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Biomedical subjects

R Sambuc

Publications and source records attributed to R Sambuc.

At least 37 records · Page 2Linked to original sources
PubMed1996

Season of birth and schizophrenia: sex difference.

1. A statistically significant increased risk of schizophrenia for individuals born in winter has been reported. The increase risk is of the order of 5-15 percent. The seasonal effect is more marked among females. This winter birth effect suggests some environmental agents, probably a neuropathogen one, acting on the foetus. 2. The present study sought to test the environmental damage hypothesis by application of the family history of psychiatric disorder distinction to season of birth data divided according to sex and using a control population. 3. From computer records, all patients admitted to the psychiatric department of Marseilles Timone hospital between January 1984 and December 1989 who satisfied DSM III, DSM III R criteria for schizophrenia were identified. Patients were then classified into two groups: family history of psychiatric disorder versus no family history. Division according to the sex was carried on after two groups were formed. 4. The data show (I) a significant excess of births in the early months of the year (p < 0.05) for all patients with no family history of psychiatric disorder, (2) a significant excess of births for females (p < 0.05) with no family history. 5. These results provide indirect support for the neurodevelopmental theory of schizophrenia.

Adult↗
PubMed1995

Prevalence surveys of nosocomial infections using a random sampling method in Marseille hospitals.

In 1992, we conducted two prevalence surveys on hospital-acquired infections (HAIs) in a group of eight university affiliated hospitals with a total of 4462 acute care beds. Most of the intensive care units (ICUs) already had a prospective surveillance scheme. The need for HAI rates that could be estimated easily and economically led us to develop a prevalence survey by using a stratified sampling method. The units were distributed into four groups: ICU; clean surgery; other surgery; and medical. In each group a sample of units was randomly selected using different sampling fractions. The first survey was conducted in May and involved 1220 patients. The second survey in November included 1389 patients. The HAI rates in May and November were 8.6% (95% CI 7.4-9.8%) and 7.1% (95% CI 6-8.2%), respectively. This study allowed us to direct resources towards high risk units and clean surgical procedures. Based on the results, prospective surveillance was implemented in units of the clean surgery group.

Burn Units↗
PubMed1995

[Validation trial of a neonatal prophylactic antibiotic protocol in the delivery room].

Maternofetal infection occurs in 1 to 10 of every 1,000 newborns. Prognosis is poor and an extremely rapid the clinical course is sometimes observed. The situation suggests that widespread use of antibiotics and more than 90% of the newborns receiving antibiotics are not infected. A prospective study based on simple, recognized criteria predictive of maternal-fetal infection was conducted in 3,392 deliveries to evaluate the effect of an antibiotic prophylaxy protocol. Specificity, sensitivity, positive and negative predictive value were evaluated for each of the eleven criteria retained with the goal of increasing sensitivity and decrease the use of unnecessary antibiotics. Among the 3,392 infants delivered from January 1989 to December 1990, 286 (8.4%) newborns entered the study and were given mezlocillin (150 mg/kg/12 h). This treatment was stopped at 48 hours of life if the infant was not infected. RESULTS. Infection was confirmed in 48 of 3,392 infants (1.4%). All were in the risk group: 48/286 (16.7%). The germs the most often found were group B Streptococcus (n = 16), Escherichia coli (n = 8) and Listeria monocytogenes (n = 3). Nine criteria were well correlated with maternal-fetal infection. The two most important criteria were maternal pyrexia above 39 degrees C and Apgar score below 7 to 5 min (poor neonatal adaptation), with a 99% and 90% and a positive predictive value of 80% and 37% respectively. Inversely, Two criteria were poorly correlated with maternal-fetal infection: labour duration above 12 hours and instrumental extraction (positive predictive value from 10% to 17%).(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1995

[Medico-economic aspects of the treatment of duodenal ulcer: from antisecretory treatment to eradication of Helicobacter pylori].

OBJECTIVES: Radical changes are currently taking place in the treatment of duodenal ulcer, where strategies of eradication of Helicobacter pylori are replacing traditional antisecretory treatment. The aim of this study is to present the economic aspects of the different therapeutic approaches. METHODS: A critical analysis based on a selected number of clinical trials and medical economic analyses published in the international literature. RESULTS: A comparative analysis of traditional ranitidine/omeprazole treatments shows that ranitidine is more cost-effective in France at short term. With regard to traditional strategies, there are no French studies comparing H2-antagonists to proton pump inhibitors. Comparative studies seem in favour of eradication of Helicobacter pylori over traditional therapies, both in terms of cost and effectiveness. CONCLUSION: Arguments comparing the effectiveness of proton pump inhibitors versus H2-antagonists have become obsolete. In current therapeutic approaches of duodenal ulcer, the level of inhibition of the acid secretion no longer plays an important role.

