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Biomedical subjects

Bahi Takkouche

Publications and source records attributed to Bahi Takkouche.

16 recordsLinked to original sources
PubMed2006

Education and dementia: a meta-analytic study.

Considerable controversy exists about the role of education in the risk of dementia. Individual studies have not been conclusive so far. To examine the hypothesis that lower education is associated with a higher risk of dementia, we carried out a meta-analysis. Observational studies published as of October 2005 that examined the association between education and risk of dementia were systematically reviewed. Relative risks (RRs) and odds ratios were extracted from cohort and case-control studies. We first compared the risk of dementia in subjects with high level of education with the risk of dementia in those with low educational level. In a subsequent analysis, we compared the risk of persons with high education with the risk of subjects with education level other than high (medium, low). We weighted log RRs for cohort studies or odds ratios by the inverse of their variances. Nineteen studies were included in our meta-analysis (13 cohort and 6 case-control studies). RRs for low versus high education level were: Alzheimer's disease (AD) 1.80 (95% CI: 1.43-2.27); non-AD dementias, 1.32 (95% CI: 0.92-1.88), and all dementias 1.59 (95% CI: 1.26-2.01). For low and medium versus high education level, the RRs were: AD 1.44 (95% CI: 1.24-1.67); non-AD 1.23 (95% CI: 0.94-1.61), and all dementias 1.33 (95% CI: 1.15-1.54). These results confirm that low education may be a risk factor for dementia, especially for AD.

Alzheimer Disease↗
PubMed2006

Factors associated with the pharmacist counselling without dispensing.

PURPOSE: To describe the pharmacist counselling without dispensing and to analysed the characteristics of pharmacies and pharmacists that provide this type of counselling, and the characteristics of customers that receive it to a greater extent. METHODS: We carried out a cohort study on a sample of 166 pharmacists in North West Spain. Different characteristics of pharmacists and clients and other variables related to counselling were measured (who initiates the consultation; type of consultation; whether or not the patient consulted with a doctor previously and who is the receptor of the counselling) were included in the models as independent variables. Pharmacist Counselling without dispensing (PhCwD) were included as dependent variable. We constructed logistic regression models. RESULTS: The response rate to the first questionnaire was 98.8% and the participation rate in the follow-up was 60%. Out of 7010 registered pharmacist counselling, 6034 were included in the final analysis (86.1%). The proportion of PhCwD is 26.3% (95%IC: 25.2-27.4). CONCLUSIONS: Our results show the number of working hours of the pharmacist and the amount of customers are associated with PhCwD. So working hours and amount customers should be reduced. Other factor that should be taken into account is the fact that pharmacists with less experience should give less counsels. Thus during the university period pharmacist counselling should be studied. Finally, our results show that an important proportion of counselling is given regardless the dispensation process, and this should be taken into account when defining the pharmacists remuneration system.

Adult↗
PubMed2005

Personal use of hair dyes and risk of cancer: a meta-analysis.

CONTEXT: Use of hair dyes has been suggested recently as a risk factor for several types of cancer in epidemiologic studies. This alarming news and controversial declarations by scientific organizations and general media have made necessary a systematic evaluation of the epidemiologic evidence. OBJECTIVE: To examine the association between personal use of hair dyes and relative risk of cancer. DATA SOURCES: We retrieved studies published in any language by systematically searching the MEDLINE (1966-January 2005), EMBASE, LILACS, and ISI Proceedings computerized databases and by manually examining the references of the original articles, reviews, and monographs retrieved. STUDY SELECTION: We included cohort and case-control studies reporting relative risk estimates and 95% confidence intervals (CIs) (or data to calculate them) of personal hair dye use and cancer. We excluded studies that dealt with occupational exposure. We carried out separate analyses for bladder, breast, and hematopoietic cancers and cancers of other sites. Seventy-nine studies were included of 210 articles identified in the search. DATA EXTRACTION: Data were extracted independently by 2 investigators. We used a standardized questionnaire to record information on study design, sample size, type of controls, year of publication, adjustment factors, and relative risks of cancer among ever users of hair dyes. When possible, we extracted association measures on use of permanent dyes and extensive use (>200 lifetime episodes of dye use). DATA SYNTHESIS: Study-specific relative risks were weighted by the inverse of their variance to obtain fixed- and random-effects pooled estimates. The pooled relative risk for ever users of hair dyes was 1.06 (95% CI, 0.95-1.18) for breast cancer (14 studies), 1.01 (95% CI, 0.89-1.14) for bladder cancer (10 studies), and 1.15 (95% CI, 1.05-1.27) for hematopoietic cancers (40 studies). Other cancers were examined by only 1 or 2 studies, of which the pooled or single relative risk was elevated for brain cancer, ovarian cancer, and cancer of the salivary glands. No effect was observed for use of permanent dyes or for extensive use. CONCLUSIONS: We did not find strong evidence of a marked increase in the risk of cancer among personal hair dye users. Some aspects related to hematopoietic cancer and other cancers that have shown evidence of increased risk in 1 or 2 studies should be investigated further.

