Biomedical subjects

M Joubert

Publications and source records attributed to M Joubert.

At least 55 records · Page 3Linked to original sources

PubMed1999

Quality criteria and access characteristics of Web sites: proposal for the design of a health Internet directory.

The increasing volume of information available on the Internet today is a problem for health care professionals who want to access rapidly data of high quality. Usual search engines and directories are not sufficient to satisfy their needs. Moreover, the information published by Web sites is not always guaranteed. Some institutions around the word deal with the definition of a set of criteria for the evaluation of medical Web sites. We base our current work on the technologies we developed previously in order to integrate sources of information of various kinds using the "Unified Medical Language System" knowledge bases. This paper focuses on quality criteria and access characteristics Web sites should satisfy to be registered in a "Health Internet Directory". The design of such a system is proposed and discussed.

Abstracting and Indexing↗

PubMed1999

Confidentiality issues within a clinical information system: moving from data-driven to event-driven design.

Within a hospital, the moving of medical information systems from retrospective data-gathering methods to prospective clinical information systems raises the question of the confidentiality of patient data. A method of improving the traditional matrix model usually used to achieve access controls is described. The event-driven model refers to the way a security system ensures that a given user has a valid "need-to" relationship to a given patient. Events are defined as the occurrence of specific data that trigger the creation or the updating of the relationship between the identity of a user and the identity of a patient (e.g., admission, discharge, transfer, prescription, and report). The creation and the deletion of the relationships between users and patients are based on numerous repositories and working lists of patients. This implementation requires an organization of the hospital activities which is able to manage, in a real-time manner, those repositories as closely as possible to the steps occurring during the patient's care process. Although this approach seems to reasonably fit the dynamic of the care process, it adds significant organizational constraints.

Computer Security↗

PubMed1998

Demographic and familial characteristics of HTLV-1 infection among an isolated, highly endemic population of African origin in French Guiana.

To determine the epidemiological characteristics of human T cell leukemia/lymphoma virus type I (HTLV-I) infection in the endemic village of Maripasoula, French Guiana, 1,614 persons (83.2% of the population) aged 2 to 91 years (mean age 21) were studied from November 1994 through April 1995. Plasma samples were screened by an HTLV-I ELISA and an IFA test (on MT2 cells), and positive samples were tested by an HTLV-I and -II type-specific Western blot. Overall seropositivity in the village was 6.7%, but HTLV-I infection was restricted to 3 of 6 ethnic groups, including the Noir-Marron (descendants of escaped African slaves, 8%), the Creoles (4.1%) and those of mixed Noir Marron/other ethnicity (3.6%). In the Noir-Marron population of 1,222 persons, including 606 men and 616 women and representing 76% of those tested, HTLV-I seroprevalence increased significantly with age in both sexes, reaching 40% in women older than 50 years. Univariate risk factors for HTLV-I seropositivity in women included older age, more pregnancies, more live births and a history of hospitalization. A cross-sectional analysis of sexual partners demonstrated an excess of discordant female HTLV-I+/male HTLV-I- couples, indicating preferential male-to-female sexual transmission. The demonstration of II HTLV-I-seropositive children aged less than 15 years, of whom 9 had a seropositive mother, suggested maternal-child HTLV-I transmission. Our results demonstrate a very high seroprevalence of HTLV-I in this South American population descended from African slaves, probably due to high rates of mother-to-child and sexual transmission within this rather isolated group.

Adolescent↗

PubMed1998

Approach to automation in immunohistochemistry.

The introduction of immunochemical techniques into the routine pathology laboratory has significantly expanded the capabilities of the pathologist in diagnostic procedures. Immunostaining represents a powerful diagnostic tool in the identification and localization of cellular antigens, in paraffin sections, frozen tissues and cell preparations. The labeled-streptavidin-biotin method provides excellent sensitivity and performance. This multistep procedure includes: incubation of the slide with primary antibody, reaction with the biotinylated secondary antibody, binding with an enzyme conjugated streptavidin and revelation with chromogen substrate. Evaluation of the finished product is directly dependent on the quality of the technique. The main critical steps of this manual method are reagents application, incubation times and rinsing. These steps could be accessible to automation. Automation in immunohistochemistry could guarantee a continuous quality of labelling in improving standardisation, optimization and traceability of operations. The required qualifications are analytical flexibility, low cost, walkaway operation, user-friendly interface and biosafety.

