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Biomedical subjects

K Bean

Publications and source records attributed to K Bean.

At least 19 recordsLinked to original sources
PubMed2006

[Prevalence of intraocular hypertension and glaucoma in a nonselected French population].

AIMS: To measure intraocular pressure (IOP) in a large human sample and to assess the prevalence of glaucoma with elevated IOP and ocular hypertension (OHT) in this population. METHODS: We measured IOP in 2,074 subjects (men: women: 1,384: 690). If the IOP was higher than 20 mmHg, a photograph of the optic disc was taken and the visual field was examined. The optic nerve head and the visual field were evaluated in 395 individuals. RESULTS: In men aged 18-39 years, mean IOP was 15.5+/-3.1 mmHg and 16.4+/-3.5 mmHg after 60 years of age. In women, IOP reached 14.5+/-3.3 and 15.9+/-3.1 mmHg, respectively. IOP greater than 21 mmHg was found in 10.1% of males and 6.4% of females. The prevalence of OHT increased with age: from 5.3% to 15.5% in men and from 3% to 7.5% in women for the same age ranges. A diagnosis of glaucoma with elevated IOP was made in 2.2% of males and 3.0% of females. The prevalence of glaucoma increased with age from 0.8% to 5.7% in men and from 0.6% to 4.7% in women under 40 years and over 60 years of age, respectively. DISCUSSION: This study confirms the increase in IOP with age and the role of aging in the prevalence of OHT and glaucoma with elevated IOP. CONCLUSION: This transversal study shows the feasibility of intraocular hypertension and glaucoma screening and prevalence assessment in a nonselected large population in France.

Adolescent↗
PubMed2006

Cardiovascular risk markers associated with the metabolic syndrome in a large French population: the "SYMFONIE" study.

OBJECTIVE: The SYMFONIE study was designed to analyze the clinical and biological characteristics, and the cardiovascular risk markers, in men and women with the metabolic syndrome compared to control subjects. RESEARCH DESIGN AND METHODS: The study population included 101,697 men and women, 18 to 80 years of age, who had a health checkup at the Centre d'Investigations Preventives et Cliniques (Paris, France) between 1997 to 2002. The metabolic syndrome was defined according to the ATpiiI-NCEP 2001 criteria. RESULTS: Out of the 66,202 men (47.4+/-11.8 years) and 35,495 women (48.5+/-13.6 years) included in this population, 6761 men (10.2%) and 2155 women (6.1%) presented the metabolic syndrome. Among subjects < or =40 years of age, the prevalence of the metabolic syndrome was 5.0% in men and 2.2% in women, and rose to 14.1% and 12.0%, respectively, among men and women >70 years of age. After adjustment for age, patients with the metabolic syndrome presented higher pulse pressure (systolic minus diastolic blood pressure), higher heart rate, lower vital respiratory capacity, lower physical activity, an increase in inflammatory status assessed through leukocyte count and dental inflammation, hepatic abnormalities, and increased levels of stress and depression. CONCLUSION: In this large French population, the prevalence of the metabolic syndrome is lower than in North American and northern European populations. Patients with the metabolic syndrome present several additional hemodynamic, inflammatory and psychological risk markers which could contribute to the poor cardiovascular prognosis of these subjects.

Adult↗
PubMed2004

Patterns of parental relatedness and pup survival in the grey seal (Halichoerus grypus).

Levels of parental relatedness can affect offspring survival and susceptibility to disease. We investigated parental relatedness of live and dead Halichoerus grypus pups between and within island populations and between possible causes of mortality. Nine microsatellites were used to calculate internal relatedness (IR) and standardized mean d2. We find that pups with higher than average levels of IR have significantly lower survival and that this varied between island populations and that certain loci contributed to the effect more than others. Although, there were no significant differences between causes of mortality, peritonitis, infection and stillborn had the highest levels of IR. These results provide evidence that parental relatedness is an important determinant of pre-weaning pup survival in the grey seal and that this may vary with cause of mortality given a larger sample size.

