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Coste J, Tebeka S, Decio V, Makovski T, Alleaume C, Gallay A, Carcaillon-Bentata L. Prevalence of post-COVID-19 condition in the French general population after the first epidemic waves. Infect Dis Now 2023; 53:104631. [PMID: 36368627 PMCID: PMC9642032 DOI: 10.1016/j.idnow.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/18/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Affiliation(s)
- J. Coste
- Corresponding author at: Public Health France, 12, rue du Val d’Osne, 94410 Saint-Maurice, France
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Makovski TT, Decio V, Carcaillon-Bentata L, Alleaume C, Beltzer N, Robineau O, Gallay A, Tebeka S, Coste J. Long COVID in France: prevalence, management and long-term impact. Eur J Public Health 2022. [PMCID: PMC9593843 DOI: 10.1093/eurpub/ckac129.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Certain percentage of population experiences persistent symptoms months after an acute Covid-19 episode (Long-COVID), with a significant impact on daily-life. Few studies exist on its prevalence and its impact among the general population. The main objective of this survey was to estimate the prevalence of Long COVID among the general adult population in France. Secondary objectives were to evaluate Long COVID management and to assess impact of this clinical condition on quality of life and mental health. Cross-sectional study was performed in March-April 2022 using an online self-administered questionnaire. The sample was selected by the quota method from a panel of volunteers. Its representativeness was ensured by appropriate weighting. Three groups were described: Long-COVID, COVID without persistent symptoms, never COVID. Post COVID-19 condition as defined by the WHO was applied for prevalence estimation. The prevalence was calculated by age and sex. Health care consumption and impact of Long COVID on quality of life and mental health will be studied comparing the three groups, using weighted adjusted polytomic regressions. Here, we present preliminary findings on Long COVID prevalence. There were 27,537 respondents, 52% females, mean age (SD) 49 (±16.5). Confirmed or probable COVID-19 was reported by 33.9% of participants; of whom 85.1% had confirmed laboratory test. Majority (65.1%) had COVID-19 <3 months ago. Long COVID concerned 1,086 (4%) participants. Prevalence was higher for females 4.6% vs. 3.3% for males, and among younger population for both sex groups. Overall, prevalence of Long COVID by age group was: 18-34 (6%), 35-49 (4.7%), 50-64 (3.4%), ≥65 (1.8%). This is a first estimation of Long COVID prevalence among the French population. Representativeness of the sample should be interpreted with caution due to a sample based on volunteers’ response. Ongoing analyses will provide clearer understanding of the impact of Long COVID. Key messages • This is a first estimation of Long COVID prevalence among the French population. • There is a significant portion of the French population impacted by persisting or reoccurring symptoms defined by Long COVID; its impact and care management will be further evaluated.
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Affiliation(s)
- TT Makovski
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - V Decio
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - L Carcaillon-Bentata
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - C Alleaume
- Department of Alert and Crisis, Santé Publique France , Saint-Maurice, France
| | - N Beltzer
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - O Robineau
- Université, Inserm Sorbonne , Paris, France
- Centre Hospitalier de Tourcoing University Lille, , Tourcoing, France
| | - A Gallay
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - S Tebeka
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
| | - J Coste
- Department of Non-communicable Diseases, Santé Publique France , Saint-Maurice, France
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Trouvin AP, Simunek A, Coste J, Medkour T, Carvès S, Bouhassira D, Perrot S. POS0018 REDUCTION OF DIFFUSE NOXIOUS INHIBITORY CONTROL IN ACTIVE INFLAMMATORY RHEUMATISM: A DEMONSTRATION OF CENTRAL SENSITISATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIn rheumatoid arthritis (RA) and spondyloarthritis (Spa), persistent pain remains challenging. It is thought to result from central pain sensitisation, which can be measured by quantitative sensory testing (QST) and conditioned pain modulation (CPM).ObjectivesThe main objective of the RAPID (Rheumatism Pain Inhibitory Descending pathways) study, was to assess descending pain modulation (through CPM paradigms) in patients with RA or Spa, comparing these patients with healthy sex- and age-matched controls. The secondary objectives were the measurement pain thresholds (heat and cold) in a non-articular, non-painful area in patients and controls as a means of