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Jean S, Candas B, Belzile É, Morin S, Bessette L, Brown JP. Utilisation des données administratives : validation d’un algorithme en surveillance de l’ostéoporose. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Jean S, Candas B, Belzile É, Morin S, Bessette L, Brown JP. Appariement des données administratives pour l’estimation de l’utilisation des ressources médicales. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Haley N, Lambert G, Jean S, Tremblay C, Frappier J, Otis J, Roy E. Sexual Heath of Adolescents in Quebec Youth Protection Centers. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.suppl_a.17ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jean S, Despert V, Bridoux L. Arthrite juvénile idiopathique (AJI) et maladies inflammatoires chroniques intestinales (MICI). Arch Pediatr 2012. [DOI: 10.1016/j.arcped.2012.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bessette L, Jean S, Lapointe-Garant MP, Belzile EL, Davison KS, Ste-Marie LG, Brown JP. Direct medical costs attributable to peripheral fractures in Canadian post-menopausal women. Osteoporos Int 2012; 23:1757-68. [PMID: 21927921 DOI: 10.1007/s00198-011-1785-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/27/2011] [Indexed: 10/17/2022]
Abstract
UNLABELLED This study determined the cost of treating fractures at osteoporotic sites (except spine fractures) for the year following fracture. While the average cost of treating a hip fracture was the highest of all fractures ($46,664 CAD per fracture), treating other fractures also accounted for significant expenditures ($5,253 to $10,410 CAD per fracture). INTRODUCTION This study aims to determine the mean direct medical cost of treating fractures at peripheral osteoporotic sites in the year post-fracture (through 2 years post-hip fracture). METHODS Health administrative databases from the province of Quebec, Canada were used to estimate the cost of treating peripheral fractures at osteoporotic sites for the year following fracture (through 2 years for hip fractures). Included in costs analyses were physician claims, emergency and outpatient clinic costs, hospitalization costs, and subsequent costs for treatment of complications. RESULTS A total of 15,827 patients (mean age 72 years) who suffered one fracture at an osteoporotic site had data for analyses. Hip/femur fractures had the highest rate of hospital stays related to fracture (91%) and the highest rate of hospital stays associated with a post-fracture complication (8%). In the year following fracture, the mean (SD) costs (2009 Canadian dollars) of treating acute fractures and post-fracture complications were: hip/femur fracture $46,664 ($43,198), wrist fracture $5,253 ($18,982), and fractures at other peripheral sites $10,410 ($27,641). The average (SD) cost of treating post-fracture complications at the hip/femur in the second year post-fracture was $1,698 ($12,462). Hospitalizations associated with the fracture accounted for 88% of the total cost of fracture treatment. CONCLUSIONS The treatment of hip fractures accounts for a significant proportion of the costs associated with the treatment of peripheral osteoporotic fractures. Interventions to reduce the incidence of fractures, particularly hip fractures, would result in significant cost savings to the health care system and would preserve quality of life in many patients.
