Biomedical subjects

P Gerin

Publications and source records attributed to P Gerin.

At least 19 recordsLinked to original sources

PubMed1992

Quality of life assessment in therapeutic trials: rationale for and presentation of a more appropriate instrument.

In therapeutic trials, quality of life studies are usually based on a health model which results in a restrictive view. Therefore, it is important to clearly define the concept of the quality of life, since ambiguous concepts can alter the results. The key to this problem is the clear distinction between the two components of the quality of life, ie subjective and objective. This latter component is the only one considered in the current medical approach. The use of the subjective quality of life introduces a number of methodological problems not found when the objective quality of life is assessed, and thus requires a specific model which can be derived from the model of life goals used by sociologists. This model is presented here and illustrated with some results obtained with a new questionnaire, the Subjective Quality of Life Profile (SQLP) questionnaire. We suggest that both subjective and objective quality of life studies should be considered in order to emphasize the humanistic approach to therapeutic indications.

Clinical Trials as Topic↗

PubMed1992

[Outcome of care in a pediatric psychiatry outpatient clinic: "photography" of seven consultation centers].

A survey was carried out on 7 pedopsychiatric outpatient centres in the area of Lyon in order to evaluate the general outcome of care in consulting children and their families. Five public centres (centres médico-psychologiques) and 2 non-profit making private centres (centre médico-psychopédagogiques and centre d'action médico-sociale précoce) were part of the survey which included 706 children and adolescents. The survey showed that many children stop attending these centres; although, the numbers were significantly higher in the public centres compared with the non-profit making private centres. The authors suggest that differences in status and management between the two types of centres, leading to different conditions of functioning, on a practical as well as on a symbolic level, may be responsible, at least in part, for the different outcome in care between the 2 types of centres.

Adolescent↗

PubMed1990

Incidence of large oesophageal varices in patients with cirrhosis: application to prophylaxis of first bleeding.

Because several studies have suggested that beta blockers are effective in the prophylaxis of first variceal bleeding in cirrhosis, screening for oesophageal varices might be appropriate. We prospectively studied 84 cirrhotic patients without obvious evidence of large oesophageal varices and previous bleeding during a mean follow up of 16 months. At entry to the study 41 patients had no oesophageal varices and in 43 these were grade 1. The subsequent percentages of patients without large oesophageal varices were 74% at one year and 52% at two years. Univariate analysis showed that a longer duration of cirrhosis (p less than 0.05) and grade 1 oesophageal varices at entry (p less than 0.001) were predictive factors for the occurrence of large oesophageal varices, whereas, multivariate analysis showed that the initial size of the oesophageal varices (p less than 0.001), a high initial Child-Pugh score, and a smaller improvement in Child-Pugh score during the study were independent risk factors. Among patients with grades 0 and 1 oesophageal varices at the start of the study the proportions with large oesophageal varices at two years were 31% and 70% respectively. We have calculated that, accepting a maximum risk of first bleeding of 10% without prophylactic treatment, a patient without oesophageal varices should be screened endoscopically every other year, while a patient with grade 1 disease should benefit from one annual upper gastrointestinal endoscopy.

Aged↗

PubMed1989

Development and use of a self-administered questionnaire for assessment of psychologic attitudes toward pregnancy and their relation to a subsequent premature birth.

This paper describes both the development of and results of the use of a self-administered questionnaire designed specifically to investigate the relation between the psychologic attitudes of pregnant women toward pregnancy and an eventual subsequent premature birth. The questionnaire (entitled Pregnancy Psychologic Attitudes Test--in relation to Premature Birth [PPAT(p)]) was derived from the synthesis of interviews with women who had given birth prematurely, comprised 40 questions grouped in six dimensions, and was used in a prospective survey. All women who had an antenatal visit in their fifth to sixth month of pregnancy in one of four maternity hospitals in Lyon, France, between October 1983 and March 1985 were asked to complete this questionnaire. A quantitative PPAT(p) score (ranging from 0 to 6) was constructed in a working sample (n = 643), and its relation with a subsequent premature birth was analyzed in a study sample (n = 1,500). Application of the logistic regression model showed, after controlling for personal and medical factors, that this relation was statistically significant. The risk of premature birth increased from 1 to 1.5 when the PPAT(p) score increased one point (p less than 0.001). This study contributes to a better understanding of psychologic factors that may affect pregnant women and be associated with premature birth. This new component must be considered in the development of policies for preventing premature birth.