detecting possible widespread hyperalgesia as another index of central sensitisation in our patients.MethodsWe included 50 RA and 50 Spa patients and 100 age- and sex-matched controls. We assessed clinical disease variables for patients, together with responses to various psychological questionnaires. All participants underwent QST with the determination of heat and cold pain thresholds (HPT-CPT) and CPM. In CPM, a conditioning stimulus was applied to a foot and the non-dominant hand in a randomised sequence. Descending pain control was assessed as the change in HPT (in °C) following a conditioning stimulus: the higher the CPM effect, the more efficient the inhibitory control.ResultsHPT and CPT were similar in patients and controls. Mean CPM effect was significantly weaker in patients than controls: 0.25°C (±2.57) and 2.79°C (±2.31) for patients and controls, respectively (p<0.0001) for conditioning on the foot; 0.57°C (±2.74) and 2.68°C (±2.12) (p<0.0001), respectively, for conditioning on the hand. The heat pain threshold was 42.35°C (± 3.68°C) for patients and 41.54°C (± 3.34°C) for healthy controls; this difference was not statistically significant. The cold pain threshold was 13.11°C (± 10.04°C) for patients and 13.28°C (± 9.34°C) for healthy controls; this difference was not significant. The weaker CPM effect in patients was associated with higher pain intensity. In all participants, a weak CPM effect was associated with high Central Sensitisation Inventory score, anxiety, depression, sleep disturbance and pain catastrophising.ConclusionDiffuse noxious inhibitory control is weaker in patients with active chronic inflammatory rheumatism than in healthy subjects, supporting the hypothesis of central sensitisation.Figure 1.Disclosure of InterestsNone declared
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Coste J, Mandereau-Bruno L, Carcaillon-Bentata L. Identification des maladies chroniques dans le Système national des données de santé : recensement des algorithmes publiés et faisabilité de leur implémentation pour la surveillance épidémiologique. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lemaire JJ, Pontier B, Chaix R, El Ouadih Y, Khalil T, Sinardet D, Achim V, Postelnicu A, Coste J, Germain V, Sarret C, Sontheimer A. Neural correlates of consciousness and related disorders: From phenotypic descriptors of behavioral and relative consciousness to cortico-subcortical circuitry. Neurochirurgie 2021; 68:212-222. [PMID: 34051246 DOI: 10.1016/j.neuchi.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/13/2021] [Accepted: 05/09/2021] [Indexed: 01/01/2023]
Abstract
We report a review of medical aspects of the consciousness. The behavioral dimension, phenotypic descriptors, relative consciousness and neural correlates of consciousness and related disorders were addressed successively in a holistic and chronological approach. Consciousness is relative, specific to each individual across time and space. Historically defined as the perception of the self and the environment, it cannot be separated from behaviors, entailing an idea of conscious behavior with metapractic and metagnostic aspects. Observation of spontaneous and evoked overt behavior distinguishes three main types of disorder of consciousness (DoC): coma, vegetative state or unresponsive wakefulness, and minimally conscious or relationally impoverished state. Modern functional exploration techniques, such as imaging, increase the understanding of DoCs and consciousness. Whether consciousness is a superior function and/or an instrumental function is discussed. Neural correlates can be subdivided into two wakefulness pathways (superior thalamic cholinergic and inferior extra-thalamic), and cortico-subcortical circuitry. The deep brain structures are those described in the well-known sensorimotor, associative and limbic loops, as illustrated in the mesolimbic model of DoC. The cortices can be segregated into several overlapping networks: (1) a global workspace including thalamo-cortical loops; (2) the default mode network (DMN) and related intrinsic connectivity networks (i.e., central executive, medial DMN and salience networks); (3) a 3-fold network comprising the fronto-parietal control system and its dorsal and ventral attentional sub-networks, the fronto-parietal executive control network, and the cingulo-opercular salience network; (4) the internal and external cortices, respectively medial, turned toward the self, and lateral, turned toward the environment. The network dynamics is the reflection of consciousness, notably anticorrelations such as the decrease in activity of the posterior cingulate-precuneus regions during attentional tasks. Thanks to recent advances in DoC pathophysiology, further significative therapeutic progress is expected, taking into account the societal context. This depends notably on the dissemination of medical knowledge and its transfer to a wider public.
