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Biomedical subjects

F Olive

Publications and source records attributed to F Olive.

9 recordsLinked to original sources
PubMed2001

[Early readmission as an indicator of hospital quality of care].

BACKGROUND: The purpose of this study was to assess early readmission as an indicator of quality of care, to estimate the frequency of avoidable emergency readmission in a French hospital, and then to describe the feasibility and contribution of routine use of this indicator. METHODS: A randomly selected sample of 469 readmissions within 30 days after a conventional hospitalization was chosen among the database of 40,242 hospitalizations during the first half of 1997. Two independent practitioners, whose true agreement was measured with a kappa test, studied the features of readmission recorded on the patient files, classing them as "unforeseeable" or "potentially avoidable". Database criteria that could automatically class the readmission in either group were analyzed. RESULTS: There were 119 unforeseeable readmissions (25.4%). The two physicians agreed on the unforeseeable nature of 97 of these readmissions and 50 of them were judged avoidable. None of the database criteria allowed identifying all unforeseeable and avoidable readmissions. Readmission via the emergency unit was a sure indicator of unforeseeable readmission in 66% of the cases and of avoidable readmissions in 60%. The frequency of unforeseen readmissions was estimated at 3.9% of all conventional stays during the first half of 1997. The frequency of avoidable readmissions was 1.5%. CONCLUSIONS: Unforeseen early readmission can be an indicator of quality of the care taking process. It is however impossible to use the current database to classify with certainty readmissions as "unforeseeable" or "avoidable". Emergency unit readmission could offer a possible approach to measuring the frequency of unforeseen readmission. This ratio can provide caretakers with information concerning the quality of care and thus help in making decisions concerning reorganization for improvement.

Academic Medical Centers↗
PubMed2001

[Birth mortality and pregnancy terminations: how can collected Diagnosis Related Group System data be used?].

In France since 1995, information on diagnoses and care are routinely collected for each patient hospitalised in a public or private hospital, using the Diagnosis Related Group system. Information on birth events constitutes a good example of possible use of this information for other aims than economic activity evaluation. In this paper, in order to highlight possible epidemiological use, some recommendations are proposed for collecting data on stillbirths and pregnancy terminations. The lack of usual knowledge on these two adverse events is the reason for this choice. While the improvements in prenatal diagnosis lead to an increase in pregnancy terminations, a minimum common core of collected data should allow routine epidemiological monitoring of these adverse perinatal events.

Abortion, Therapeutic↗
PubMed2000

[Evaluation of inpatient satisfaction. Comparison of different survey methods].

OBJECTIVES: To assess the impact of patient satisfaction survey method on response rate, data quality and satisfaction. PATIENTS AND METHODS: Four modes of data collection were assessed during a randomized trial that included 400 inpatients discharged from a teaching hospital. RESULTS: The response rate was 58% within the mail survey group (72% with follow-up letter) versus 73% and 81% within the home and telephone interview group (p < 0.01). 69% of the mailed questionnaires contained no missing values versus 94% and 96% for home and telephone interview modes (p < 0.01). The global satisfaction scale score was greater within the mail survey groups (8.1/10 without follow-up letter and 7.9 with follow-up letter) than within the telephone interview group (7.8) and the face to face interview group (7.3), (p < 0.05). CONCLUSION: Mail survey with follow-up letter constitutes an operational method despite lower data quality and overestimation of patients' satisfaction scores.

Adult↗
PubMed1998

[Industrial waste as indicator of population size: possible utilization in mountain resort tourist stations?].

BACKGROUND: Epidemiological studies, conducted in touristic resorts, often face the difficulty of assessing the size of the referent population. Recently, some population size indicators, have been tested. Among them, the amount of municipal waste seems to be easy and readily accessible. The purpose of the study is to describe how this indicator can be used in touristic mountain resorts. METHODS: Four touristic resorts were chosen in Isère departement (France): Alpe d'Huez, Deux Alpes, Chamrousse, plateau du Vercors. The evolution of municipal waste over several years was used to compute an individual output level for residents and for tourists. This waste indicator was compared with data on tourists reservations in hotels in the resorts. RESULTS: We found a good fit during touristic seasons in three resorts (Spearman test). For the last one (Chamrousse), the correlation rate was low. We think that the type of tourism is different in this resort with many non residents. CONCLUSIONS: This indicator is reliable but needs further validation by sample surveys across several sites and several types of lodging. We propose to estimate the size of the referent population, based on an individual output of 1 kg per person and per day for residents and 0.5 kg per person per day for tourists.

