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Biomedical subjects

R Lagasse

Publications and source records attributed to R Lagasse.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Maternal and child health in the Fourth World. Initial results of a socio-epidemiological survey].

This paper presents the results of a qualitative survey of young mothers in deprived conditions, which was conducted as a part of a broader socio-epidemiological research on health inequalities amongst mother and child. This survey reveals that this group is not solely distinguished in terms of socio-economic categories. Cultural dimensions play also an important role in explaining their health related behaviour. The survey was aimed at determining the logic and principles of coping with health and sickness. The specific attitudes and behaviour of the survey group was described through fourteen dimensions (definition and perception of health, prevention, relations with professionals, networks used...). The results show that any approach of the health problems of this group has to take its specific health culture into account and that this approach is inevitable in any effort to promote health and reduce social inequalities for the so-called "Fourth World".

Adult↗
PubMed1989

[Carbon monoxide poisoning in the Brussels metropolitan area. Home survey technics and proposals for action].

A previous study, preliminary to the organisation of a prevention campaign against carbon monoxide poisoning in Brussels, has confirmed the magnitude of this problem and shown the following two main risk indicators: the "age of the building" and the "nationality of the resident". Therefore, the actions conducted as part of this campaign, were principally focused on run down areas with high concentrations of immigrants. What's more, the possibility has been offered to every diagnosed victim to benefit from a free expertise of his equipment, in order to get a technical diagnosis. The analysis of our data related to all visits conducted from october 87 to april 88 shows that: 1. "resident's nationality" is not a risk factor, strictly speaking. When socio-economic standard is held constant, the risk appears to be identical in all nationalities; 2. most of the victims are underprivileged families; 3. among all apparatuses having been considered responsible for the accidents, around 2/3 are water-heaters; 4. if all kinds of apparatuses are considered, the most frequent faults seems to imply the users' responsibility, lack of maintenance, defective connection with the smoke evacuation system), but for water-heaters, which are responsible for the majority of accidents, the main cause appears to be linked to a defective installation, namely the ventilation of the room not being in accordance with the officials norms.

Belgium↗
PubMed1989

[Geographical variations in mortality due to diseases amenable to medical intervention in Europe--Commission of European Communities: atlas of avoidable deaths].

The urgent need to develop measures of the outcome of health-care services has led to the collaboration of 10 countries of the European Community in the production of the European Community atlas of avoidable death (1974-1978). Seventeen disease groups were chosen for which it was considered that death within specified age groups should be either wholly or substantially avoidable when appropriate medical care is sought and provided in good time. Mortality from these causes was compared across 360 health-service administrative areas in the participating countries. For all diseases there was considerable variation in mortality both within and between the countries of the European Community and it is suggested that high levels of mortality from these causes should be viewed by health authorities as warning signals of potential failures of health-care services. Work is in progress on a further edition of the Atlas for the years 1980-1984. Changes in avoidable mortality over time could indicate which health authorities have persistent problems and which authorities are succeeding in reducing avoidable mortality.

Adolescent↗
PubMed1988

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↗
PubMed1987

Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection.

A seroepidemiological study was performed on HTLV-III, T. pallidum, C. trachomatis and Hepatitis B virus (HBV), in Butare, Rwanda, among 33 female prostitutes, 25 male customers of prostitutes, and 60 male and female controls. As compared with female controls the prostitutes had a higher prevalence of antibodies to HTLV-III (29/33 versus 4/33, p less than 0.001), T. pallidum (TPHA: 27/33 versus 6/33, p less than 0.001; RPR: 19/33 versus 2/33, p less than 0.001; FTA-Abs: 27/33 versus 5/33, p less than 0.001) and C. trachomatis (IgG IF: 31/33 versus 13/33, p less than 0.001). HBV serological markers were more often detected in the prostitutes than in the female controls (31/33 versus 18/33, p less than 0.001) although HBs antigen carriage rate was similar in both groups. As compared with male controls, the male customers of prostitutes had more frequently detectable antibodies to HTLV-III (7/25 versus 2/27, p = 0.05), and a positive RPR (10/25 versus 1/27, p less than 0.01). Among the 118 individuals studied, odds ratios and trend analysis disclosed a significant association between HTLV-III seropositivity and a positive TPHA, RPR, FTA-Abs, Chlamydia IgG IF test and serological markers to HBV. No association was found between HTLV-III seropositivity and HBs Ag carriage. This study suggests that HTLV-III has to be considered as an infectious agent transmitted among promiscuous Central African heterosexuals by sexual contact and/or parenteral contact with unsterile needles used for STD treatments.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Avoidable mortality in Belgium].

