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Biomedical subjects

R Salamon

Publications and source records attributed to R Salamon.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Short-stay hospitalization of elderly persons: first step toward institutionalization?].

One month outcome after hospitalization was studied in 1695 persons aged 75 and over, living in the community and admitted to acute care medical units: only 9.6% of them were then institutionalized. Returning home requires a high level of independence for feeding, mental status and continence. The level of dependence of institutionalized patients was particularly high for dressing or bathing, technical care, mental status and security. A multivariate analysis showed that the only independent predictors of institutionalization were: sex, living alone, mental status and hospital type. The role played by physical disability must be counterbalanced by the effective physical assistance, brought to the elderly by institutional or informal home care after hospitalization. These results allow early identification of persons at high risk of institutionalization.

Activities of Daily Living↗
PubMed1990

[A randomized study of the treatment of threatened premature labor. Nifedipine versus ritodrine].

The authors compare the efficiency of two drugs in the treatment of threatened premature labour, the one being the calcium inhibitor (nifedipine) and the other a beta-mimetic drug (ritodrine). 62 patients after random selection were divided into two groups: 32 treated with ritodrine and 30 treated with nifedipine. The treatment was carried out over 7 days. The success rate was similar in both groups -72% for the ritodrine group and 63.33% for the nifedipine group. Women receiving nifedipine had slightly greater gain in weeks, six as against five for ritodrine. The side effects which were often found with nifedipine were; hot flushes (in 10 cases) and headaches (4 cases). These symptoms appeared 15-30 minutes after the first dose and were transitory. No neonatal complications were found. The ease with which a calcium inhibitor can be given suggests that it should be used more frequently in the treatment of threatened premature labour and particularly when there are contra-indications to the use of beta-mimetic drugs.

Adult↗
PubMed1989

[Electrophysiologic study of syncope. Prediction of results].

In order to determine the factors predictive of dysrhythmia or disorders of conduction, 20 variables were analysed retrospectively in 201 patients who had undergone electrophysiological exploration. The electrophysiological abnormalities found to be significant were major sinus dysfunction (corrected post-stimulation atrial pause longer than 1 second), subnodal block (HV interval greater than 70 ms) or induction of sustained monomorphous ventricular tachycardia. The electrophysiological exploration gave abnormal results in 50 patients (25 per cent) with ventricular tachycardia in 36, subnodal block in 11 and sinus dysfunction in 5. Multivariate analysis brought out 4 independent variables that were predictive of electrophysiological study results. Presence of a cardiac disease (P less than 0.001), male sex (P less than 0.001), bundle branch block (P = 0.002) or injury consecutive to a syncope (P = 0.003) were associated with an abnormal exploration. The odd ratio of an abnormal electrophysiological exploration in the presence of a variable as compared with the reverse situation was 10, 6.25, 3.8 and 5 respectively. Postprandial syncopes were associated with a negative exploration (P = 0.06). Combining these variables and using a logistic regression model would provide an estimate of the probability of a positive or negative electrophysiological study. The selection of a high probability group would then indicate whether or not an electrophysiological study would be required.

Aged↗
PubMed1989

Epidemiological surveillance of suicides and attempted suicides in Aquitaine, south-west France, using an original computer network of sentinel general practitioners.

To improve the epidemiological study of suicide and attempted suicides in Aquitaine, France, we developed a comprehensive surveillance system based on the input of Sentinel General Practitioners (SGPs). From October 1986 to May 1988, for each case of suicide or attempted suicide, the SGPs reported epidemiological data to our system through a computer network of personal home terminals (Minitels). Data included age, sex, method and result of attempt and antecedents. In an analysis of the relationship between the suicidal method, antecedents and results of suicidal act, the principal findings were a high rate of antecedents of suicide attempts by drug overdoses, hangings and drownings; and no antecedents for attempts by the use of firearms. This may show that the increasing accessibility of firearms is making it more likely that impulsive suicide attempts will be lethal.

Adult↗
PubMed1989

[What role do smoking and air conditioning play in the occurrence of otorhinolaryngological and upper respiratory symptoms in the personnel of a hospital center?].

