PubMed Health⌕ Search

Biomedical subjects

J Baillargeon

Publications and source records attributed to J Baillargeon.

At least 37 records · Page 2Linked to original sources
PubMed1999

Temporal trends in AIDS-related survival.

Although research indicates that AIDS-related survival has improved over calendar time, studies of temporal AIDS-related survival patterns are often confounded by the stage of AIDS diagnosis. The objective of the present study was therefore to assess temporal trends in AIDS-related survival from clinical indicators other than point of AIDS diagnosis. The study sample consisted of 2126 adult HIV-positive patients who were treated between 1987 and 1996 at a large southwestern academic medical center. Proportional hazards analyses indicate that survival from each of the following clinical baselines improved in a linear fashion over calendar period: first CD4 count, first CD4 count of 200 or greater, first CD4 count less than 200, and diagnosis of Pneumocystis carinii pneumonia, cytomegalovirus, and Mycobacterium avium complex. These findings indicate that previously estimated survival trajectories have persisted through the mid-1990s, even when defining survival from clinical indicators other than AIDS diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Determinants of HIV-related survival among Texas prison inmates.

Research indicates that being incarcerated adversely affects disease progression and overall health status. Because HIV infection is a growing problem among prison populations in the United States, understanding how incarceration affects HIV-related survival patterns is critical. The present study examined determinants of HIV-related survival in a cohort of 2380 Texas Department of Criminal Justice (TDCJ) inmates who were treated for HIV/AIDS, dating from January 1, 1992 and June 31, 1997. Assessment of the study factors indicated that there were no substantial violations of the assumptions of the Cox's proportional hazards (PH) model in the present study population. Furthermore, to address the potential problem of censoring-related bias, mortality information was collected on all inmates who were paroled on the basis of disease status. The present study's findings indicate that the following factors were associated with significant decreases in HIV-related survival in the TDCJ prison population: male gender, older age, self-report of no known HIV transmission risk factors, and presence of cytomegalovirus (CMV), Mycobacterium avium complex (MAC), and Pneumocystis carinii pneumonia. Moreover, survival decreased in a monotonic fashion with decrease in baseline CD4 count. While the majority of the present study's findings were consistent with those reported for non-incarcerated populations, it will be important for investigators to assess whether these findings persist among future cohorts of prison inmates.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Determinants of survival in HIV-positive patients.

Variation in the clinical stage at which AIDS is diagnosed has hindered the ability of investigators to generate survival estimates which are stable across study cohorts. As a result, little is known about how clinical and sociodemographic factors are associated with survival, independent of AIDS diagnosis stage. By estimating survival following seroconversion while adjusting for baseline CD4 lymphocyte count, the present study generated survival determinants which were unconfounded by time-related changes in AIDS diagnosis. This study's findings indicate that the following factors were associated with significant decreases in HIV-related survival: older age; self-report of no known HIV transmission risk factors; and presence of cytomegalovirus, Mycobacterium avium complex, and Pneumocystis carinii pneumonia. Furthermore, survival decreased in a monotonic fashion with decreases in baseline CD4 count and with increases in calendar period. While this study's findings are consistent with previous investigators' reports of AIDS survival determinants, it will be important for future investigators to refine and update estimates of HIV-related survival determinants as clinical care for HIV-infected patients continues to improve.

Adult↗
PubMed1999

Immunological predictors of HIV-related survival.

While the prognostic role of CD4 lymphocyte count is well established, little is known about how other immunological factors are associated with HIV-related survivorship. CD8 lymphocyte count is reported to inhibit growth of HIV in vitro and to deter the development of cytomeglovirus infections. Scarce information exists, however, on its association with HIV-related survivorship. The objective of the present study therefore was to assess whether survival estimation could be improved by including CD8 lymphocyte count as a prognostic factor. The study sample consisted of 904 adult HIV-infected patients who were treated between 1992 and 1997 at a large southwestern academic medical centre in the US. Survival analysis using proportional hazards modelling showed that baseline CD4 lymphocyte was highly and positively predictive of HIV-related survival. By contrast, baseline CD8 count was not predictive of survival in the study cohort. While the interaction between CD4 and CD8 was not statistically significant in the present study sample, decomposition of this effect indicates that these factors may operate synergistically to predict survival. In conclusion, these findings suggest that clinicians may improve their prognostic accuracy by relying on both CD4 and CD8 lymphocyte counts rather than relying exclusively on CD4 counts.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Characteristics of the healthy worker effect: a comparison of male and female occupational cohorts.