Analysis of Variance↗
PubMed2002

Combined effects of systolic blood pressure and serum cholesterol on cardiovascular mortality in young (<55 years) men and women.

AIMS: To evaluate the combined effects of the two most frequent modifiable risk factors, systolic blood pressure and serum cholesterol, on cardiovascular and coronary mortality, in a large French population aged 18 to 55 years. METHODS AND RESULTS: We studied 108,879 men (mean age 39.1+/-9.4 years) and 84,931 women (mean age 37.3+/-10.0 years) who had a health check-up at the IPC Center between 1978 and 1988. Mortality data for a mean period of 13 years were analysed. Systolic blood pressure and cholesterol levels were classified according to the cut-points proposed by international guidelines. In men, the prevalence of high cholesterol was more than twice as high in hypertensives as in normotensives; in women, it was more than three times higher. The combination of these two risk factors has additive effects on cardiovascular disease and coronary heart disease risk. In men, a borderline elevation of both systolic blood pressure (130-139 mmHg) and cholesterol (200-239 mg x dl(-1)) leads to a three- to four-fold increase in cardiovascular disease risk. Men with systolic blood pressure >or=160 mmHg represent a small percentage (about 5%) who have a 10-fold increase in cardiovascular disease and coronary heart disease risk, especially when high cholesterol is present. In women of the same age, similar trends were observed, but the results were less significant, probably due to the low cardiovascular disease mortality rates. CONCLUSIONS: In conclusion, in French subjects under 55 years of age, a combination of high systolic blood pressure and high serum cholesterol dramatically increased cardiovascular disease and coronary heart disease risk, especially in men. A more aggressive public health policy is needed to prevent the development of risk factors in younger subjects.

Adult↗
PubMed2001

Reduced pulmonary function is associated with central arterial stiffness in men.

The association of impaired pulmonary function with cardiovascular morbidity and mortality has been reported in several prospective studies. The nature of this association and the mechanisms underlying it are unknown. Both atherosclerosis and central arterial stiffness might be involved. We recently reported, in a 4-yr longitudinal study, that reduced lung function predicts the development of carotid atherosclerotic plaques. In the present study, we report the associations of aortic stiffness with lung function measurements. One hundred and ninety-four men, aged 30 to 70 yr and free of coronary heart disease, who volunteered for a standard health examination were included. FEV(1) and FVC were used to assess lung function. Aortic stiffness was estimated from the carotid-femoral pulse-wave velocity (PWV), which increases proportionally with an increase in aortic stiffness. PWV was significantly and negatively associated with FEV(1) and FVC (partial correlation coefficients adjusted for age and height: -0.27 [p < 0.001] and -0.24 [p < 0.001], respectively). For every 1 SD increase in PWV (2.5 m/s), FEV(1) decreased by 195.2 +/- 50.1 ml (p < 0.001) in an age- and height-adjusted analysis. The corresponding decrease in FVC was 190.4 +/- 55.0 ml (p < 0.001). Further adjustment for cardiovascular risk factors (weight, smoking habits, hypercholesterolemia, diabetes, and hypertension) did not markedly alter these results. In addition, negative associations of PWV with lung function measurements were observed within each category of cardiovascular risk factors. This study suggests that reduced pulmonary function is independently associated with aortic stiffness in men. The interrelations between pulmonary and vascular alterations should be thoroughly investigated.

Adult↗
PubMed2001

Pulse pressure and heart rate: independent risk factors for cancer?

In the present study, the roles of heart rate (HR) and pulse pressure (PP) on cancer mortality, after taking into account physical activity, cigarette smoking, alcohol consumption and other confounding factors or underlying disease, were examined in men. The study included 125,513 men aged 20 to 95 years who had a health check-up at the IPC Center between 1978 and 1988. HR and PP were classified into three groups: < 60, 60-80, > 80 bpm for HR and < 50, 51-64, > or = 65 mmHg for PP. Adjusted risk ratios related to the increment from one class of HR or PP to the next for all cancer mortality were 1.4 (1.2-1.5) and 1.3 (1.1-1.4), respectively. This relationship was independent of several known risk and confounding factors, especially cigarette smoking and physical activity, and could not be explained by the presence of underlying disease.

