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Biomedical subjects

F A Allaert

Publications and source records attributed to F A Allaert.

At least 19 recordsLinked to original sources
PubMed2002

[Acne in adult women: data from a national study on the relationship between type of acne and markers of clinical hyperandrogenism].

INTRODUCTION: The role of hyperandrogenism in acne occurring or persisting in adult women is controversial. Studies reported have often been carried out in hospital settings. The aim of this nationwide prospective and descriptive study was to evaluate the frequency of clinical hyperandrogenism in a large number of adult acneic women visiting dermatologists in a non-hospital setting. PATIENTS AND METHODS: Three hundred and fifteen dermatologists completed clinical questionnaires concerning the next five female patients with acne at their private practices. These patients had to be between 25 and 45 years of age. The questionnaire covered patients' demographic characteristics, medical history, gynaecological status and acne history. Patients' acne, seborrhea and cycle disorders were described, as well as other signs suggesting hyperandrogenism, such as hirsutism and alopecia. RESULTS: A total of 1 135 questionnaires were analyzed. Nearly 50 p. 100 of the patients had major scalp or facial seborrhea, 18.4 p. 100 hirsutism, 7 p. 100 alopecia and 32.2 p. 100 menstrual cycle abnormalities. When these signs were present, acne was more often retentional, with more scarring and more widespread. CONCLUSION: This prospective study in a large number of patients in a non-hospital setting shows that acne in adult women is frequently associated with clinical hyperandrogenism.

Acne Vulgaris↗
PubMed2001

Body fluid osmolality and tonicity in preterm infants.

In adult patients, a recent physiological approach for the osmoregulatory system based on body fluid tonicity (the so-called effective osmolality) seems to provide better information on water movements than does the classical body fluid osmolality. To evaluate whether plasma or urinary tonicities could give a better assessment of osmoregulation than plasma and urine osmolalities in sick preterm infants cared for in a NICU. A prospective study was conducted in 30 preterm infants (BW=1284+/-377 g; GA=28.8+/-1.7 weeks). Fifteen consecutive 8-h urine collections were performed for each infant from the 8th h of life (450 periods). A plasma sample was obtained at the end of each urine collection. Sodium, potassium, creatinine, osmolality and tonicity were measured or calculated in urine and blood samples as often as possible. Hypernatremia (PNa=146-149 mmol/l) was observed in seven infants (23.3%) and in 5.9% of the periods. Fifty-three percent of the infants and 20.4% of the periods presented with plasma hyperosmolality (>300 mosmol/kg H2O). The relationship between Posm and PNa was significant, but the clinical relevance was weak (r(2)=0.411; P<0.001). Plasma osmolality (Posm) positively correlated with urine osmolality (Uosm), but did not correlate significantly with CH2O/100 ml GFR. Plasma tonicity (2x(PNa+PK)) positively correlated with both urine tonicity (2x(UNa+UK)) and effective water clearance (EWC/100 ml GFR). On an individual basis, the linear relationship between urine and plasma osmolalities was significantly weaker than the relationship between urine and plasma tonicities. This study suggests that the calculation of plasma and urine tonicities allows a better assessment of water movements in body fluid compartments than plasma and urine osmolalities.

Blood↗
PubMed2001

An approach for integrating heterogeneous information sources in a medical data warehouse.

In recent years, medical professionals are witnessing an explosive growth in data collected by various organizations and institutions. At the same time, the ongoing developments of networking technologies provide doctor with the capability to access these data across the boundaries of interconnected computers. In this paper we present a medical data warehousing methodology that aims to use data semantics to regroup and merge patients' medical data from different health information systems, which may be autonomous and heterogeneous. The proposed solution takes into account European laws concerning the security and anonymity of personal data.

Database Management Systems↗
PubMed2001

[Frequency and detection rate of silent myocardial ischemia by Holter monitoring in patients with stable coronary insufficiency under treatment. Study of 95,725 recorded hours].

