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Biomedical subjects

J Chaperon

Publications and source records attributed to J Chaperon.

At least 73 records · Page 4Linked to original sources
PubMed1990

Prognostic factors of myelodysplastic syndromes--a simplified 3-D scoring system.

From 1 January 1982 to 31 December 1986 in five haematological centers of the west of France (Rennes, Rouen, Nantes, Tours and Angers), we have collected 503 cases of myelodysplastic syndrome (MDS). These cases were classified by FAB recommendation as followed: 85 refractory anemia with ring sideroblasts (RARS); 273 refractory anemia in which 86 were without blasts (RA), 153 were with excess of blasts (RAEB) and 34 were with excess of blasts and in transformation (RAEB-t); 111 chronic myelomonocytic leukaemia (CMML); and 34 cases with borderline features. The point date for statistical study was 31 December 1988, and the scoring method of Bournemouth was applied to compare with our findings (62% resulted in death, 18% in leukemic transformation). It was demonstrated that haemoglobin, platelets, and bone marrow-blasts are the best factors to predict survival or leukaemic transformation (LT). But peripheral neutrophils don't affect the survival time excepted when lower than 500 microliters (13 months vs 19.6 months). A scoring system based on haemoglobin (Hb), platelets (Pl), and bone marrow blasts (BMB) may be represented in a three-dimensional space and is a good tool to know the own value of each parameter. This 3-D system shows that BMB and Pl are the most important factors and are correlated with survival, per cent of death, and LT (p less than 0.0001). The LT is observed in 18% of the whole population. RAEB and RAEB-t progress in AML2 (14.6%) or AML4 (1.4%), and CMML progress in AML2 (8.1%) or AML4 (11.7%). We observed that monocytes are not good parameters to predict the type of leukemic transformation. Furthermore, survival of RA treated with Ara-C(ld) or not treated was similar.

Aged↗
PubMed1990

[Diagnostic splenectomy. Apropos of 38 cases].

The authors report a retrospective study of 38 splenectomies performed as a diagnostic procedure. In the first group, the diagnosis was made by surgery: 27 cases (71.1%) included the usual large number of lymphomas. In the second group, there was no conclusion: 11 cases (28.9%), patients were younger and the spleen was lighter with a statistical significance (p less than 0.006 and p less than 0.003). Three of the 11 patients in the second group subsequently developed a malignant blood disease. Morbidity was high: out of 38 cases, 14 complications occurred in 11 patients (28.9%). One patient died on the fifty fifth postoperative day. The authors consider that splenectomy for undiagnosed splenomegaly is an effective procedure for diagnosing lymphoma, but not without risk. Indications for surgery must be carefully evaluated. It is more questionable in young, asymptomatic patients or in the case of moderate splenomegaly. After surgery, with no histologic diagnosis only a long-term survey will differentiate patients with malignant blood diseases from patients with idiopathic splenomegaly.

Adolescent↗
PubMed1989

Microbial organisms carried by brown-banded cockroaches in relation to their spatial distribution in a hospital.

A simultaneous study of cockroach (Supella supellectilium) distribution and of associated carried bacterial flora has been made in the main hospital in Rennes (France). Wild cockroaches carry a high number of bacterial species that can be related to the normal environmental flora and a contaminant flora acquired from particular environments. The diversity of carried bacterial species reveals a proximity factor between continguous floors of the building which leads us to suppose that cockroaches are able to forage from one floor to the other.

Animals↗
PubMed1981

[Mortality: comparison of mortality between a specific industry and the French population (author's transl)].

Mortality statistics are underutilized in France. Authors show that it is possible to use them for small population (125 000). Classical statistical methods are utilized. The interpretation of the results is difficult with regard to the quality of National data. Comparison data conclude that mortality rates are lower within the industry for lung and gastrointestinal disease, suicide, injuries and that three health problems are more prevalent: alcholism, injuries for young men and cancer.

Accidents, Occupational↗
PubMed1979

[Health indexes and "sanimetry": conceptual aspects of recent research on the measurement of a population's state of health (author's transl)].