Anti-Ulcer Agents↗
PubMed1994

Effect of heavy smoking on nasal resistance.

Smoking is a part of our sociocultural environment. Its medical consequences are probably still underestimated. In this prospective clinical study, we explored the relationship between heavy smoking and nasal resistance. Anterior rhinomanometry was performed in 26 smokers and 26 non-smokers. Each group contained 13 men and 13 women. Analysis of variance of nasal resistance measurements using age and weight as covariables showed no significant difference between sexes. In contrast, a highly significant increase was noted between smokers and non-smokers. Age and weight had no influence on these results. Rhinomanometry proved to be an excellent method of detection for these modifications. Similar studies on the effects of passive smoking and of atmospheric and occupational pollutants should follow in the near future.

Adult↗
PubMed1992

[Epileptic crisis during and after cerebrovascular diseases. A clinical analysis of 78 cases].

Seventy-eight patients with post-stroke seizures were studied retrospectively to determine the clinical, EEG and CT features of these seizures and their prognosis. There were 57 cerebral infarctions and 21 hemorrhages. Twenty-eight (36%) initial seizures occurred within one month after the stroke (0-24 hours in 19 cases) and were classified as early-onset seizures. Fifty (64%) initial seizures occurred more than 3 months after the stroke (3-12 months in 33 cases) and were classified as late-onset seizures. Compared with a population of 1938 strokes admitted during the same period, the proportion of patients with alcohol abuse, infarction in the anterior cerebral artery territory, watershed infarcts and lobar haemorrhages was significantly greater in our series. The proportion did not vary with the nature of the stroke (infarction or hemorrhage), except for early onset seizures in which the proportion of hemorrhages was significantly greater. Nor did it vary with the cause of hemispheric infarctions (cardioembolism or atherothrombosis or others). Ninety-five percent of the lesions affected the cerebral cortex or the subcortical white matter or both. Of all 78 initial seizures, 64% were partial motor (simple or secondarily generalized); 32% were primarily generalized, and 4% were partial not motor; status epilepticus was seen in 14% of the cases. An initial EEG, performed in 76 patients was normal in 7. Among the remaining 69 patients EEG showed focal or diffuse slowing down in 63% and epileptic features in 37% (including 10 cases of PLEDs). Early post-seizure EEG and repeated recordings significantly increased the specificity of EEG.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1992

[Extracellular and intracellular activity of sparfloxacin against Mycobacterium avium complex and Mycobacterium xenopi].

Activity of the new fluoroquinolone sparfloxacin against 30 strains of M. avium complex and 25 strains of M. xenopi was tested in vitro. Sparfloxacin was used alone (determination of MICs and MBCs) and in combination with ethambutol and rifabutin. Synergy studies with determination of the FIC and FBC indices showed that the sparfloxacin-ethambutol combination was synergistic against 10 M. avium complex strains and 12 M. xenopi strains. With the three-drug combination (sparfloxacin-ethambutol-rifabutin), synergy was found against 12 M. avium and 14 M. xenopi strains. Studies of intracellular bacteria showed that the decrease in viable bacteria with the three-drug combination was 1 log for M. avium and 2 log for M. xenopi.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[The significance of quantified EEG in Alzheimer's disease. Changes induced by piracetam].

One study was performed in 12 patients with presenile Alzheimer's disease (group I), the other one in 16 patients with mild senile dementia of Alzheimer type (group II). In each study, patients were divided into two randomized parallel groups, one receiving placebo, the other piracetam (9 g daily in group I piracetam and 2.4 g daily in group II piracetam) during three months, piracetam induced a decrease in EEG power on the 2-6 Hz range (group I piracetam), 3-5 Hz and 7 Hz (group II piracetam) and an increase of EEG power in the 9-11 Hz range (group I piracetam) and in the 10 Hz and 13 Hz frequencies (group II piracetam). There was also a significant improvement in the Trail Making Test part A in group II piracetam. Correlations between decreased EEG low frequency components and improvement in some psychometric tests were found significant in the two groups. It seems that the main effect of piracetam was to induce increased alertness. The same results were found in both studies; the good reproducibility suggests that EEG spectral analysis is a reliable tool in the assessment of psychotropic drug effects.