France↗
PubMed1997

Basal total opioid peptide release in the striatum of rats with cholestasis from bile duct resection: a study by the use of in vivo microdialysis.

The opiate withdrawal-like reaction experienced by patients with cholestatic liver disease after the ingestion of the opiate antagonist nalmefene led to the hypothesis that increased opioidergic neurotransmission/neuromodulation in the central nervous system (CNS) contributes to the pathophysiology of cholestasis. The state of antinociception, which is stereospecifically reversed by naloxone, documented in rats with cholestasis from bile duct resection supports this hypothesis. To further study the opioid system in this animal model of cholestasis, we studied the release of endogenous opioid peptides into the extracellular fluid of the dorso-lateral striatum by the technique of in-vivo microdialysis. Total opioid peptide concentration in the dialysate was measured by a solid phase radioimmunoassay with an antibody directed against the N-terminus of the Tyr-Gly-Gly-Phe-X amino acid sequence after acetylation. Basal total opioid peptide release was significantly higher after surgery in both sham resected and bile duct resected animals. However, basal (unstimulated) total opioid peptide release in the striatum of rats was not altered by cholestasis. It is inferred that the opioidergic abnormalities of cholestasis are not associated with an appreciable increase in the release of endogenous opioids into the extracellular fluid of the striatum. Abnormal processing of specific opioid peptides in cholestasis however, cannot be excluded.

Acetylation↗
PubMed1995

Epidemiology of primary hyperoxaluria type 1. Société de Néphrologie and the Société de Néphrologie Pédiatrique.

Primary hyperoxaluria type 1 (PH1) always leads to oxalate accumulation throughout the body (oxalosis). Currently available epidemiological data only concern patients with end-stage kidney disease requiring renal replacement therapy (RRT). French nephrologists have been questioned about PH1 patients who were under their care between 1988 and 1992. Exhaustive answers were obtained and 90 cases of PH1 were collected. The average prevalence rate of PH1 was 1.05/10(6) and its average incidence rate was 0.12/10(6)/year. The median age at onset was 5 years (0-63) and initial symptoms involved the urinary tract in 82% of the cases. Half the patients were younger than 10 years at the time of diagnosis on the basis of urine oxalate (89%) +/- urine glycolate (43%) +/- plasma oxalate (71%) +/- hepatic alanine:glyoxylate amino-transferase activity (48%). At the time of the survey, 36% of patients were on a conservative treatment, 37% were transplanted and 27% were on maintenance haemodialysis; the crude mortality rate was 19% (median age 36 years). Patients on dialysis started RRT at a median age of 25 years. Transplanted patients received their first transplant at a median age of 29.5 years; among those patients with more than 1 year follow-up, 15 received an isolated kidney transplant (one success), one had a isolated liver transplant (one success) and 10 combined liver-kidney transplant (eight successes). These data confirm the rarity of PH1 together with its poor prognosis; as shown in the European experience, early combined liver-kidney transplantation seems to be the best therapeutic proposal.

Adolescent↗
PubMed1994

DQB1*0602 and DQA1*0102 (DQ1) are better markers than DR2 for narcolepsy in Caucasian and black Americans.

In the present study, we tested 19 Caucasian and 28 Black American narcoleptics for the presence of the human leucocyte antigen (HLA) DQB1*0602 and DQA1*0102 (DQ1) genes using a specific polymerase chain reaction (PCR)-oligotyping technique. A similar technique was also used to identify DRB1*1501 and DRB1*1503 (DR2). Results indicate that all but one Caucasian patient (previously identified) were DRB1*1501 (DR2) and DQB1*0602/DQA1*102 (DQ1) positive. In Black Americans, however, DRB1*1501 (DR2) was a poor marker for narcolepsy. Only 75% of patients were DR2 positive, most of them being DRB1*1503, but not DRB1*1501 positive. DQB1*0602 was found in all but one Black narcoleptic patient. The clinical and polygraphic results for this patient were typical, thus confirming the existence of a rare, but genuine form of DQB1*0602 negative narcolepsy. These results demonstrate that DQB1*0602/DQA1*0102 is the best marker for narcolepsy across all ethnic groups.

Black People↗