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Affiliation(s)
- J-J Lemaire
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France.
| | - B Pontier
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
| | - R Chaix
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Y El Ouadih
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - T Khalil
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
| | - D Sinardet
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - V Achim
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - A Postelnicu
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - J Coste
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
| | - V Germain
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
| | - C Sarret
- Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
| | - A Sontheimer
- Service de neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Institut Pascal, université Clermont Auvergne CNRS SIGMA, Clermont-Ferrand, France
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Coste J, Bizouarn P, Leplège A. [The troubled epistemology of the first wave of research on Covid-19]. Rev Epidemiol Sante Publique 2020; 68:269-271. [PMID: 32948361 PMCID: PMC7486037 DOI: 10.1016/j.respe.2020.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- J Coste
- SAPRAT EA 4116, école pratique des hautes études, université PSL et université de Paris, 75014 Paris, France.
| | - P Bizouarn
- Service d'anesthésie-réanimation, hôpital Laennec, CHU, Nantes, et laboratoire SPHERE, université Paris Diderot-CNRS, UMR 7219, 75007 Paris, France
| | - A Leplège
- Département d'histoire et de philosophie des sciences, IHSS, université de Paris, 75013 Paris, France
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Laanani M, Imbaud C, Tuppin P, Poulalhon C, Jollant F, Coste J, Rey G. Contacts with health services during the year prior to suicide death in France (2013-2015). Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study was designed to describe contacts with health services during the year before suicide death in France, and to compare the prevalent mental and physical conditions in these people to those of the general population.
Methods
Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals, national health insurance general scheme beneficiaries (i.e. 76% of the population living in France), aged 15 years or older, who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population.
Results
The study included 19,144 suicide decedents. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room (46.2% of suicide decedents consulted a general practitioner during the month before death, 16.7% attended an emergency room). During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold (SPR 95% CI: 7.7-8.1) more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3, 95% CI: 3.1-3.6) and epilepsy (SPR=2.7, 95% CI: 2.4-3.0).
Conclusions
General practitioners and emergency departments have frequent contacts with suicide decedents during the last weeks before death and are at the forefront of suicide risk identification and prevention in individuals with mental, but also physical conditions.
Key messages
Mental and physical conditions are more common among suicide decedents than in the general population, and contacts with primary care services are frequent in the last weeks prior to suicide. Primary care services (general practitioners and emergency rooms) should be targeted for suicide preventive interventions.
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Affiliation(s)
- M Laanani
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
- Strategy and Research Department, French National Health Insurance, Paris, France
| | - C Imbaud
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
| | - P Tuppin
- Strategy and Research Department, French National Health Insurance, Paris, France
| | - C Poulalhon
- Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France
| | - F Jollant
- Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France
- McGill Group for suicide studies, McGill University, Montréal, Canada
| | - J Coste
- Université de Paris, Paris, France
- Biostatistics and Epidemiology unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- French National Public Health Agency, Saint-Maurice, France
| | - G Rey
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
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Coste J, Tarquinio C, Rouquette A, Montel S, Pouchot J. Cross-cultural adaptation and validation of the French version of the credibility/expectancy questionnaire. Further insights into the measured concepts and their relationships. Psychologie Française 2020. [DOI: 10.1016/j.psfr.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Weill A, Nguyen P, Yoldjian I, Fontanel S, Froelich S, Coste J. Exposition prolongée à de fortes doses d’acétate de cyprotérone et risque de méningiome chez la femme : une recherche-action de santé publique en France. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Neumann A, Giral P, Weill A, Coste J. Estimation de l’effet de l’arrêt d’un traitement préventif chez les sujets âgés à partir des données médico-administratives : exploration de l’utilisation des modèles structuraux marginaux sur l’exemple des statines. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Laanani M, Weill A, Blotière PO, Pouchot J, Carbonnel F, Coste J. Factors associated with mechanical and systemic adverse events after colonoscopy (France, 2010-2015). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
More than one million colonoscopies are performed every year in France. They are associated with risks of mechanical and systemic serious adverse events (SAEs) which can be associated with patient, procedure, endoscopist, and facility characteristics. We tried to identify the factors associated with colonic perforation, gastrointestinal bleeding, splenic injury, shock, myocardial infarction, stroke, pulmonary embolism, acute renal failure, and urolithiasis after colonoscopy.
Methods
We analysed data from the French national claims databases (SNDS). A total of 4,088,799 patients, 30 years or older, undergoing a first screening or diagnostic colonoscopy between 2010 and 2015 were identified. SAE rates were estimated, and risk factors associated with SAEs were identified using multilevel logistic regression models, adjusted for patient, colonoscopy, endoscopist, and facility characteristics.