Adult↗
PubMed2001

Combined effects of heart rate and pulse pressure on cardiovascular mortality according to age.

OBJECTIVES: The aim of the study was to assess the combined effects of pulse pressure (PP) and heart rate (HR) on cardiovascular mortality in a large French population. DESIGN: The study population was composed of 125,513 men and 96,301 women aged 16-95 years who had a health check-up at the IPC Center between January 1978 and December 1988. Subjects taking antihypertensive treatment were excluded. Mortality was assessed for an 8-year period. HR and PP were classified into three groups. HR groups were: < 60, 60-79 and > or = 80 beats per minute (bpm). PP groups were: < 50, 50-64 and > or = 65 mmHg. RESULTS: In men, PP and HR were both positively associated with cardiovascular mortality risk. In women, mean arterial pressure (MAP) but not PP or HR was associated with cardiovascular mortality. In men, a combined elevation of PP and HR was associated with an important increase of cardiovascular mortality risk. The group with the highest PP and the highest HR had a 4.8-fold increase in cardiovascular mortality risk as compared to the reference group (PP < 50 mmHg and HR < 60 bpm). This effect was more pronounced in younger men (5.4-fold increase) than in older men (3.7-fold increase), as compared to the reference groups of the same age. In women, the combined effects of PP and HR on cardiovascular mortality were not significant. CONCLUSION: A combined elevation of the two components of pulsatile arterial stress is associated with an important increase in cardiovascular mortality in men, especially in younger men. In women, steady-state stress (evaluated primarily by MAP), but not pulsatile stress, is an important determinant of cardiovascular mortality.

Adolescent↗
PubMed2001

Telomere length as an indicator of biological aging: the gender effect and relation with pulse pressure and pulse wave velocity.

Chronological age is the primary determinant of stiffness of central arteries. Increased stiffness is an independent indicator of cardiovascular risk. The aim of this study was to determine whether telomere length, a possible index of biological aging, provides a better account than chronological age for variation in arterial stiffness, evaluated by measuring pulse pressure and aortic pulse wave velocity. The study population included 193 French subjects (120 men, 73 women), with a mean age of 56+/-11 years, who were not on any antihypertensive medications. Telomere length was evaluated in white blood cells by measuring the mean length of the terminal restriction fragments. Age-adjusted telomere length was longer in women than in men (8.67+/-0.09 versus 8.37+/-0.07 kb; P=0.016). In both genders, telomere length was inversely correlated with age (P<0.01). Multivariate analysis showed that in men, but not in women, telomere length significantly contributed to pulse pressure and pulse wave velocity variations. In conclusion, telomere length provides an additional account to chronological age of variations in both pulse pressure and pulse wave velocity among men, such that men with shorter telomere length are more likely to exhibit high pulse pressure and pulse wave velocity, which are indices of large artery stiffness. The longer telomere length in women suggests that for a given chronological age, biological aging of men is more advanced than that of women.

Age Factors↗
PubMed2001

Cardiovascular mortality in hypertensive men according to presence of associated risk factors.

