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Biomedical subjects

D Mallet

Publications and source records attributed to D Mallet.

14 recordsLinked to original sources
PubMed2006

Development of a COPD severity score.

OBJECTIVE: Treatment of chronic obstructive pulmonary disease (COPD) is based on symptom control. This suggests that COPD severity can be determined by analyzing treatment intensity. The objective of this analysis was to develop and validate a severity score for adult COPD based on treatments. RESEARCH DESIGN: Using principal components analysis, a COPD severity score was developed using data based on treatments extracted from an employer claims database (development group). Variables included were identified from literature review and clinical expert opinion. External validity was tested in a separate group of adult chronic bronchitis patients in whom principal components analysis was re-conducted and factor loadings were compared to the development group. Construct validity was tested by comparing the incidence of acute exacerbations of chronic bronchitis (AECB) in patients with high and lower severity scores. To illustrate the use of the COPD severity score, effectiveness of alternative AECB antibiotic treatments was compared in a separate patient sample categorized by severe versus mild/moderate COPD. RESULTS: In the development group (n = 2068), principal components analysis produced a single main factor for severity scoring. Of the 12 variables contributing to this factor, the 6 with the highest factor loadings were treatment related. The factor performed similarly in the external validity group (n = 9127) as it did in the development group. In construct validity testing, severe COPD patients were 4 times more likely to have AECB episodes than mild/moderate patients. Patients with severe COPD and an AECB were more likely to fail treatment with antibiotics than those with mild/moderate COPD. Based on the COPD severity score developed, we found that treatment of patients with severe COPD and an AECB with fluoroquinolones was more likely to result in treatment failure than treatment with macrolides (OR = 2.01; p = 0.03). CONCLUSIONS: The analysis was successful in developing and validating a method to score COPD severity based on treatments. This method may prove useful in providing insights about the benefits of COPD treatments.

Anti-Bacterial Agents↗
PubMed2002

Quantification of the sensitivity increase of a micro-high-performance liquid chromatography-electrospray ionization mass spectrometry system with decreasing column diameter.

This study details the sensitivity achieved with capillary columns when used with a micro-HPLC-electrospray ionization MS system. It is comprised of two sections, the first is the comparative study of three columns, one of narrow-bore diameter and two of capillary diameter. The second section compares three columns of decreasing diameter in the capillary scale. All the experiments achieved enhanced sensitivity using capillary columns. The increase in the experimental MS response ranged from -20% to +20% compared to the UV experimental response when decreasing the internal diameter of the columns used. When comparing the experimental MS response to the maximum theoretical UV response achievable, the increase in response ranged from 40 to 50%.

Chromatography, High Pressure Liquid↗
PubMed2002

[Society, medicine and caregiver stress].

CARING STAFF DISTRESS: Is a theme regularly discussed among those who care for patients. The current approach is in favor of the psychological interpretation of this distress. This approach is obviously pertinent, but could be widened to a more sociological vision: is the demand that society places on medicine excessive? THE SEARCH FOR AUTONOMY: The demand of the society emerges in a social universe that privileges the autonomy of the individual. Medicine serves this research for autonomy. Techniques, instrumentalization of the body, and the search for mastery engender the collective utopia of the perfect body; medicine has become a new faith, keeper of potential redemption measures. THE MEDIATOR FUNCTION OF CARING STAFF: Part of the caring staff distress is generated by the encounter between the utopia of health and the reality of suffering patients. In the present context of our society, one of the caring staff's missions is to act as mediator between the patient and the experience of the disease, the patient and the representation that he/she has of his/her body and health, and society and the expectations society projects on medicine.

Attitude to Health↗
PubMed2000

Modalities of palliative care in hospitalized patients with advanced AIDS.

This prospective multidisciplinary survey started in October 1994. The survey assessed the modalities of care of hospitalized patients with advanced AIDS in an Infectious and Tropical Diseases Unit with regards to the practices of palliative care in a Palliative Care Unit. Seventy-eight (78) AIDS patients with CD4 < or = 30/mm3 who had 102 consecutive hospitalizations were recruited. Types (symptomatic or curative) and number of drugs administered to the patients, as well as biological and radiological investigations performed were recorded. Symptoms were concomitantly assessed on a weekly basis by self-evaluation of the patients themselves and by physicians. The results showed that the practices of care were different in the two units according to the specific goals and norms of each unit. A higher density of care was delivered at the Infectious and Tropical Diseases Unit. Symptoms assessed by both patients and physicians were underestimated by physicians in frequency and in intensity. In conclusion, an integrated approach including objective and subjective criteria should enable a better adjustment of the palliative and curative therapeutic strategies in advanced AIDS. These would concomitantly take into account the wishes of the patient and the goals regarding care in the unit where the patient is hospitalized.

AIDS-Related Opportunistic Infections↗
PubMed1998

Adenosine and migraine.

BACKGROUND: Adenosine is a powerful natural vasodilator that participates in the control of cerebral and meningeal blood flow. In this context, it could be involved in the pathophysiology of migraine, since it was previously reported that intravenous adenosine can precipitate crises in migraine patients. METHODS: We have investigated circulating adenosine levels in 12 patients suffering from migraine without aura, during crises and in crisis-free periods, and have compared the levels noted to those of a population of 10 controls. To determine if there are interactions between adenosine and serotonin, we examined the effect of adenosine and antagonists on the uptake and the release of (14C) serotonin by platelets. RESULTS AND CONCLUSION: We have reached a dual conclusion: 1) during migraine headaches there is an increase (mean 68%) in circulating adenosine levels and this increase may participate in cephalalgia; 2) activation of A2 receptors by adenosine causes a dose-dependent serotonin uptake by platelets. This inhibition of uptake could participate in the rapid elimination of serotonin in migraine sufferers. As a result of this, the use of adenosine antagonists could be an effective complementary treatment for migraine.

Adenosine↗
PubMed1993

Antibiotic susceptibilities of Afipia felis in axenic medium and in cells.

Afipia felis, one of the putative agents of cat scratch disease (CSD), is a facultative intracellular bacterium. Although CSD is considered not to be susceptible to antibiotic therapy, sporadic case reports indicated that aminoglycosides may be effective. We determined the in vitro antibiotic susceptibilities of three A. felis strains in axenic medium and in a cell model. In axenic medium, A. felis was susceptible to imipenem, aminoglycosides, and rifampin when using either the broth dilution technique or the agar technique. When grown in HeLa cells, A. felis was susceptible to amikacin and tobramycin but was resistant to the other compounds tested. Despite its intracellular location, A. felis can apparently be reached by aminoglycosides. Thus, the in vitro data presented here are in accord with the clinical data obtained in patients suffering CSD.

Anti-Bacterial Agents↗