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Biomedical subjects

M Dramaix

Publications and source records attributed to M Dramaix.

At least 91 records · Page 5Linked to original sources

A woman's attitude toward pregnancy. Can it predispose her to preterm labor?

A prospective study was designed to assess the relationship between a woman's attitude toward pregnancy, sociomedical factors and preterm labor among 434 consecutive pregnant women who filled out a self-reporting, multiple choice questionnaire at 24-28 weeks' gestation. The score on "poor investment in pregnancy," evaluating the maternal attitude toward pregnancy and the antepartum fetomaternal relationship, was the best predictor of preterm labor, followed by the risk score based upon sociomedical factors. Psychologic factors could play a significant role in the onset of preterm labor.

Adult↗

Lymphocyte response is enhanced by supplementation of elderly subjects with selenium-enriched yeast.

The effect of selenium supplementation on plasma selenium concentrations and lymphocyte-proliferation responses to mitogens was investigated in 22 elderly institutionalized subjects. Subjects were assigned to a 6-mo trial with either 100 micrograms Se/d (as selenium-enriched yeast) or a placebo. Plasma selenium concentrations of the selenium-supplemented group increased from 0.84 +/- 0.26 to 1.55 +/- 0.33 mumol/L (mean +/- SD) after 2 mo and the values plateaued thereafter. The mean response of lymphocytes to mitogens in elderly subjects tended to be lower than responses in healthy adults, although responses remained within the 5-95% confidence-interval limit for healthy adults. During selenium supplementation the proliferative response to pokeweed mitogen increased significantly (+79% of baseline concentrations after 4 mo, P less than 0.01) and reached the upper limit of the usual range for adults after 6 mo (+138%, P less than 0.001). In accordance with previous studies in animals and in vitro, this investigation demonstrates for the first time immunostimulatory properties of selenium-enriched yeast in elderly humans.

Aged↗

Social differences in low birthweight and preterm deliveries in twins.

The relationship between low social class and low birthweight or preterm deliveries is well established in singletons but not in twins. We present a study using all twin deliveries registered in Belgium in 1983 and in Aberdeen between 1951 and 1983. No significant relationship was found between social class and low birthweight, very low birthweight or preterm deliveries in the Belgian sample. In Aberdeen, we found significantly higher rates of low birthweight twins in low social classes. This increase of low birthweight twins in low social classes occurred in Aberdeen during the period 1951-1968, but not in the more recent data.

Belgium↗

Premature death among outpatients at a community mental health center.

In a ten-year prospective study, mortality among psychiatric outpatients under age 40 was investigated in a sample of 322 Belgian patients who first visited a community mental health center in a district of Brussels between 1970 and 1973. Fifteen of the patients died before age 40. Compared with 15 matched controls from the group of living patients, the deceased patients had a higher incidence of concurrent physical illness and changed residence less frequently. The standardized mortality ratio for male patients in the study was 5.05 times greater than expected for a sample of the general population of Belgium, and for women it was 5.63 times greater. Not all of the excess mortality could be attributed to suicide. Results confirmed previous findings of excess mortality due to natural causes in this population and of the greater incidence of mortality during the first years of treatment.

Adolescent↗

[Activity of the sympathetic nervous system and of the renin-angiotensin system in the acute stage of myocardial infarction].

We studied sympathetic and renin-angiotensin systems activity in a series of 175 patients suffering from acute myocardial infarction. These two systems were both overactivated especially in the cases complicated by hemodynamically documented left heart failure. The response of these systems to acute heart failure was in the same range for patients younger or older than 65 years and the witness (norepinephrine and plasma renin levels) of sympathetic and renin-angiotensin activities were good independent prognostic factors of in-hospital mortality.

Acute Disease↗

Improved prediction of left ventricular mass by regression analysis of body surface potential maps.