The healthy worker effect (HWE) poses a serious methodological problem to investigators of occupational cohorts in that it may mask mortality excesses that result from occupational exposures. This problem is further complicated by the fact that the strength of the HWE generally varies according to sociodemographic, employment, and time-related factors. While the HWE has been well documented among numerous cohorts of male workers, little is known about its expression among female occupational workers. Follow-up mortality data on 44,154 employees from the Hanford nuclear facility for the period of 1944-1986 were examined using standardized mortality ratio (SMR) analysis to assess whether modifiers of the HWE were expressed differently in females than in males. Results of this analysis show that while the HWE was modified by race, age at hire, occupational class, and length of follow-up in both male and female cohorts, different patterns of modification emerged across the two subgroups. Learning about how gender differentiates expression of the HWE will help investigators more precisely assess the confounding effect of the HWE in studies of working cohorts. Therefore, this study's findings are relevant for designing and interpreting future occupational cohort studies.

Adult↗
PubMed1997

Inhibition of prostaglandin endoperoxide synthase-2 expression in stimulated human monocytes by inhibitors of p38 mitogen-activated protein kinase.

Prostaglandin endoperoxide synthase (PGHS; cyclooxygenase), the rate-limiting enzyme in the conversion of arachidonic acid to prostanoids, has two isoforms. PGHS-1 is constitutively expressed and involved in homeostasis, whereas PGHS-2 is inducible in monocytes in response to proinflammatory agents. Using freshly elutriated human monocytes, we examined the effect on PGHS-2 expression of certain cytokine-suppressive anti-inflammatory drugs such as SK&F 86002. Incubation with serum-treated zymosan (STZ) stimulated the expression of PGHS-2 in a time- and dose-dependent manner. SK&F 86002 dose-dependently inhibited this STZ-induced expression of PGHS-2 protein, which correlated with a decrease in prostaglandin E2 and thromboxane A2 production. However, suppression of PGHS-2 expression is not the result of suppressed cytokine production, because SK&F 86002 suppressed PGHS-2 expression initiated by IL-1beta and TNF-alpha, in addition to other stimuli. Moreover, this effect was selective in that the protein expression of two other important enzymes involved in the metabolism of arachidonic acid, cytosolic phospholipase A2 and 5-lipoxygenase, was not affected. Stimulation with STZ caused a time-dependent increase in levels of PGHS-2 mRNA; incubation with cytokine-suppressive agents caused a decrease of these levels, suggesting the involvement of transcription and/or mRNA stability events in the inhibition of PGHS-2. These results indicate a new and potentially important anti-inflammatory property of SK&F 86002, namely the specific suppression of PGHS-2 induction.

Arachidonate 5-Lipoxygenase↗
PubMed1995

Food habits and pancreatic cancer: a case-control study of the Francophone community in Montreal, Canada.

In a population-based case-control study of pancreatic cancer and nutrition among the Francophone population of Montreal (Quebec, Canada), a total of 179 cases and 239 controls matched for age, sex, and language (French) were interviewed between 1984 and 1988. Data on food habits, methods of food preparation and preservation, and related information were obtained through a questionnaire. The study found an increased risk of pancreatic cancer associated with a high consumption of salt [relative risk (RR) = 4.28; 95% confidence interval (CI) = 2.20-8.36], smoked meat (RR = 4.68; CI = 2.05-10.69), dehydrated food (RR = 3.10; 95% CI = 1.55-6.22), fried food (RR= 3.84; 95% CI = 1.74-8.48), and refined sugar (RR = 2.81; 95% CI = 0.94-8.45). An inverse association was found with the consumption of food with no preservatives or additives (RR = 0.08; 95% CI = 0.01-0.59), raw food (RR = 0.28; 95% CI = 0.10-0.75), and food prepared by presto or high-pressure cooking (RR = 0.35% 95% CI = 0.15-0.81), electricity (RR = 0.30; 95% CI = 0.90), or microwave oven (RR = 0.56; 95% CI = 0.34-0.92). Cooking with firewood was associated with a significantly higher risk for pancreatic cancer (RR = 4.63; 95% CI = 1.15-16.52). The results of this study suggest that food habits may play an important role in the etiology of cancer of the pancreas among French Canadians in Montreal, whereas other food habits may reduce the risk of this disease.