To evaluate the risk of cardiovascular disease (CVD) mortality in hypertensive men according to the presence of associated risk factors (ARFs). The population was composed of 29 640 normotensive men without ARFs (reference group) and 60 343 hypertensive men (with and without ARFs) who had a standard health checkup at the Centre d'Investigations Préventives et Cliniques between 1978 and 1988. Mortality data for a mean period of 14 years were analyzed. The following ARFs were considered: total cholesterol >/=2.5 g/L, personal history of diabetes, smoking (current smokers), body mass index >28 kg/m(2), and heart rate >80 bpm. CVD risk related to the presence of isolated hypertension (assessed in hypertensive subjects without ARFs versus the reference group) increased linearly from 15% at the age of 30 years to 134% at the age of 80 years. In hypertensive subjects, one additional ARF increased CVD risk by 56% (47% to 65%, P<0.01) in younger subjects but only by 4% (-8% to 17%, P=NS) in older subjects. The role of hypercholesterolemia and tobacco smoking in CVD mortality was significantly higher in hypertensive subjects aged <55 years than in hypertensive subjects aged >/=55 years (P<0.01), whereas the roles of tachycardia and obesity were not affected by age. In younger hypertensive subjects, evaluation of CVD risk and therapeutic strategies should target ARFS: In older subjects, the presence of high blood pressure levels seems to be the major determinant of CVD risk.

Adult↗
PubMed2000

A decrease in diastolic blood pressure combined with an increase in systolic blood pressure is associated with a higher cardiovascular mortality in men.

OBJECTIVES: The study evaluated the risk of cardiovascular mortality according to combined spontaneous (non-treatment-related) changes in both systolic and diastolic blood pressure (BP). BACKGROUND: Long-term longitudinal changes in blood pressure may be a more accurate determinant of cardiovascular risk since changes in systolic or diastolic blood pressure over a period of time reflect the evolution of arterial and arteriolar alterations. METHODS: Two independent French male cohorts were studied: the IPC cohort (Investigations Préventives et Cliniques) composed of 15,561 men aged 20 to 82 years who had had two visits spaced four to 10 years apart, and the Paris Prospective Study composed of 6,246 men aged 42 to 53 years, examined annually for a period of four years. None of the subjects were taking antihypertensive medication. Annual changes in BP were estimated, and subjects were divided into groups according to the increase, lack of change, or decrease of systolic or diastolic BP. Nine groups were formed by combining the changes of systolic and diastolic BP. Cardiovascular mortality was assessed for a mean period of 13.5 years for the IPC Study and 17 years for the Paris Prospective Study. RESULTS: In both cohorts, after adjustment for age and major risk factors, the group with an increase in systolic and a decrease in diastolic BP presented the highest relative risk of cardiovascular mortality compared to the group with no changes in either systolic or diastolic BP (relative risk: 2.07 [1.05 to 4.06] in the IPC Study and 2.16 [1.16 to 4.01] in the Paris Prospective Study). CONCLUSIONS: Assessment of spontaneous changes of BP over a long period of time can contribute to the evaluation of cardiovascular risk. Subjects whose systolic BP increased while their diastolic BP decreased had the highest cardiovascular risk independently of absolute values of BP or other risk factors.

Adult↗
PubMed2000

How can hypertensive patients be better treated? The contribution of combination therapy.

Recent studies demonstrated that target blood pressure (BP) in treated hypertensive patients should be below 140 mmHg for systolic blood pressure (SBP) and below 90 mmHg for diastolic blood pressure (DBP). However, population studies from several countries have demonstrated that in clinical practice the proportion of controlled hypertensive patients is less than 30%. In order to elucidate these questions in France we analysed a large population of 145,000 subjects examined at the Centre d'Investigations Préventives et Cliniques in Paris (IPC). Among those with high BP at the time of their IPC visit, only 20% received an antihypertensive treatment. Among those receiving an antihypertensive treatment, less than 27% (24% in men and 30% in women) presented with BP values less than 140 mmHg for SBP and less than 90 mmHg for DBP. This analysis also showed that 72% of hypertensive patients presented with at least one modifiable associated cardiovascular risk factor and that more than 30% of hypertensive men and more than 25% of hypertensive women presented with at least two associated risk factors. The use of combination therapies could help to increase the percentage of well-controlled hypertensive subjects. It has been shown that in order to reach this BP level, combination therapy should be used in more than two-thirds of the treated subjects. The trandolapril-verapamil combination is the first fixed combination of an angiotensin-converting enzyme inhibitor and a non-dihydropyridine calcium-channel blocker. Administered once daily, this combination reduces BP more than a classic monotherapy. The effects of the trandolapril-verapamil combination on risk factors are either neutral (metabolic parameters), or even beneficial (reduction in heart rate).