Automation↗

PubMed1998

Modeling and implementing a database on drugs into a hospital intranet.

Our objective was to develop a drug information service, implementing a database on drugs in our university hospitals information system. Thériaque is a database, maintained by a group of pharmacists and physicians, on all the drugs available in France. Before its implementation we modeled its content (chemical classes, active components, excipients, indications, contra-indications, side effects, and so on) according to an object-oriented method. Then we designed HTML pages whose appearance translates the structure of classes of objects of the model. Fields in pages are dynamically fulfilled by the results of queries to a relational database in which information on drugs is stored. This allowed a fast implementation and did not imply to port a client application on the thousands of workstations over the network. The interface provides end-users with an easy-to-use and natural way to access information related to drugs in an internet environment.

Chemistry, Pharmaceutical↗

PubMed1998

[Neonatal hypoxemia due to misaligned pulmonary vessels with alveolar capillary dysplasia].

BACKGROUND: Refractory hypoxemia in the newborn requires a precise diagnostic investigation for optimal and fast management. CASE REPORT: A full term newborn presented with refractory hypoxemia associated with radiologically clear lung fields and extrapulmonary shunt. Echocardiography ruled out a cardiac malformation. The persistence of hypoxemia despite treatment of the extrapulmonary shunt and the absence of parenchymatous pulmonary disease led to suspect misaligned lung vessels with alveolar capillary dysplasia. This diagnosis was confirmed by post mortem microscopic examination of the lung. CONCLUSION: The diagnosis of misaligned lung vessels with alveolar capillary dysplasia can be suspected on clinical features. The disposition of pulmonary veins must be checked to recognize this disease in case of neonatal death with pulmonary hypertension.

Capillaries↗

PubMed1998

ARIANE: integration of information databases within a hospital intranet.

Large information systems handle massive volume of data stored in heterogeneous sources. Each server has its own model of representation of concepts with regard to its aims. One of the main problems end-users encounter when accessing different servers is to match their own viewpoint on biomedical concepts with the various representations that are made in the databases servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet and to propose a method to realize it. This method is based on the knowledge sources provided by the Unified Medical Language System (UMLS) project of the US National Library of Medicine. Experiments concern queries to three different information servers: PubMed, a Medline server of the NLM; Thériaque, a French database on drugs implemented in the Hospital Intranet; and a Web site dedicated to Internet resources in gastroenterology and nutrition, located at the Faculty of Medicine of Nice (France). Accessing to each of these servers is different according to the kind of information delivered and according to the technology used to query it. Dealing with health care professional workstation, the authors introduced in the ARIANE project quality criteria in order to attempt a homogeneous and efficient way to build a query system able to be integrated in existing information systems and to integrate existing and new information sources.

Computer Communication Networks↗

PubMed1998

[Galen vein aneurysm. Review of the literature and report of 2 cases].

Aneurysm of the vein of Galen is a rare congenital disease, with a generally poor prognosis. It represents less than 1% of cerebral arteriovenous malformations. The intrauterine diagnosis of this vascular anomaly has been facilitated by vascular exploration with pulsed and color Doppler sonography. According to some studies focused on prognostical criteria, the perinatal prognosis seems to be invariably compromised when signs of cardiac decompensation develop prenatally, knowing that early delivery may generate additional complications in the very premature infant. Medical treatment is inefficient, because of the large, persisting systemic shunt, so that pregnancy termination may be performed, after parental consent, in some cases demonstrating all signs of cardiac decompensation. On the other hand, infants with normal velocity waveforms and a low extent of the systemic shunt have a good extrauterine adaptation. A full clinical evaluation of the affected neonates at the end of the first week of live is now the best way to select the infants for intravascular embolization.

Cerebral Veins↗

PubMed1998

Implementation of a database on drugs into a university hospital Intranet.