Aged↗
PubMed1990

[Neonatal screening for phenylketonuria and hypothyroidism. An optimizing system].

Screening for phenylketonuria and hypothyroidism in neonates is currently performed on blood samples collected on the 5th day of life. The efficacy of blood-sampling is evaluated subsequently. Double-sampled and non-sampled children are not always identified. We present a system which provides complete control of child, and was tested experimentally over one year on the 4,260 births in a maternity hospital. The sampling done by the maternity hospital as very thorough: only 0.47% of the children were not sampled spontaneously (ET = 1.07 10(-3)). The sampling of children transferred to pediatric units before the 5th day was a little less rigorous: 6.06% were not sampled before the telephone reminder (ET = 1.86 10(-2)). After a year our system ensured a 100% sampling after identification and telephone reminder for non sampled children, and allowed us to spot and count cases of double-sampling.

Hospital Information Systems↗
PubMed1988

[Anonymity in epidemiological surveys: study and initiation of a new method].

The authors propose a system of registering epidemiological data which ensures strict observation of anonymity. Data are made anonymous at the source: the practitioners who possess the medically confidential information themselves compute the code number creating anonymity through a nonreversible calculation formula: it is impossible to work back from the number to the patient's identity, even if one has the formula and powerful computer resources. This method differs from simple data encoding whose key could either be discovered or revealed: it requires neither keys nor a secret but effects a definitive and irreversible transformation. In compliance with the recommendations of the committee on Ethics, of the French "Ordre des Médecins" and of the Law on Data Processing and Liberties, the method was subjected to a double test for reliability, experimental and theoretical.

Computers↗
PubMed1987

Comparison of once and twice daily administration of captopril plus hydrochlorothiazide on 24 h blood pressure levels.

The anti-hypertensive effect of captopril 50 mg plus hydrochlorothiazide 25 mg, given once or twice daily, was investigated by 24 h monitoring in hypertensive patients in a controlled, randomized, double-blind, cross-over trial. Ten patients with blood pressure (BP) greater than 160 and/or 95 mm Hg after a 15 day placebo period, were randomly assigned to one of two treatments, in which they either received the combination once daily in the first month, twice daily in the second and once daily in the third (Treatment Group A) or twice daily in the first month, once daily in the second month and twice daily in the third month (Treatment Group B). The anti-hypertensive effect of the drug combination was assessed by 24 h monitoring using a Dinamap 845 to establish mean BP levels and circadian curves. After 1 month the twice daily administration was more effective than the once daily, but after 2 months, and throughout the third month, there was no difference in the anti-hypertensive efficacy of the combination given either once or twice daily.

Blood Pressure↗
PubMed1986

Neurologic complications following carotid artery surgery: pathophysiology and predictive factors.

This study analyzes the results of 457 carotid artery operations done in 416 patients by the same surgeon during a five-year period. A total of 27 central neurologic complications were observed, 14 were transient and 13 were permanent neurologic deficits, nine of which resulted in death. The causes of these accidents were: embolism (12), intolerance to clamping (7), carotid thrombosis (3), and reperfusion injury (2). In three cases no cause could be found. Preoperative predictive factors for these complications were analyzed statistically by multivariate analysis techniques. A high-risk group was identified, characterized by diffuse atherosclerotic disease and by the presence of a previous neurologic deficit. The prevention of neurologic complications in carotid surgery goes far beyond the controversy of whether or not a temporary inlying shunt should be used. In our opinion indications for shunting are limited. Neurologic complications can be prevented by maintaining awareness of certain temporary contraindications in patients with permanent neurologic deficits and by exacting operative techniques.

Carotid Artery Diseases↗
PubMed1983

[A new thyrotoxicosis index. (Calculation Basis and applications)].

A new thyrotoxicosis index (pointer) is calculated according to frequency of signs and symptoms in a well documented population of 189 thyrotoxicosis and pseudo thyrotoxicosis cross maintained patients. Applied to a computerized population of 3 596 thyroid complained patients, this index provides four groups. Index greater than equal to 8,5 : thyrotoxicosis is quite sure (92.5%), 8,5 less than equal to index less than equal to 5 : 3 of 5 patients are thyrotoxicosic 5 less than index less than -- 1 : 1 of 5 patients is thyrotoxicosic (rough thyrotoxicosis, index less than equal to -- 1 : thyrotoxicosis can be refuted (98%).

Humans↗