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Biomedical subjects

Jean Roche

Publications and source records attributed to Jean Roche.

4 recordsLinked to original sources
PubMed2005

[Driving and Alzheimer's disease].

Although most aged people remain safe drivers, a greater risk for crashes due to medical conditions is observed in the elderly. Impairment of important functions for safe driving such as visuospatial skills, attention, memory and judgement are observed in dementia, particularly in Alzheimer's disease. The accident rate increases from 9.4 accidents per million vehicle kilometers traveled for 80 to 85 year-old drivers, but raises to 163.6 for drivers with moderate AD. Patients and their families should be informed that patients with mild dementia related to Alzheimer's disease (stage 1 on the Clinical Dementia Rating, CDR), have a substantially increased rate of traffic accidents and therefore should not drive. But subjects in the pre-dementia phase (stage 0.5 at the CDR, mild cognitive impairment) also pose significant driving safety problems. In most States of the USA, and many European countries, but not in France, law requires regular investigating of driving performance in the elderly.

Accidents, Traffic↗
PubMed2004

[Violence towards elderly persons].

Elder abuse is a common problem that affects 5% of the geriatric population. Authors describe many types of elder abuse: physical, emotional, financial and neglect (passive or active). The elderly are the fastest growing segment of the population in France. Consequently, the number of cases will likely increase as the geriatric population grows. Elder abuse receives less attention so only a few of these cases are reported. Elder abuse involves a complicated relationship among an individual's medical problems, social situation, and ability to function in the environment. The victims show typical risk factors such as living with the abuser, dependence on care, and cognitive impairment. The abusers live frequently in social isolation. Abuse is correlated with the emotional and financial dependence of the caregivers on their victims. Physicians are in ideal position to recognise, manage and help prevent elder mistreatment and neglect. To comprehensively evaluate elder abuse, a multidisciplinary approach is vital. Assessment and management should focus on both the patient and the caregiver. Patients with immediate danger should be hospitalised for safety and elder abuse be reported to the public attorney.

Activities of Daily Living↗
PubMed2002

Terlipressin in patients with cirrhosis and type 1 hepatorenal syndrome: a retrospective multicenter study.

BACKGROUND & AIMS: Type 1 hepatorenal syndrome (HRS) is a severe complication of cirrhosis associated with a short median survival time (<2 weeks). Although the administration of terlipressin improves renal function, its effect on survival is unknown. This study investigated predictive factors of survival in patients with type 1 HRS treated with terlipressin. METHODS: Ninety-nine patients with type 1 HRS treated with terlipressin in 24 centers were retrospectively studied. Terlipressin-induced improved renal function was defined as a decrease in serum creatinine value to <130 micromol/L or a decrease of at least 20% at the end of treatment. RESULTS: At inclusion, the Child-Pugh score was 11.8 +/- 1.6 (mean +/- SD). Terlipressin (3.2 +/- 1.3 mg/day) was administered for 11 +/- 12 days. Renal function improved in 58% of patients (serum creatinine decreased by 46% +/- 17% from 272 +/- 114 micromol/L). Median survival time was 21 days. Survival rate was 40% at 1 month. Multivariate analysis showed that improved renal function and Child-Pugh score < or =11 at inclusion were independent predictive factors of survival (P < 0.0001 and 0.02, respectively). Thirteen patients underwent liver transplantation (92 +/- 95 days after HRS onset), 10 of whom had received terlipressin and had had improved renal function. CONCLUSIONS: This retrospective uncontrolled study shows that in patients with type 1 HRS, terlipressin-induced improved renal function is associated with an increase in survival. Thus, a randomized trial investigating the effect of terlipressin on survival in patients with type 1 HRS should be performed.

Aged↗