Search PubMed⌕ Search

Biomedical subjects

X Thirion

Publications and source records attributed to X Thirion.

65 records · Page 4Linked to original sources
PubMed1990

The ethical approach to AIDS: a bibliographical review.

This bibliographical study involved first the exploitation of four data-banks: Medline, CNRS, Bioethics and AIDS, with the following key words (in conjunction with AIDS): ethics, human rights, confidentiality, legislation, jurisprudence. A total of 412 references were listed between 1983 and the end of 1987. Examination of the quantitative increase of articles over these years shows that, while references to AIDS and/or HIV infection--referred to as 'AIDS' for brevity--increased by about one third per year, the number of papers treating ethical problems linked to AIDS doubled each year. This increase makes it clear that these problems are important and pressing, that they are evolving rapidly and can be given no easy solution. After reading and analysis of accessible articles in readily comprehensible languages, the different themes can be classified in two categories: 1: Measures intended to protect society (starting with the most coercive); quarantine and isolation; discriminatory measures concerning specific groups; non-respect of the confidential nature of medical information; application of the penal code; screening; obligatory declaration and registration; testing of blood given by donors; vaccination and medical innovations, therapeutic assays; information, education. 2. Measures intended to protect the individual: fundamental rights of the patient: his/her right to confidentiality, to information and to treatment; civil rights: civil liberty, right to education, right to work, etc...; rights of the healthy individual: right of those in contact with the patients, safety of hospital staff, of those receiving blood-transfusions, etc... The legislation adopted in the various countries and the main opinions to be found in these articles are listed and analysed, and for each particular theme it is possible to refer to a list of the 232 most important articles. While the debate seems to concentrate on the conflict between the right of society to protect itself against the spread of infection and the 'civil' rights of the infected minorities, our conclusion tends to reduce this antagonism, showing that, particularly as far as the confidential nature of medical information is concerned, measures intended to protect the individual also protect society.

Acquired Immunodeficiency Syndrome↗
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↗
PubMed1985

[PROTIS, an expert system applied to the treatment of non-insulin-dependent diabetes. Evaluation of its efficacy].

PROTIS is an expert system devised to help general practitioners in the treatment of diabetes. It provides weighted results in ranking order from the most indicated to the most contra-indicated treatment. The reliability of PROTIS was tested comparatively by asking the system and two diabetologists involved in its design to analyze 250 clinical cases. The therapeutic advice given by PROTIS was considered satisfactory in 91.2% of the cases and erroneous, though without vital consequences, in 4.4%. The system was unable to propose any treatment in 4.4% of the cases. Most errors or non-responses could be corrected. This evaluation showed that PROTIS faithfully reproduces the reasoning of diabetologists and could serve as an example of what an expert system could do for the general practitioner.

Artificial Intelligence↗
PubMedDate not supplied

Plasma plasminogen activator inhibitor-1 in angina pectoris. Influence of plasma insulin and acute-phase response.

Plasminogen activator inhibitor-1 (PAI-1) is an important physiological inhibitor of fibrinolysis. It circulates in blood both in free active form and in inactive form complexed with tissue type plasminogen activator (t-PA). Control mechanisms for its synthesis and release from hepatocytes and endothelial cells are important in the pathogenesis of thrombosis. Possible risk factors for myocardial infarction include high insulin and PAI-1 levels, which correlate with one another in healthy subjects, and fibrinogen, which together with PAI-1, is an acute-phase reactant. We therefore studied the interrelationships between PAI-1, plasma insulin, and acute-phase proteins in 67 patients with angina pectoris. Plasma insulin correlated strongly (r = 0.59, p less than 0.001) with PAI activity, free PAI-1 antigen (r = 0.60, p less than 0.001), and total PAI-1 antigen (r = 0.58, p less than 0.001). The acute-phase proteins, fibrinogen and C-reactive protein, correlated significantly with t-PA antigen, total PAI-1 antigen, and PAI-1/t-PA complexes but not with PAI activity or free PAI-1. The results suggest that insulin stimulates synthesis and release of free PAI-1 (probably via hepatocytes as previously shown with cell culture) and that endothelial cell synthesis and release of t-PA, together with PAI-1, reflects a nonspecific acute-phase response to chronic vascular disease. Hyperinsulinemia found in patients with angina pectoris could play a role in the development of myocardial infarction via the induction of high plasma PAI-1 activity.

Acute-Phase Proteins↗
PubMedDate not supplied

[Dependence on psychotropic drugs and substitution treatment: recent trends. The OPPIDUM study of the Centers for Evaluation and Information on Drug Dependence (CEIP), October 1997].