Adult↗

PubMed1989

[Evaluation of psychotherapy in clinical practice].

Empirical research on psychotherapies must be integrated into clinical practice. This is highly beneficial for both this research and the clinical practice itself. When research protocols are focused upon the everyday clinical problems and practice, filling up the corresponding scales or questionnaires does not appear any more as a tedious extra charge. Instruments are available which are based upon clinical usual approaches, and allow for reliable enough assessments of various and meaningful data (concerning symptoms, global health-sickness level, patient/therapist relationships, patients' involvement, etc....). Patients' and therapists' discourses can be analysed from tape recordings or from their responses to open-ended questions. Profiles of changes can be drawn, rather than unidimensional indexes of change. Naturalistic approach does not spoil the spontaneous clinical situation; but experimental settings are possible in some very precise circumstances. When a clinical staff decides to undertake such a research program, many institutional problems arise in an unusual way and thus can often be solved. Collectively filling up the questionnaires is frequently appreciated by the clinical staff. Patients usually appreciate to be questioned about their feelings and opinions concerning themselves and their treatment. However, if auto-evaluation brings highly worthwhile local benefits, the general conclusions of such empirical researches should be very cautiously discussed.

Follow-Up Studies↗

PubMed1989

[Functional study, in man, of congestive gastropathy in cirrhosis by measurement of potential difference].

The morphologic features of the gastric mucosa in patients with cirrhosis have been well investigated. The aim of this study was to evaluate its functional disruption by measuring the gastric potential difference. Forty patients were investigated, 12 control subjects and 28 consecutive cirrhotic patients with endoscopically proved congestive gastropathy. Potential difference was measured the morning, on an empty stomach, at least 3 days after endoscopy; the method used a double channel gastric perfused probe placed under fluoroscopy 10 cm above the cardia, and a subcutaneous reference, both connected to a millivoltimeter via gelose agar-KCl bridges. Potential difference was recorded in each case 20 min before (baseline) and after local instillation of lysine acetylsalicylate (500 mg) as a provocative test. Cirrhotic patients had significantly lower basal potential difference than controls (-28.3 +/- 1.5 mV vs -33.8 +/- 1.3mV, p = 0.007). Potential difference was significantly lower in patients with severe gastropathy than in patients with mild gastropathy (-20.5 +/- 2.1 and -28.9 +/- 1.6 mV, respectively, p less than 0.01). After stimulation with acetylsalicylate, the area under curve and the irritability index were greater in patients with gastropathy (81.4 +/- 12.8 vs 41.2 +/- 8.6 mV.min, p = 0.032 and 0.935 +/- 0.19 vs 0.290 +/- 0.07 mV.mV.min, p = 0.022, respectively). These differences were explained by a higher drop in potential difference (delta DPmax/baseline; 28.1 +/- 3 vs 16.1 +/- 3 p. 100, p = 0.006) whereas basal return time remained unchanged (16.2 +/- 2.1 vs 13.7 +/- 2.2 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Aspirin↗

PubMed1979

[Original method of multivariate analysis, adapted for comparison of mean evoked potentials: E2 test].

This paper describes a multivariate statistical method of analysis for the comparison of 2 paired series. For such paired series, this test, called E2, is analogous to the generalized Hotteling T2 test, as epsilon test (pairing method) is analogous to Student's t test. Here we give an example of its application to a comparison of curves, in this particular case average auditory evoked potentials, picked up at symmetrical points on the scalp.

Acoustic Stimulation↗

PubMed1975