Biomedical subjects

J-P Janssens

Publications and source records attributed to J-P Janssens.

4 recordsLinked to original sources

PubMed2005

Asthma outpatient education by multiple implementation strategy. Outcome of a programme using a personal notebook.

More than 10 years after publication, international guidelines remain poorly implemented. To better implement them, we need to develop new strategies adapted to the expectations of patients and health professionals outside hospital settings and to ensure better outpatient follow up in the community. We developed a bilingual education programme including a brochure designed to support an interdisciplinary health care network and measured hospitalisations (H), work absenteeism (WA), emergency visits (EV), asthma medication (AM) and quality of life (QL Juniper) before and 12 months after the intervention. All QL scores improved significantly in comparison with pre-intervention values. Health service use decreased dramatically when comparing the 12 months prior to and after the intervention(H: 35-8%, WA: 39-14%, EV: 88-53%). The final cost/benefit ratio of the programme was 1.96. Interdisciplinary implementation strategy of patient education is cost-effective, improves quality of life for asthmatics, and reduces strain on health services. Such a health care network does not require an expensive infrastructure and is better adapted to the reality and competences of clinical practice.

Adolescent↗

PubMed2005

High hepatotoxicity of pyrazinamide and ethambutol for treatment of latent tuberculosis.

Pyrazinamide (PZA) combined with either ethambutol (EMB) or a fluoroquinolone for 6-12 months is one of the treatments recommended for latent tuberculosis infection (LTBI) in contacts exposed to multidrug-resistant tuberculosis (MDR-TB). The aim of the present study was to describe the side effects related to combined PZA and EMB treatment given for LTBI, in contacts previously exposed to MDR-TB. In total, 12 consecutive contacts, all of African origin and aged 38+/-5 yrs, were treated with daily PZA (23+/-4 mg.kg(-1)) and EMB (17+/-4 mg.kg(-1)) at Geneva University Hospital outpatient clinic (Switzerland), as a result of contact-tracing procedures for two patients with contagious MDR-TB. Clinical status and liver function tests (aspartate aminotransferase (ALAT) and alanine aminotransferase (ASAT)) were monitored monthly. In seven cases (58%) treatment was discontinued after a median of 119 days, due to hepatic toxicity in six cases (ALAT or ASAT elevation more than four times the upper normal limit), and gastrointestinal symptoms in one case. In conclusion, combined pyrazinamide and ethambutol for latent tuberculosis infection may be associated with a high risk of hepatic toxicity, and warrants close monitoring. There is clearly a need for alternative preventive treatments for contacts exposed to multidrug-resistant tuberculosis.

Adult↗

PubMed2005

Normal values for respiratory resistance using forced oscillation in subjects>65 years old.

The aim of the present study was to determine reference values and predictive variables for respiratory impedance (Zrs) by the forced oscillation technique (FOT) in subjects aged>65 yrs. The investigation involved a prospective study of nonsmoking subjects, with normal forced expiratory volumes. The Zrs parameters, which included average resistance between 4-16 Hz (R4-16), average resistance between 4-30 Hz (RM), resonant frequency (FN), capacitance (C) and inertance (I), were measured along with forced expiratory manoeuvres. Every subject had each parameter measured in the same sequence using FOT and spirometry. A total of 223 subjects aged 83+/-8 yrs were included in the study. The mean values for forced expiratory volume in one second (FEV1) % predicted were 110+/-23. The forced vital capacity (FVC) % pred was 114+/-21 and the FEV1/FVC % pred was 112+/-11. The mean values for the Zrs parameters were: R4-16: 0.25+/-0.07 kPa.s-1.L-1; RM: 0.25+/-0.06 kPa.s-1.L-1; FN: 11.0+/-2.8 Hz; I: 1.17+/-0.26 Pa.L-1.s-2; and C: 20.5+/-9.0 mL.hPa-1. In multiple regression models adjusted for age, sex, height and weight, height was the most influential predictor for Zrs parameters based on the magnitude of the regression coefficient. In conclusion, it was found that height was the best predictor for respiratory impedance parameters. Contribution of age and weight was negligible. However, the level of predictability for respiratory impedance parameters by regression equations was low.

Age Factors↗

PubMed2003

[Lung embolism in the elderly].

Elderly people have an increased risk of suffering from thrombo-embolic events. Lung embolism is often found as a cause of death in autopsies in elderly people. However, it is unknown whether the increased age is a risk factor per se or whether elderly people suffer more often from co-morbidities associated with a higher thrombo-embolic risk. Immobility is the most important risk factor for thrombo-embolic events. Other risk factors include trauma, surgery, venous stase, genetic factors (thrombophilia) and a history of past thrombo-embolic events. Although the probability of suffering from a thrombo-embolic event increases with age, it can be difficult to find the correct diagnosis in elderly people: symptoms like dyspnoe or chest pain might be explained by other cardio-pulmonary diseases. In this review, we would like to give an overview about the diagnostic and therapeutic steps in elderly people.

Aged↗