Adolescent↗
PubMed1999

Determinants of left ventricular mass in a French male population.

The aim of this analysis was to study the determinants of left ventricular mass evaluated by echocardiography. A total of 843 healthy men aged 47-61 years, who had a standard health check-up at the Centre d'Investigations Preventives et Cliniques (IPC Center), were included in the study. None of the subjects were being treated for cardiovascular disease at the time of their visit and each had a standard clinical and biological examination. The answers to a lifestyle questionnaire, weight at 20 years and family history were recorded. All subjects had an echocardiogram to evaluate left ventricular mass. Left ventricular mass values were adjusted for height using the ratio of left ventricular mass to height. Current body mass index, systolic and diastolic blood pressure, brachial circumference, triglycerides and a family history of sudden death were positively associated with this ratio (p < 0.01). Physical activity and tobacco consumption were associated with left ventricular mass. Body mass index at 20 years, variation of body mass index since that age, systolic blood pressure and family history of sudden death explain 21% of the ratio of left ventricular mass/height (body mass index at 20 years: 11.8%; variation of body mass index: 5.1%; systolic blood pressure: 2.3%; and family history of sudden death: 0.4%). The other factors explain only 1.4% of this variance and were not significantly associated with the ratio of left ventricular mass to height. Body mass index at 20 years was the strongest determinant of left ventricular mass, suggesting that left ventricular mass at middle age is in large measure determined much earlier in life. A family history of sudden death before the age of 60 years is also an important determinant of left ventricular mass, independent of obesity. These factors must be taken into account in order to prevent an increase in left ventricular mass.

Age Factors↗
PubMed1997

Comparison of single-dose oral grepafloxacin with cefixime for treatment of uncomplicated gonorrhea in men. The STD Study Group.

In a randomized open study, 351 male patients with uncomplicated gonorrhea were given single oral doses of grepafloxacin (400 mg) or cefixime (400 mg). In the 299 microbiologically evaluable patients, urethral infections were cured in 99% (147 of 149) of those receiving grepafloxacin and 97% (145 of 150) of those given cefixime. Eradication rates for both regimens were 100% in the 16% (47 of 299) of participants who were infected with penicillin-resistant Neisseria gonorrhoeae and 97% in the 21% (62 of 299) of participants infected with tetracycline-resistant strains. Grepafloxacin is a well-tolerated alternative to cefixime for treatment of uncomplicated gonorrhea in males.

Administration, Oral↗
PubMed1996

Clinical outcomes and mortality after hip fracture: a 2-year follow-up study.

The aim of this study was to evaluate the burden of hip fractures, which occurred in the French region of Picardie, in 1992, among 1103 women and 356 men, whether the fractures occurred at home or in a community (i.e., patients who depended on a collective service). The data are part of the PICAROS study, which was designed to assess prospectively the outcome of patients as judged by clinical, economical, and quality of life factors. Patients and/or proxies were questioned during the 2nd or 3rd week following the fracture, and again at 3, 6, 12, and 24 months after the fracture. The survey was conducted by home interview. Recruitment criteria were: 1) all patients with a hip fracture as defined by the International Classification of Disease (ICD); 2) 20 years of age and over; 3) admitted to one of the 34 surgical units from the region, public and private, and had an operation or not. Patients with metastatic or myelomatous fractures or fractures on prothesis device were not included. For the present analysis, patients under 50 years of age were excluded. Among people aged 50 years and over, 3% of the general population lived in a community; 32% of hip fractures were from a community. Patients in a community, aged 60-69, had 15 times more risk of having a hip fracture than subjects of the same age at home. The excess risk decreased with age and stabilized over 85 years of age at two to threefold. During the 24 month follow-up, 394 women and 173 men died. Among those surviving, 87% were interviewed at 2 years. We analysed seven classes of complications, according to the ICD: (1) pressure sores and blisters; (2) pulmonary infections; (3) urinary infections; (4) surgical complications; (5) orthopedic complications; (6) thrombosis and embolisms; and (7) secondary hip fractures. Patients coming from a community had a higher risk of mortality, pressure sores, surgical complications, and pulmonary and urinary infections. From an economical perspective, the institutionalized population would seem to be a profitable target for the prevention of fractures and their complications.