Breast Neoplasms↗
PubMed2005

Do pharmacists' opinions affect their decision to dispense or recommend a visit to a doctor?

PURPOSE: To assess the relation between the pharmacists' opinions and the decision to dispense drugs without medical prescription and to recommend a visit to a doctor. METHODS: We carried out a cohort study on a sample of 166 pharmacists in North-West Spain. Pharmacists' opinions on prescription practice of the doctors, on pharmacists' qualification to dispense drugs without medical prescription, on their responsibility about dispensed drugs, on clients' qualification for self-medication, and pharmacists' perception of their work were collected through a personal interview. Dispensing and the recommendation to the patient to visit their doctor were measure in the follow-up. We constructed logistic regression models. RESULTS: The response rate to the first questionnaire was 98.8% and the participation rate in the follow-up was 60%. Pharmacists who considered that doctors prescribed excessively were less likely to dispense without medical prescription (OR = 0.48) and to send the client to the doctor more often (OR = 2.33). On the other hand, those who considered themselves to be capable to dispense without prescription do so frequently (OR = 1.24). A major appreciation of the pharmacist as a health educator was associated with a higher dispensing (OR = 3.81). Pharmacists who considered that customers' qualification for self-medication was good recommended, more frequently visiting a doctor (OR = 1.58). CONCLUSIONS: Our results show that the pharmacists' opinions are associated with their practice of counseling. Therefore, any program designed with the purpose of changing dispensing habits of the pharmacists should identify and take into account their opinions.

Adult↗
PubMed2005

Current global iodine status and progress over the last decade towards the elimination of iodine deficiency.

OBJECTIVE: To estimate worldwide iodine nutrition and monitor country progress towards sustained elimination of iodine deficiency disorders. METHODS: Cross-sectional data on urinary iodine (UI) and total goitre prevalence (TGP) in school-age children from 1993-2003 compiled in the WHO Global Database on Iodine Deficiency were analysed. The median UI was used to classify countries according to the public health significance of their iodine nutrition status. Estimates of the global and regional populations with insufficient iodine intake were based on the proportion of each country's population with UI below 100 microg/l. TGP was computed for trend analysis over 10 years. FINDINGS: UI data were available for 92.1% of the world's school-age children. Iodine deficiency is still a public health problem in 54 countries. A total of 36.5% (285 million) school-age children were estimated to have an insufficient iodine intake, ranging from 10.1% in the WHO Region of the Americas to 59.9% in the European Region. Extrapolating this prevalence to the general population generated an estimate of nearly two billion individuals with insufficient iodine intake. Iodine intake was more than adequate, or excessive, in 29 countries. Global TGP in the general population was 15.8%. CONCLUSION: Forty-three countries have reached optimal iodine nutrition. Strengthened UI monitoring is required to ensure that salt iodization is having the desired impact, to identify at-risk populations and to ensure sustainable prevention and control of iodine deficiency. Efforts to eliminate iodine deficiency should be maintained and expanded.

Child↗
PubMed2004

Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies.

OBJECTIVE: To explore the association between migraine and risk of ischaemic stroke. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Observational studies published between 1966 and June 2004 (identified through Medline and Embase) that examined the association between migraine and risk of ischaemic stroke. RESULTS: 14 studies (11 case-control studies and 3 cohort studies) were identified. These studies suggest that the risk of stroke is increased in people with migraine (relative risk 2.16, 95% confidence interval 1.89 to 2.48). This increase in risk was consistent in people who had migraine with aura (relative risk 2.27, 1.61 to 3.19) and migraine without aura (relative risk 1.83, 1.06 to 3.15), as well as in those taking oral contraceptives (relative risk 8.72, 5.05 to 15.05). CONCLUSIONS: Data from observational studies suggest that migraine may be a risk factor in developing stroke. More studies are needed to explore the mechanism of this potential association. In addition, the risk of migraine among users of oral contraceptives must be further investigated.

Adolescent↗
PubMed2004

Factors related with prescription requirement to dispense in Spain.