A cross-sectional study of the risk factors of upper respiratory symptoms has been carried out in September 1987 among the 220 employees of the Dax General Hospital. The study was not able to prove that air conditioning contributed to the occurrence of this symptomatology, but showed that smoking was associated with the disease. Prevalence of symptoms was 34% among the employees who were smokers (32% of the personnel) and only 19% among the non-smokers (p less than 0.025). In the context of the national campaign against smoking, reducing the tobacco consumption at work in buildings with air conditioning systems is likely to decrease substantially the frequency of building sickness among the personnel. This recommendation seems particularly relevant to hospital settings.

Adult↗
PubMed1988

[Predictive factors of the therapeutic result in the prevention of auricular fibrillation. Role of electrophysiological studies].

A population of 50 patients suffering from paroxysmal attacks of atrial fibrillation was studied prospectively to evaluate the prognostic value of 20 variables: 6 clinical variables: sex, age, cardiopathy, number of arrhythmic attacks, "vagal" triggering, failure of class IA antiarrhythmic agents; 3 echocardiographic variables: left ventricular diastolic diameter and percentage of fibre shortening, left atrial diameter; 6 basic electrophysiological data: threshold, refractory periods at 110 and 150/min, modalities of induction of a sustained arrhythmia; 4 results observed with an infusion of flecainide in doses of 2 mg/kg: arrest or persistence of the arrhythmia, whether or not it could be reinduced and value of refractory periods; doses of flecainide administered orally. With a mean +/- SD follow-up period of 7.7 +/- 7.3 months, preventive treatment with flecainide 233 +/- 7 mg failed in 16 patients (32 per cent) and succeeded in 34 patients (68 per cent). Analysis of Kaplan-Meier curves and use of Cox's multidimensional model showed that two electrophysiological data were of prognostic value: atrial effective refractory period, and non-inducibility of the arrhythmia after intravenous administration of flecainide. Thus, the probability of failure increases with the refractory period value and decreases with the non-inducibility of the arrhythmia.

Aged↗
PubMed1987

Prevalence of legionellosis among adults: a study of community-acquired pneumonia in France.

Over a 24-month period, 274 patients with community-acquired pneumonia were hospitalized in Departments of Medicine at hospitals in Bordeaux, Lyon, Marseille, and Toulouse. Etiology of the pneumonia was determined either by organism identification or by indirect immunofluorescence in only 139 cases (51%). The most frequently isolated etiological agents were Streptococcus pneumoniae (34 cases), Legionella pneumophila (29 cases) and Mycoplasma pneumoniae (24 cases). The majority of patients with legionellosis were male (79%), middle aged (mean age: 53 years), and living in urban areas (69%). Their clinical features were atypical and did not differ from those of other pneumonias. Four patients with legionellosis (13.8%) died. L. pneumophila was isolated directly in only three instances. The study confirms the high prevalence of legionellosis (20%) among pneumonias of identified etiology. The fact that these cases had an atypical clinical presentation and that isolation of the organism was difficult reinforce the need to apply the CDC criteria for the interpretation of positive serological titers.

Age Factors↗
PubMed1987

[Factors related to length of hospitalization of elderly patients during short stay].

Length of stay of elderly patients in hospitals can be subdivised into a medical stay followed by a social stay. The average length of stay of 2134 patients aged 75 and over, admitted to 23 medical or geriatric acute wards in Aquitaine, was 13.6 days; 18% of the patients experienced a social stay of at least one day. The mean social stay was almost null (1 day) when the patient returned home, but could reach 5 days when he was discharged to a long term care facility. The kind of hospital, domicile in a rural area, the social network, and the grounds for hospitalization were significantly related to the total length of stay, but explained only 5% of variance if diagnosis was not taken into account. This percentage rose to 29% in the group with "bronchitis" as a main diagnosis. The length of social stay was related to the grounds for hospitalization, but also to recent family modifications; it did not depend on the kind of hospital. These results suggest a lack of accessibility to nursing-homes, following acute hospitalization.

