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M Deschamps

Publications and source records attributed to M Deschamps.

At least 37 records · Page 2Linked to original sources
PubMed1996

Cervical cytology screening. How can we improve rates among First Nations women in urban British Columbia?

OBJECTIVE: To determine Pap smear screening rates among urban First Nations women in British Columbia; to identify facilitators and barriers; and to develop, implement, and evaluate specific interventions to improve Pap smear screening in Vancouver. DESIGN: Computer records of band membership lists and the Cervical Cytology Screening Program registry were compared to determine screening rates; personal interviews and community meetings identified facilitators and barriers to urban screening programs. A community advisory committee and the project team collaborated on developing specific interventions. SETTING AND PARTICIPANTS: Purposive sample of British Columbia First Nations women, focusing on women living in Vancouver. INTERVENTIONS: Poster, art card, and follow-up pamphlet campaign; articles in First Nations community papers; community meetings; and Pap smear screening clinics for First Nations women. MAIN OUTCOME MEASURES: Pap smear screening rates among BC First Nations women according to residence and reasons for not receiving Pap smears. RESULTS: Pap smear screening rates were substantially lower among First Nations women than among other British Columbia women; older women had even lower rates. No clear differences were found among First Nations women residing on reserves, residing in Vancouver, or residing off reserves elsewhere in British Columbia. Facilitators and barriers to screening were similar among women residing on reserves and in Vancouver. Many First Nations women are greatly affected by health care providers' attitudes, abilities to provide clear information, and abilities to establish trusting relationships. CONCLUSIONS: Family physicians are an important source of information and motivation for Pap smear screening among First Nations women.

Adolescent↗
PubMed1996

Clinical determinants of mammographic dysplasia patterns.

The association between the clinical manifestations of benign breast disease (BBD) and mammographic patterns was investigated among 1394 women (923 pre-menopausal and 471 post-menopausal) participating to the Canadian National Breast Screening Study in Vancouver, who completed a questionnaire designed to collect detailed information on the symptoms and signs of BBD, hormonal, reproductive and dietary factors. Mastalgia was present in 637 (46%) women and was cyclical in 505 (79%). Breast swelling was noted in 331 women (23%) and mammary dysplasia involving 50% or more of the breast parenchyma in 733 (43%). Mastalgia was highly associated with breast swelling (odds ratios [OR] = 29.9, 95% confidence interval [CI] = 21.3-41.8), particularly when cyclical and characterized by tenderness with pain (OR = 58.4, 95% CI = 39.1-87.0). The relative risk for mammary dysplasia involving 50% or over of the breast parenchyma was significant in pre-menopausal women having breast swelling (OR = 2.96, 95% CI = 1.81-4.83), being highest in women with cyclical mastalgia associated with tenderness and pain (OR = 3.43, 95% CI = 1.49-7.92); similar associations were noted in post-menopausal women. This study indicates that mastalgia is strongly related to breast swelling, especially when tenderness is associated with pain. Furthermore, mastalgia associated with breast swelling is highly related to the presence of mammary dysplasia involving 50% or more of the breast parenchyma in both pre- and post-menopausal women, suggesting that cyclical tenderness and breast swelling may carry an increased breast cancer risk.

Adult↗
PubMed1994

Human pharmacokinetic study of immediate-release (codeine phosphate) and sustained-release (codeine Contin) codeine.

The authors compared, in a double-blind, randomized, crossover study in 13 healthy adult volunteers, the single- and multiple-dose pharmacokinetics, relative bioavailability, and side effects of a new oral sustained-release formulation of codeine (SRC) containing 150 mg codeine base, with oral immediate-release codeine phosphate (IRC). Sustained-release codeine was given at a dose of 150 mg every 12 hours for 5 doses; IRC was given at a dose of 60 mg (2 x 30 mg) every 4 hours for the first 3 doses, and 30 mg every 4 hours thereafter for 12 doses. Plasma codeine levels were determined using a sensitive and specific high-performance liquid chromatography method and corrected for dose administered and codeine base equivalent. Mean values for single-dose pharmacokinetic parameters for SRC and IRC, respectively, were: Cmax of 217.8 and 138.8 ng/mL; Tmax of 2.3 and 1.1 hours; AUC0-inf of 1202.3 and 1262.4 ng.mL-1.hour-1; and t1/2el of 2.6 hours for both formulations. Their respective mean steady-state pharmacokinetic parameters were: Cmax of 263.8 and 222.9 ng/mL; Tmax of 3.2 and 1.1 hours; AUC0-12h of 1576.4 and 1379.1 ng.mL-1.hour-1; and t1/2el of 2.8 and 2.3 hours. These results indicate comparable bioavailability between both formulations with SRC providing delayed peak plasma levels. The sustained-release character of SRC can be explained by a delayed absorption, which is not limiting to drug elimination. Sustained-release codeine provides higher plasma codeine levels over a broader time interval and is expected to improve pain management.