PURPOSE: To identify factors associated with prescription requirement to dispense. METHODS: We carried out a cross-sectional study on a sample of 166 pharmacists in North-West Spain. The following independent variables were collected through a personal interview: pharmacist's education and speciality, characteristics of the pharmacy, and its socio-economic environment. We constructed multiple regression models using as dependent variables: requirement of prescription to dispense five drugs which have to be dispensed with a prescription; and opinion on whether a prescription should be required to dispense these drugs. RESULTS: The response rate was 98.8%. A proportion of 65.9% of pharmacists dispense antibiotics without any prescription. This proportion is 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for ACE inhibitors, 13.4% for benzodiazepines and 84.8% for oral contraceptives. A higher requirement prescription was found to be associated with the antecedent of a speciality training of the pharmacist (p = 0.028) and his or her age (p < 0.001). A low prescription requirement is associated with the condition of being owner of the pharmacy (p = 0.032), with a high economic level of the population attended (p = 0.016) and with the size of the pharmacy (p = 0.045). CONCLUSIONS: The proportion of pharmacists who dispense drugs without a prescription is extremely high. Our results suggest that in order to increase quality of dispensing, it is necessary to increase pharmacist education and direct efforts of awareness primarily at pharmacists in charge, who are young and work in large pharmacies.

Adult↗
PubMed2004

The role of tomato products and lycopene in the prevention of prostate cancer: a meta-analysis of observational studies.

PURPOSE: To determine whether intake of tomato products reduces the risk of prostate cancer using a meta-analysis. METHODS: We systematically searched MEDLINE and EMBASE and contacted authors to identify potential studies. Log relative risks (RRs) were weighed by the inverse of their variances to obtain a pooled estimate with its 95% confidence interval (CI). Logistic regression and Poisson regression analyses were used to determine the effect produced by a daily intake of one serving of tomato product. RESULTS: Eleven case-control studies and 10 cohort studies or nested case-control studies presented data on the use of tomato, tomato products, or lycopene and met our inclusion criteria. Compared with nonfrequent users of tomato products (1st quartile of intake), the RR of prostate cancer among consumers of high amounts of raw tomato (5th quintile of intake) was 0.89 (95% CI 0.80-1.00). For high intake of cooked tomato products, this RR was 0.81 (95% CI 0.71-0.92). The RR of prostate cancer related to an intake of one serving/day of raw tomato (200 g) was 0.97 (95% CI 0.85-1.10) for the case-control studies and 0.78 (95% CI 0.66-0.92) for cohort studies. CONCLUSIONS: Our results show that tomato products may play a role in the prevention of prostate cancer. However, this effect is modest and restricted to high amounts of tomato intake. Further research is needed to determine the type and quantity of tomato products with respect to their role in preventing prostate cancer.

Carotenoids↗
PubMed2002

Intake of wine, beer, and spirits and the risk of clinical common cold.

To examine whether intakes of wine, beer, spirits, and total alcohol are associated with the risk of common cold, in 1998-1999 the authors analyzed data from a cohort study carried out in a population of 4,272 faculty and staff of five Spanish universities. Usual alcohol intake was assessed at baseline by means of a standardized frequency questionnaire that was validated in a random sample of the population. The authors detected 1,353 cases of common cold. Total alcohol intake and beer and spirits consumption were not related to the occurrence of common cold, whereas consumption of wine was inversely associated with the risk of common cold. When drinkers of >14 glasses of wine per week were compared with teetotalers, the relative risk was 0.6 (95% confidence interval: 0.4, 0.8) after adjustment for age, sex, and faculty/staff status. The association was stronger for red wine. These results remained unaltered after adjustment for total alcohol intake and for other potential risk factors for common cold. Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold.

Alcohol Drinking↗
PubMed2002

A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson's disease.

We conducted a systematic review to summarize the epidemiological evidence on the association between cigarette smoking, coffee drinking, and the risk of Parkinson's disease. Case-control and cohort studies that reported the relative risk of physician-confirmed Parkinson's disease by cigarette smoking or coffee drinking status were included. Study-specific log relative risks were weighted by the inverse of their variances to obtain a pooled relative risk and its 95% confidence interval (CI). Results for smoking were based on 44 case-control and 4 cohort studies, and for coffee 8 case-control and 5 cohort studies. Compared with never smokers, the relative risk of Parkinson's disease was 0.59 (95% CI, 0.54-0.63) for ever smokers, 0.80 (95% CI, 0.69-0.93) for past smokers, and 0.39 (95% CI, 0.32-0.47) for current smokers. The relative risk per 10 additional pack-years was 0.84 (95% CI, 0.81-0.88) in case-control studies and 0.78 (95% CI, 0.73-0.84) in cohort studies. Compared with non-coffee drinkers, relative risk of Parkinson's disease was 0.69 (95% CI, 0.59-0.80) for coffee drinkers. The relative risk per three additional cups of coffee per day was 0.75 (95% CI, 0.64-0.86) in case-control studies and 0.68 (95% CI, 0.46-1.00) in cohort studies. This meta-analysis shows that there is strong epidemiological evidence that smokers and coffee drinkers have a lower risk of Parkinson's disease. Further research is required on the biological mechanisms underlying this potentially protective effect.