Results
Increasing age was associated with an increasing incidence of mechanical and systemic SAEs. Cancer and cardiovascular comorbidities were associated with mechanical SAEs, and a higher number of pre-existing conditions was associated with shock and acute renal failure. Polypectomy, especially of polyps larger than 1 cm, was associated with an increased risk of perforation (OR = 4.1; 95% CI, 3.4-5.0) and bleeding (OR = 13.3; 95% CI, 11.7-15.1). Mechanical SAEs were associated with the endoscopist’s experience, while systemic SAEs were more frequent in public hospitals than in private clinics.
Conclusions
SAEs related to colonoscopy were more frequent in older patients and in those with comorbidities. Mechanical SAEs were more frequent when colonoscopy was performed by less experienced endoscopists. Systemic SAEs were more frequent in public hospitals, reflecting patient selection processes. The risk of both mechanical and systemic SAEs should be taken into account when deciding to perform colonoscopy, particularly in older patients with multiple pre-existing conditions.
Key messages
Systemic SAEs are not uncommon after colonoscopy and, together with intestinal SAEs, should be considered when considering the need for colonoscopy. Patients at risk of SAEs should be identified and colonoscopy should be performed by experienced endoscopists in these patients. Less invasive alternatives should also be considered in these patients.
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Affiliation(s)
- M Laanani
- EPI-PHARE, Saint-Denis, France
- Department of Public Health Studies, French National Health Insurance, Paris, France
| | - A Weill
- EPI-PHARE, Saint-Denis, France
- Department of Public Health Studies, French National Health Insurance, Paris, France
| | - P O Blotière
- Department of Public Health Studies, French National Health Insurance, Paris, France
| | - J Pouchot
- Internal Medicine unit, Georges Pompidou European Hospital APHP, University Paris Descartes, Paris, France
| | - F Carbonnel
- Gastroenterology Unit, Paris Sud University Hospitals, APHP, Le Kremlin-Bicêtre, France
| | - J Coste
- Department of Public Health Studies, French National Health Insurance, Paris, France
- Biostatistics and Epidemiology Unit, Cochin Hospital APHP, University Paris Descartes, Paris, France
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Laroche F, Azoulay D, Trouvin AP, Coste J, Perrot S. Fibromyalgia in the workplace: risk factors for sick leave are related to professional context rather than fibromyalgia characteristics- a French national survey of 955 patients. BMC Rheumatol 2019; 3:44. [PMID: 31673681 PMCID: PMC6815377 DOI: 10.1186/s41927-019-0089-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 09/26/2019] [Indexed: 12/28/2022] Open
Abstract
Background Work and workplace factors are important in fibromyalgia management. We investigated factors associated with sick leave in professionally active women living with fibromyalgia. Methods A questionnaire for fibromyalgia patients in employment was developed by pain and occupational physicians and patients' organizations. Women in full-time work, screened for fibromyalgia with the FiRST questionnaire, were recruited for a national online survey. Sick leave over the preceding year was analyzed. Results In 5 months, we recruited 955 women, with a mean of 37 days of sick leave in the previous year: no sick leave (36%), up to 1 month (38%), 1 to 2 months (14%), more than 2 months (12%). In the groups displayed no differences in demographic characteristics, fibromyalgia symptoms, functional severity and psychological distress were observed. However, they differed in workplace characteristics, commute time, stress and difficulties at work, repetitive work, noisy conditions, career progression problems and lack of recognition, which were strong independent risk factors for longer sick leave. Sedentary positions, an extended sitting position, heavy loads, exposure to thermal disturbances and the use of vibrating tools did not increase the risk of sick leave. Conclusions Women with fibromyalgia frequently take sick leave, the risk factors for which are related to the workplace rather than fibromyalgia characteristics. Perspective This is the first study to assess the impact of occupational and clinical factors on sick leave in women living with fibromyalgia. Risk factors were found to be related to the workplace rather than fibromyalgia and personal characteristics. Workplace interventions should be developed for women with fibromyalgia.