Several databases on drugs have been developed worldwide for drug information functions whose sources are now electronically available. Our objective was to implement one of them in our University hospitals information system. Thériaque is a database which contains information on all the drugs available in France. Before its implementation we modeled its content (chemical classes, active components, excipients, indications, contra-indications, side effects, and so on) following an object-oriented method. From this model we designed dynamic HTML pages according to the Microsoft's Internet Database Connector (IDC) technics. This allowed a fast implementation and does not imply to port a client application on the thousands of workstations over the network of the University hospitals. This interface provides end-users with an easy-to-use and natural way to access information related to drugs in an Intranet environment.

Computer Communication Networks↗

PubMed1998

Conceptual integration of information databases into an Intranet.

Large information systems handle massive volume of data stored in heterogeneous sources of information. Each server has its own model of concepts representation with regard to its aims. One of the main problems encountered by end-users when accessing different servers is to match their own viewpoint on biomedical concepts with their various representations that are made in the database servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet, and to propose a method to realize it. Moreover, this method provides designers of web sites with a powerful tool to manage them on the basis of an ontology of the biomedical domain. This method is based on the knowledge sources provided by the Unified Medical Language System project of the U.S. National Library of Medicine and exploits intensively the conceptual graphs theory.

Computer Communication Networks↗

PubMed1998

Towards semantic integration within an existing medical information system.

Talking about the problems of integration in medical information systems, the necessity to provide end users with a consistent and coherent view of patient's data, has been largely reported. In order to attempt this goal, systems need to perform semantic integration. We propose a pragmatic way to describe the semantics of the elements of a database, based on a bottom-up three steps process: 1. a back documentation of the elements of the system from their description contained in the data catalog of the database 2. a first semantic extension to transform a data catalog into a data dictionary 3. a second semantic extension to create a dictionary of the medical concepts from a data dictionary. This dictionary of concepts can be considered as the final result of "semantic integration". It contains a set of entities directly understandable by the end users. These entities are deduced or built from the elements collected and characterized in the data dictionary. This work reports the conceptual analysis and the implementation of such a data dictionary.

Database Management Systems↗

PubMed1998

Review of biomedical knowledge and data representation with conceptual graphs.

The basis of conceptual graphs theory is an ontology of types of concepts. Concepts issued from the ontology are interlinked by semantic relationships and constitute canonical conceptual graphs. Canonical graphs may be combined to derive new conceptual graphs by means of formation rules. This formalism allows to separate knowledge representation into a conceptual level and a domain-dependent level, and enables to share and reuse a representation. This paper presents conceptual graph applications to biomedical data and concept representation, classification systems, information retrieval, and natural language understanding and processing. A discussion on the unifying role conceptual graphs theory plays in the implementation of knowledge-based systems is also presented.

Artificial Intelligence↗

PubMed1998

[Extension of an acinar cell pancreatic carcinoma with cystic changes invading the Wirsung canal].

We report a case of acinar cell carcinoma of the pancreas with misleading cystic changes. A 32-year-old woman presented with symptoms suggesting acute pancreatitis on chronic pancreatitis. The abdominal computed tomography and the endoscopic retrograde pancreatography demonstrated hypertrophy of the pancreatic head associated with global dilatation of main pancreatic duct and secondary canals and a 5 cm communicating cyst. A intraductal papillary-mucinous tumor was suggested. Microscopic findings showed a poorly differentiated adenocarcinoma. Six months later, a liver metastasis was detected. The microscopic appearance was different, suggesting acinar cell carcinoma, confirmed by immunohistochemistry. Only two other cases of acinar cell carcinoma with cystic component have been reported in the literature.

Adult↗

PubMed1998

Towards interoperability of information sources within a hospital Intranet.

Information is usually available in heterogeneous data format and various legacy sources. Interoperability appears to be a major approach for applications to access information. The project ARIANE is devoted to provide end-users with an easy to use and natural access to information databases. In this frame we defined actors able to operate the mediation between end-users and information servers: a "broker" which selects appropriate resources and "mediators" which access data suppliers. We have implemented a web-oriented stand-alone prototype accessing three types of information sources: a bibliographical server, a SQL database server and a hypertext server. Both broker and mediators exploit the Unified Medical Language System knowledge sources, especially the Information Sources Map which allows a way to identify information servers.