The concept of avoidable mortality leads to an attempt at using specific mortality rates as output measures of health services. The analysis covered 43 Belgian districts between the years 1974 and 1978. Two Belgian areas were compared along a dimension defined by two axes of a correspondence factor analysis: Flanders which is associated with low SMR of avoidable mortality and Wallonia which has high rates. The persistence of high mortality in Wallonia was confirmed. Factorial scores for each district were used as indexes for geographical heterogeneity. Variations in these indices, including patient consultation rates and technical medical procedures, remained even after adjustment for socio-economic differences.

Adolescent↗
PubMed1987

Treatment of bacillary dysentery: a comparison between enoxacin and nalidixic acid.

A prospective randomized study has been conducted in Rwanda to compare the efficacy of enoxacin versus nalidixic acid for the treatment of bacillary dysentery in adults. Seventeen patients received nalidixic acid and 21 received enoxacin. All isolates (37 shigella, 1 campylobacter) were sensitive in vitro to the two drugs. All patients showed a favourable clinical and bacteriological response and the results obtained with both drugs were comparable. Enoxacin seems to be a good alternative to nalidixic acid for bacillary dysentery due to multiresistant shigella.

Adult↗
PubMed1987

[Episiotomy and prevention of complete and complicated tears. A study in 3 European countries].

The rates of third-degree tears in deliveries with and without episiotomy were compared in five samples: three French samples, a Belgian one and a Dutch one. Those samples corresponded to 48,430 single vaginal deliveries. The rates of episiotomy ranged from 29.3% to 54.2%. The results demonstrate that the risk of third-degree tears in vertex uncomplicated deliveries without episiotomy is low, and that in numerous cases third-degree tears are not prevented by an episiotomy. When uncomplicated deliveries of primipara were considered, results from four of the five samples showed that third-degree tears were not significantly more frequent in deliveries without episiotomy.

Belgium↗
PubMed1986

Reversibility of severe hypothyroidism with supplementary iodine in patients with endemic cretinism.

The reversibility of thyroid dysfunction in children with endemic cretinism treated with supplemental iodine is unknown. To study this question we conducted a five-month follow-up of 51 patients with cretinism (age 14 and below), who were randomly assigned to treatment (0.5 ml of intramuscular iodized oil) and control groups. The geometric mean initial serum level of thyrotropin (223 microU per milliliter; SD, 97 to 513) and the mean (+/- SD) initial serum level of thyroxine (1.0 +/- 1.2 micrograms per deciliter) indicated that all patients had severe hypothyroidism. Within one month after receiving the iodized oil, 13 of 14 of the younger patients (less than 4 years) and 1 of 9 of the older patients (4 to 14 years; P less than 0.001) had thyrotropin values below 20 microU per milliliter. Five months after treatment, the levels of thyrotropin had decreased and those of thyroxine had increased in all children, but greater changes occurred in the 13 younger patients than in the 14 older patients. The mean levels of thyrotropin were 2 microU per milliliter (SD, 0.6 to 6) vs. 38 microU per milliliter (SD, 11 to 132; P less than 0.001), and the mean (+/- SD) levels of thyroxine were 13.1 +/- 2.8 vs. 8.1 +/- 4.6 micrograms per deciliter (P less than 0.001). In the untreated group, 3 of the 9 younger patients and none of the 15 older patients recovered normal thyroid function within five months. We conclude that iodine supplementation restored a biochemically euthyroid state in all younger children with cretinism but only some of the older children. In addition, some younger patients became euthyroid without iodine supplementation.

Adolescent↗
PubMed1986

Ischemic heart disease and regional variations of socio-cultural characteristics in Belgium.

Ischemic heart disease (IHD) can be considered as a 'cultural disease'. It is surprising to see how IHD is differentially distributed in Belgium on both sides of the linguistic frontier, with higher prevalence, incidence and mortality rates in the South as compared to the North. Therefore, various socio-cultural characteristics have been under investigation in two samples of middle-aged men, in order to determine the most discriminative ones, according to the subjects' cultural belonging. The largest differences are found in the professional activities area, suggesting that stress related to profession might be responsible for the geographical distribution of the disease.

Age Factors↗
PubMed1985

Do breech presentations in twins and singletons run different risks?

We have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.

