PubMed Health⌕ Search

Biomedical subjects

J Cornuz

Publications and source records attributed to J Cornuz.

48 records · Page 3Linked to original sources
PubMed1999

[Tobacco taxation: economic and public health issues].

Cigarette smoking is a major public health issue. An increase of cigarette tax might be a way for promoting tobacco control. This article reviews the economist's perspective of tobacco control. It shows that a crucial economic criteria for supporting an increase of cigarette tax--the cost of externalities--is not fulfilled, since smokers may well have been paying their own financial externalities. However, the theory of rationale addiction cannot fully explain smoking behavior because of risk perception bias. The nicotine dependence and the onset of nicotine addiction occurring mostly during childhood and adolescence explain why consumption decision cannot be assumed to be the product of informed, rational choice by mature individuals. Children and teenagers fail to appreciate the risks associated with behavior and heavily discount the future. Protecting children and teenagers constitutes the strongest argument favoring increased taxation of cigarettes.

Adolescent↗
PubMed1998

Influence of anthropometric parameters and biochemical markers of bone metabolism on quantitative ultrasound of bone in the institutionalized elderly.

The assessment of bone quality by quantitative ultrasound (QUS), a transportable and relatively cheap method, shows some correlations with bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry (DXA) and with fracture risk. To examine its correlation with bone metabolism in a population of institutionalized elderly people known to be at high risk for vitamin D deficiency and secondary hyperparathyroidism, QUS of the calcaneus and biochemical parameters were measured in 264 women aged 85 +/- 7 (SD) years and in 103 men aged 81 +/- 8 years living in 19 nursing homes. Vitamin D deficiency was frequent in this population: 41.9% of the women and 31.4% of the men had a serum 25-hydroxyvitamin (25OHD) level below the 2.5th percentile level of 3276 normal Swiss adults (6.2 micrograms/l or 15.5 mmol/l). Hyperparathyroidism was less frequent: serum parathyroid hormone (PTH) levels were above the 97.5th percentile level of normal adults (70 pg/l) in 18.9% of women and 9.8% of men. In women, QUS data correlated significantly with age (r = -0.297), body mass index (BMI) (r = 0.403), calcium (r = 0.220), PTH (r = -0.296), 25OHD (r = 0.298) and alkaline phosphatase (AP) (r = -0.170) for broadband ultrasound attenuation (BUA), and with age (r = -0.195), BMI (r = 0.208), PTH (r = -0.174), 25OHD (r = 0.140) and AP (r = -0.130) for speed of sound (SOS). In men, ultrasound data correlated with BMI (r = 0.326), calcium (r = 0.199), 25OHD (r = 0.258) and AP (r = -0.311) for BUA, and with AP (r = -0.196) for SOS. In women, but not in men because of their smaller number, a multivariate analysis was performed to examine relationships between age, BMI, biochemical markers and QUS. Age, BMI, PTH and phosphate explained 30% of the variance of BUA and 10% for SOS. In conclusion, QUS of bone evaluates characteristics of bone that are influenced, at least partially, by age, BMI and the secondary hyperparathyroidism due to vitamin D deficiency.

Age Factors↗
PubMed1996

Importance of findings on the initial evaluation for cancer in patients with symptomatic idiopathic deep venous thrombosis.

BACKGROUND: The relation between thrombosis and cancer is well documented, but the clinical evaluation appropriate for detecting underlying cancer in patients with deep venous thrombosis remains unknown. OBJECTIVES: To 1) determine the appropriate initial evaluation for cancer in patients with idiopathic deep venous thrombosis and 2) estimate the incidence of subsequently diagnosed cancer in patients who were not found to have cancer when deep venous thrombosis was diagnosed. DESIGN: Retrospective cohort study. SETTING: Urban, tertiary care teaching hospital. PATIENTS: 986 consecutive patients (637 women and 349 men; mean age +/- SD, 53 +/- 17 years) who had no risk factors for venous disease and had venous ultrasonography because idiopathic deep venous thrombosis was suspected. MEASUREMENTS: Initial clinical evaluation was assessed by using chart review. The incidence of cancer at a median of 34 months after diagnosis of deep venous thrombosis was obtained through hospital chart review (38%), computerized record extraction (54%), mailed questionnaires (6%), telephone interviews (1%), or a death registry (1%). RESULTS: Deep venous thrombosis was diagnosed in 142 patients (14%); 136 of the 142 were hospitalized. Cancer was diagnosed in 16 of these 136 patients (12%) during the index hospitalization. All 16 of these patients had one or more abnormalities on at least one of the four components of the clinical examination: history, physical examination, basic laboratory testing, or chest radiography. The probability of detecting cancer increased as the number of findings suggestive of cancer on the four components of the clinical evaluation increased. Cancer was diagnosed in none of the 56 patients with deep venous thrombosis who did not have findings on the clinical evaluation. The probability of cancer-free survival during follow-up (median, 34 months) was similar in patients with (3 of 122 [2.5%]) and without (23 of 844 [2.7%]) deep venous thrombosis and in the age- and sex-matched U.S. population. CONCLUSIONS: A clinical evaluation that includes a comprehensive medical history, physical examination, routine laboratory testing, and chest radiography seems to be appropriate for detecting cancer in these patients. Additional testing should be guided by any abnormalities detected by this clinical evaluation.

