Social inequalities in disability-free life expectancy in the French male population, 1980-1991.

We calculate aggregate indicators of population health for occupational groups to gauge changes in health disparities during the 1980-1991 period. The study is based on the experiences of French adult men in three major occupational classes: managers, manual workers, and an intermediary occupational group. Life table models show that managers have longer life expectancy and disability-free life expectancy (DFLE) than manual workers, and a shorter life expectancy with disability.

[Contribution of disability-free life expectancy indicators to the study of social inequities in health].

In looking at increases in disability-free life expectancy we examine the scope and evolution of social inequalities in health. As early as the end of the 18th century, Moheau had already emphasised the differences in life expectancy according to profession but it wasn't until much later that official statistics could confirm them. Despite the growing concern related to this phenomenon, the data are lacking for tracking its evolution and understanding its causes.

[Socio-ethic of cancer chemoprevention].

Cancer chemoprevention envisions a reduction in the incidence of the disease through direct action using various chemical products. Chemoprevention trials involve healthy subjects, as a consequence careful ethical consideration must be given to such interventions. The classical contract between the patient and his doctor is altered in this situation and the numerous consequences of extrapolation of results to the general population must be considered.

Viable malignant cells after primary chemotherapy for disseminated nonseminomatous germ cell tumors: prognostic factors and role of postsurgery chemotherapy--results from an international study group.

Purpose: To assess the value of postsurgery chemotherapy in patients with disseminated nonseminomatous germ-cell tumors (NSGCTs) and viable residual disease after first-line cisplatin-based chemotherapy.

Patients And Methods: The outcome of 238 patients was reviewed. Tumor markers had normalized in all patients before resection.

Continual reassessment methods in phase I trials of the combination of two drugs in oncology.

Most phase I trials in oncology use standard methods for treating successive groups of patients with increasing doses in order to determine the maximum tolerated dose (MTD). These methods have been criticized because they treat many patients at suboptimal dose levels, and do not provide an accurate estimation of the best dose level. Continual reassessment methods for the study of toxicity in single agent phase I trials have recently been advocated since they present many advantages over traditional methods.

Anal sphincter reconstruction by dynamic graciloplasty after abdominoperineal resection for cancer.

Purpose: Chronic low-frequency electrical stimulation can safely transform fatiguing muscle into fatigue-resistant muscle. This fundamental discovery was used to reconstruct the anal sphincter. Dynamic graciloplasty was found to be effective in the treatment of fecal incontinence.

Health expectancy indicators.

An outline is presented of progress in the development of health expectancy indicators, which are growing in importance as a means of assessing the health status of populations and determining public health priorities.

[Validation of a new interactive software monitoring a controlled-flow infusion pump for cisplatin dosage regimen adjustment].

Adaptive dosing of cisplatin (CDDP) results in reduced haematological and renal toxicity but it has never been clearly shown that it affects the tumoral response rate. Before undertaking a clinical randomized study of CDDP monitoring versus standard dose, a comparative study was performed between a new software dedicated to the interactive adjustments--the AJI software--and the APIS software for clinical pharmacokinetics which incorporates a bayesian procedure and a population information computed according to a three compartment model. CDDP was administered by continuous infusion at variable rates with a controlled flow pump during four days in order to reach the target of 1.

[Anorectal malignant melanomas. Apropos of 5 cases. Review of the literature].

This study reports five cases of anorectal melanoma treated at Centre Val d'Aurelle-Paul Lamarque in Montpellier. There follows a discussion based upon the literature of epidemiological, clinical, histopathological and therapeutic aspects. Surgery is the treatment of choice but there is major controversy regarding the best method.

Mental status examination of an exceptional case of longevity J. C. aged 118 years.

Background: The mental status examination of an extreme case of longevity, J. C., aged 118 years and 9 months, is documented in order to further knowledge regarding profiles of morbidity in the extremely elderly.

The application of disability data from epidemiological surveys to the development of indicators of service needs for dependent elderly people.

Increases in the prevalence of disability due to the ageing of the population have given rise to the need for simple indicators which may be used to estimate service needs and to assess whether resources have been fairly distributed. The present study involved the validation of an indicator based on confinement level by reference to epidemiological studies of disability, social support, and living conditions in three regions of France. Using factorial correspondence analysis and regression methods it was found that such an indicator could adequately summarize more complex empirical observations and thus provide a means of classifying elderly populations into four dependency groups.

The impact of a comprehensive multi-dimensional geriatric assessment programme on duration of stay in a French acute medical ward.

The impact of a multi-dimensional geriatric assessment (MDGA) programme on the reorientation of the elderly person at discharge is described. One hundred and six elderly persons from a hospital catchment area identified for its poor level of social services, poor living conditions and high prevalence of dependency were allocated to either an experimental or control group. The experimental group was given the multi-dimensional assessment in the first three days of admission while the control group was subject to the usual hospital procedures.