AIM OF THE STUDY: To determine in standard living conditions the circadian variation of the symptomatic and silent electrocardiographic ischaemia in patients with chronic stable coronary insufficiency. To evaluate the influence of the past history of the patients on the circadian variations of the symptomatic and silent ischaemic events. METHODS: The patients included in the study presented with stable angina pectoris and have undergone a 96 hours Ambulatory ECG (AECG) monitoring with a low-weight and compact material which did not modify their daily activities (R-test). The system records the trace that the patient has initiated it himself following the onset of symptoms and makes possible to distinguish between silent and symptomatic ischaemia. The same experienced cardiologist validated all the AECG records. RESULTS: 1,022 patients aged 64.6 +/- 11.0 years suffering of coronary insufficiency from 5.8 +/- 6.0 years have undergone an electrocardiographic record by an R-test for a total duration of 95,725 hours. Of the 1,022 records, 3,258 ischaemic events have been validated: 295 (9.1%) were symptomatic and 2,963 (90.9%) were silent which correspond to a ratio of 1 versus 9 while this ratio is usually described as 1 versus 4. By 26.5% (n = 271) of the patients, ischaemia have been detected and among them more than a half (54.6%, n = 148) were presenting only silent ischaemia. Of these patients who present silent ischaemia, it was recorded during the first 24 hours by only 63.7% of them which is the usual duration of an ambulatory ECG monitoring. This percentage increases to 83.1% after 48 hours and to 94.1% after 72 hours. CONCLUSION: By more than one third (36.3%) of the patients with stable coronary insufficiency, an ambulatory ECG monitoring recorded during only 24 hours is insufficient to detect a silent ischaemia which will happen later. A record duration of 48 hours reduces this risk to 20% of the patients and of 72 hours to less than 5%.

Activities of Daily Living↗
PubMed2001

A virtual intranet and data-warehousing for healthcare co-operation.

As patient's medical data is disseminated in different health structures, developing a medical or epidemiological patient-oriented data warehouse has some specific requirements compared to intra healthcare structure data-warehousing projects. The difference is that the healthcare structures implicated in a patient-oriented data warehouse project require some considerations about the confidentiality of the patient data and of the activities of healthcare structures. Building a data-warehousing system at a regional level, for example in cancerology, requires the participation of all concerned health structures, as well as different health professionals. The heterogeneity of sources medical data of has to be taken into account for choosing between several organizational configurations of the data warehousing system. In top of data warehousing, we propose a concept of Virtual Intranet, which provides a solution to the problem of medical information security arising from heterogeneous sources.

Computer Communication Networks↗
PubMed2001

The Swiss solution for anonymously chaining patient files.

Being able to link the successive hospitalizations of a given patient for epidemiological surveys together by preserving patient anonymity requires a specific procedure. For its medical hospital statistics, Switzerland has adopted anonymous record linkage procedure, ensuring an irreversible transformation of identity and allowing the linkage of anonymous files. Concepts, algorithms and organization have been developed by the Federal Statistical Office. Algorithms are closed to those developed in Dijon University Hospital.

Algorithms↗
PubMed2000

Law and standards.

A comparison is made between the widely different processes of creating legislation and that of developing standards. Despite their very different origins, in practical terms standards can influence the development of legislation as well as demonstrating compliance with legislative requirements.

Handwriting↗
PubMed2000

Comparison of in-vivo antibacterial activity of two skin disinfection procedures for insertion of peripheral catheters: povidone iodine versus chlorhexidine.