Adult↗
PubMed1996

Why did Swiss citizens refuse to ban tobacco advertising?

A ban on tobacco advertising is one of the major tools to promote tobacco control. Swiss citizens recently refused to modify the Swiss Constitution to ban tobacco advertising. This case study shows how a strong alliance among the tobacco industry, the state, the media, and sports and cultural activities planners made it difficult for people to make an informed decision. The promoters of the ban were unable to provide counter-arguments to the mostly fallacious claims made by the opponents regarding the likely health and economic impact of this ban. A comparison to successful campaigns in Canada and New Zealand provides insight regarding factors missing in the Swiss campaign which might have been useful in obtaining support from Swiss citizens.

Adolescent↗
PubMed1994

[Smoking cessation: importance for the patient and role of the practitioner].

Tobacco is the single most important cause of avoidable morbidity and early mortality in many countries. Smoking cessation is associated with a reduction in the prevalence of related symptoms as well as a progressive decrease in the occurrence of related diseases. Thus, there is a rapid decline in the occurrence of cardiovascular diseases in individuals who stop smoking; there is also a decline in the occurrence of lung cancer, although delayed and with a slower decrease rate. This is an important message for physicians and patients: Physicians should systematically offer counselling and information to their patients who smoke. The message should be tailored to the patient's status and must be different for a patient who has already decided to quit than for a patient who is not considering cessation in the near future. To help patients who have decided to stop and incite other patients who smoke to quit, physicians should be aware of the mechanisms involved in acquiring and breaking tobacco dependence (learning pathways, physiological dependence, behavioral analysis). Physicians should be trained to use methods which have proved effective in a physician's practice and to manage difficulties which may arise during cessation (e.g. craving, weight gain), as well as appropriate use of nicotine skin patches or chewing gum. From a public health standpoint, widespread action by physicians to promote smoking cessation among their patients could be one of the most effective clinical preventive measures.

Attitude to Health↗
PubMed1993

[Childbirth without fear in case of Von Willebrand's disease].

We report two cases of von Willebrand (type I) disease with vWF antigen levels of 21 and 25%, vWF ristocetin cofactor concentrations of 32 and 30%, and coagulation FVIII levels of 10 and 50% respectively. Template bleeding times were 20 and 11 minutes respectively. Both of these women exhibited a progressive and marked improvement of the vWF/FVIII complex during pregnancy. In the first, all parameters had completely normalized in the 37th week when a cesarean section was performed without hemorrhagic complications. The second case had borderline normal levels of the vWF/FVIII complex in the 37th week and underwent normal delivery in the 39th week. The improvement persisted for at least one week post-partum and in the first case values were still higher 10th weeks after delivery than they had been prior to the pregnancy. These observations and similar cases in the recent literature suggest that obstetrical operations and normal delivery are not associated with major blood losses in cases of moderately severe vWD of type I. These patients probably will not need vWF/FVIII concentrates for adequate hemostasis.

Adult↗
PubMed1992

Serum 25-hydroxyvitamin D: distribution and determinants in the Swiss population.

The serum 25-hydroxyvitamin D [25(OH)D] concentration was measured in a representative sample of the general adult population in Switzerland (n = 3276). The median concentration was 46 nmol/L and no significant difference was found between men and women. Between the ages of 25 and 74 y, 25(OH)D was not significantly correlated with age (r2 = 0.01). Six percent of the population was vitamin D deficient [ie, 25(OH)D less than or equal to 20 nmol/L] and between 34% and 95% had a relatively low concentration of vitamin D (ie, less than 38 or less than 95 nmol/L, respectively). Among the determinants of low 25(OH)D were indicators of little sunshine exposure, such as the winter season [odds ratio (OR) 2.4, 1.5-3.7 (95% confidence interval)] and less than 30 min of time spent outdoors daily by individuals greater than 65 y of age (OR 5.6, 1.5-21.2), as well as indicators of low nutritional intake of vitamin D, such as the absence of regular intake of butter or margarine (OR 2.0, 1.3-3.1) and the consumption of few dairy products (OR 1.7, 1.2-2.4).

