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Biomedical subjects

Serge Fanello

Publications and source records attributed to Serge Fanello.

9 recordsLinked to original sources
PubMed2006

[Addictive behavior after starting buprenorphine maintenance treatment].

OBJECTIVE: This study of a cohort of drug addicts receiving buprenorphine maintenance treatment in a district in western France focused on changes in their drug use and their social and work lives. It also looked at the health consequences of their drug use before and after maintenance treatment (mean: four years). POPULATION AND METHODS: From the files of an agency providing services to drug addicts, we randomly selected 180 of the 236 patients receiving buprenorphine maintenance treatment (BMT). Usable questionnaires were returned by 118 subjects (66% response rate). This self-administered questionnaire included 32 items. RESULTS: The respondents accounted for half the population receiving drug maintenance treatment and were representative of the population for age and sex. The mean age was 30 +/- 5 years, mean BMT dose 6,5 mg/day, and mean duration of drug maintenance treatment 47 +/- 27 months. Other drug use diminished during the four years of maintenance treatment: three of every four heroin users had stopped, opiate users dropped from 31% to 5% of the population, and cocaine use followed a similar trend. Benzodiazepine use also fell, but remained relatively frequent (27%, compared with 68% four years earlier). Drinking patterns changed from strongly alcoholic beverages to lower-proof drinks. Arrest rates dropped from 70% to 25%. The percentage of persons seropositive for HIV (4%) and HCV (33%) remained low, but too many subjects had not been screened (35%). Roughly 10% of these subjects had returned to work, mainly those who had cut their drug use most. CONCLUSION: While our survey reveals some positive points, especially a reduction in illegal drug use, several negative observations appeared, including combined use of cannabis and benzodiazepines, inadequate screening, and misuse of BMD. These results underline how important it is for care providers to focus simultaneously on medical treatment and identification of co-morbidities and to provide social work when necessary. The employment rate remains too low.

Adult↗
PubMed2005

[Foodborne botulism, epidemiologic aspects].

With a mean of 30 cases reported per year, following Italy, France ranks second in the European countries in terms of incidence of botulism. Food stuff of commercial origin, of artisanal or industrial manufacture fabrication, is increasingly implicated in the genesis of outbreaks of botulism. Moreover, the modern methods of conserving food (vacuum packed food, frozen food...) allow the development of Clostridium bacteria. The diversification of the risks related to the type of products incriminated and to the new conservation methods, associated with the extension of commercial exchanges, result in the risk of widespread internationally outbreaks of botulism.

Botulism↗
PubMed2005

[Botulism, a clinical diagnosis].

Foodborne botulism results from the effect of a neurotoxin produced by a sporulated anaerobic bacillus called Clostridium botulinum. The mode of contamination occurs through the consumption of foodstuff, already contaminated by the neurotoxin. Following an incubation period that varies from 2 hours to 8 days, the symptoms start with intestinal problems. Then paralysis of the cranial nerve pairs sets in, classically manifested by diplopia, dysphagia, dysphonia, areactive mydriasis and ptosis. The onset of motor disorders occurs in descending order with possible involvement of the respiratory muscles, hence requiring reanimation measures and sometimes mechanical ventilation. The diagnosis of botulism is clinical. Identification of the botulinum toxin in the blood or faeces of the patients or in the contaminating food stuff confirms the diagnosis.

Botulism↗
PubMed2005

[Foodborne botulism, prevent and treatment].

The United States and Europe agree that the treatment of botulism is based on symptomatical measures and, notably, on mechanical ventilation when the respiratory function is impaired. Opinions diverge regarding the specific treatment represented by anti-botulinum serum: used systematically in the United States and frequently in many European countries, France never uses it other than in a few cases. Identification of the contaminating foodstuff is a fundamental element in limiting extension of the disease. Reducing the delay in declaration and the identification and correction of bad cooking practices would help to reduce the number of cases of botulism.

Botulism↗
PubMed2005

[Key points.]

FOODBORNE BOTULISM, PREVENT AND TREATMENT:

Journal Article↗
PubMed2004

Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

STUDY DESIGN: Randomized parallel-group comparative trial with a 6-month follow-up period. OBJECTIVE: To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. SUMMARY OF BACKGROUND DATA: Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. METHODS: Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. RESULTS: After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. CONCLUSIONS: This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Absenteeism↗
PubMed2002

Biomechanical strains on the hand-wrist system during grapevine pruning.

OBJECTIVES: In order to understand the high prevalence of musculoskeletal disorders of the hand among vineyard workers, we conducted a study to evaluate biomechanical strains on the hand-wrist system during grapevine pruning. METHODS: Surface electromyography (sEMG) activity of the right flexor digitorum muscle and wrist posture were analysed in six healthy vineyard workers using the same hand-powered pruning shears during grapevine pruning. RESULTS: The biomechanical strains on the hand-wrist system were high during grapevine pruning. Mean sEMG activity during pruning was high [23.5% (standard error of the mean (SEM): 0.4) in the maximal voluntary handgrip contraction (MVC)], as was the mean cutting frequency per minute (38; range=24-48). Approximately 14% of cuts were performed with the wrist in extreme flexion/extension (F/E) (>60% of the maximum range). Numerous cuts required moderate (20%-40% of the maximum range) or extreme (>50% of the maximum range) ulnar deviation (17% and 12% of cuts, respectively). Approximately 18% of cuts required both high muscular activity (sEMG >15% MVC) and extreme ulnar/radial (U/R) deviation of the wrist (>50% of the maximum range). CONCLUSION: Pruning imposes high biomechanical strains on the hand-wrist system in view of the repetitiveness of the task. The magnitude of physical exposure during pruning explains the high prevalence of hand disorders among vineyard workers. The use of ergonomic pruning shears is advised to lower force exertion and to reduce the frequency of awkward wrist postures during pruning.

Adult↗