Skin disinfection is a key step in the prevention of nosocomial infections especially prior to invasive procedures such as the insertion of peripheral catheters. Alcohol-based antiseptics improve bactericidal activity and decrease the time needed for skin disinfection in emergencies. A randomized study was performed in two groups of 22 volunteers to compare the in vivo bactericidal effect of two rapid disinfection procedures using povidone iodine (PVP-I) in scrub formulation followed by alcoholic PVP-I, or chlorhexidine in scrub formulation followed by alcoholic chlorhexidine. Bacteria were recovered using the cylinder scrub method. Comparison of reductions in the aerobic and anaerobic flora from baseline levels to each of the three sampling times (30 sec, 3 min, 2 h) showed no significant difference between the two procedures Log(10)reduction after 30 seconds was around 1.5 for the aerobic flora and 1.1 for the anaerobic flora. After 3 minutes the corresponding values were 2.1 and 1.8, and after 2 hours 2.0 and 1.3. The products were well tolerated in both groups. The two procedures had comparable rapid bactericidal activity in vivo.

Adult↗
PubMed2000

[Security services: an overview of the French legislation on cryptography].

This paper deals with the main security services of data protection: integrity, authentication, nonrepudiation and confidentiality. It describes the different tools which may be used to achieve these security objectives: encryption, digital signature, access controls, integrity control, audit and certification. The French legislation concerning encryption has been recently updated in order to simplify the use of encryption techniques for personal data security. This legislation describes different authorization or reporting procedures according to the type of the request (application, equipment, import or export of encryption techniques) and the security level required.

Algorithms↗
PubMed2000

[Security of healthcare data networks used for epidemiological studies].

Record linkage, for compiling sameperson records from various source files, can improve the feasibility of epidemiological research using populationbased studies. The question is comply with the European legislation on data privacy and data security. For example, a computerized record hash coding and linkage procedure is described to link medical information within the framework of epidemiological followup. Before their extraction, files are rendered anonymous using a oneway hash coding based on the standard hash algorithm (SHA) function. Once rendered anonymous using the software ANONYMAT, the linkage of patient information can be accomplished by means of a mixture model, taking into account several identification variables. An application of this anonymous record linkage procedure was carried out in order to link medical files on cancer, from 3 hospitals of the French RhôneAlpes region. This application stresses how the use of the ANONYMAT software allows compliance with the legislation on data confidentiality without entailing problems on data availability.

Computer Communication Networks↗
PubMed2000

Anonymous statistical methods versus cryptographic methods in epidemiology.

Sensitive data are most often indirectly identifiable and so need to be rendered anonymous in order to ensure privacy. Statistical methods to provide anonymity require data perturbation and so generate data processing difficulties. Encryption methods, while preserving confidentiality, do not require data modification.

Computer Security↗
PubMed1999

[Inhaled corticosteroid therapy in mild and moderate persistent asthma. Acceptability of a new inhalation system: the jet].

The objectives of this study were to assess the acceptability and efficacy of Jet (a metered dose inhaler with a 100 ml chamber giving 250 micrograms beclomethasone dipropionate per puff) in patients with mild to moderate asthma using a dose-for-dose schedule in substitution for their standard metered dose inhaler with or without an inhalation chamber. An open trial was conducted over 5 weeks in 356 asthma patients treated with inhaled corticosteroids at a mean 914 +/- 198 micrograms/24 h dose. beta 2-agonists were used by all patients, either systematically (prescription) or as needed. Prior to the study, 27% of the patients used a standard metered dose inhaler with a large-volume inhalation chamber and 73% used a standard metered dose inhaler alone. The rate of nocturnal, early morning, and diurnal symptoms and cough decreased by 31.4, 33.4, 46.9, and 37.0% respectively and the variability of peak expiratory flow rate fell from 2 +/- 0.08% to 0.9 +/- 0.02% in the group using the metered dose inhaler with the chamber and from 1.3 +/- 0.04 to 0.5 +/- 0.01% in the group using the standard metered dose inhaler. The investigators determined that treatment efficacy was good or excellent in 94.8%. These findings should be confirmed by studies comparing Jet directly with other inhalation chamber systems or with standard metered dose inhalers. For 97.5% of the patients, it was easy to learn to use Jet and 88.2% of the patients felt no discomfort when using Jet; 64.8% of the patients stated they experienced clinical improvement. At the end of the trial, 77.9% of the patients (76.3% of those who used the inhalation chamber during the study and 78.4% of those who used the metered dose inhaler alone) stated they preferred Jet over their prior system.