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Affiliation(s)
- F Laroche
- 1Pain department, Paris Medicine Sorbonne University and Saint-Antoine Hospital, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
| | - D Azoulay
- 1Pain department, Paris Medicine Sorbonne University and Saint-Antoine Hospital, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
| | - A P Trouvin
- 2Pain department, Cochin Hospital, Paris Descartes University, INSERM U987, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - J Coste
- Biostatistics, Cochin Hospital, Paris Descartes University, Paris, France
| | - S Perrot
- 2Pain department, Cochin Hospital, Paris Descartes University, INSERM U987, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
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Grave C, Boucheron P, Rudant J, Mikaeloff Y, Tubert-Bitter P, Escolano S, Hocine M, Coste J, Weill A. Vaccination antigrippale et risque de syndrome de Guillain-Barré : étude par la méthode d’analyse des séries de cas à partir des données du Système national des données de santé (2010–2014). Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Sbidian E, Mezzarobba M, Weill A, Coste J, Rudant J. Persistence of treatment with biologics for patients with psoriasis: a real‐world analysis of 16 545 biologic‐naïve patients from the French National Health Insurance database (SNIIRAM). Br J Dermatol 2018; 180:86-93. [DOI: 10.1111/bjd.16809] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 01/04/2023]
Affiliation(s)
- E. Sbidian
- Département d’études en santé publique Direction de la stratégie, des études et des statistiques Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris F‐75020 France
- AP‐HP Hôpitaux universitaires Henri Mondor Département de Dermatologie UPEC 51, av du Maréchal de Lattre de Tassigny Créteil F‐94010 France
- INSERM Centre d'Investigation Clinique 1430 Créteil F‐94010 France
- EA 7379 EpidermE Université Paris‐Est Créteil UPEC Créteil F‐94010 France
| | - M. Mezzarobba
- Département d’études en santé publique Direction de la stratégie, des études et des statistiques Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris F‐75020 France
| | - A. Weill
- Département d’études en santé publique Direction de la stratégie, des études et des statistiques Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris F‐75020 France
| | - J. Coste
- Département d’études en santé publique Direction de la stratégie, des études et des statistiques Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris F‐75020 France
| | - J. Rudant
- Département d’études en santé publique Direction de la stratégie, des études et des statistiques Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris F‐75020 France
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Coste J, Rouquette A, Valderas J, Rose M, Leplège A. The French PROMIS-29. Psychometric validation and population reference values. Rev Epidemiol Sante Publique 2018; 66:317-324. [DOI: 10.1016/j.respe.2018.05.563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 05/01/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022] Open
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Bouyer B, Rudnichi A, Dray-Spira R, Zureik M, Coste J. Thromboembolic risk after lumbar spine surgery: a cohort study on 325 000 French patients. J Thromb Haemost 2018; 16:1537-1545. [PMID: 29893460 DOI: 10.1111/jth.14205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Indexed: 01/24/2023]
Abstract
Essentials The risk of venous thromboembolism (VTE) after lumbar spine surgery (LBS) is not precisely known. More than 320 000 patients who underwent LBS in France between 2009 and 2014 were followed-up. The overall risk of VTE after LBS is less than 1% but modulated by patient and procedural factors. Surgical device implantation, anterior approach and complex surgery increase the risk of VTE. SUMMARY: Background Postoperative venous thromboembolism (VTE) is a severe complication, the risk of which after lumbar spine surgery (LBS) is not precisely known. Objective To estimate the incidence of VTE after LBS, and to identify individual and surgical risk factors. Methods All patients aged >18 years who underwent LBS in France between 2009 and 2014 were identified. Among 477 024 patients screened, exclusions concerned recent VTE or surgery, and multiple surgeries during the same hospital stay. Results In 323 737 patients (mean age 52.9 years, 51.4% male), we observed 2911 events (0.91%) after a median time of 12 days (Q1-Q3: 5-72 days). The multivariate adjusted Cox model showed increased risks associated with age (4% per year of age; 95% confidence interval [CI] 3.8-4.3), obesity (hazard ratio [HR] 1.32, 95% CI 1.18-1.46), active cancer (HR 1.65, 95% CI 1.5-1.82), previous thromboembolism (HR 5.41, 95% CI 4.74-6.17), severe paralysis (HR 1.47, 95% CI 1.17-1.84), renal disease (HR 1.28, 95% CI 1.04-1.6), psychiatric disease (HR 1.21, 95% CI 1.1-1.32), use of antidepressants (HR 1.13, 95% CI 1.03-1.24), use of contraceptives (HR 1.56, 95% CI 1.19-2.03), extended surgery for scoliosis (HR 3.61, 95% CI 2.96-4.4), implantation of pedicular screws with a 'dose-effect' association, and an anterior approach (HR 1.97, 95% CI 1.6-2.43) or a combined approach (HR 2.03, 95% CI 1.44-2.84). Conclusions The overall VTE risk after LBS is moderate (< 1%) but is widely modulated by several easily identifiable risk factors. The surgical community should be aware of this heterogeneity, adapt prevention according to patients and to the procedure, and use drug prophylaxis in the event of a high risk being present.