Adult↗
PubMed1993

Colon cancer in seven siblings.

In a case-control study of cancer of the colon it was found that 96 out of 332 (29%) cases had a positive family history of cancer of the colon (2 cases and more) as compared with 19 out of 473 (4%) controls. 3 colon cancer cases reported that 6 of their respective relatives were also affected with the same cancer. We were able to do a complete follow-up study of one family where 7 out of 12 sibling (P < 0.05) had confirmed pathological diagnoses of cancer of the colon. The mean age at diagnosis among these familial colon cancer cases was 64 years (60 years for females and 73 years for males) and all tumours were located in the caecum or right colon (a common characteristic of colon cancer in this family). There was no history of familial adenomatous polyposis in this family. It is unlikely that the significantly high proportion of familial colon cancer found could be due to chance. This suggests that both environmental and genetic factors play an important role in the aetiology of colon cancer.

Adenocarcinoma↗
PubMed1993

A population-based case-control study of cancer of the bile ducts and gallbladder in Quebec, Canada.

In a population-based case-control study of pancreatic cancer in Greater Montreal between 1984 and 1988, a total of 24 patients with cancer of the bile ducts and 33 patients suffering from cancer of the gallbladder were compared to 239 population-based controls. This study was part of the SEARCH program of the International Agency for Research on Cancer. In cases of cancer of the bile ducts, smoking nonfiltered cigarettes produced a relative risk of 2.82 and a 95% confidence interval of 1.01-7.86 after adjustment for age, sex, other smoking habits, alcohol consumption, schooling, and respondent status. Laxative intake was associated with a risk of 2.87 (1.00-8.22). Coffee drinkers were collectively at lower risk than non-drinkers: OR = 0.26 (0.07-0.95). In patients with cancer of the gallbladder, constipation was related to a risk of 3.19 (1.02-9.95) after adjustment for the same factors. In cases with previous gallbladder problems, the risk was found to be significant [OR = 7.96 (2.03-31.2)], 8 times greater in cases than in controls.

Adult↗
PubMed1992

A collaborative case-control study of nutrient intake and pancreatic cancer within the search programme.

Case-control studies of pancreatic cancer were conducted in 5 populations with moderate to high rates and differing dietary practices, using a common protocol and questionnaire. Comprehensive diet histories were completed for a total of 802 cases and 1669 controls identified in Adelaide (Australia), Montreal and Toronto (Canada), Utrecht (The Netherlands) and Opole (Poland). Positive associations were observed with intake of carbohydrates and cholesterol, and inverse associations with dietary fiber and vitamin C. These relationships were generally consistent among the 5 studies, and showed statistically significant and generally monotonic dose-response relationships. The relative risks for highest vs. lowest quintile of intake were estimated for carbohydrates to be 2.57 (95% confidence interval 1.64-4.03), cholesterol 2.68 (1.72-4.17), dietary fiber 0.45 (0.30-0.63), and vitamin C 0.53 (0.38-0.76). The consistency, strength, and specificity of these associations provides evidence for the hypothesis that some or all of these dietary factors may alter the risk of pancreatic cancer.

Adult↗
PubMed1992

[Diabetes mellitus and pancreatic cancer: a case-control study in greater Montreal, Quebec, Canada].

In a population-based case-control study of dietary risk factors in French Canadians in Montreal, a total of 179 cases and 239 controls were interviewed between 1984 and 1988. It was found that the frequency of diabetes was almost three times higher in cases of pancreatic cancer (16%) than in the controls (6%), with an Odds Ratio (OR) of 2.52 and a Confidence Interval (CI) of 1.04-6.11. Fifty per cent of the pancreatic cancer cases had this disease before the cancer was diagnosed, compared with 71% of the controls at the time of the study. Those aged 50 years and over accounted for 75% of the cases and 71% of the controls (diabetic subjects); 68% of the cases were treated with a combination of diet and oral hypoglycemic agents compared with 86% of the controls. Insulin was used by 32% of the cases and 14% of the controls. These results suggest that diabetes may play a major role in the etiopathogenesis of pancreatic cancer in this urban population. A lot of controversy remains about the precise role of diabetes, and further studies are needed for a better assessment and understanding of the mechanisms of this association.