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Wipff J, Dumitrescu MA, Lorrot M, Kettani S, Faye A, Lacassagne S, Bader-Meunier B, Mouy R, Wouters C, Desjonquères M, Jean S, Despert V, Duquesne A, Quartier P, Job-Deslandre C. Création d’une cohorte française d’ostéites chroniques multifocales récidivantes : premiers résultats. Arch Pediatr 2012. [DOI: 10.1016/j.arcped.2012.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jean S, Tanyi JL, Montone K, Mcgrath C, Lage-Alvarez MM, Chu CS. Papillary thyroid cancer arising in struma ovarii. J OBSTET GYNAECOL 2012; 32:222-6. [DOI: 10.3109/01443615.2011.645921] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jean S, Candas B, Belzile É, Morin S, Bessette L, Dodin S, Brown JP. Algorithms can be used to identify fragility fracture cases in physician-claims databases. Osteoporos Int 2012; 23:483-501. [PMID: 21336492 DOI: 10.1007/s00198-011-1559-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 01/10/2011] [Indexed: 01/06/2023]
Abstract
SUMMARY Physician-billing claims databases can be used to determine the incidence of fractures in the community. This study tested three algorithms designed to accurately and reliably identify fractures from a physician-billing claims database and concluded that they were useful for identifying all types of fractures, except vertebral, sacral, and coccyx fractures. INTRODUCTION To develop and validate algorithms that identify fracture events from a physician-billing claims database (PCDs). METHODS Three algorithms were developed using physician's specialty, diagnostic, and medical service codes used in a PCD from the province of Quebec. Algorithm validity was assessed via calculation of positive predictive values (PPV; via verification of a sample of algorithm-identified cases with hospitalization files) and sensitivities (via cross-referencing respective algorithm-identified fracture cases with a well-characterized fracture cohort). RESULTS PPV and sensitivity varied across fracture sites. For most fracture sites, the PPV with algorithm 3 was higher than with algorithms 1 or 2. Except for knee fracture, the PPVs ranged from 0.81 to 0.96. Sensitivities were low at the vertebral, sacral, and coccyx sites (0.40-0.50), but high at all other fracture sites. For 95% of fractures, the fracture site identified by algorithm agreed with the fracture site from patients' medical records. Fracture dates identified by algorithm were within 2 days of the actual fracture date in 88% of fracture cases. Among cases identified by algorithm 3 to have had an open reduction (N = 461), 95% underwent surgery according to their respective medical charts. CONCLUSION Algorithms using PCDs are accurate and reliable for identifying incident fractures associated with osteoporosis-related fracture sites. The identification of these fractures in the community is important for helping to estimate the burden associated with osteoporosis and the utility of programs designed to reduce the rates of fragility fracture.
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Bessette L, Davison KS, Jean S, Roy S, Ste-Marie LG, Brown JP. The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial. Osteoporos Int 2011; 22:2963-72. [PMID: 21311871 DOI: 10.1007/s00198-011-1533-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
Abstract
UNLABELLED This study assessed whether osteoporosis diagnosis and treatment after an osteoporotic fracture can be increased by providing osteoporosis reading material to patients and family doctors or by watching a videocassette about osteoporosis. Educating patients about osteoporosis had little impact on whether a woman received an osteoporosis diagnosis or treatment. INTRODUCTION The purpose of this study was to investigate the impact of two education-based interventions on osteoporosis diagnosis and treatment in women ≥ 50 years of age after fragility fracture. METHODS Six to eight months after fracture, women were randomized into three groups: (1) control, (2) written materials, or (3) videocassette and written materials. Written materials for both the patient and physician detailed osteoporosis, fragility fracture, and available treatments; written materials for physicians were provided through patients. The educational videocassette presented similar information as the written material, but in greater depth. Rates of osteoporosis diagnosis and treatment following intervention were compared among groups using survival analysis methods. Statistical significance was set at p < 0.0167. RESULTS At randomization, 1,174 women were without osteoporosis diagnosis and treatment, and after follow-up, 12% of the control group, 15% of the written materials group (p = 0.073), and 16% (p = 0.036) of the videocassette and written materials group were diagnosed with osteoporosis (statistical comparisons to control). Treatment rates were 8% for the control group, 12% for the written materials group (p = 0.052), and 11% for the videocassette and written materials group (p = 0.157). At randomization, 1,314 women were without treatment and after follow-up therapy was initiated in 10% of the control group, 13% of the written materials group (p = 0.107), and 13% of the videocassette and written materials group (p = 0.238). CONCLUSIONS The educational interventions assessed in this trial were not satisfactory to increase osteoporosis diagnosis or treatment in recently fractured women to a clinically meaningful degree.