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Affiliation(s)
- B Bouyer
- French National Agency for Medicines and Health Products Safety, Saint Denis, France
- AP-HP and Paris-Descartes University, Paris, France
- Paris-Sud University, Paris, France
| | - A Rudnichi
- French National Agency for Medicines and Health Products Safety, Saint Denis, France
| | - R Dray-Spira
- French National Agency for Medicines and Health Products Safety, Saint Denis, France
| | - M Zureik
- French National Agency for Medicines and Health Products Safety, Saint Denis, France
- Versailles Saint-Quentin-en-Yvelines University, Versailles, France
| | - J Coste
- AP-HP and Paris-Descartes University, Paris, France
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Dupont A, Weill A, Mikaeloff Y, Bolgert F, Coste J, Rudant J. Risque de syndrome de Guillain-Barré après une chirurgie : une étude de type « case-crossover » à partir des données du Sniiram (2009–2014). Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Abstract:Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.
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Abstract
Summary
Objective:
Recent results published by Coste et al. in discriminant analysis with ordinal responses showed the superiority of optimal discriminating analysis for ordinal responses (ODAO) both in terms of classification and simplicity of implementation compared to classic methods (Fisher’s discrimination, logistic regression) applied to medical data (prognostics of burns) and to simulated data. Nevertheless, the solutions obtained by ODAO may be sensitive to re-sampling (i.e the estimated coefficients by ODAO may show excessive sensitivity to the training sample). This study proposes some solutions to control the fluctuations of sampling and to ensure model stability.
Methods:
We used intensive computational methods and bootstrapping, at the outset of model building in order to reduce the sampling variability of estimated coefficients. Thus, the estimation of the coefficients was not based on the minimization of a classification criterion of the training sample, but on the minimization of an aggregate criterion of bootstrapped replications of a classification criterion. Five aggregate criteria were studied.
Results:
The improvement in terms of robustness appeared in 30% of the test cases with moderate training sample size and 55% of those with small training sample size.
Conclusion:
Simulated test cases showed that bootstrapping can help construct more robust models in difficult classification situations and small training samples which are particularly frequent.
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Mazières B, Coste J, Euller-Ziegler L, Fardellone P, Fautrel B, Pouchot J, Rat AC, Roux CH, Saraux A, Verrouil E, Guillemin F. Prevalence of pelvic Paget's disease of bone in France. Bone 2018; 107:143-144. [PMID: 29175270 DOI: 10.1016/j.bone.2017.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 11/15/2022]
Affiliation(s)
- B Mazières
- Université Paul-Sabatier, Faculty of Medicine and Toulouse University Hospital, Department of Rheumatology, Toulouse, France.
| | - J Coste
- Université Paris Descartes, EA 4360 APEMAC, and Assistance publique - Hôpitaux de Paris, Hôtel Dieu, Unit of Biostatistics and Epidemiology, Paris, France.
| | - L Euller-Ziegler
- Université Nice Cote d'Azur and Academic Hospital, Department of Rheumatology, Nice, France.
| | - P Fardellone
- Inserm U 1088, Faculty of Medicine and University Hospital, Department of Rheumatology, Amiens, France.
| | - B Fautrel
- Pierre-et-Marie-Curie Paris 6 University, School of Medicine and Assistance publique - Hôpitaux de Paris, Pitié-Salpétrière University Hospital, Department of Rheumatology, Paris, France.
| | - J Pouchot
- Université Paris Descartes, EA 4360 APEMAC, and Assistance publique - Hôpitaux de Paris, Hôpital européen Georges Pompidou, Department of Internal Medicine, Paris, France.
| | - A-C Rat
- Inserm CIC-EC CIE6 and Brabois University Hospital, Department of Rheumatology, Nancy, France.
| | - C-H Roux
- Academic Hospital, Department of Rheumatology, Nice, France.
| | - A Saraux
- Rheumatology unit, Brest University Hospital and LabEx IGo, Inserm U1227, Brest, France.
| | - E Verrouil
- Department of Rheumatology, Toulouse University Hospital, Toulouse, France.
| | - F Guillemin
- Université de Lorraine, EA 4360 APEMAC, and Inserm CIC 1433 Clinical Epidemiology, Nancy, France.