Case-Control Studies↗
PubMed2002

Intake of vitamin C and zinc and risk of common cold: a cohort study.

To examine whether intake of vitamin C and zinc is associated with a decrease in the risk of a common cold, we analyzed data from a cohort study carried out in a population of 4,272 faculty and staff from five Spanish universities. Participants were 21-65 years of age, were full-time workers at those universities, and did not have antecedents of asthma or chronic obstructive pulmonary disease. Daily intake of vitamin C and zinc was assessed at baseline by means of a food frequency questionnaire of which the validity and reproducibility were determined in a sample of the population. Subjects were traced for 1 year to detect episodes of common cold, the diagnosis of which was based on symptoms and was validated by additional clinical signs. We detected 1,667 cases of common cold in 79,240 person-weeks of follow-up. Intake of vitamin C and zinc was not related to the occurrence of common cold. Compared with the first quartile of intake, women in the fourth quartile of vitamin C intake showed an adjusted incidence rate ratio of 1.0 (95% CI = 0.7-1.3), and for zinc intake this figure was 1.1 (95% CI = 0.8-1.5). The incidence rate ratios for men in the fourth quartile were 1.1 (95% CI = 0.8-1.4) for vitamin C and 1.3 (95% CI = 0.9-1.8) for zinc.

Adult↗
PubMed2002

Interaction between aspirin and ACE Inhibitors: resolving discrepancies using a meta-analysis.

BACKGROUND: Recently, studies have attempted to explore the interaction between ACE inhibitors and aspirin (acetylsalicylic acid) when both drugs are used concomitantly to reduce mortality in patients with coronary artery disease. Results have been conflicting due, in part, to sub-optimal methods used to explore this interaction. METHODS: We reviewed systematically all studies on mortality in patients treated with ACE inhibitors and aspirin and conducted a meta-analysis in order to explore the interaction between both drugs and resolve discrepancies. To be included, each study had to provide data on mortality of patients who received both drugs, either drug and no drug. These data were necessary to calculate the synergy index (S) and its 95% confidence interval (CI) that we used to quantify the effect due to interaction between ACE inhibitors and aspirin. After testing for heterogeneity of effects, we pooled the S values from the individual studies into one summary measure. Subsequently, we compared our results with those obtained through the most common but incorrect method of evaluating interaction. This method uses significance testing of the relative risk of mortality when a 'product term' between ACE inhibitors and aspirin is entered in a logistic regression model. RESULTS: Eight studies met the inclusion criteria. The pooled synergy index S indicates slight but precise antagonism between ACE inhibitors and aspirin (S = 0.91; 95% CI 0.80 to 1.03). In contrast, the pooled 'product term' is not significant and would have lead to the conclusion of absence of interaction (p = 0.15). CONCLUSION: There seems to be an antagonistic interaction between ACE inhibitors and aspirin. Former discrepancies were due to inadequate assessment of interaction. Results from the Studies on Left Ventricular Dysfunction (SOLVD) and Heart Outcome Prevention Evaluation (HOPE) trials that assessed the effect of combined administration of ACE inhibitors and aspirin were not included in this meta-analysis because those trials did not provide enough data to compute the S statistic. It is possible that results from on-going trials such as Women's Atovarstatin Trial on Cholesterol (WATCH) will shed more light on ACE inhibitor and aspirin interaction in the future.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription.

OBJECTIVE: To assess the influence of pharmacists' opinions on their dispensing medicines with a "medical prescription only" label without requiring a doctor's prescription. METHODS: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the pharmacist regarding the dispensed drugs; d) the customer' qualifications for self-medication; and e) the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. RESULTS: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. CONCLUSION: Our results suggest that to increase the quality of dispensing: a) the importance of the pharmacist's duty in controlling drug consumption should be stressed; b) pharmacies' workload should be optimized; and c) perceptions of physicians' prescribing practices among pharmacists should be improved.

Adult↗