Apgar Score↗
PubMed1985

Episiotomy and third-degree tears.

The relation of episiotomy to third-degree perineal tears was investigated in 21 278 singleton deliveries. The incidence of episiotomy was 28.4% (n = 6041). Third-degree tears occurred in 1.4% (85) of the deliveries with episiotomy and in 0.9% (132) of the deliveries without episiotomy (P less than 0.01). To avoid the effect of confounding factors, we analysed a sub-sample that included only vertex presentations with spontaneous occipitoanterior vaginal deliveries. After stratification for birthweight and parity, no relation between episiotomy and third-degree tear was found.

Birth Weight↗
PubMed1984

Increased risk of primary hypothyroidism in preterm infants.

Serum levels of thyroid stimulating hormone, thyroxine, triiodothyronine, free T4, thyroxine-binding globulin, reverse T3, and the TSH secretory areas and peak T3 after intravenous injection of 40 micrograms thyrotropin-releasing hormone were determined weekly from day 5 to 6 to 11 weeks of age in 42 unselected full-term and 61 preterm Belgian infants. The results on day 5 indicated a progressive deficit of thyroid function related to the degree of prematurity. In 92 infants this deficit progressively decreased with age and disappeared at 5 to 7 weeks. However, 11 infants developed biochemical evidence of overt but transient hypothyroidism. Belgian neonates are relatively iodine deficient, and this factor affects the constitution of iodine stores within the thyroid gland: (1) the urinary concentrations of iodine in the 103 infants studied in Belgium were markedly lower than in 30 infants from California; and (2) The iodine concentration of the thyroid gland in preterm infants who died during the 10 first days of life was almost three times lower in Brussels than in Toronto. The results indicate that, in Belgium, the effects of relative iodine deficiency on thyroid function are superimposed on and mask the physiologic state of tertiary hypothyroidism in prematurity.

Belgium↗
PubMed1984

Endemic infantile hypothyroidism in a severe endemic goitre area of central Africa.

Thyroid function and exposure to dietary goitrogenic factors (iodine deficiency and thiocyanate overload) were studied at birth and from birth to 7 years in 200 neonates and 347 children living in the severe endemic goitre area of Ubangi, Northern Zaire. Serum T4 was at the lower limit of normal at birth (104 +/- 4 nmol/l) and stayed at that level during the first year of life (123 +/- 9) (NS), but decreased to 75 +/- 8 (P less than 0.001) at 2-4 years and to 62 +/- 6 (P less than 0.001) at 5-7 years of age. Mean serum FT4 decreased from 10.4 +/- 0.9 pmol/l during the first year to 8.2 +/- 1.0 (NS) at 2-4 years (NS) and to 7.7 +/- 0.9 (P less than 0.05) at 5-7 years. Mean serum TSH was 10.4 (8.4-12.9) mU/l (geometric mean +/- 1 SEM) during the first year, 10.1 (7.5-13.7) (NS) at 2-4 years and 24.3 (18.5-31.9) (P less than 0.05) at 5-7 years. Mean serum T3 was 3.23 +/- 0.12 nmol/l during the first year and remained stable thereafter. The frequencies of low T4 (T4 less than 77 nmol/l), high TSH TSH (TSH greater than 50 mU/l), and low T4 and T3 (T3 less than 1.69 nmol/l) were twice as high at 5-7 years as in the first year (respectively 65%, 42% and 15%). The urinary iodide concentration of the children was stable and low throughout the study period. By contrast, serum thiocyanate concentration which was high at birth (129 +/- 5 mumol/l) decreased to normal values between 3 and 12 months of age and increased again during and after weaning (1 to 3 years of age) to reach a value of 138 mumol/l which was comparable to that observed in adults in the same area. Thiocyanate concentration was high (133 +/- 7 mumol/l) in the mothers' serum but low in the mothers' milk (57 +/- 3 mumol/l) (P less than 0.001). Multivariate analysis showed that both iodine deficiency and thiocyanate overload were explanatory factors of the serum levels of T4, FT4 and TSH in children. In conclusion, our results show that infantile hypothyroidism is much more frequent at 5-7 years of age than at birth or during the first year of life. The deterioration in thyroid function during and after weaning is linked to persistent iodine deficiency accompanied by an increase in thiocyanate overload. The variability in the age of onset, the severity, and the duration of infantile hypothyroidism might explain the wide range of psychomotor and physical abnormalities observed in a large proportion of subjects in this area.

Adolescent↗