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Lambert G, Haley N, Jean S, Tremblay C, Frappier JY, Otis J, Roy E. P1-S2.29 Risky sexual practices among youth in Quebec Care Centers. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Polard T, Jean S, Gauthier L, Laplanche C, Merlina G, Sánchez-Pérez JM, Pinelli E. Mutagenic impact on fish of runoff events in agricultural areas in south-west France. AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2011; 101:126-134. [PMID: 20970859 DOI: 10.1016/j.aquatox.2010.09.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 09/15/2010] [Accepted: 09/20/2010] [Indexed: 05/30/2023]
Abstract
When heavy rainfall follows herbicide application, the intense surface runoff causes stream water contamination. Aquatic organisms are then briefly exposed to a complex mixture of contaminants. The aim of the present study is to investigate the genotoxic impact of such events on fish. A model fish, the Crucian carp (Carassius carassius) was exposed in controlled conditions, for 4 days, to water sampled daily in the Save River (France). The watershed of this stream is representative of agricultural areas in south-west France. Three hydrological conditions were compared: basal flow, winter flood, and spring flood. Chemical analysis of the water samples confirmed the higher contamination of the spring flood water, mainly explained by a peak of metolachlor. Genotoxicity was evaluated by micronucleus (MN) test and comet assay in peripheral erythrocytes. A significant increase in DNA breakdowns compared to controls was detected by the comet assay for all conditions. Exposure to spring flood water resulted in the highest damage induction. Moreover, induced chromosomal damage was only detected in this condition. In addition, fish were exposed, for 4 days, to an experimental mixture of 5 herbicides representative of the spring flood water contamination. Fish exhibited moderate DNA damage induction and no significant chromosomal damage. The mutagenicity induced by field-collected water is then suspected to be the result of numerous interactions between contaminants themselves and environmental factors, stressing the use of realistic exposure conditions. The results revealed a mutagenic impact of water contamination during the spring flood, emphasizing the need to consider these transient events in water quality monitoring programs.
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Polard T, Jean S, Merlina G, Laplanche C, Pinelli E, Gauthier L. Giemsa versus acridine orange staining in the fish micronucleus assay and validation for use in water quality monitoring. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2011; 74:144-149. [PMID: 20828819 DOI: 10.1016/j.ecoenv.2010.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 07/29/2010] [Accepted: 08/01/2010] [Indexed: 05/29/2023]
Abstract
This study concerns a comparative analysis of the acridine orange and Giemsa staining procedures for the fish erythrocyte micronucleus assay. The goal was to optimize the assay in the context of field water monitoring. Fish (Carassius carassius) were exposed to a reference genotoxic agent, cyclophosphamide monohydrate 5 mg l(-1) for 2, 4, and 6 days before testing. Slides from each individual were scored using the two procedures. The results show that the assay was more sensitive when acridine orange was used. When slides were Giemsa stained, the presence of ambiguous artefacts, leading to false positives and increasing random variance, reduced the contrast between exposed and control samples. Acridine Orange staining was then applied in the context of water quality monitoring. Fish were exposed for 4 days to water sampled in two hydrological contexts: basal flow and spring flood. The results show that exposure to spring flood water in an agricultural stream can induce mutagenicity.
