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Biomedical subjects

I Côté

Publications and source records attributed to I Côté.

10 recordsLinked to original sources
PubMed2005

Health-related quality of life in hypertension: impact of a pharmacy intervention programme.

BACKGROUND AND OBJECTIVE: In a previous study, we observed that a pharmacy-based intervention programme decreased the blood pressure of hypertensive patients. The objective of the present study was to assess the effect of this pharmacy programme on the health-related quality of life (HRQOL) of individuals treated for hypertension. METHODS: In a quasi-experimental cohort pilot study, we recruited 91 participants from nine pharmacies in the Quebec City area. We offered the intervention programme over a 9-month period to participants enrolled at four of the pharmacies. The other participants were not exposed to pharmaceutical services other than those usually given by their pharmacists. We used the SF-36 to evaluate HRQOL. Covariance analysis was used to test for significant differences of HRQOL scores between participants exposed and not exposed to the programme. RESULTS AND DISCUSSION: When compared with the non-exposed participants, those receiving the intervention and with high income had an improvement in vitality score (P=0.05). On the contrary, low-income exposed participants did not show this benefit and had a decline in mental health score (P=0.01). Improvement in vitality is likely due to increased physical activity and to a reduction in systolic blood pressure in the high-income exposed group. The negative effect of the programme on the mental health of those exposed in the low-income group might be due to the fact that the programme was not effective in reducing blood pressure and may therefore have caused anxiety. CONCLUSION: Pharmacists' interventions can have both a positive and negative impact on the HRQOL of individuals, treated with antihypertensive agents, depending on income level.

Aged↗
PubMed2001

Tolerability of antihypertensive drugs in a community-based setting.

BACKGROUND: Outside the experimental environment of clinical trials, the tolerability of angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and the angiotensin II antagonist losartan has not been compared. OBJECTIVES: The purpose of this study was to estimate, in current clinical practice, the 3-month cumulative incidence of side effects among first-time users of losartan, ACEIs, and CCBs for hypertension. METHODS: We conducted a prospective cohort study through a network of 173 pharmacies across Canada to identify patients with hypertension who were newly prescribed monotherapy with losartan, an ACEI, or a CCB. Individuals were interviewed by telephone 3 times over a 3-month period to determine perceived side effects of the antihypertensive medication prescribed. Data were analyzed using a multivariate logistic regression model. RESULTS: Among the 663 eligible individuals, the 3-month cumulative incidence of perceived side effects was 52.5% (42/80), 60.2% (222/369), and 69.6% (149/214) for those treated with losartan, an ACEI, and a CCB, respectively. After adjustment for sex, age, level of education, number of symptoms perceived the week before entering the study, prior use of antihypertensive drugs, current use of any other drug, drug insurance coverage, and duration of hypertension, the odds of reporting a side effect were significantly higher among patients treated with an ACEI (odds ratio [OR] = 1.78: 95% CI, 1.02-3.12) or a CCB (OR = 2.65; 95% CI, 1.47-4.78) compared with patients treated with losartan. CONCLUSIONS: In a community-based setting, we observed that losartan is better tolerated than ACEIs and CCBs. Given that the occurrence of side effects may contribute to lower adherence to drug treatment, the low incidence of side effects associated with losartan makes it an attractive antihypertensive drug choice.

Adolescent↗
PubMed2001

Allorecognition.

Until recently, the vigorous T cell response via the direct pathway has overshadowed studies involving the indirect pathway. Thus, while the direct pathway has previously been considered to be the main driving force in alloimmune responses, there is an increasing body of data to support a prominent role of the indirect pathway in transplant rejection. Most importantly, while the direct anti-donor alloresponse diminishes with time after transplantation, the indirect alloresponse is likely to be permanently active due to traffic of recipient dendritic cells (DCs) through the graft. Consequently, the future challenge in the induction of allograft tolerance is to design interventions that will target the cells involved in the indirect pathway, especially the T cells with indirect allospecificity.

