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C Bonifacj

Publications and source records attributed to C Bonifacj.

8 recordsLinked to original sources

Validation of a food-frequency questionnaire using multiple-day records and biochemical markers: application of the triads method.

BACKGROUND: A food-frequency questionnaire (FFQ) used to assess usual food intake in Southern France has been validated by the classical means of multiple-day food records. To minimise over-estimation of the correlation between the dietary assessments by the FFQ and the reference method, which occurs if the random errors of questionnaire and reference measurement are positively correlated, a triangular comparison, the method of triads, was used. METHODS: We applied the triads model by comparing the FFQ with two multiple-day food records and three biomarkers. Only 87 subjects were included and completed the protocol. One biomarker (beta-carotene) was used for the 87 subjects and two biomarkers (urinary nitrogen and potassium) were measured in only 40 subjects. RESULTS: For beta-carotene intake assessment, the triad model, including the weighed multiple records (PETRA), was the best with estimates of validity coefficient of 0.39 [confidence interval (CI) 0.18-0.60] for the FFQ, 0.52 (CI 0.24-0.86), for PETRA and 0.85 (CI 0.43-1) for plasma levels of the nutrient. For protein and potassium intake assessment, the triad model including the estimated multiple records was the best only for the estimates of FFQ validity coefficient (0.61; CI 0.28-0.96 and 0.31; CI 0.09-0.66 respectively). CONCLUSION: Accuracy of the dietary assessment methods permitted a satisfactory estimation of the validity coefficient for beta-carotene intake by the FFQ, despite a small sample. However, the validity coefficients for protein and potassium showed wide CI values, indicating that a sample size < 50 subjects appears unsatisfactory for validation.

Adult↗

Prognostic value of myocardial lactate dehydrogenase subunit ratio in heart transplant recipients.

BACKGROUND: Allograft coronary artery disease (CAD) is a major long-term complication in heart transplant recipients. Unfortunately, methods for early estimation of the likelihood of development of the disease are not currently available. Lactate dehydrogenase (LDH) is composed of heart and muscle subunits. The prevalence of these subunits in LDH isoenzymes (LDH1 through LDH5) is an accurate indicator of myocardial metabolism and allows indirect estimation of oxygen availability to cardiocytes. This study investigated the prognostic value of myocardial LDH composition for the occurrence of morbid events in patients with severe allograft CAD. METHODS: Eighty-eight heart transplant recipients were followed up for a median of 4.3 years. The isoenzymes of LDH and the ratio of the heart and muscle subunits (H/M) were determined in 526 endomyocardial biopsy samples. RESULTS: Eleven patients (12%) died from allograft CAD during follow-up. They had significantly lower H/M ratios compared with event-free patients, with clear differences as early as 6 months after operation. A threshold value of 2.75 was derived from receiver operating characteristic curve analysis. Patients showing H/M values < or =2.75 had a significantly higher mortality rate than did those with higher values (p=.0003). Importantly, the H/M ratio emerged as the most powerful independent prognostic factor of death by allograft CAD (p=.001) in a multivariate model. CONCLUSIONS: Poor myocardial aerobic metabolism estimated through low H/M values was highly predictive of cardiac death resulting from severe allograft CAD. Analysis of LDH isoenzyme profile in routine endomyocardial biopsies might be of clinical value.

Adolescent↗

Comparison of dietary assessment methods in a southern French population: use of weighed records, estimated-diet records and a food-frequency questionnaire.