Adult↗
PubMed1992

Rate of death from cervical cancer among native Indian women in British Columbia.

OBJECTIVE: To compare the rates of death from cervical cancer among native Indian women and non-native women in British Columbia from 1953 to 1984. DESIGN: Retrospective analysis of data retrieved from the British Columbia Division of Vital Statistics. MAIN OUTCOME MEASURES: Age-standardized death rate and relative rate. RESULTS: The rate of death from cervical cancer was significantly higher among the native women than among the non-native women throughout the study period. No deaths from cervical cancer were recorded in women under 20 years of age. Among those 20 to 64 the relative rate increased from 3.83 in 1953-62 to 6.53 in 1973-84; among those 65 or more it decreased slightly. For the entire study period the relative rate for women 20 to 64 years old was 5.95 and for those 65 or older 2.98. CONCLUSION: The rate of death from cervical cancer among native women in British Columbia is unacceptably high, probably because the provincial screening program does not reach as many native women as it does non-native women.

Adult↗
PubMed1992

The evaluation of analgesic effects in cancer patients as exemplified by a double-blind, crossover study of immediate-release versus controlled-release morphine.

We compared the effects of controlled-release and immediate-release morphine preparations in adult patients with moderate-to-severe cancer pain and report methodologic approaches to pain evaluation. The study consisted of a two-phase randomized crossover trial preceded by a titration phase; all phases were conducted under double-blind conditions. To evaluate pain intensity, a visual analogue scale (VAS) and the Present Pain Intensity scale of the McGill Pain Questionnaire were used. Additional morphine solution for breakthrough pain was used as an outcome measure. Pain was evaluated nine times daily, which permitted correlation of pain scores with the pharmacokinetic patterns of the test drugs. Side effects were rated once daily, using a scale from 0 to 3. To assess the relative importance of side effects, a toxicity index was designed based on both the intensity and duration of each side effect. The overall VAS pain scores during treatment with controlled-release and immediate-release morphine were 1.3 (SD = 0.1) and 1.4 (SD = 0.2), respectively. Use of supplemental morphine solution for breakthrough pain expressed as the percentage of the daily dose of the test drug was 5.5% for the controlled-release drug and 10.9% for the immediate-release drug. Differences in pain scores, side effects, and supplemental morphine requirement between the two groups were not significant. We discuss methodologic issues in double-blind clinical trials of analgesics, in particular the validity of "Patient Preference" as an outcome measure and problems related to the titration phase.

Adult↗
PubMed1992

The effects of viscoelasticity on the reflection and transmission of ultrasonic waves by an orthotropic plate.

In this paper both theoretical and experimental investigations on the reflection and transmission of an incident plane wave by immersed viscoelastic orthotropic plates are presented. Taking the anisotropy of the layer into account the reflection and transmission coefficients are expressed in terms of nine complex elastic constants. In agreement with the Snell's laws, any waves generated in the layer are bulk heterogeneous plane waves. Using a method already described in the isotropic case, the reflection and transmission coefficients are obtained as a function of the reflection and refraction coefficients of bulk heterogeneous plane waves at the two single solid/liquid interfaces, which limit the plate. In this way, these coefficients can be easily expanded in Debye's series. In addition, for many incident and azimuthal angles, the calculations are compared with trial results on a composite made of unidirectional carbon fibers and epoxy matrix. Finally, by the measurement of the variation of attenuation versus the frequency, a linear model permits the computations in a large frequency range. Conclusions are carried out regarding the use of the LLW method in the inverse problem to recover elastic constants of composite materials.

Acoustics↗
PubMed1992

[Contribution of 99m Tc-HMPAO single-photon emission-computed tomography to the perioperative evaluation of subarachnoid hemorrhage caused by ruptured aneurysms].

Twenty one cases of proven subarachnoid hemorrhage (S.A.H.) have been analysed in a protocol especially including transcranial doppler (T.C.D.) and 88mTc-H.M.P.A.O. single photon emission tomography (H.M.P.A.O.-S.P.E.C.T.). Seventeen patients were intraoperatively studied. All data were compared with clinical grading, computerized tomography (C.T.) and angiography. S.P.E.C.T. is a quite recent method of measuring and three-dimensional imaging of brain perfusion. It provides important information for the diagnosis of ischemic syndromes in S.A.H. Sixty-two S.P.E.C.T.-scans were performed in twenty one patients. Fifty-eight were abnormal and showed significant abnormalities of brain perfusion varying in extent and severity. In this preliminary study, we set out to validate the clinical use of H.M.P.A.O.-S.P.E.C.T. for the diagnosis of "vapospasm" comparing S.P.E.C.T. data with classical criteria. We propose a classification which allowed us to quantify the ischemic risk in an attempt to adapt the global therapeutic management to hemodynamic data. This method appears to be very sensitive and reliable in this field. It will introduce, if these first results are confirmed, important criteria for the evaluation of patients presenting with S.A.H. as far as prognosis and treatment are concerned, especially in regard to timing of surgery and institution of medical hemodynamic therapy.

