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F Doyon

Publications and source records attributed to F Doyon.

At least 19 recordsLinked to original sources
PubMed2001

Is cancer mortality increasing in France?

Long-term trends in cancer mortality are reported by site. Overall, cancer mortality has been decreasing in France since 1987 in the male population and since 1968 in the female population. Improvement in treatments and diagnosis should lead to persistently declining mortality rates, unless the tobacco epidemic reverses the trend in female mortality.

Female↗
PubMed2001

[Evaluation of diagnostic methods].

AIM: Describe the statistical tools for the evaluation of a diagnostic test. MATERIAL AND METHODS: Description of the methods and practical examples based on published data. RESULTS: The following methods are described: 1) reproducibility of a measurement, both for a qualitative and a quantitative result, 2) comparison of a new diagnostic test to a reference test, 3) comparison of two diagnostic tests, 4) sample size computation. CONCLUSION: The tools required to evaluate diagnostic tests rigorously are available and simple. They should be used more often.

Data Interpretation, Statistical↗
PubMed2001

[Cancer prevalence in France].

To measure the frequency of cancer in a given country on a given year, one can use the number of new diagnosis or the number of deaths, but one can also consider the number of patients who have had a cancer diagnosed in the past and are still alive. This indicator is called prevalence. We present here estimations for the prevalence of cancer at 5 years in France, by sex and by site of cancer. These estimations are based on the number of new diagnoses in 1995 and on survival rates observed in Europe. In year 2000, 620,000 persons (310,000 men and 310,000 women) were followed up in France for a cancer diagnosed within the last 5 years. The most prevalent cancers were breast (136,000 cases), colorectal (91,000 cases) and prostate (83,000 cases) cancers.

Adolescent↗
PubMed1999

Epidemiology of bacterial infection during management of open leg fractures.

In a randomised double-blind trial conducted between 1990 and 1994, 616 patients from 43 centres, pefloxacin (group P, 316 patients) and a cefazolin-oxacillin combination (group C, 300 patients) were compared in the prophylaxis of bone infection after grade 1 and 2 open leg fractures. Samples were obtained at emergency, before and during surgery, and from drain aspirates. Antimicrobial susceptibility, slime production and adherence properties of the bacteria were tested. Cultures at emergency and before surgery showed similar distributions of gram-positive and gram-negative bacteria in both groups, while wound closure and infecting isolates showed prevailing gram-positive bacteria in group P and gram-negative bacteria in group C. Positive cultures at each stage were correlated with the occurrence of infection but were not predictive of the infecting species, which were nosocomial bacteria in most cases. Positive cultures at wound closure warn of a higher infection risk. Twenty-one of 316 (6.6%) patients in group P and 24 of 300 (8%) in group C were considered infected within 3 months. The difference is not significant (chi-square test = 0.42; P = 0.51). Infecting strains were isolated from 38 patients (group P, 18; group C, 20). Infecting species, although not predictable, appear to be those escaping the spectrum of the prescribed antimicrobial prophylaxis.

4-Quinolones↗
PubMed1999

Diagnosis of nosocomial pneumonia in cancer patients undergoing mechanical ventilation: a prospective comparison of the plugged telescoping catheter with the protected specimen brush.

STUDY OBJECTIVES: Quantitative culture of protected samples of lower respiratory tract secretions obtained by a fiberoptic protected specimen brush (PSB) is widely accepted for the diagnosis of ventilator-associated pneumonia (VAP), but this diagnostic procedure is time consuming, expensive, and may give rise to iatrogenic complications, especially in cancer patients who often present with thrombocytopenia. The plugged telescoping catheter (PTC) could be a satisfactory alternative to the PSB in this setting. The aim of the present study was to evaluate the interest of the PTC to diagnose VAP in ventilated cancer patients. DESIGN: A prospective observational study. SETTING: A 15-bed medical-surgical ICU in a comprehensive cancer center. PATIENTS AND INTERVENTIONS: Over a 9-month period, 42 patients suspected of having bacterial VAP during mechanical ventilation underwent 69 bronchial samplings: a blinded PTC and a fiberoptic PSB were performed successively in each case. A positive culture for both sampling procedures was defined as the recovery of > or = 10(3) cfu/mL of at least one potential pathogen. The PSB result was taken as the reference standard. MEASUREMENTS AND RESULTS: The overall agreement between the techniques was 87% (60/69). PTC had a sensitivity of 67%, a specificity of 93%, a positive predictive value of 71%, and a negative predictive value of 91%. CONCLUSIONS: We conclude that the accuracy of the blinded PTC compares well with that of the PSB for the diagnosis of VAP in cancer patients. The sensitivity of the PTC observed herein, which is slightly lower than that described in previous studies, may be due to the blinded nature of the method: the indications for initial or secondary coupling with a directed sampling method in patients with suspicion of localized pneumonia remain to be determined.

