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Biomedical subjects

M Rey

Publications and source records attributed to M Rey.

At least 55 records · Page 3Linked to original sources
PubMed1998

Psychological symptomatology following parental death in a predominantly minority sample of children and adolescents.

Examined the psychological correlates related to experiencing the death of a parent, the main and interactive effects of sex, race, and age on youth distress and the degree of cross-informant correspondence on the outcome measures. The predominately minority sample included 80 bereaved youth and 45 nonbereaved youth. Youth and their legal guardians completed a battery of questionnaires, including measures assessing the youth's psychological symptomatology. Results revealed that bereaved youth manifested greater psychological and behavior problems than their nonbereaved counterparts on guardian-reported measures (Child Behavior Checklist [CBCL]). The clinical significance of parental death experienced during childhood is indicated by the magnitude of distress exhibited by the bereaved sample; almost one quarter of bereaved youth scored in the clinical distress range (T score > or = 63) on the CBCL Externalizing and Internalizing Distress scales. The effect of parental death on guardian-reported externalizing distress was moderated by race, such that distress levels did not significantly differ between bereaved and nonbereaved minority youth but did differ significantly among bereaved and nonbereaved nonminority youth. Finally, the degree of cross-informant agreement was relatively low but consistent with prior studies. Study implications for interventions with bereaved youth and directions for future research are discussed.

Adaptation, Psychological↗
PubMed1997

Risk of Hepatitis A Infection among Young Travelers to Developing Countries: The Need for Vaccination.

In France, as in most industrialized countries, the seroprevalence of hepatitis A virus (HAV) infection decreases due to improvements in hygiene and sanitation, but is still frequent in developing countries.1 In a cohort of military recruits followed up in France, this rate fell from 50% in 1978 to 16% in 1994.2 It is likely, therefore, that young travelers from industrialized countries would not have prior immunity and would be more susceptible to HAV infection when visiting endemic areas.3 However, a safe and effective vaccine for hepatitis A has been available since 1992.4 To highlight the need for this vaccination in young people traveling to such countries, we report a cluster of cases of hepatitis A in a troop of French scouts after they visited a West African village.

Journal Article↗
PubMed1997

Outbreak of trichinosis in France associated with eating horse meat.

The investigation of a trichinosis outbreak in Auvergne, France identified 23 cases in 12 households living in two cities-Clermont-Ferrand and Montluçon-between 15 February and 7 March 1991. One patient required intensive care, 15 had major symptoms, and seven had minor or no symptoms. Two case control studies demonstrated a significant (p < 0.01) association between eating horse meat and acute trichinosis. Veterinary services found that three supermarkets where the patients had bought horse meat during the suspected period had been supplied by a single wholesaler. The analysis of the wholesaler's records revealed that the implicated horse meat had been imported from a slaughterhouse in the United States. This outbreak occurred despite a requirement in France for all meat from horses slaughtered in France and in countries exporting meat to France to be examined systematically for trichinella.

Adult↗
PubMed1997

[Contribution of non-linear mathematics (chaos theory) to EEG analysis].

Since 1963, nonlinear dynamics or "chaos theory" were widely used in various area of physics. The first application to the analysis of the human electroencephalogram (EEG) was performed in 1985. A tutorial revue of some concepts of nonlinear dynamics is presented with the various results obtained since 1985. The dimensional complexity of the EEG (DC) seems a good descriptor of the "desynchronisation" or decorrelation of the EEG: DC is high with eyes open, during a mental task and also during a tonic epileptic discharge. DC is low with eyes closed, during slow wave sleep, and during a clonic epileptic discharge. The measure of DC could allow a more objective comparison between various states of electrical cerebral activity.

Electroencephalography↗
PubMed1997

High blood cadmium levels are not associated with consumption of traditional food among the Inuit of Nunavik.