OBJECTIVE: The main objective of the study was to develop appropriate dietary assessment instruments for the French Mediterranean region and to validate the measurements they provide. SUBJECTS AND METHODS: Three different assessment methods were submitted to a sample of 150 male and female volunteers. 98 completed the protocol, which consisted of a 4 d weighed dietary record (PETRA) and a 7 d estimated-diet record (S7) based on a check list and a set of photographs, both these records being completed once in each season of the year, and a semi-quantitative (standard portion) food-frequency questionnaire (FFQ) including questions eliciting socio-demographic and anthropometric data, which was completed once only. The days when PETRA was used to evaluate food consumption coincided with the first 4 d of S7 (S4). RESULTS: Validation was based on nutrients and foods. Energy-adjusted Pearson correlation coefficients between S4 and PETRA ranged from 0.32 for vitamin E to 0.81 for vitamin C (mean: 0.65 for 21 nutrients). There was practically no misclassification in opposite extreme quartiles. Spearman correlation coefficients ranged from 0.63 for fish and sea-food to 0.90 for wine (mean: 0.76 for 16 food groups). There was practically no misclassification in opposite extreme quartiles. De-attenuated energy-adjusted Pearson correlation coefficients between FFQ and S7 ranged from 0.22 for proteins and monounsaturated fatty acids to 0.80 for iron (mean: 0.45). 10% or less of subjects were misclassified in opposite extreme quartiles (except for vitamin C, 12%). Spearman correlation coefficients ranged from 0.25 for green-yellow-red raw vegetables to 0.76 for wine (mean: 0.42). 8% or less of subjects were misclassified in opposite extreme quartiles (except for citrus fruit, 11%). CONCLUSIONS: Portion estimation using the set of photographs was validated by the correlation between S4 and PETRA for both nutrients and foods. The FFQ provides a reasonably reliable measure of macronutrient intake and a good measure of micronutrient intake when compared with the data in the literature. It performs less well for food intake. Better results can be achieved for FFQ: (i) by using the set of photographs instead of standard portions and (ii) by adding further questions on foods which are insufficiently covered.

Adult↗

[Case control studies of the risk factors for deep-vein thrombosis in an adult population hospitalized in internal medicine].

BACKGROUND: The ain of this study was to demonstrate risk factors for deep-vein thrombosis in adults in a hospital setting. MATERIALS AND METHODS: From May 1993 to Februrary 1995, 233 patients hospitalized in the internal medicine unit at the Montpellier University Hospital for deep-vein thrombosis were included. Each case was matched to a control case for age, hospitalization unit, and use or not of anti-thrombosis prophylaxy. Venous thrombosis was diagnosed in patients and confirmed to be absent in controls using duplex Doppler when phlebography findings were unconvincing. To eliminate possible false negatives (poor sensitivity of duplex Doppler in asymptomatic patients), all controls were contacted by telephone 3 to 6 months after discharge to ascertain whether or not they had been rehospitalized and if so for what reason. The patients and controls responded to questions designed to identify risk factors for deep-vein thrombosis described in the literature (patient characteristics, personal and family history, surgical history, associated diseases, abnormal blood tests, medical treatment, life style). RESULTS: The three main risk factors for deep-vein thrombosis for all ages and both sexes identified by multivariate analysis were: personal history of venous thrombosis (OR = 4.7, 95% CI = [2.4; 8.9]), family history of venous thrombosis (OR = 3.3, 95% CI [1.8; 5.9]) and surgical during the preceding 45 days (OR = 3.7, 95% CI = [1.2; 10.9]). In non-menopaused women, the main risk factor was minidose oral contraception (OR = 6.9, 95% CI = [1.9; 25.4]). CONCLUSION: In our population of hospitalized patients in an internal medicine unit, the main risk factor for thrombosis appeared to be, in general, a past history of venous thrombosis and in non-menopaused women, minidose oral contraception.

Adult↗

Comparative evaluation of blood culture using the Vital automated system and the Becton-Dickinson Septi-Chek BHI-S biphasic and Sch bottles.

A comparative study was performed using 1,168 aerobic and anaerobic blood culture pairs from 395 patients, during which 5-10 mL of blood were collected in both Septi-Chek BHI-S biphasic and Septi-Chek Sch bottles (Becton-Dickinson, Meylan, France) and Vital AER and Vital Ana bottles (bioMérieux, Marcy-l'Etoile, France). The bottles were analyzed by using a 7-day protocol for Vital and a 12-day protocol for Septi-Chek. The Vital bottles revealed negative were all subcultured at the end of the protocol. Of the 374 positive Septi-Chek bottles, only 202 bottles gave a positive subculture. Of the 245 positive Vital bottles, 223 bottles led to the isolation of a microorganism. Thirty-five septic episodes were detected by Septi-Chek compared to 38 by the Vital system (only clinically significant isolates were taken into consideration). Four septic episodes were detected by Vital only (one episode implicating coagulase-negative Staphylococcus, one Streptococcus pneumoniae, one Pseudomonas aeruginosa and one Candida albicans, involving a total of 15 bottles). One septic episode implicating Bacteroides fragilis was detected by Septi-Chek only (five bottles). Among the negative Vital bottles, only six bottles gave a positive terminal subculture. This study validates the reliability of the Vital system to detect positive blood cultures.

Bacteria↗

Amniocentesis before 15 weeks' gestation: technical aspects and obstetric risks.

