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Biomedical subjects

P Messy

Publications and source records attributed to P Messy.

9 recordsLinked to original sources

Data quality in a DRG-based information system.

The aim of this study initiated in May 1990 was to evaluate the quality of the medical data collected from the main hospital of the "Hospices Civils de Lyon", Edouard Herriot Hospital. We studied a random sample of 593 discharge abstracts from 12 wards of the hospital. Quality control was performed by checking multi-hospitalized patients' personal data, checking that each discharge abstract was exhaustive, examining the quality of abstracting, studying diagnoses and medical procedures coding, and checking data entry. Assessment of personal data showed a 4.4% error rate. It was mainly accounted for by spelling mistakes in surnames and first names, and mistakes in dates of birth. The quality of a discharge abstract was estimated according to the two purposes of the medical information system: description of hospital morbidity per patient and Diagnosis Related Group's case mix. Error rates in discharge abstracts were expressed in two ways: an overall rate for errors of concordance between Discharge Abstracts and Medical Records, and a specific rate for errors modifying classification in Diagnosis Related Groups (DRG). For abstracting medical information, these error rates were 11.5% (SE +/- 2.2) and 7.5% (SE +/- 1.9) respectively. For coding diagnoses and procedures, they were 11.4% (SE +/- 1.5) and 1.3% (SE +/- 0.5) respectively. For data entry on the computerized data base, the error rate was 2% (SE +/- 0.5) and 0.2% (SE +/- 0.05). Quality control must be performed regularly because it demonstrates the degree of participation from health care teams and the coherence of the database.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection

[Statural growth of Moghrabin children living in France].

In order to compare the statural growth of French and Maghrebian children living in France, the authors measured the height of 1,243 children aged between one month and 16 years. The study showed no significant difference at any age between the two ethnic groups. It is therefore possible, in daily medical practice, to use the same age charts for French and maghrebian children living in France.

Adolescent

Prognostic factors and indications for surgical treatment of acute aortic dissections: a report based on 191 observations.

A total of 191 acute aortic dissections were examined to define prognostic factors for surgical intervention. Overall survival rate reached 40% in the 94 patients operated upon and 8% in the 97 patients not operated upon. Among the 122 patients with involved ascending aorta, survival rate was 2% in the 42 nonoperated patients versus 42% in 80 patients undergoing surgery. Since 1977, overall survival rate has reached 60% in the surgical group (21 of 35 patients) and 20% in the nonsurgical group (5 of 25 patients). Factors that showed a significant correlation with postoperative death include: persistent shock; persistent anuria; persistent neurologic deficit; diffuse intravascular coagulation; and involvement of either the celiac trunk, superior mesenteric artery, or both renal arteries at angiography. With the exception of those patients exhibiting any of these high-risk factors, emergency surgical treatment is recommended for all dissections that involve the ascending aorta.

Adult

[Antibiotic susceptibility testing by the disk method. Comparative evaluation of 5 commercial systems].

The systems studied were: bioMerieux, Difco, Institut Pasteur Production, Oxoid (media, discs, standards of interpretation). Each batch was tested for pH value and calcium and magnesium concentrations. The activity of 19 antibiotics was determined by use of three reference strains (E. coli ATCC 25922, S. aureus ATCC 25923, P. aeruginosa ATCC 27853). The most suitable inoculum was defined after testing three different methods of preparation. The susceptibility of each strain to each antibiotic was studied 30 times using each system. The reproducibility of the diameters with each system and the intersystem variance was calculated. This allowed groups of homogeneity between the different systems to be defined. The results were interpreted according to the various existing standards (manufacturer, French committee of SFM, WHO) yielding an overall discordance of 0,29%, of little practical importance. Finally the reliability of each system was evaluated according to WHO, data. The Difco medium gave the most accurate results with the other media tending to produce excessively large zones of inhibition.

Anti-Bacterial Agents

[The influence of diet on the urinary excretion of total, free and conjugated non-dialysable hydroxyproline in the normal adult (author's transl)].

Having established reference values for the different forms of urinary excretion of hydroxyproline on the basis of the results obtained in 12 normal subjects aged from 20 to 43 years, the authors studied the influence of three diets on the excretion of total, free and conjugated hydroxyproline. Urinary levels of total and peptide dialysable hydroxyprolines were found to be highly sensitive to the dietary collagen content, whilst free hydroxyproline increased only when the dietary collagen intake was very high. Peptide non-dialysable hydroxyproline, corresponding to peptides of molecular weight 6000-8000 was not influenced by diet. The ratio dialysable hydroxyproline/non-dialysable hydroxyproline varied from reference values if the diet was loaded with collagen. Only the ratio free hydroxyproline/non-dialysable hydroxyproline seemed to be independent of diet in the subjects studied.

Adult

[Study of Urinary excretion of total, free, and non-dialysable conjugated hydroxyproline in paraplegics].

Eighteen paraplegics with or without neurogenic osteo-arthropathy (POAN) were evaluated for variations in their urinary excretion levels of total (T), and free (L) hydroxyproline and its non-dialysable (ND) and dialysable (D) peptide fractions. Increases in urinary hydroxyproline, moderate rises in free hydroxyproline and more substantial increases in dialysable and non-dialysable peptide fractions could be observed in these patients who all were affected with osteoporosis of disuse. Only variations in dialysable hydroxyproline could be used to differentiate between POAN + and POAN - patients. Of the various ratios which were analyzed (ND/T, L/ND, and D/ND), the D/ND ratio appears to be the most useful for diagnosis and monitoring of patients with POAN.

Adolescent

[Validation and factor analysis of a phobia scale. The French version of the Marks-Mathews fear questionnaire].

The fear questionnaire (Marks and Mathews) is presented in an original french translation. The questionnaire's validity, sensibility and reliability are studied in four groups: agoraphobia with panic attacks, obsession-compulsion, social phobia and control. The scale has a good empirical validity especially for agoraphobia measurement. However in our study the boundaries between obsession compulsion and social phobia appear questionable. Principal components analysis yields four factors similar to those found by Marks and Mathews: agoraphobia, blood and injury phobia, social phobia, and anxiety-depression (including one panic item).

Adult

Predictive value of MMPI scales on smoking cessation programs outcomes.

Five hundred and fifty-eight cigarette smokers were randomized in 4 groups: acupuncture, behavior therapy, placebo and waiting list. The MMPI scales showed stability across pretest, posttest and a one-year follow-up. Principal components analysis isolated a "depression-psychasthenia" factor accounting for 61% of the variance. Moreover 43% of the subjects had an abnormal MMPI profile. Segmentation isolated predictive factors: a high number of pathological MMPI scales predicted failures in any kind of treatment. Acupuncture yielded better outcomes when the profiles were normal. Behavior therapy and placebo had better outcomes when the anxiety index was abnormal. The study underscores the role of personality factors in tobacco addiction and their influence on cessation programs outcomes.

Acupuncture Therapy