25-Hydroxyvitamin D 2↗
PubMed1991

[Prevalence of risk factors for osteoporosis and distribution of calciuria and hydroxyprolinuria in an elderly population of a general practice. Results of a survey among 32 practitioners of the Vaud and Fribourg districts].

169 postmenopausal women and 84 male patients aged over 59 years from the outpatient consultations of 32 general practitioners were examined. The most frequently encountered risk factors for osteoporosis were low physical activity (41% of women, 27% of men), low intake of dairy products (37%/21%), smoking (11%/22%), while the particularly relevant risk factors were more rare, such as corticotherapy (7%/9%) and early menopause (17%). The risk factors were not more frequent than in 550 persons of the same age screened among the Swiss general population in another study. The same group of persons also yielded reference values for urinary calcium and hydroxyproline in the fasting urine, which are both considered as markers of bone turnover and as potential tools for screening osteoporosis. The urinary values were independent of age, body mass index, calcium intake, and the duration of the postmenopausal period. They were different from those found in 38 patients with Paget's disease, 66 patients with malignant hypercalcemia and 25 with bone metastasis from breast cancer. Calcium and hydroxyproline excretion are expressed as a ratio of urinary creatinine. Percentiles 10 and 90 of urinary calcium are 0.058 and 0.363 mmol/mmol (male) and 0.062 and 0.523 mmol/mmol (women). Percentiles 10 and 90 for urinary hydroxyproline are 0.006 and 0.024 mmol/mmol (male) and 0.010 and 0.025 mmol/mmol (women).

Aged↗
PubMed1988

Ischemic stroke as the presenting manifestation of localized systemic cancer.

A cerebral infarct due to a thrombosis of the left pericallosal artery was the first manifestation of an ovarian adenocarcinoma in a 42-year-old woman. A paraneoplastic origin was suggested by the observation that this patient had chronic intravenous coagulation and subsequently developed migratory thrombophlebitis (Trousseau's syndrome) despite high dose vitamin K antagonists therapy. This was supported by the fact that all manifestations of the hypercoagulable state disappeared following surgical cure of the cancer. Because cerebral infarction can be the first manifestation of a potentially curable cancer, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process, if there is laboratory or clinical evidence od disseminated intravascular coagulation.

Adenocarcinoma↗
PubMedDate not supplied

Smoking cessation counseling by residents in an outpatient clinic.

BACKGROUND: Training residents in smoking cessation counseling could be part of tobacco control policy. The effect of such an intervention is unknown in Europe. This study provides an assessment of smoking cessation counseling practices by Swiss residents after an intervention based on behavioral modification. METHOD: In a pre-post blind test trial on smoking cessation counseling practices, residents' perceptions about their own ability to counsel smoking behavior among smoking patients were evaluated for 15 residents trained in general internal medicine and in 247 and 155 smoking patients' reports, respectively before and after a training intervention targeting residents, based on behavioral theory of smoking cessation. RESULTS: Changes in counseling were assessed by interviews with patients. After the intervention, residents asked about smoking habits (77 vs 68%), advised to quit (43 vs 28%), provided counseling for cessation (25 vs 10%), gave self-help materials (7 vs 1%), and arranged follow-up visits (5 vs 1%) more often than before. Residents' self-perception of confidence (5.4 vs 4.6/10) and effectiveness (5.3 vs 4.0/10) in counseling also increased after the intervention. After adjusting for daily cigarette consumption and smoking duration, the likelihood of attempting to quit smoking at either 6 or 12 months was increased in the group of patients attended after the intervention (odds ratio 1.52, 95% confidence intervals 1.07-2.48). However, the likelihood of quitting smoking was not increased among these patients (odds ratio 1.07, 95% CI 0.96-1.14). CONCLUSIONS: Short-term smoking cessation counseling by residents was substantially improved by the intervention. Smokers attended after the intervention were more likely to attempt to quit smoking, but not to have quit at 6- or 12-month follow-up.

Adolescent↗