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Gagnon C, Chouinard M, Laberge L, Veillette S, Bégin P, Breton R, Jean S, Brisson D, Gaudet D, Mathieu J. Health supervision and anticipatory guidance in adult myotonic dystrophy type 1. Neuromuscul Disord 2010; 20:847-51. [DOI: 10.1016/j.nmd.2010.08.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 08/25/2010] [Accepted: 08/26/2010] [Indexed: 11/30/2022]
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Laberge L, Prévost C, Perron M, Mathieu J, Auclair J, Gaudreault M, Richer L, Jean S, Veillette S. Clinical and genetic knowledge and attitudes of patients with myotonic dystrophy type 1. Public Health Genomics 2010; 13:424-30. [PMID: 20689257 DOI: 10.1159/000316238] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 06/03/2010] [Indexed: 11/19/2022] Open
Abstract
AIMS The goal was to assess clinical and genetic knowledge and attitudes in patients affected by myotonic dystrophy type 1 (DM1). METHODS Two hundred patients with molecular confirmation of the diagnosis of DM1 completed a multi-choice questionnaire. DM1 patients' knowledge and views were compared to clinically normal DM1 noncarriers (n = 264) and controls (n = 1,474). RESULTS Knowledge of the DM1 mode of inheritance was better in noncarriers than in patients (p < 0.001). Noncarriers were more aware than DM1 patients of the common clinical characteristics of DM1 such as limitations in physical activities and problems related to employment, schooling, activities of daily living, parenthood, peer relationships, and personality (p < 0.001). Compared to controls, DM1 patients felt less informed about the availability of clinical genetic services (p < 0.05) and new genetic technologies (p < 0.001). Among patients, logistic regression revealed that each additional year of education (p < 0.05) and each additional 100 CTG repeats (p < 0.01), respectively, increased and decreased the odds of knowing the DM1 mode of inheritance by about 23% and 18% respectively, independently of age, age at onset of symptoms, gender, severity of muscular impairment, and intellectual quotient. CONCLUSIONS DM1 patients' genetic knowledge is significantly dependent of the level of education and the number of CTG repeats. Healthcare providers should be aware of this situation in order to adjust counselling and education accordingly.
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Leslie WD, O'Donnell S, Lagacé C, Walsh P, Bancej C, Jean S, Siminoski K, Kaiser S, Kendler DL, Jaglal S. Population-based Canadian hip fracture rates with international comparisons. Osteoporos Int 2010; 21:1317-22. [PMID: 19802507 PMCID: PMC5101056 DOI: 10.1007/s00198-009-1080-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 09/09/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY We identified hospitalizations throughout Canada during 2000-2005 in which the most responsible diagnosis was a proximal femoral fracture. Use of the US fracture risk assessment tool (FRAX) would be inappropriate for Canada as it would overestimate fracture risk in Canadian women and older men. INTRODUCTION It is recommended that the WHO fracture risk assessment tool should be calibrated to the target population. METHODS We identified hospitalizations for women and men throughout Canada during the study period 2000-2005 in which the most responsible diagnosis was a proximal femoral fracture (147,982 hip fractures). Age-standardized hip fracture rates were compared between Canadian provinces, and national rates were compared with those reported for the USA and Germany. RESULTS There were relatively small differences in hip fracture rates between provinces, and most did not differ appreciably from the Canadian average. Hip fracture rates for women in Canada in 2001 were substantially lower than in the USA (population-weighted rate ratio 0.70) and were also lower than in Germany for 2004 (population-weighted rate ratio 0.74). CONCLUSIONS Overall hip fracture rates for Canadian women were found to be substantially lower than those for the USA and Germany. This study underscores the importance of assessing country-specific fracture patterns prior to adopting an existing FRAX tool.
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Jean S, Adams SF, Facciabene A, Peng X, Coukos G. Rapid, durable restoration of malignant ascites-derived antigen presenting cell immunogenicity by toll-like receptor agonists. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bessette L, Jean S, Davison KS, Roy S, Ste-Marie LG, Brown JP. Factors influencing the treatment of osteoporosis following fragility fracture. Osteoporos Int 2009; 20:1911-9. [PMID: 19333675 DOI: 10.1007/s00198-009-0898-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 02/03/2009] [Indexed: 01/06/2023]
Abstract
UNLABELLED Treatment rates of osteoporosis after fracture are very low. Women who suffer a fragility fracture have a greater chance of receiving anti-fracture treatment if they had low bone mineral density (BMD), a fracture at the hip, femur or pelvis, administration of calcium and vitamin D supplements and/or an age > or =60 years. INTRODUCTION This investigation identifies the predictors of osteoporosis treatment 6 to 8 months following fragility fracture in women >50 years of age. METHODS In this prospective cohort study, women were recruited 0 to 16 weeks following fracture and classified as having experienced fragility or traumatic fractures (phase 1). Six to 8 months following fracture, women completed a questionnaire on demographic features, clinical characteristics and risk factors for osteoporosis (phase 2). Osteoporosis treatment was defined as initiating anti-fracture therapy (bisphosphonate, raloxifene, nasal calcitonin and teriparatide) after fracture in those previously untreated. RESULTS Of the 1,273 women completing phase 1, 1,001 (79%) sustained a fragility fracture, and of these women, 738 were untreated for osteoporosis at phase 1 and completed the phase 2 questionnaire. Significant predictors of treatment included BMD result, fracture site, administration of calcium and vitamin D supplements at the time of fracture and age > or =60 years. All other risk factors for osteoporosis, such as fracture history after the age of 40 years, family history of osteoporosis and comorbidities did not significantly influence the treatment rate. CONCLUSIONS Physicians largely based their decision to treat on BMD results and not on the clinical event-fragility fracture.
