 28 days does not differ significantly between the three registries (from 26% to 30%). The highest case fatality rates were observed in patients aged 25-34 and 55-64. The frequency of previous history of cardiovascular disease and the management of the cases were not different between regions. Diagnostic criteria problems are discussed.

Adult↗