Aged↗
PubMed1996

The Asthma Impact Record (AIR) index: a rating scale to evaluate the quality of life of asthmatic patients in France.

Asthma is a chronic disease, which affects patients' daily lives. The goal of this study was the development of a disease-specific scale to evaluate quality of life in asthmatic patients in France: The Asthma Impact Record Index (AIR Index). The study was conducted with the participation of 486 asthmatic patients using the following steps: 1) selection of dichotomous items; 2) reduction of the number of items; 3) study of reproducibility of the questionnaire; 4) weighting of items; 5) study of the reliability and validity of the final version of the AIR Index. The final version of the AIR Index contains 63 unweighted items. The items were classified into subscales representing the main dimensions of quality of life: 1) physical, which was itself split into two subscales: a) physical activities; and b) symptoms; 2) psychological; and 3) social or relational. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all subscales (range 0.79-0.94). The concurrent validity, evaluated by studying the relationship between the score values on the global scale and the subscales, and the parameters reflecting disease severity, was also high. We conclude that the AIR Index might represent a useful evaluative and discriminant instrument in studying quality of life in asthma in French populations.

Adult↗
PubMed1995

Change in alcohol, tobacco and coffee consumption in pregnant women: evolution between 1988 and 1992 in an area of high consumption.

OBJECTIVE: Analyse the evolution of alcohol, tobacco and coffee consumption during pregnancy in a population characterized by a high level of consumption and a low socioeconomic situation. STUDY DESIGN: Data were obtained from two studies done with the same protocol and questionnaire in the Roubaix Public Maternity Hospital in 1988 (176 women) and 1992 (235 women); the two periods were compared using univariate tests and multiple logistic regression to control for social factors. RESULTS: Between 1988 and 1992, there was a clear decrease in alcohol consumption, a slight decrease in coffee consumption and an increase in tobacco use. These changes affected usual consumption as well as consumption during pregnancy. The increase in tobacco use was no longer significant after controlling for social factors. However, the decrease in alcohol consumption affected all women regardless of sociodemographic characteristics, and remained significant after controlling for these characteristics. CONCLUSION: Several factors support the hypothesis that the decrease in the reported alcohol consumption is real, for consumptions in the low to moderate range. However, it is difficult to identify the role of the several factors involved in this evolution: behaviour of the general population, attitude among pregnant women, information and sensitization of prenatal care providers. Besides, one negative aspect needs to be considered: the stability of the incidence of fetal alcohol syndrome, probably reflecting the stability of the proportion of very heavy consumers.

Alcohol Drinking↗
PubMed1995

Attitudes and behavior of pregnant women and health professionals towards alcohol and tobacco consumption.

The objective of this study was to identify those factors that influence pregnant women's behavior towards alcohol consumption, so that they could be taken into account when developing alcohol prevention programs in prenatal care. Tobacco use was also studied to identify similarities and differences in attitudes and behavior. A sample of 176 women was interviewed using a structured questionnaire in the prenatal clinics or post-partum wards. Most women were aware that alcohol and tobacco could be harmful to their babies; however heavy drinkers recognized the influence of alcohol in pregnancy less often than the others. Sixty percent of the women, even among the light drinkers, thought that two drinks per day was a reasonable level of consumption during pregnancy. When asked who could be helpful in decreasing their alcohol consumption, most women mentioned their husband, and the doctor or midwife. This is in contrast to our finding that less than 20% of heavy drinkers were advised to reduce alcohol consumption, as compared to 70% of heavy smokers. The results point to the potential for more active interventions on alcohol reduction by health personnel during prenatal care.

Adult↗