The major health indexes based on the classical concepts of mortality and morbidity are reviewed while emphasizing their limitations: underestimation of health problems socio-economic impact, inadequacy for the evaluation of certain main objectives of health care delivery systems, purely negative measurement of health. This paper investigates the recent attempts to improve these aspects: extension of the concept of morbidity by the introduction of disability measurements and the development of a "positive health" concept. Finally, a discussion is presented of the major health indexes whose development is based on the use of these concepts and the main conceptual, methodological problems they give rise to.

Delivery of Health Care↗
PubMed1978

[Statistical study of results of Hemalog D (author's transl)].

The data which Hemalog D obtains from blood samples of non hematologic patients have been analyzed statistically and compared with those obtained from an eye count. As well as usual statistical techniques, i.e. correlation coefficient and paired t-test, a more sophisticated multidimensional method was used : the Factorial Analysis of Correspondences. We have analyzed two samples. For the first sample, that of "all-comers", the reproductibility of the results given by the machine was shown to be excellent, and always superior to that of the eye count. The machinen-technician agreement is reasonably good except for the monocytes and basophiles. The preceeding conclusions were found to be true for the second sample, i.e. "with discrepancies", and in addition, it was shown that an eye count on 400 elements gives a result closer to that of the machine than does a reading on 100 elements.

Analysis of Variance↗
PubMedDate not supplied

[Predictive factors of mortality and morbidity in colectomy patients over 75 years of age. Report of 69 cases].

Sixty nine patients over 75 years old who had a colectomy were retrospectively studied. The carcinoma of the colon represented the main indication for 42 cases (60.9%) and 22 patients (31.9%) were immediately operated. The influence of parameters such as age, sex, visceral defects, emergency, performance of a colostomy or associated intervention, type of colic pathology, was statistically studied. The age (p less than 0.05), emergency (p less than 0.03) and the number of defects greater than or equal to 3 (p less than 0.04) contribute to mortality. The number of defects greater than or equal to 3 (p less than 0.006) contributes to general morbidity. Only complications connected with the operation by itself significantly prolong the duration of hospitalization (p less than 0.02). The authors draw the conclusion that the age by itself is not a contra-indication for operation except in case of associated polyvisceral failure. In addition, it is required to carry out an early detection of colic lesions in elderly subjects in order to contemplate surgery before complications whose prognosis is fearsome (54.5% of death in emergency operation).

Age Factors↗
PubMedDate not supplied

[Splenectomy for hematologic disease in patients over 70 years of age. Apropos of 38 cases].

A retrospective series of 38 splenectomies performed in patients over 70 for haematology diseases is reported. There were no post-operative deaths and 8 patients (21%) had complications which resolved favourably. Paradoxically, mortality and morbidity were lower in elderly patients although the difference was not statistically significant. No factor predictive of post-operative outcome was found. It was concluded that age is not a contraindication although the clinical situation is a predominant factor in patient selection.

Aged↗
PubMedDate not supplied

[Obstruction of the small intestine caused by bridles and adherences. Analysis of 157 operated cases].

We retrospectively studied a series of 157 patients who were operated for post-operative occlusion of the small bowel. Our aim was to analyze the clinical and operative aspects with particular emphasis of the factors predicting intestinal necrosis. We also reviewed the literature. There were 103 females and 54 males with a mean age of 61 and 51 years respectively (p < 0.01). Patients with neoplasia, hernia or irradiated bowel syndrome were excluded. Perioperative variables were analyzed and compared with the incidence of intestinal necrosis and post-operative morbidity and mortality. Data were compared with the chi 2 test. The most frequent prior surgery was appendectomy (33%) and pelvic operations (25%). The mean latency period was 15 years and 5 patients (3%) developed immediate post-operative occlusion (mean 7 days). The preoperative interval was 24 hours on the average. The pathologies involved were: bridles 48%, bridles + adherences 35%, adherences 17%. No clinical sign could distinguish between these three categories, but strangulation was more frequent in patients with bridles (p < 0.003). The following factors were significantly related to intestinal necrosis: signs of abdominal defence (p < 0.0002), white-cell-count > 16000 (p < 0.002), systolic hypotension (p < 10(-7)) and the lack of a history of occlusion (p < 0.04). Mortality was 6% (all at age > 70 years). Age was the only factor significantly related to morbidity-mortality. Emergency surgery shoulder be performed for patients at risk of intestinal necrosis, especially elderly patients.

Adolescent↗