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Sbidian E, Mezzarobba M, Rudant J, Weill A, Coste J. Persistance des traitements systémiques dans le psoriasis : étude en vie réelle en France à partir des données du SNIIRAM. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Weill A, Rudant J, Coste J. Utilisation des données de l’assurance maladie française pour étudier l’usage et les effets des médicaments en vie réelle : revue de 216 articles publiés entre 2007 et 2016. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Raguideau F, Blotière PO, Coste J, Zureik M, Dray-Spira R, Weill A. Persistance d’un niveau élevé d’exposition à l’acide valproïque parmi les femmes enceintes : les résultats d’une étude observationnelle sur les données du Sniiram/PMSI. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.01.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Weill A, Rudant J, Coste J. Utilisation des données de l’Assurance maladie française pour étudier la qualité des pratiques et la sécurité des soins dans le domaine du médicament : revue de 204 articles publiés entre 2007 et 2016. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Bougard D, Brandel JP, Belondrade M, Beringue V, Segarra C, Fleury H, Laplanche JL, Mayran C, Nicot S, Green A, Welaratne A, Narbey D, Fournier-Wirth C, Knight R, Will R, Tiberghien P, Hai k S, Coste J. Detection of prions in the plasma of presymptomatic and symptomatic patients with variant Creutzfeldt-Jakob disease. Sci Transl Med 2016; 8:370ra182. [DOI: 10.1126/scitranslmed.aag1257] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 05/12/2016] [Accepted: 11/17/2016] [Indexed: 12/13/2022]
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Zerroug A, Gabrillargues J, Coll G, Vassal F, Jean B, Chabert E, Claise B, Khalil T, Sakka L, Feschet F, Durif F, Boyer L, Coste J, Lemaire JJ. Personalized mapping of the deep brain with a white matter attenuated inversion recovery (WAIR) sequence at 1.5-tesla: Experience based on a series of 156 patients. Neurochirurgie 2016; 62:183-9. [PMID: 27236731 DOI: 10.1016/j.neuchi.2016.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/29/2015] [Accepted: 01/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Deep brain mapping has been proposed for direct targeting in stereotactic functional surgery, aiming to personalize electrode implantation according to individual MRI anatomy without atlas or statistical template. We report our clinical experience of direct targeting in a series of 156 patients operated on using a dedicated Inversion Recovery Turbo Spin Echo sequence at 1.5-tesla, called White Matter Attenuated Inversion Recovery (WAIR). METHODS After manual contouring of all pertinent structures and 3D planning of trajectories, 312 DBS electrodes were implanted. Detailed anatomy of close neighbouring structures, whether gray nuclei or white matter regions, was identified during each planning procedure. We gathered the experience of these 312 deep brain mappings and elaborated consistent procedures of anatomical MRI mapping for pallidal, subthalamic and ventral thalamic regions. We studied the number of times the central track anatomically optimized was selected for implantation of definitive electrodes. RESULTS WAIR sequence provided high-quality images of most common functional targets, successfully used for pure direct stereotactic targeting: the central track corresponding to the optimized primary anatomical trajectory was chosen for implantation of definitive electrodes in 90.38%. CONCLUSION WAIR sequence is anatomically reliable, enabling precise deep brain mapping and direct stereotactic targeting under routine clinical conditions.