Bacteria↗
PubMed1999

[Infection prophylaxis in open leg fractures. Comparison of a dose of pefloxacin and 5 days of cefazolin-oxacillin. A randomized study of 616 cases].

THE PURPOSE OF THE STUDY: Was to compare the efficacy of a single 800 mg injection of Pefloxacin (PF) versus 2 days of cefazolin (1 gr.Q.6 H) followed by 3 days of oxacillin (1 gr.Q.8 H) in patients with an open tibial fracture and to examine the predictive factors for infection. A double-blind double dummy, multicentric, randomized trial was performed. 616 adults with an open tibial fracture requiring single-stage bone coverage were included. The end point was wound infection within 3 months. RESULTS: Within 3 months, 21/316 patients were infected in the PF group (6.6 p. 100) versus 24/300 in the CZ-OX group (8 p. 100), the difference was not significant (95 p. 100 Cl for difference: -4.8 p. 100 to 2.1 p. 100). Twenty one strains were isolated in 18 infected patients in the PF group, and 27 in 20 patients in the CZ-OX group. Negative gram bacteria were less frequent in the PF group (10 p. 100) than in the CZ-OX group (48 p. 100), and positive gram bacteria were more frequent in the PF group (90 p. 100) than in the CZ-OX group (52 p. 100). Independent risk factors for infection were severe contamination, widespread contusion, unstable fracture, positive sample in the emergency room and at the end of surgery. Resistant infecting bacteria rate was 24 p. 100 in infected cases. CONCLUSION: There was no difference in infection rates after surgery for open tibial fractures between a 800 mg injection of Pefloxacin and 2 days of pephazolin followed by 3 days of oxacillin. Infecting bacteria were mainly nosocomially acquired.

Adult↗
PubMed1996

Bacteremia and severe sepsis in adults: a multicenter prospective survey in ICUs and wards of 24 hospitals. French Bacteremia-Sepsis Study Group.

To examine the relationships between bacteremia and severe sepsis and assess the influence of characteristics of infection on the risk of severe sepsis and outcome of bacteremia, we analyzed all clinically significant episodes of bacteremia occurring during a 2-mo prospective survey of 85,750 admissions to adult wards and intensive care units (ICUs) of 24 hospitals in France. Incidence rates of bacteremia and of bacteremic severe sepsis were 9.8 (95% CI: 9.2 to 10.5) and 2.6 (95% CI: 2.2 to 2.9), respectively, per 1,000 adult admissions; these rates were eight and 32 times higher in ICUs than in wards, respectively. Independent risk factors for severe sepsis during bacteremia included age (p < 0.001) and an intraabdominal (p < 0.001), pulmonary (p < 0.001), neuromeningeal (p = 0.004), or multiple (p < 0.001) source of bacteremia, but not categories of organisms involved. The probability of death at 28 d after bacteremia was 25% (95% CI: 23% to 29%), and was 54% (95% CI: 48% to 61%) in patients with bacteremic severe sepsis. The risk of death after bacteremia increased with age (p < 0.001), a rapidly or ultimately fatal underlying disease (p < 0.001), and the presence of severe sepsis (p < 0.001), shock (p = 0.03), and infection caused by gram-positive organisms other than coagulase-negative staphylococci, relative to other organisms (p < 0.001). A primary urinary tract source of infection was associated with a better prognosis (p = 0.03). We conclude that whereas sources of infection influence both the risk of severe sepsis and the outcome of bacteremia, the microbiologic characteristics of infection influence only the outcome, with gram-negative organisms and coagulase-negative staphylococci posing a lesser risk than other organisms.