Animals↗
PubMed2000

Tc-99m MAG3 evaluation of recipients with En bloc renal grafts from pediatric cadavers.

Tc-99m MAG3 scintigraphy is a well-established test to monitor patients who have received renal grafts. The shortage of available kidneys has forced the development of alternative sources of donors. En bloc pediatric renal grafts have been used for more than 10 years with good results, but mechanical complications are still a concern. No reports have illustrated the Tc-99m MAG3 scintigraphic aspect of the most common complications resulting from en bloc pediatric renal grafts. The authors describe three recipients of en bloc renal graft. One patient had thrombosis of one of the two grafts, one patient had postrenal obstruction of only one of the grafts, and a third patient progressed normally.

Adult↗
PubMed2000

Health-related quality-of-life measurement in hypertension. A review of randomised controlled drug trials.

In hypertension, tolerability of drug treatment is important because individuals may see the use of antihypertensive medications as more troubling than their seemingly symptomless disease. This may result in noncompliance and ineffectual long term treatment. In the past 15 years, new antihypertensive medications have been marketed on the basis of the advantages they offer with regard to adverse effects and the unavoidable impact of such adverse effects on a person's quality of life. When related to health, quality of life refers to the physical, psychological and social dimensions of health that are influenced by a person's experiences, beliefs, expectations and perceptions. To measure this concept, many instruments, either generic or specific, may be used. The purpose of this study is to describe, by way of a critical review of the literature, the instruments that are most often used in the measurement of health-related quality of life (HR-QOL) in people using antihypertensive drug treatments. We carried out a search of the literature published in English in the period January 1966 to July 2000, looking for randomised controlled trials of antihypertensive drugs. Using the Medline database, we included 77 papers in our review. Our main finding suggests that HR-QOL changes associated with antihypertensive treatment are measured with many different instruments. In almost all studies, at least 1 instrument specific to a health dimension was used, whereas not many used a generic instrument only. The most commonly measured HR-QOL dimensions were cognitive function, symptomatic well-being, sexual function, psychological well-being, sleep dysfunction, social participation and general health perception. Since the choice of dimensions to measure depends not only on the disease but also on the drug, this review adds further evidence that a generic instrument as well as a preference measurement should be added to a specific instrument.

Antihypertensive Agents↗
PubMed1999

Evaluation of the contamination of marine algae (Seaweed) from the St. Lawrence River and likely to be consumed by humans.

The goal of the study was to assess the contamination of marine algae (seaweeds) growing in the St. Lawrence River estuary and Gulf of St. Lawrence and to evaluate the risks to human health from the consumption of these algae. Algae were collected by hand at low tide. A total of 10 sites on the north and south shores of the St. Lawrence as well as in Baie des Chaleurs were sampled. The most frequently collected species of algae were Fucus vesiculosus, Ascophyllum nodosum, Laminaria longicruris, Palmaria palmata, Ulva lactuca, and Fucus distichus. Alga samples were analyzed for metals (As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, and Zn), iodine, and organochlorines. A risk assessment was performed using risk factors (e.g., RfD of the U.S. EPA, ADI of Health Canada, etc.). In general, concentrations in St. Lawrence algae were not very high. This was especially true for mercury and the organochlorines, concentrations of which were very low or below detection limits. Consequently, health risks associated with these compounds in St. Lawrence algae were very low. Iodine concentration, on the other hand, could be of concern with regard to human health. Regular consumption of algae, especially of Laminaria sp., could result in levels of iodine sufficient to cause thyroid problems. For regular consumers, it would be preferable to choose species with low iodine concentrations, such as U. lactuca and P. palmata, in order to prevent potential problems. Furthermore, it would also be important to assess whether preparation for consumption or cooking affects the iodine content of algae. Algae consumption may also have beneficial health effects. Scientific literature has shown that it is a good source of fiber and vitamins, especially vitamin B12.

Environmental Exposure↗