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Sankaranarayanan R, James MA, Burtchaell S, Holloway R, Hoyt RH, Mchenry B, Fedewa MM, Penot JP, Jacquot C, Bonet JF, Pochet H, Jean S, Fressonnet R, Penot MP, Weiss A, Abecasis JA, Leal S, Monge J, Fartouce S, Santos JM, Silva A, Costa R, Leao MIP, Mori RF, Giannini G, Costa SPL, Silva KR, Penteado IM, Palka P, Lange A, Donnelly JE, Adsett M, Hayes JR, Stafford WJ, Hirayama Y, Kawamura Y, Sato N, Saito T, Hotta D, Kikuchi K, Ohori K, Hasebe N, Cabrera Bueno F, Alzueta J, Fernandez-Pastor J, Pena-Hernandez JL, Molina-Mora MJ, Barrera A, De Teresa E, Ayala Paredes F, Roux JF, Scazzuso F, Lavallee L, Poirier M, Chaumont J, Iorgulescu C, Vasile A, Dorobantu M, Vatasescu RG, Lefflerova K, Lupinek P, Bytesnik J, Cihak R, Krausova R, Vancura V, Kautzner J, Blich M, Suleiman M, Zeidan Shwiri T, Marai I, Boulos M, Amikam S, Lilli A, Magnacca M, Svetlich C, D'addario S, Baratto MT, Ghidini Ottonelli A, Savino K, Casolo G, Wolber T, On C, Binggeli C, Holzmeister J, Brunckhorst C, Duru F. Poster Session 2: Results (pacing), indications (pacing). Europace 2009. [DOI: 10.1093/europace/euq204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Laberge L, Bégin P, Dauvilliers Y, Beaudry M, Laforte M, Jean S, Mathieu J. A polysomnographic study of daytime sleepiness in myotonic dystrophy type 1. J Neurol Neurosurg Psychiatry 2009; 80:642-6. [PMID: 19211594 DOI: 10.1136/jnnp.2008.165035] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess contributors to excessive daytime sleepiness (EDS) in myotonic dystrophy type 1 (DM1), to characterise subjects with sleep-onset REM periods (SOREMPs), and to verify whether self-reported instruments and respiratory function tests can predict multiple sleep latency test (MSLT) and sleep-disordered breathing. METHODS A sample of 43 DM1 patients without selection bias underwent polysomnography (PSG) for two consecutive nights and MSLT, completed a sleep diary and Epworth Sleepiness Scale (ESS), and were assessed for respiratory function and narcolepsy symptoms. RESULTS ESS scores (ES) > or =11 and MSLT mean sleep latency (MSL) < or =8 min were found in 21 (50.0%) and 19 (44.2%) subjects, and either in 30 (69.8%) subjects. ES did not relate to MSL. Subjects with subjective sleepiness (ES> or =11) reported more cataplexy-like and sleep paralysis symptoms, longer habitual sleep times, and higher sleep efficiency and REM sleep per cent than those without. Subjects with objective sleepiness (MSL< or =8 min) had a higher stage 4 sleep per cent. Subjects with > or =2 SOREMPs (25.6%) showed higher muscular impairment, lower MSL, higher ES, and more cataplexy-like symptoms than those with < or =1 SOREMP. Apnoea-hypopnoea index (AHI) > or =5, predominantly obstructive, was found in 37 (86.0%) subjects, and AHI >30 in 12 (27.9%). Neither subjective nor objective sleepiness could be explained by AHI, nor satisfactorily predicted by daytime respiratory abnormalities. CONCLUSIONS DM1 entails frequent EDS but with different phenotypes and distinct mechanisms involved. The high prevalence of daytime sleepiness and severe sleep apnoeas found in this study supports the routine use of clinical sleep interviews, PSG and MSLT in DM1, and emphasises the need for more randomised trials of psychostimulants.