Adult↗
PubMed1991

Tobacco, alcohol, and coffee and cancer of the pancreas. A population-based, case-control study in Quebec, Canada.

A population-based, case-control study of pancreatic cancer was carried out in greater Montreal between 1984 and 1988. A total of 179 cases and 239 population-based controls were interviewed. This study was part of the SEARCH program of the International Agency for Research on Cancer of the World Health Organization. A strong positive association was observed between total cigarette smoking and risk of pancreatic cancer (odds ratio [OR] = 3.76; 95% confidence interval [CI], 1.80 to 7.83). The OR for current smokers in the highest quintile of number of cigarettes was 5.15 compared with 3.99 for exsmokers. Those who consumed alcohol were in general at lower risk than nondrinkers. Coffee drinkers were collectively at lower risk than nondrinkers, particularly when coffee was consumed with meals, not on empty stomach.

Adult↗
PubMed1991

Nutritional factors and pancreatic cancer in the francophone community in Montréal, Canada.

In a population-based case-control study of dietary risk factors for pancreatic cancer, a total of 179 cases and 239 controls were interviewed between 1984 and 1988. This study demonstrated an increased risk of pancreas cancer associated with high levels of reported energy intake. After adjustment for age, sex, response status, lifetime cigarette consumption and energy intake, there appeared to be an association with total fat intake (odds ratio in highest quartile relative to lowest quartile 2.24 [95% Confidence Interval (0.74, 6.73)] and, particularly, saturated fat [OR = 4.32, 95% CI(1.39,13.7)]. Although dietary cholesterol intake appeared to increase risk and a number of many micro-nutrients were apparently associated with reductions of risk, none were statistically significant. The results are consistent with a role of nutritional factors in the etiology of pancreatic cancer. The magnitude of the risks involved emphasizes the necessity for larger studies of this topic.

Adult↗
PubMed1984

Barnum meets the computer: a critical test.

The effects of type of assessment device (computer vs. human) on subjects' acceptance of a favorable or unfavorable personality feedback were investigated. Forty-four French-speaking subjects were administered a fictitious personality questionnaire and were asked to evaluate how appropriate the personality feedback was as a description of themselves and people in general. Contrary to predictions, there was no interaction between the type of assessment device and the favorability factors. Two previous findings were nevertheless replicated: (a) in all conditions the favorable description was better accepted than the unfavorable one and, (b) subjects rated the favorable description as being more appropriate for themselves than for people in general.

Journal Article↗
PubMed1983

[Predictive value of preoperative acidity tests in ulcer recurrence after supraselective vagotomy].

The authors have analysed the predictive value of the basal and peak gastric acidity levels, measured preoperatively, in a series of 27 supraselective vagotomies. They recommend care in the choice of this operation for hypersecretors and they propose criteria for the preoperative selection of the candidates. They suggest determination of the preoperative basal gastric acidity level and a cimetidine suppression test to identify patients at high risk for recurrence of the ulcer.

Adult↗
PubMed1982

Gastro-cutaneous syndrome: peptic ulcer/hiatal hernia, multiple lentigines/café-au-lait spots, hypertelorism, and myopia.

We report the familial occurrence in a French Canadian family of peptic ulcer/hiatal hernia, multiple lentigines/café-au-lait spots, apparent hypertelorism, and myopia caused by a pleiotropic autosomal dominant gene with high penetrance and variable expressivity. Other probable but rarer components of the syndrome include ischemic heart disease, congenital heart disease, and maturity onset diabetes. Symptoms of peptic ulcer/hiatal hernia usually started in the second or third decade and were associated, as least in some examined individuals, with relatively increased acid secretion and abnormal dermatoglyphics.

Adolescent↗