Computer Communication Networks↗

PubMed1997

Role of the thermic effect of food in malnutrition of patients with chronic obstructive pulmonary disease.

Malnutrition in patients with chronic obstructive pulmonary disease (COPD) is classically ascribed to an increased resting energy expenditure (REE) secondary to high cost of breathing. However, malnutrition correlates only weakly with the severity of respiratory dysfunction, which suggests other mechanisms. The aim of the present study was to determine the possible role of diet-induced thermogenesis (DIT). Therefore, we evaluated the relationship between DIT and nutritional status, in particular fat-free mass (FFM) estimated by bioelectrical impedance analysis in 26 patients with stable COPD (mean FEV1 +/- SEM = 36.5 +/- 3.8% of predicted). Ten patients were undernourished (weight < 90% of ideal body weight [IBW] and/or FFM < 69% of IBW), and 16 were normally nourished. Diet-induced thermogenesis was determined by comparing postprandial energy expenditure and REE, the latter being measured after an overnight fast and the former over 4 h after a mixed test meal of 0.4 times REE load. No statistical difference in DIT was found between undernourished and eutrophic patients. There was no relationship between DIT and nutritional or functional parameters, notably FFM. These results suggest that malnutrition is not a consequence of an increased DIT.

Body Composition↗

PubMed1997

A UMLS-based method for integrating information databases into an Intranet.

The Internet and the World Wide Web provide today end-users with capabilities to access universally to information in various and heterogeneous databases. The biomedical domain benefits from this new technology, specially for information retrieval by searching and browsing various sites. Nevertheless, end-users may be disoriented by specific ways to access information on different servers. In the framework of an Intranet design and development, we present a method for integrating information databases based on knowledge sources of the UMLS. The method provides designers of a Web site with facilities to implement an easy and homogeneous access to information. The pages are built dynamically and displayed according to a style sheet and their content stored in a database during the design phase. The database also describes the links between pages. Moreover, this organization provides administrators with powerful capabilities to manage Web sites.

Databases as Topic↗

PubMed1997

[Sarcomatoid variant of chromophobe renal cell carcinoma. Report of 2 cases].

In this paper, we report two cases of sarcomatoid carcinoma arising in chromophobe carcinoma. The sarcomatoid component appeared as white, shiny areas, occupying less than 10% of each tumor and containing numerous mitotic figures. Whereas both components expressed cytokeratin, only the carcinomatous cells were positive for epithelial membrane antigen and only the sarcomatoid cells were found to express vimentine. Sarcomatoid transformation in chromophobe cell carcinoma has been reported exceptionally. An aggressive behavior may be expected. The variable proportion of sarcomatoid component may lead to multiplication of the samples, especially when white, firm and shiny areas are detected on gross findings.

Aged↗

PubMed1996

Plasma concentrations and pharmacokinetics of idebenone and its metabolites following single and repeated doses in young patients with mitochondrial encephalomyopathy.

OBJECTIVE: The pharmacokinetics and tolerance of idebenone after single or repeated doses have been studied in young patients with mitochondrial encephalomyopathy. RESULTS: No significant adverse effects were noted. In 3 out of 7 patients idebenone induced overall stimulation and improvement in arousal. Plasma concentrations of idebenone and its main metabolites were determined and the pharmacokinetic parameters of idebenone after single and repeated doses were estimated. During the single dose study, the mean plasma concentrations of idebenone and its main metabolites and mean pharmacokinetic parameters were comparable to published results (Cmax = 452.2 ng.ml-1, tmax = 2.3 h, AUC = 26 micrograms. ml-1.h, t1/2 beta = 16.5 h). During the repeated doses study, no significant difference was found between mean residual plasma concentrations of idebenone on Day 2 (47 ng.ml-1) and Day 5 (70.6 ng.ml-1), and mean t1/2 beta of idebenone after the single and after repeated dose studies, i.e., there was no evidence of accumulation. Although idebenone did not appear to accumulate during this study, the coadministration of anticonvulsants, often prescribed during mitochondrial encephalomyopathy, can affect its pharmacokinetics.

Adolescent↗