Adult↗
PubMed1996

[Current trends in lung cancer mortality in France].

Lung cancer is the first cause of death from cancer in males in France. This cancer is responsible for 19,000 deaths in males and 3,000 deaths in females. We studied the geographical and temporal variations in lung cancer mortality in France. The average increase in mortality clearly decreased in males, changing from 2.4% between 1971 and 1985 to 0.7% between 1985 and 1992. In females, this tendency is reversed. Even though the rates were stable and very low before 1971, we have since observed a progressive increase which has intensified during the past years. Thus the average annual increase changed from 1.5% between 1971 and 1985 to 3% between 1985 and 1992. The geographic comparisons between the two studied periods (1971-78 and 1987-92) showed important differences between males and females. The geographic disparities among males were stable between these two periods. The excess observed mortality rate was maintained in the north-east. Among females, few geographic variations were observed during the first period. The second period however, showed distinct excess mortality rates in urban areas and large conglomerations as compared to the rest of France. In summary, the increase in the mortality rates for lung cancer is more pronounced in females and seems to have diminished in males, particularly in urban areas. This tendency started in the 1980s.

Adult↗
PubMed1995

Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis.

OBJECTIVE: To examine the incidence, risk factors, and outcome of severe sepsis in intensive care unit (ICU) patients. DESIGN AND SETTING: Inception cohort study from a 2-month prospective survey of 11,828 consecutive admissions to 170 adult ICUs of public hospitals in France. PATIENTS: Patients meeting clinical criteria for severe sepsis were included and classified as having documented infection (ie, documented severe sepsis, n = 742), or a clinical diagnosis of infection without microbiological documentation (ie, culture-negative severe sepsis, n = 310). MAIN OUTCOME MEASURES: Hospital and 28-day mortality after severe sepsis. RESULTS: Clinically suspected sepsis and confirmed severe sepsis occurred in 9.0 (95% confidence interval [CI], 8.5 to 9.5) and 6.3 (95% CI, 5.8 to 6.7) of 100 ICU admissions, respectively. The 28-day mortality was 56% (95% CI, 52% to 60%) in patients with severe sepsis, and 60% (95% CI, 55% to 66%) in those with culture-negative severe sepsis. Major determinants of both early (< 3 days) and secondary deaths in the whole cohort were the Simplified Acute Physiology Score (SAPS) II and the number of acute organ system failures. Other risk factors for early death included a low arterial blood pH (< 7.33) (P < .001) and shock (P = .03), whereas secondary deaths were associated with the admission category (P < .001), a rapidly or ultimately fatal underlying disease (P < .001), a preexisting liver (P = .01) or cardiovascular (P = .002) insufficiency, hypothermia (P = .02), thrombocytopenia (P = .01), and multiple sources of infection (P = .02). In patients with documented sepsis, bacteremia was associated with early mortality (P = .03). CONCLUSIONS: Only three of four patients presenting with clinically suspected severe sepsis have documented infection. However, patients with clinically suspected sepsis but without microbiological documentation and patients with documented infection share common risk factors and are at similarly high risk of death. In addition to the severity of illness score, acute organ failures and the characteristics of underlying diseases should be accounted for in stratification of patients and outcome analyses.

Adult↗
PubMed1992

[Statcan: a telematic system for checking mortality and incidence of cancer in France].

Statcan is an interactive system for consulting cancer mortality and incidence data in France. This system is accessible through the Minitel network and provides information concerning cancer mortality: number of deaths, basic rates, standardized rates for the French, European and world population, cumulative rates up to the age of 74 years as well as specific rates by age, sex and cancer site for France as a whole from 1968 to 1988 and by region for 1968, 1975 and for 1979-1988. National incidence data are available for 5 regions between 1978 and 1982. several complementary chapters provide information explaining the methodology used and help in formulating the questions.

Computer Communication Networks↗