The aim of this study was to identify the latest trends in psychotropic drug use and the effect of the increase of maintenance treatments for serious opioid addiction. The results are based on data from OPPIDUM, an annual survey primarily concerned with the consumption of licit and illicit drugs. The study involved 1066 drug addicts recruited during the month of October 1997 from 38 French health centres connected with the Centres for Evaluation and Information on Drug Addiction (CEIP). The most frequently reported drugs were benzodiazepines (n = 323), some of which, especially flunitrazepam (Rohypnol, n = 123), are extremely addictive. The data showed a slight decrease in heroin consumption as well as a marked increase in the use of maintenance treatments. The association between benzodiazepines and buprenorphine (Subutex) should consequently be studied, whether buprenorphine is being used illicitly or prescribed as a maintenance treatment.

Anti-Anxiety Agents↗
PubMedDate not supplied

[Attitude of psychiatrists to electrotherapy].

Psychiatrists practising in South-Eastern regions of France answered a questionnaire whose objective was to evaluate the technical conditions of the use of electroconvulsivotherapy (ECT), and to ascertain the way in which this therapy affected the lives of the patients (ECT is currently experiencing a revival in neuropsychiatric literature). Among the 400 psychiatrists who gave a complete response to the questionnaire, 22 per cent stated that they use ECT to treat inpatients. The authors try to define a typology of ECT users and non-users. The technical and scientific pragmatism of users contrasts with the highest moral reasons of non-users, although the latter do not form an homogeneous group. Factorial analysis methods were used to describe these populations with the most accuracy. The statistical analysis shows 4 sub-groups of psychiatrists: ECT users (22%); those who will never treat their patients with ECT because of ethical considerations (16%); those who will only use ECT for very serious inpatients but do not as yet have any ECT equipment at their disposal (58%); and the persons uncommitted about the use of ECT (4%).

Attitude of Health Personnel↗
PubMedDate not supplied

[A surveillance method for products used by drug addicts examined in emergency units].

Products used in a toxicomaniac way are in rapid change, and different from different area. Users too have to be better known. Authors present a simple survey method of these products, based on sample use. First results seem to be correct. These method may be used, associated with others, in a network as those existent for many years in the United States.

Adult↗
PubMedDate not supplied

[Benzodiazepine levels in drivers involved in traffic accidents].

A study of benzodiazepine impregnation of 234 drivers involved in road accidents showed a higher level of impregnation than that usually observed in the general population and a different frequency of this impregnation in the two populations. Although a significant correlation was found between responsibility of the driver and positivity of benzodiazepine assays, this result must be interpreted with caution and does not permit to attribute the responsibility for the accident to the presence of benzodiazepine in blood.

Accidents, Traffic↗
PubMedDate not supplied

[Kidney traumatism in general surgery (65 cases)].

From September 1989 to September 1994, 65 patients, 15 females and 50 males, with a mean age of 32 +/- 14 years were admitted in the emergency unit for renal trauma. In 38.5% of cases multiple trauma was present. Lesional mechanism was most frequently contusions (49.2%) and deceleration injuries (43.1%). Gross hematuria or microscopic hematuria were presents in 72.3% of cases. The sensibility of systematic abdominal echography was 100% in case of perirenal hematoma and 65% in case of parenchymatous lesions. Only 23 patients were operated (35.3%) because of low blood pressure. None secondary operation was necessary in abstention group. Global mortality was 7.7%. Postoperative morbidity was 20% and specific morbidity in abstention group was 10.7%.

Accidents, Occupational↗
PubMedDate not supplied

[Observation of illicit or misused psychotropic drugs (O.P.P.I.D.U.M.): five years of surveillance of products consumed by drug addicts at Marseille].

The aim of O.P.P.I.D.U.M. is the survey of products used by drug addicts. A five year survey, based on regular pools, has provided interesting results. 1,283 patients (80 per cent men, about 27 years old, 1/4 employed) used 2,241 drugs. The most frequent was heroin, followed by benzodiazepines, cannabis and cocaine. Flunitrazepam was the most commonly misused product, taken by users who started consumption earlier, with a higher rate of unemployment and imprisonment. Cocaine was as often taken intravenously as by sniffing, and most often used before imprisonment. Ecstasy (M.D.M.A.) has appeared recently. Codeine taken alone was used by subjects older than the heroin users, more frequently employed and virtually never prison inmates: this suggests the existence of an unofficial detoxication and substitution process. Confidence of clinicians needs anonymity of the records and return of information. Such a campaign is about to be launched.

Adolescent↗