Aneurysm, Ruptured↗
PubMed1992

Barriers to cervical cytology screening in native women in British Columbia.

The British Columbia (BC) Cervical Cytology Screening Programme (CCSP), implemented since 1955, has resulted in a 75% decrease in both the mortality from and incidence of invasive squamous cervical carcinoma. However, despite this effect, the Native Indian population still present an overall mortality rate four times higher than that of the non-Native population. A demonstration project was initiated in four Native Indian Band communities of BC to determine the reasons underlying these findings. The participation patterns to the CCSP were investigated and revealed that the overall percentage of participation to the CCSP among Native Indian women was 30% lower than that of the non-Native population. Reasons for the under-participation to the CCSP were explored. A total of 36 women, 9 in each of the 4 communities, including current users, ex-users and never users, were interviewed. Reasons for not participating in the CCSP were due mainly to (1) the lack of knowledge about the Pap test and about its importance; (2) feelings of embarrassment and shamefulness; (3) lack of continuity of care due to the high turnover of physicians in the Native communities. Based on the study findings, a pilot CCSP clinic will be implemented in each community. In addition to taking cervical smears, this pilot project will include education sessions, notification about the results of the test, and recall for annual check up.

British Columbia↗
PubMed1991

Humanized antibodies for antiviral therapy.

Antibody therapy holds great promise for the treatment of cancer, autoimmune disorders, and viral infections. Murine monoclonal antibodies are relatively easy to produce but are severely restricted for therapeutic use by their immunogenicity in humans. Production of human monoclonal antibodies has been problematic. Humanized antibodies can be generated by introducing the six hypervariable regions from the heavy and light chains of a murine antibody into a human framework sequence and combining it with human constant regions. We humanized, with the aid of computer modeling, two murine monoclonal antibodies against herpes simplex virus gB and gD glycoproteins. The binding, virus neutralization, and cell protection results all indicate that both humanized antibodies have retained the binding activities and the biological properties of the murine monoclonal antibodies.

Amino Acid Sequence↗
PubMed1990

Diet and histologic types of benign breast disease defined by subsequent risk of breast cancer.

The authors investigated the relation between diet and histologic types of benign breast disease defined by subsequent risk of breast cancer in a case-control study of volunteers who entered the Vancouver Center of the Canadian National Breast Screening Study between 1983 and 1985. Proliferative benign breast disease (n = 124) was inversely associated with vitamin A supplementation (vitamin A user vs. nonuser, odds ratio (OR) = 0.5) and frequent green vegetable consumption (frequent vs. rare consumption, OR = 0.3), whereas severe atypias and borderline carcinoma in situ (n = 32) were directly associated with frequent meat fats consumption (frequent vs. rare consumption, OR = 3.2) with no association with vitamin A or vegetable consumption. No dietary relations were found for histologic types of benign breast disease at no increased risk for subsequent breast cancer (n = 274). The implications of these findings in relation to the etiology of breast cancer are discussed.

Breast Neoplasms↗
PubMed1989

Retinoid chemoprevention timing and dose intensity.

The concept of chemoprevention is generating increasing attention among oncologists. This article discusses the issue of dose of chemopreventive agents in relation to the stages of tumor development. Vitamin A-deficient animals have an increased susceptibility to cancer development, and epidemiologic studies have shown an inverse relationship between intake of food rich in vitamin A and/or beta-carotene and cancer risk. These data suggest that physiologic levels of these natural substances exert a protective effect against cancer development. In the presence of precursor lesions, however, this protective effect has been overwhelmed and pharmacologic doses of chemopreventive agents are required to induce regression or to arrest the progression of these lesions. Phase I pharmacologic and toxicologic studies, and Phase II dose-intensity investigation of chemopreventive agents in patients having precancerous lesions need to be carried out. Such studies would enable to select the least toxic effective chemopreventive dose for intervention trials in high-risk populations, which could then be undertaken based on evidence of activity.

Antineoplastic Agents↗
PubMed1986

Study of benign breast disease in a population screened for breast cancer.

We are conducting a study to determine whether risk factors associated with specific pathologic subtypes of benign breast disease (BBD) are similar to those for breast cancer and to evaluate the relationship between clinical and mammographic features of BBD. All women participating in the Canadian National Study of Breast Cancer Screening in Vancouver, B.C., Canada (expected 10,000) are invited to complete a questionnaire designed to gather clinical and epidemiologic information on BBD. Preliminary analysis of the first 736 participants indicates that breast pain and/or tenderness is a significant problem which in its severe from is distressing, anxiety provoking, and adversely affecting quality of life. Breast pain and tenderness is also associated with an increased frequency of clinical signs of BBD and of dense mammographic patterns.

Adult↗