Adolescent↗
PubMed1999

[The Prolair Autohaler in the treatment of adult asthma in current practice].

OBJECTIVE OF THE STUDY: To describe the use of the Prolair Autohaler (Prolair AH) in the conditions of "natural" prescription so as to define its place in the therapeutic arsenal available to practitioners. NATURE OF THE STUDY: Open study conducted in any practice of liberal chest physicians. RESULTS: Three hundred and seventy six patients (56.1%) were treated by Prolair AH and 296 (43.9%) continued their usual treatment with a standard aerosol doser (BDP ADS) that contained the same active principle, used with an inhalation chamber (65 patients, around 22%) or without (231 patients around 78%). The comparisons between the two groups, made at the end of two months of treatment, showed significant differences in efficacy of the two therapies. The percentage of patients who presented a respiratory shortage was significantly lower at day 60 in the Prolair AH group than in the BDP ADS (33.6% vs 41.4%; p < 0.05) though the percentages were comparable at inclusion. Peak problems were significantly more frequent at inclusion in the Prolair AH group (45.5% vs 37.8%; p < 0.05) but at day 60 were significantly less frequent (14.6% vs 22.9%; p < 0.05). Up to day 60, in each treatment group, the same percentage of patients presented whistling (Prolair AH 21.8% vs 22.9%; p: NS) although initially they were significantly more frequent in the patients of the Prolair AH group (60.3% vd 49.8%; p < 0.01). Improvement of DEP measured theoretically was significantly more important (p < 0.05) in the Prolair AH group which passed from 67.6% to 78.8% against 70.5% to 75.6% in the BDP ADS group. CONCLUSION: When prescribed to patients with a more evolutive asthma and poor coordinators, Prolair Ahas produced results that are comparable to or better than those of patients treated with ADS that contains the same active principle, together or not with an inhalation chamber.

Administration, Inhalation↗
PubMed1999

[Psychosocial effects of angina. Results of a cross-sectional survey of 3,654 patients].

The consequences of angina were assessed by a questionnaire completed by 1,528 out-hospital doctors (79% of general practitioners, 21% of cardiologists) on 3,654 patients. This population comprised 2,304 men (64%) and 1,282 women (36%) with a mean age of 69.5 years (men: 67.1, women: 73.8 years). Previous myocardial infarction was present in 36.6% of cases and the average number of angina attacks was 3.1 per month. Angina seemed to affect the social behaviour of 25 to 30% of patients, the affective behaviour of 40% of patients and everyday life style in 60% of cases. Sixty per cent of patients had difficulties in their work and 60% also had psychological consequences of the angina. The social consequences of angina were different according to the patient's gender. Women were more affected in family life and men in their affective behaviour. The psychological consequences were also different: women were more likely to be anxious or depressed whereas men were usually more irritable. The incidence of anxio-depressive reactions with age was not studied (the female population was older). The higher incidence of anxio-depressive symptoms in women may be partially explained by their age at the time of diagnosis and the difference in prognosis between men and women when coronary artery disease is established.

Aged↗
PubMed1999

Can a database be anonymous?

Sensitive data are most often indirectly identifiable and so need to be rendered anonymous in order to ensure privacy. Statistical methods to provide anonymity require data perturbation and so generate data processing difficulties. Encryption methods, while preserving confidentiality, do not require data modification.

Computer Communication Networks↗
PubMed1999

Application of the medical data warehousing architecture EPIDWARE to epidemiological follow-up: data extraction and transformation.

In this paper, we present an application of EPIDWARE, medical data warehousing architecture, to our epidemiological follow-up project. The aim of this project is to extract and regroup information from various information systems for epidemiological studies. We give a description of the requirements of the epidemiological follow-up project such as anonymity of medical data information and data file linkage procedure. We introduce the concept of Data Warehousing Architecture. The particularities of data extraction and transformation are presented and discussed.

Computer Systems↗