Electrocardiographic left ventricular (LV) hypertrophy involving ST-T abnormalities, in addition to high QRS voltages, is associated with increased risk of cardiovascular disease mortality. Unfortunately, conventional electrocardiographic criteria have limited utility in the quantitative assessment of LV hypertrophy. Body surface potential maps, which contain diagnostic information not present in commonly used lead systems, were recorded from 117 thoracic sites and 3 limb electrodes in 72 normal subjects and 84 patients with LV hypertrophy. Multiple regression analysis was performed separately for 54 women and 102 men on 120-lead data, using as features instantaneous voltages on time-normalized P, PR, QRS and ST-T waveforms. Leads and features for optimal prediction of echocardiographically determined LV mass were selected. A total of 6 features from 3 torso sites in men, and from the same 3 sites plus 2 others in women, yielded correlations between echocardiographic and electrocardiographic estimates of LV mass of 0.89 and 0.88, respectively. The standard errors of the estimate (SEE), or average errors in predicting LV mass from the regression equations, were 31 and 22 g, respectively. The single most potent predictor in both sexes was a mid-QRS voltage measured on a lead positioned 10 cm below V1; QRS duration, late QRS and early-to-mid T-wave amplitudes recorded in the lower left flank contributed significantly to the performance of both regression models. The optimal electrode sites for electrocardiographic prediction of LV mass were outside the conventional lead locations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Late results of surgical repairs of tetralogy of Fallot].

The late results of 115 children with tetralogy of Fallot born and corrected between 1969 and 1988 are analyzed; the patients were distributed into 3 anatomical groups: normal pulmonary annulus (group A, 49 patients) annular stenosis (group B, 56 patients) and pulmonary atresia (group C, 10 patients). The probability of survival 15 years after correction is 97 p. 100 in cumulated groups A and B and 72 p. 100 in group C (p = 0.005). The probability of reoperation ten years after correction is 4 p. 100 in cumulated groups A and B without a previous shunt, 20 p. 100 in A and B with a previous shunt (p less than 0.05) and 55 p. 100 in group C (p = 0.0004). The proportion of serious cardiac sequellae amounts to 17 p. 100 in group A, 55 p. 100 in group B and 100 p. 100 in group C (p = 0.0005). As a whole, 55 p. 100 of the adolescents operated on for tetralogy of Fallot during infancy present a residual problem of some severity.

Actuarial Analysis↗

Calculation of power for matched pair studies when randomization is by group.

A formula is given for the calculation of the statistical power of paired intervention trials in which the units of randomization are groups rather than individuals. Factors affecting the power of such trials are also investigated and an example is given where the power of group randomization is compared to that of individual randomization.

Humans↗

Epidemiological survey of insomniac subjects in a sample of 1,761 outpatients.

Clinical data about insomnia and its treatment were collected in a sample of 1,761 patients who had consulted general practitioners for insomnia. In this sample, we found an incidence of 53% of patients presenting some psychiatric symptoms. We also estimated that 24% of those patients suffered from a depressive disorder, confirming previous findings of the high association of insomnia with affective disorders and other psychiatric conditions.

Ambulatory Care↗

Is the quality of care in twins and in singletons related?

We investigated if it is possible to use the data collected in twins to identify areas with high rates of operative deliveries, preterm deliveries and low birthweight infants in singletons. Our data correspond to all deliveries registered in Belgium in 1983. A significant correlation was found between the rates of cesarean sections in twins and in singletons. A significant correlation was also found between the rate of deliveries at a gestational age of less than 32 weeks in twins and the rate of deliveries at less than 37 weeks in singletons. However, correlations between other preterm rates, low birthweight rates and vacuum extraction or forceps rates, were nonsignificant. We conclude that the use of twins as tracers of the quality of care in singletons is of limited value.

Belgium↗

Prevention of coronary heart disease: how far is the Belgian population from the recommended nutritional goals and ideal serum cholesterol levels?

For 15 years, recommendations concerning the primary prevention of coronary heart disease (CHD) have been made by international bodies or national agencies. In a national Belgian nutritional study (the B.I.R.N.H. Study), the authors review how far the Belgian population is from the recommended nutritional goals and ideal serum cholesterol. They also make comparisons between genders and look at differences according to the linguistic background (French- or Dutch-speaking subjects). Only a small percentage of the Belgian population reach the nutritional goals for total fat intake in males (8.4%) and females (7%), saturated fat intake (7.0% and 6.2%, respectively), and P/S ratio (13.5% and 12.4%, respectively). The percentages reaching nutritional goals are somewhat higher for polyunsaturated fat intake (27.9% and 28.6%, respectively) and dietary cholesterol (39.4% and 54.6%, respectively). A total of 29.9% of the male population, and 32.7% of the female population are at 'high risk' of CHD according to their serum cholesterol levels. In general the results are better for the Dutch-speaking population than for their French-speaking counterparts. In conclusion, despite modifications in eating patterns and a decrease in CHD mortality in Belgium during the 1970s, a very high percentage of males and females are still far from the recommended nutritional goals and ideal serum cholesterol levels.