High levels of cadmium in the liver and kidneys of caribous and sea mammals of the Canadian Arctic have led to recommendations to remove such offal from the traditional diet. Blood cadmium levels have been found to be very high in samples of Inuit volunteers, hence the hypothesis that the Inuit might be exposed to cadmium through their diet. This survey of a population-based random sample of Nunavik residents (n = 518) confirms that blood cadmium of Inuit is indeed very high by comparison to published reports. Blood cadmium levels are closely associated with the current smoking status and are independent of dietary patterns among nonsmokers. Plasma omega-3 fatty acids concentrations have been used to assess the reliability of the dietary information collected by questionnaires and to test for any association of blood cadmium with the consumption of sea mammals. Blood cadmium levels are not related to the reported consumption of sea mammals. Blood cadmium levels are very high among smokers and are associated with levels of exposure to tobacco. Among nonsmoking Inuit, blood cadmium levels are comparable with those reported in nonsmokers elsewhere in the world. In reference to international standards, blood cadmium concentrations are high enough among the Inuit to warrant energetic public health interventions.

Adolescent↗
PubMed1997

Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation.

BACKGROUND: The potential adverse effects of ketamine in neurosurgical anesthesia have been well established and involve increased intracranial pressure (ICP) and cerebral blood flow. However, reexamination of ketamine is warranted because data regarding the effects of ketamine on cerebral hemodynamics are conflicting. METHODS: Eight patients with traumatic brain injury were studied. In all patients, ICP monitoring was instituted before the study. Control of ICP (less than 25 mmHg), hemodynamic values, and blood gas tension (partial pressure of carbon dioxide in arterial blood between 35-38 mmHg) was obtained with propofol infusion (3 mg x kg(-1) x h(-1)) and mechanical ventilation. The effects of three doses of ketamine, 1.5, 3, and 5 mg/kg, respectively, on ICP, cerebral perfusion pressure, jugular vein bulb oxygen saturation, middle cerebral artery blood flow velocity, and electric activity of the brain (EEG) were measured. The three doses were administered intravenously at 6-h intervals over 30 s through a central venous line. Systemic and cerebral hemodynamics and end-tidal carbon dioxide were continuously monitored and recorded at 1-min intervals throughout the 30-min study periods. RESULTS: Ketamine, in all three doses studied (1.5, 3, and 5 mg/kg) was associated with a significant decrease in ICP (mean +/- SD: 2 +/- 0.5 mmHg [P < 0.05], 4 +/- 1 mmHg [P < 0.05], and 5 +/- 2 mmHg [P < 0.05]) among the study patients regardless of the ketamine dose used. There were no significant differences in cerebral perfusion pressure, jugular vein bulb oxygen saturation, and middle cerebral artery blood flow velocity. Ketamine induced a low-amplitude fast-activity electroencephalogram, with marked depression, such as burst suppression. CONCLUSIONS: These results suggest that ketamine may not adversely alter cerebral hemodynamics of mechanically ventilated head-trauma patients sedated with propofol. These encouraging results should be confirmed in larger groups of similar patients.

Adolescent↗
PubMed1997

Comparison of mortality risk: a score for very low birthweight infants.

AIM: To develop and evaluate a score which quantifies mortality risk in very low birthweight (VLBW) infants (birthweight below 1500 g) at admission to the neonatal intensive care unit. METHODS: Five hundred and seventy two VLBW infants admitted from 1978 to 1987 were randomly assigned to a cohort (n = 396) for score development and a cohort (n = 176) for score validation. Two hundred and ninety four VLBW infants admitted from 1988 to 1991 were used to compare risk adjusted mortality between the two eras. RESULTS: Using multiple regression analysis, birthweight, Apgar score at 5 minutes, base excess at admission, severity of respiratory distress syndrome, and artificial ventilation were predictive of death in the development cohort. According to regression coefficients, a score ranging from 3 to 40 was developed. At a cutoff of 21, it predicted death in the validation cohort with a sensitivity of 0.85, a specificity of 0.73, and a correct classification rate of 0.76. The area under the receiver operating characteristic curve was 0.86. There was no significant difference in risk severity and in risk adjusted mortality between the eras 1978-87 and 1988-91. CONCLUSION: The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk.

