Biomedical subjects

M Zureik

Publications and source records attributed to M Zureik.

40 records · Page 3Linked to original sources

PubMed1995

Combined effects of blood pressure and body mass index on left ventricular structure in middle-aged males: cross-sectional and 2-year longitudinal results.

OBJECTIVE: To compare the 2-year longitudinal with the cross-sectional relationships of blood pressure and body mass index with echocardiographic left ventricular measurements in middle-aged males with no history of cardiovascular disease or hypertension. METHODS: M-mode echocardiograms of adequate quality were obtained at initial and 2-year follow-up examinations in 177 subjects. Measurements of left ventricular wall thickness and internal dimensions were made, and estimates of left ventricular mass/height were calculated. Longitudinal changes in left ventricular measurements and risk factors were computed as the differences between the follow-up and initial values. RESULTS: Systolic blood pressure (SBP) was significantly associated with left ventricular mass/height and wall thickness in cross-sectional and in longitudinal analyses. Similar results were observed after adjusting for age, body mass index, sport activity and heart rate. Although body mass index was strongly related to left ventricular mass/height, wall thickness and internal dimension in the cross-sectional study, no significant associations were observed between changes in body mass index and in left ventricular measurements. CONCLUSIONS: The present study emphasizes the differential effects of spontaneous changes in blood pressure and body mass index on the evolution of the left ventricular mass in middle-aged males. Spontaneous changes in SBP during the 2-year follow-up period were associated with rapid changes in left ventricular structure. The 2-year period might not have been sufficient for body mass index to induce changes in left ventricular structure. The duration and amplitude of body weight changes which entail changes in left ventricular mass remain to be determined by further longitudinal investigations.

Blood Pressure↗

PubMed1995

Peak expiratory flow rate variability in population surveys. Does the number of assessments matter?

We investigated the effect of reducing the number of daily peak expiratory flow (PEF) measurements on (1) the amplitude of PEF variability and (2) the relationships of this amplitude to bronchial reactivity to methacholine. One hundred seventeen workers (mean age = 38.7 years +/- 9.5; men = 86.3%) recorded their highest of three PEF measurements, every 3 waking hours, ie, 5 times a day, for 7 days, each using a newly purchased peak flowmeter (Vitalograph), and underwent methacholine challenge tests. The variability of PEF of each subject was expressed using the three sets of indices: amp%mean, ie, highest of the daily measurements considered minus the lowest/mean x 100, averaged over 6 days from the second to the seventh, amp%highest (same as amp%mean, but with the highest daily measurements as denominators) and SD%mean (calculated initially as single measures using the data of the 6 days considered, with standard deviation (SD) of each subject's PEF measurements). For each set, we used the indices constructed with the five daily measurements of each day (gold standard), with the first, third, fourth, and fifth, the first, third, and fourth, the first and third, and the first and fourth. The PEF variability was significantly reduced when reducing the number of daily measurements, only when the amp%mean and the amp%highest sets were used. No decrease was observed with the SD%mean set of indices, and SD%mean constructed with the first, third, fourth, and fifth daily measurement was satisfactory. Whatever the sort of index used, three daily measurements were sufficient to identify the group of subjects with excessive variability in relation to methacholine reactivity.

Adult↗

PubMed1995

[Hospital discharge planning and length of hospital stay in elderly patients admitted through the emergency department].

A prospective study was organized in two teaching hospitals in Paris, including 426 elderly patients aged 75 and more, who had been hospitalized through the medical emergency department. The goal of the study was to assess the influence of difficulties of orientation at discharge on the length of stay, independently of other risk factors. The mean length of stay was 18.3 +/- 15.4 days. Orientation at discharge toward a social or a nursing care institution was associated with a 12 days longer mean length of stay than a home discharge. A longer length of stay was also associated with: a strictly social problem at admission, the diagnoses of dementia, confusion, social problem, fall or general health impairment, a short or long-term fatal prognosis, a poor mental status, refusal of home discharge as expressed by the referent person. Multivariate analysis showed that discharge toward a social or a nursing care institution was the first explanatory factor, explaining 12% of variance. These results suggest that the hospital discharge management has a major influence on the elderly length of hospital stay. Therefore, an interdisciplinary care management, including social and geriatric evaluation as soon as the patient is admitted at the emergency department, should be evaluated, in order to avoid problems of orientation that may occur at discharge.

Age Factors↗

PubMed1995

Misuse of pressurized metered dose inhalers by asthmatic patients treated in French private practice.

Although metered dose inhalers (MDIs) are widely used to treat asthma, clinical studies suggest that misuse is frequent. We studied the frequency of, and factors related to, misuse of MDIs in asthmatic patients of French private practice. 264 chest specialists or general practitioners completed questionnaires including characteristics of patients and asthma, technique in using inhalers and previous instruction, for three consecutive asthmatics aged > 6 years and currently using MDIs: 668 adults (mean age 47.8 years +/- 18.5, 51.8% males) and 100 children (mean age 11.5 years +/- 2.1, 72.0% males) were included. Adequate technique (deep inspiration synchronized with inhaler activation, followed by holding breath for 5 seconds) was used by 33.2% of adults and 26.0% of children; optimal technique (same, plus shaking the inhaler before use and activating it only once) was used by 22.1% of adults and 20.0% of children. The main factor related to misuse of MDIs was absence of previous instruction. However only 26.5% of instructed adults and 22.1% of instructed children used the optimal technique. Misuse of MDIs is a public health problem and instruction is unlikely to solve it. The use of different types of devices, like dry powder breath-actuated inhalers should be encouraged.

Adolescent↗