[Dynamics of asthma mortality in France: seasonal fluctuations and peak mortality in 1985-87].

In the face of an observed increase in asthma mortality since the end of the 70's an analysis of the time series of the deaths for the period 1979-89 was conducted; which shows a peaking of mortality between 1985 and 1987. A different seasonal component of asthma mortality has been identified for the age group 5-34 and over 34 group. For the later, mortality was found to peak during winter and dropping to the lowest point in summer, well synchronised with the mortality due to respiratory infection.

[Proctectomy and colo-anal anastomosis after high-dose irradiation of cancers of the lower third of the rectum. Functional and oncological results].

This prospective study was designed to evaluate morbidity and functional and oncological outcomes in patients with carcinoma of the distal third of the rectum treated by high-dose radiation therapy followed by conservative surgery. Twenty-two patients with adenocarcinoma of the distal third of the rectum treated after June 1990 were included in the study. Mean distances separating the tumor from the upper edge of the levator ani muscle and from the anal verge were 17 mm and 47 mm, respectively.

Evaluation of the bioequivalence of tablet and capsule formulations of granisetron in patients undergoing cytotoxic chemotherapy for malignant disease.

Granisetron is a novel, highly specific 5-hydroxytryptamine receptor antagonist given prophylactically to patients undergoing chemotherapy. An open, randomized, crossover trial was performed with 37 patients (24 females and 13 males) undergoing cytotoxic chemotherapy for malignant disease to compare an oral tablet (1-mg tablet given twice daily) with a clinical-trial capsule (1-mg capsule given twice daily). Complete pharmacokinetic data were determined for 24 patients (14 females and 10 males).

Conservative treatment for low rectal carcinoma by local excision with or without radiotherapy.

Thirty-seven patients with low rectal carcinoma were treated by transanal resection between January 1979 and December 1988. Adjuvant radiotherapy was used in eight patients before operation, in 13 after operation and six patients had both preoperative and postoperative radiotherapy. The selection criteria for transanal resection were low, superficial tumours treated conservatively with curative intent (group 1, 18 patients) or patients medically unfit for (12) or refusing (seven) abdominoperineal resection (APR) (group 2, 19 patients).

[Conservative surgery of breast cancer. Development of ideas and methods].

Conservative breast cancer surgery has been accepted by the medical profession, but the operative procedures remain to be specified. The decision to conserve the breast must take into account the tumour size/breast volume ratio. The amount of healthy breast tissue to be removed around the tumour must be determined.

Potential contribution of 131I-labelled monoclonal anti-CEA antibodies in the treatment of liver metastases from colorectal carcinomas: pretherapeutic study with dose recovery in resected tissues.

20 patients with liver metastases from colorectal carcinoma undergoing laparotomy received 15-60 mg intravenously, either intact or fragments of, anti-carcinoembryonic antigen (anti-CEA) monoclonal antibodies labelled with 0.55-1.48 GBq (15-40 mCi) of 131I, 3-8 days prior to operation.

[Ultradian variations of interleukin-1 beta concentration (IL-1 beta), interferon gamma (IFN-gamma) and soluble IL-2 receptors (RIL-2) in healthy volunteers humen].

The aim of this study consisted in underlining the concentrations' evolution in time of two cytokines: IL-1 beta and IFN-gamma, as well as that of RIL-2 (soluble receptor for IL-2), in healthy volunteers. Under normal physiological conditions, these molecules are secreted in small amounts, according to a sequential chronology. Thus, 25 blood samples were carried out from each of the four subjects included in the study, one every 20 minutes, during 8 hours.

Adenosine phosphorothioates (ATP alpha S and ATP tau S) differentially affect the two steps of mammalian pre-mRNA splicing.

We have investigated the function of ATP hydrolysis in mammalian pre-mRNA in vitro splicing using adenosine phosphorothioates (ATP alpha S and ATP tau S) known to affect the activity of a number of ATP-requiring enzymes. Spliceosome assembly, but neither one of the two transesterification reactions involved in splicing, occurs with ATP alpha S suggesting that at least two types of ATP-requiring factors are brought into play. ATP alpha S has no effect in the presence of normal ATP and, therefore, spliceosomes assembled in the presence of ATP alpha S remain competent for splicing when supplied with normal ATP.

[Appendiceal carcinoid tumor of systematic detection. When to propose right hemi-colectomy and how to monitor? Thoughts apropos of a case and review of the literature].

In relation to a case of carcinoid tumor of the appendix discovered after appendectomy and already metastatic, we discuss the prognostic factors of these lesions. Size is the most important one. For tumors less than two centimetres diameter, site, mesoappendix and lymph node involvement do not fully summarize the aggressiveness of the disease.