Apgar Score↗
PubMed1997

[The return of diphtheria in Europe. Is the French population protected?].

Following the generalized vaccination of children, the European countries achieved the elimination of diphtheria. However the huge epidemic which rages since 1990 in the New Independent States of ex-URSS, culminating in 1994-1995 (with respectively 47,802 and 50,412 notified cases), has showed that diphtheria could be still threatening. A serosurvey was carried out in France on 1,025 adult patients attending the emergency wards of three hospitals, located in different parts of this country. This study showed the insufficient immunity of adults, for lack of a routine programme for revaccination: only half of them have antibodies assuring their protection. The antitoxic immunity decreases according to age. This decline is more marked in women than in men, most of them being reimmunized during the military service. These data confirm the alarming results of similar serosurveys performed in others industrialized countries. The present risk of importing diphtheria in these countries requires a strengthening of clinical and bacteriological surveillance of all cases of infections attributable to C. diphtheriae, and could justify a revaccination programme for adult population, including a regular booster, at 10 year-interval, of a reduced dose of diphtheria toxoid (d), and/or using the combined toxoid Td in the wounded, instead of tetanus toxoid alone.

Adolescent↗
PubMed1997

[How to manage vaccinations in the elderly traveler].

Along with the growth of travels, the ageing of the population multiplies the number of older travellers. 13% of travellers could be at least 65 years old. It is admitted that there is no upper age limit to perform immunizations. Immunizations are all the more useful for older people because age generally aggravates infectious diseases. With age the immune response decreases definitely, especially that depending on cellular immunity, as well as the humoral response, as it has been observed with vaccinations against tetanus, flu, pneumococcal infections and hepatitis B. The first series of immunizations could be more affected by age than boosters. But a lot of questions still remain unanswered. Is there a maximum age beyond which the immune response would be unadapted to such an extent that it would be necessary to modify the immunization protocols as well as the periodicity of boosters? 75 years? 80 years? Is this age the same for all individuals? Is that a matter of a lower level of the antibody response, or rather of a slower, delayed response? The planning of older travellers immunizations meets another difficulty: their often vague knowledge of past immunization records and infectious diseases. One is often reduced to conjectures. Thus men, who have served in the army since the beginning of World War II are supposed to have got the first series of immunization against tetanus and diphtheria, but how can we restore their immunity (once we have defined the maximum age) when boosters have been either insufficient or missing? Conversely for women born before 1945, who were probably never immunized, a first series of immunization is warranted. On the other hand, since the immunization against poliomyelitis only came into effect in the sixties, most older adults have never been immunized but have acquired in the past a natural immunity from their contact with wild polio viruses. Naturally acquired antipoliovirus immunity doesn't seem to have decreased with age, unlike antidiphtheria and antitetanus immunity, as shown by recent serologic studies. Thus would a single booster with inactivated polio vaccine be sufficient to reinforce the immunity of most older travellers who have never been immunized? Considering these uncertainties, one could think of carrying out a serologic assessment prior to establishing an immunization program, as it has already been recommended for the immunization against hepatitis A. What would its feasibility be? There are quite a lot of questions to discuss. May this round table help define these questions and specify which investigations would be necessary to solve them, as well as program more rationally the immunizations of the older traveller.

Aged↗
PubMed1996

[Seroprevalence of markers of viral hepatitis A, B and C in hospital personnel at the Clermont-Ferrand University Hospital Center].

OBJECTIVES: Evaluate risk of hepatitis A, B and C infection and anti HBV vaccination policy in hospital personnel. METHODS: A sample of 440 health care workers (7.5% of the personnel at the Clermont-Ferrand University Hospital) representing 74.5% people directly involved in health care and 25.5% other workers were selected at random and stratified by work classification and age. A questionnaire was used to establish personal data on viral hepatitis status and blood samples were drawn for serological tests. RESULTS: Seroprevalence for hepatitis A was 52% with no significant difference between health care and other workers. For hepatitis B, 88.3% of the population had been vaccinated and anti-HBs titre was > or = 10 mIU/ml for 91.6% and > or = 50 mIU/ml for 86.1%. Seroprevalence for anti-HBc was 7% and none of the subjects were positive for HBs antigen. Anti-hepatic C antibodies were found in 2 health care workers (0.7%). CONCLUSION: These findings emphasize the need to persue further preventive actions against hepatitis A, B and C and the requirement for continued efforts in elementary hygiene.