In a prospective case-control study, early amniocenteses (EAC, n = 242) at between 12 and 14 weeks gestation, were compared with standard amniocenteses (SAC, n = 242) performed at between 15 and 24 weeks gestation. The medical records of these 484 cases were reviewed for indications, success rate, color and volume of amniotic fluid, gestational age, number of needle insertions, location of the placenta, culture failure rate, obstetric complications and therapeutic abortion rate. There were no significant differences between the two groups in success rate, in culture success rate or in the outcome of the pregnancies. The volume of the sample taken was smaller in the EAC patients (P < 0.001), and therapeutic abortions were performed significantly earlier (P < 0.02.) Results show that EAC is feasible from 11 weeks' gestation, and can be performed for the usual indications as an alternative to chorionic villus sampling. In the near future, cytogenetic techniques will enable results to be obtained in less than a week.

Adult↗

Increased prevalence of soft tissue hand lesions in type 1 and type 2 diabetes mellitus: various entities and associated significance.

Sixty Type 1 (insulin dependent) and sixty Type 2 (non insulin dependent) diabetic patients attending a diabetology unit were examined in search of limited joint mobility, Dupuytren's disease, flexor tenosynovitis and carpal tunnel syndrome, in comparison with two populations of 60 non diabetic controls matched for sex and age with the Type 1 and the Type 2 diabetic patients. Microangiopathic and neuropathic complications, glycaemic control, blood pressure and tobacco consumption were simultaneously assessed in 39 of the 60 type 1 and in all the type 2 diabetic patients. The prevalence of the various soft tissue hand lesions was higher in both diabetic populations (respectively Type 1 and Type 2) than in their control populations: Limited joint mobility: 33.3 and 26.7% vs 5.0 and 8.3% (both p < 0.01); Dupuytren's disease: 35.0 and 30.0% vs 6.7 and 10.0% (both p < 0.01); flexor tenosynovitis: 23.3 and 16.7% vs 0.0 and 3.3% (p < 0.01 and p < 0.05); carpal tunnel syndrome: 26.7 and 15.0% vs 3.3 and 5% (p < 0.01 and NS). The prevalence of limited joint mobility in Type 1 diabetes was independently associated with increasing age (p < 0.05) and to lower extent with increasing duration of diabetes (p = 0.05), whereas the prevalence of Dupuytren's disease only correlated with increasing age in both types of diabetes (p < 0.05). In Type 2 diabetes, the prevalence of flexor tenosynovitis also increased independently with age (p < 0.05), and the prevalence of limited joint mobility increased in the opposite way to the body mass index after adjustment on age, duration of diabetes and sex (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Experience with intraperitoneal insulin infusion from implantable programmable systems in type 1 (insulin-dependent) diabetes mellitus previously treated by external pumps.

The feasibility of the continuous intraperitoneal insulin infusion from implantable programmable systems was evaluated in 17 Type 1 (insulin-dependent) diabetic patients currently treated by external pumps. Eight subjects were using a continuous subcutaneous insulin infusion (cumulated experience: 7.4 patients x years) and nine subjects had a cumulated experience of 61.4 patients x years of continuous intra peritoneal insulin delivery by external pumps. The two studied implantable systems (A and B) were delivering the same pH neutral surfactant-stabilized semi-synthetic human insulin, but at the respective concentrations of 400 units per ml in group A (n = 12) and of 100 units per ml in group B (n = 5), via a peritoneal catheter. The pump was implanted in a subcutaneous pocket created in the abdominal wall under general anesthesia. The reported trial of implantable programmable systems is 21 patient x years with an individual experience of 1.2 +/- 0.4 years (mean +/- SD). A sustained and stable glycaemic control was obtained, as indicated by the haemoglobin A1c: 7.4 +/- 1.3% (normal range: 4.3-6.1%), the mean blood glucose: 7.4 +/- 2.1 mM.l-1, the standard deviation of blood glucose values: 3.4 +/- 0.4 mM.l-1 and the percentages of 13.1 +/- 4.5% and 6.1 +/- 6.1% of blood glucose values respectively over 11 mM.l-1 and under 2.8 mM.l-1 after one year. The only metabolic event to occur was one episode of ketoacidosis secondary to a catheter obstruction. No hypoglycaemic coma occurred contrasting with incidences of 0.54 and 0.05 per patient x year during subcutaneous external and intraperitoneal pumps respectively (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