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Bouquinet E, Balestra J, Bismuth E, Bruna AL, Gallet S, Harvet G, Jean S, Jousselme C. Maladie chronique et enfance : image du corps, enjeux psychiques et alliance thérapeutique. Arch Pediatr 2008; 15:462-8. [DOI: 10.1016/j.arcped.2008.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 01/14/2008] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
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Jean S, Cinel I, Dellinger R. Effect of the inspiratory flow pattern on inspiration/expiration transition of lung vibrations in mechanically ventilated patients. Crit Care 2008. [PMCID: PMC4088675 DOI: 10.1186/cc6525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, Brown JP. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int 2008; 19:79-86. [PMID: 17641811 DOI: 10.1007/s00198-007-0426-9] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 05/22/2007] [Indexed: 10/23/2022]
Abstract
UNLABELLED In women aged 50 years or more who experienced a fracture, 81% suffered a fragility fracture. Six to eight months after fragility fracture, 79% had either not been investigated for osteoporosis or prescribed anti-fracture therapy. Despite fragility fractures being common in this population osteoporosis is under-diagnosed and under-treated. INTRODUCTION The objective of this study was to evaluate the diagnostic and treatment rates for osteoporosis six months following fragility fracture. METHODS This prospective cohort study was set in the general community from the Province of Quebec, Canada. Women at least 50 years of age who suffered a fracture were recruited during their initial visit to the hospital and had their fracture type classified as either fragility or traumatic. Six-to-eight months after fragility fracture, women were again contacted to evaluate the diagnostic and treatment rates of osteoporosis. RESULTS Of the 2,075 women recruited over a 25 month period 1,688 (81%) sustained a fragility fracture and 387 (19%) sustained a traumatic fracture. Nine hundred and three participants with a fragility fracture were again contacted six-to-eight months after fracture. For the 739 women not on treatment on the recruitment day, only 15.4% initiated pharmacological therapy in the six-to-eight-month period following fracture and 79.0% had either not been investigated for osteoporosis or prescribed anti-fracture treatment. CONCLUSIONS The proportion of fragility fractures to total fractures is higher than previously reported. Despite the availability of diagnostic modalities, effective treatments, and adequate health care assessments, there is a substantial care gap in the management of osteoporosis.
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Said W, Jean S, Guenard C, Benseghir T, Duvauferrier R, Marin F. [What is your diagnosis? Giant intraspongiform discal hernia of the L5 vertebral body]. ACTA ACUST UNITED AC 2007; 88:1203-4. [PMID: 17878886 DOI: 10.1016/s0221-0363(07)89936-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cinel I, Jean S, Gratz I, Deal E, Tay C, Littman J. Acoustic monitoring of one-lung ventilation with vibration response imaging. Crit Care 2007. [PMCID: PMC4095256 DOI: 10.1186/cc5362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jean S, Cinel I, Tay C, Wang Z, McGinly D. Correlation of lung vibration and airflow. Crit Care 2007. [PMCID: PMC4095257 DOI: 10.1186/cc5363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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