Adult↗
PubMed1996

First biochemical evidence of differential functional effects following Gamma Knife surgery.

Clinical experience with radiosurgery for epilepsy on lesions located in highly functional areas has suggested the possibility of Gamma-Knife-induced functional effects without deterioration of the underlying cerebral cortex. To investigate these hypothetical functional changes, we have developed a special frame dedicated to small-animal radiosurgical experimental models, allowing purely atlasguided protocols. The left striatum of the first series of rats was targeted with high doses (200 Gy maximum) for validation of this new device. The same target was used with lower doses (50 Gy at the 50% isodose) in the second series to evaluate the biochemical changes and their chronology. The main biochemical changes occurred between 59 and 90 days after Gamma Knife irradiation, with different amplitudes depending on the biochemical parameter observed. Differential effects were first observed between glutamate decarboxylase and choline acetyltransferase, and secondarily between excitatory amino acids (AAs) and non-excitatory AAs, particularly gamma-aminobutyric acid. These preliminary results need to be confirmed and completed by further experimental studies. However, Gamma-Knife-induced differential biochemical effects provide the basis for a promising new concept for functional radiosurgery and particularly the Gamma Knife surgery of epilepsy.

Animals↗
PubMed1996

Color density spectral array for quick evaluation of sleep during nasal continuous positive airway pressure.

EEG color density spectral array enables quick evaluation of sleep. The aim of the study was to evaluate if an easily calculated sleep score based on this method could be used to assess the improvement of sleep after nasal continuous positive airway pressure (CPAP) in patients with sleep apnea syndrome (SAS). Eight hours of sleep are displayed on a single sheet along with EEG amplitude, 2 EEG channel spectra (FFT), electromyogram envelope and electro-oculogram. The x-axis corresponds to time, the y-axis to EEG frequency (range 0-16 Hz), and the color to the frequency power. This system allows the detection of sleep spindles, REM sleep and deep sleep (stages 3 and 4) as well as the evaluation of the sleep cyclic organization and its fragmentation by apnea. Based on these findings a sleep score is calculated. Eight young normal subjects were successively recorded as well as 15 SAS patients and with and without nasal CPAP. During the 1st night, the sleep score was lower in SAS patients than in normal subjects. With CPAP the apnea number decreased and the sleep score returned to normal in all patients except 1. A positive correlation was found between sleep score and duration of stage 2, stage 3 or REM sleep. A negative correlation was found between sleep score and the apnea index. This sleep score enables a quick and reliable evaluation of sleep in patients with SAS before and during nasal CPAP.

Adult↗
PubMed1996

Diphtheria s European come back.

Since children have been vaccinated routinely, diphtheria has been eliminated in most European states and the recent occurrence of a large epidemic in the Newly Independent States (NIS) of the former USSR was unexpected. The resurgence of diphtheria in th

Journal Article↗
PubMed1996

[Reflex epilepsy with seizures induced by mental calculation, playing chess and scrabble].

Reflex seizures induced by higher mental activity is rare. We report the case of a young man with myoclonic jerks and generalized tonico-clonic convulsion precipitated by calculation, playing chess and scrabble. Routine EEG, including hyperventilation and photic stimulation, showed no abnormality. Tests stimulation procedures, including spatial tasks, induced focal and generalized EEG spike-wave complex and myoclonic jerks. Valproate was effective in reducing epileptic seizures during a follow-up period of three years. Comparison of our case with previously reported reflex epilepsy with seizures induced by higher mental activity is discussed.

Adult↗