Adult↗

The Belgian Heart Disease Prevention Project: 10-year mortality follow-up.

The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference in risk profile change was greatest at two years, intermediate at four years and minimal at six years. Total and cause-specific mortality rates were systematically followed from the 6th to the 10th year. Follow-up at 10 years was 99.3% complete. The differences between intervention and control groups in total, coronary and cardiovascular mortality reduced from the 6th to the 10th year. The results suggest that changes in risk profile are rapidly followed by changes in cardiovascular mortality, but this applies in both directions. Thus risk reduction should be maintained in order to achieve a long-lasting preventive effect.

Adult↗

Comparison of the attack rates of acute myocardial infarction in two Belgian towns.

Comparison of the attack rates for acute myocardial infarction in two Belgian towns AMI attack rates in two Belgian towns. Belgium is divided in two main regions: Flanders in the North with a Dutch-speaking population, and Wallonia in the South with a French-speaking community. From 1982 onwards, a register of acute myocardial infarction has been in operation in Ghent, a Flemish town, and in Charleroi in Wallonia, following the procedures of the MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases) study. Annual attack rates of myocardial infarction are presented for a 5-year period. During this period, the annual attack rates for men are 10-20% higher in Charleroi than Ghent. In women, the ratio between the two cities is less clear. The results of this community registers confirms the regional differences observed previously in Belgium using other epidemiological techniques.

Adult↗

Limitations on the prognostic value of predischarge data after myocardial infarction.

Clinical variables and those obtained by non-invasive techniques were studied prospectively in a series of 306 patients discharged from hospital after an acute myocardial infarction. The predictive value of the data at two and 12 months was assessed by univariate and multivariate analyses. The best correlation was found for age, hypertension, bundle branch block, early and late heart failure, x ray cardiothoracic ratio, digoxin use, the number of metabolic equivalents reached during the stress test, echocardiographic wall motion score index, left ventricular end diastolic diameter, left ventricular ejection fraction, and the presence of an aneurysm. The prognostic value of the same data at 12 months was studied in those surviving for two months. There was a noticeable decline in the relative risk of all but two of the factors (number of metabolic equivalents, ventricular arrhythmias). All of the predictive variables except the x ray cardiothoracic ratio, number of metabolic equivalents, and the presence of an aneurysm lost their discriminant power. The explanation for this is the strength of statistical relations of these variables with the outcome at two months. They continued to influence the score at 12 months even when the entire patient series was considered. In conclusion, the study shows that the predictive value of most of the predischarge variables usually taken into account in the assessment of risk in patients one year after infarction does not extend beyond the first two months.

Aged↗

A double blind study of 2 mg versus 4 mg nicotine-gum in an industrial setting.

In a double blind randomised trial to aid smoking cessation a 2 mg nicotine gum (n = 101) was compared with a 4 mg gum (n = 98), in smokers of at least 15 cigarettes/day. The trial involved blue and white collar workers and took place at their working place (industrial setting). Intervention during the one year follow-up period was minimal. At 3 months 36.2% of the 2 mg nicotine gum group reported to have stopped smoking, against 44.8% in the 4 mg group (non-significant difference). At one year in the 2 and 4 mg groups respectively 22.3 and 32.2% reported smoking abstinence (non significant difference). However in a sub-group with a higher nicotine-dependence score, only 18.5% were abstainers at one year in the 2 mg nicotine gum group against 32.9% in the 4 mg nicotine gum, which is a significant difference at the p = 0.05 level. This is however a post-hoc finding and should be taken with caution.

Body Weight↗

Protection against ischemic heart disease in the Belgian Physical Fitness Study: physical fitness rather than physical activity?

Occupational and leisure time physical activity and conventional risk factors were determined in the Belgian Physical Fitness Study, a prospective study of 2,363 healthy male factory workers who were aged 40-55 years at entry in 1976-1978 and who were followed for five years. Physical fitness, defined as the interpolated physical working capacity at heart rate 150 beats per minute, was measured in 2,109 subjects. In this subgroup, there were 31 myocardial infarctions and sudden deaths. Smoking, physical fitness, and high density lipoprotein cholesterol (HDL cholesterol) were independent risk indicators for subsequent ischemic heart disease, while both physical activity scores were not. It is concluded that in this healthy, predominantly sedentary population, the fitness level, but not the physical activity pattern, is an independent protective factor against ischemic heart disease.

Adult↗