Aged↗
PubMed1986

Risk of preangioplasty occlusion and myocardial infarction in one-vessel-disease patients scheduled for percutaneous transluminal coronary angioplasty.

Coronary occlusion or myocardial infarction occurred in 50 of 394 (13%) one-vessel-disease patients awaiting percutaneous transluminal coronary angioplasty (PTCA). To identify risk factors for these events, we first matched the 37 patients who demonstrated occlusion on the immediate preangioplasty repeat angiogram with 37 patients who did not. Matching was based on the time interval between angiograms, the date of the procedure, and the site of the lesion. Preangioplasty occlusion patients did differ from controls by age (47 +/- 11 vs 54 +/- 8 years, P less than .01), smoking status (34/37 vs 24/37, P less than .01), and angina class (2.6 +/- 1.0 vs 2.3 +/- 0.7, P less than .10) at the time of the first angiogram. Second, we pooled the data of the 37 preangioplasty occlusion patients with those of the 13 patients with preangioplasty myocardial infarction. The 50 cases with complication (coronary occlusion or myocardial infarction) were younger (47 +/- 12 vs 54 +/- 8 years, P less than .01), more often smokers (42/50 vs 24/37, P less than .05), and more symptomatic (2.7 +/- 0.8 vs 2.3 +/- 0.7, P less than .05) than the 37 controls. This study suggests that young smokers with severe angina are at high risk of preangioplasty occlusion and/or myocardial infarction; prompt management of these patients, when considered for PTCA, seems advisable.

Angiography↗
PubMed1986

Constrained poststratification.

Adjustment for covariates (or poststratification) is frequently used in the analysis of randomized clinical trials. The purpose of such analysis is mainly to eliminate some residual bias resulting from any imbalance between treatment groups for some important covariates. Usually, covariate effect is modeled with the data at hand. In this paper, we present a new method of poststratification ("constrained poststratification") which consists of estimating the prognostic significance of covariates in a large historical data base, transferring the model's coefficients into the (smaller) randomized trial data set, and estimating treatment effects conditional on this a priori information. In a simulated experiment, constrained poststratification allowed not only reduction of the bias but also enhancement of the efficiency of the estimation of treatment effect.

Bayes Theorem↗
PubMed1986

[Measuring severity in trauma resuscitation].

ISS is the most widely used anatomic trauma severity index. This scale uses clinical judgement. It is therefore a subjective method, the validity of which is somewhat questionable. The aim of this study was to compare the clinical index ISS with a new non-specific score; the "simplified acute physiology score" (SAPS). Five-hundred trauma patients were checked retrospectively. Were excluded small traumas which did not require ICU hospitalization. ISS were all calculated by the same specialist and SAPS was drawn out of the initial blood sample examination. The sensitivity (proportion of true positive) and the specificity (proportion of true negative) were calculated for the two scores at all different cut-off points. "Receiver operating characteristic curves" (ROC) were drawn and their areas were compared by means of the Hanley test. The best Youden index, i.e. the fewest false positives for the most true positives, was also calculated. Mean ISS was 23.3 +/- 9.2. Youden index was 0.1; sensitivity and specificity were respectively 57 and 52% for the cut-off points. Mean SAPS was 8.7 +/- 4.3. Youden index was 0.3 and sensitivity and specificity were respectively 68 and 62%. ROC curve area for SAPS was 0.69 +/- 0.02. ROC curve area for ISS was 0.56 +/- 0.03 (p = 0.0001). In trauma, SAPS seemed to be a better predictor of outcome than ISS.

Evaluation Studies as Topic↗
PubMed1986

[Management of pregnancy at risk: evaluation of fetal movements, determination of total plasma estriol and placental lactogen hormone in relation to fetal heart rhythm].

The authors studied 50 at-risk pregnancies to decide how useful fetal movements were prognostically. They compared this method with electronic measurements of fetal cardiac rhythm. The results show that it is both sensitive and specific. The levels of total oestriols and of plasma placental lactogen hormone when compared with the fetal heart rhythm are just as specific and sensitive.

Estriol↗