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Affiliation(s)
- A Zerroug
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - J Gabrillargues
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - G Coll
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Vassal
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - B Jean
- Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - E Chabert
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Claise
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - T Khalil
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - L Sakka
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Feschet
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - F Durif
- Service of neurology, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - L Boyer
- Service of radiology, CHU de Clermont-Ferrand, 63003 Clemront-Ferrand, France
| | - J Coste
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-J Lemaire
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
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Sarret C, Lemaire J, Sontheimer A, Coste J, Pereira B, Feschet F, Roche B, Renou J, Boespflug‐Tanguy O. ISDN2014_0298: REMOVED: Cerebral atrophy is linked to clinical severity and worsens with aging in patients with Pelizaeus–Merzbacher disease and Spastic Paraplegia type 2. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
| | | | | | - J. Coste
- IGCNC – Université d'AuvergneFrance
| | | | | | - B. Roche
- IGCNC – Université d'AuvergneFrance
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Shah A, Coste J, Lemaire JJ, Schkommodau E, Hemm-Ode S. Use of quantitative tremor evaluation to enhance target selection during deep brain stimulation surgery for essential tremor. Current Directions in Biomedical Engineering 2015. [DOI: 10.1515/cdbme-2015-0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Deep brain stimulation (DBS), an effective surgical treatment for Essential Tremor (ET), requires test stimulations in the thalamus to find the optimum site for permanent electrode implantation. During these test stimulations, the changes in tremor are only visually evaluated. This, along with other parameters, increases the subjectivity when comparing the efficacy of different thalamic nuclei. We developed a method to quantitatively evaluate tremor during the test stimulations of DBS surgery and applied to 6 ET patients undergoing this treatment. From the quantitative data collected, we identified effective stimulation amplitudes for every test stimulation position and compared it with the ones identified visually during the surgery. We also classified the data based on the thalamic nuclei in which the center of the stimulating contact was present during test stimulations. Results indicate that, to achieve the same reduction in tremor, on average, the stimulation amplitude identified by our method was 0.6 mA lower than those identified by visual evaluation. The comparison of the different thalamic nuclei showed that stimulations in the Ventro-oral and the Intermediolateral nuclei of the thalamus result in higher reduction in tremor for similar stimulation amplitudes as the frequently targeted Ventrointermediate nucleus. We conclude that our quantitative tremor evaluation method is more sensitive than the widely used visual evaluation. Using such quantitative methods will aid in identifying the optimum target structure for patients undergoing DBS.
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Affiliation(s)
- A. Shah
- Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132 Muttenz, Swtizerland
| | - J. Coste
- Image-Guided Clinical Neuroscience and Connectomics (EA 7282), Université Clermont Auvergne, Université d’Auvergne, Clermont-Ferrand, France and Service de Neurochirurgie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - JJ. Lemaire
- Image-Guided Clinical Neuroscience and Connectomics (EA 7282), Université Clermont Auvergne, Université d’Auvergne, Clermont-Ferrand, France and Service de Neurochirurgie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - E. Schkommodau
- Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132 Muttenz, Swtizerland
| | - S. Hemm-Ode
- Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132 Muttenz, Swtizerland
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Linglart A, Tauber M, Bougneres P, Lebouc Y, Chatelain P, Geffner ME, Santen R, Kopchick J, Coste J, Touze E, Carel JC. Growth hormone treatment for childhood short stature and risk of stroke in early adulthood. Neurology 2015; 84:1062-3. [DOI: 10.1212/wnl.0000000000001385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bellanné-Chantelot C, Coste J, Ciangura C, Fonfrède M, Saint-Martin C, Bouché C, Sonnet E, Valéro R, Lévy DJ, Dubois-Laforgue D, Timsit J. High-sensitivity C-reactive protein does not improve the differential diagnosis of HNF1A-MODY and familial young-onset type 2 diabetes: A grey zone analysis. Diabetes Metab 2015; 42:33-7. [PMID: 25753245 DOI: 10.1016/j.diabet.2015.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/04/2015] [Accepted: 02/05/2015] [Indexed: 12/13/2022]
Abstract
AIM Low plasma levels of high-sensitivity C-reactive protein (hs-CRP) have been suggested to differentiate hepatocyte nuclear factor 1 alpha-maturity-onset diabetes of the young (HNF1A-MODY) from type 2 diabetes (T2D). Yet, differential diagnosis of HNF1A-MODY and familial young-onset type 2 diabetes (F-YT2D) remains a difficult challenge. Thus, this study assessed the added value of hs-CRP to distinguish between the two conditions. METHODS This prospective multicentre study included 143 HNF1A-MODY patients, 310 patients with a clinical history suggestive of HNF1A-MODY, but not confirmed genetically (F-YT2D), and 215 patients with T2D. The ability of models, including clinical characteristics and hs-CRP to predict HNF1A-MODY was analyzed, using the area of the receiver operating characteristic (AUROC) curve, and a grey zone approach was used to evaluate these models in clinical practice. RESULTS Median hs-CRP values were lower in HNF1A-MODY (0.25mg/L) than in F-YT2D (1.14mg/L) and T2D (1.70mg/L) patients. Clinical parameters were sufficient to differentiate HNF1A-MODY from classical T2D (AUROC: 0.99). AUROC analyses to distinguish HNF1A-MODY from F-YT2D were 0.82 for clinical features and 0.87 after including hs-CRP. For the grey zone analysis, the lower boundary was set to miss<1.5% of true positives in non-tested subjects, while the upper boundary was set to perform 50% of genetic tests in individuals with no HNF1A mutation. On comparing HNF1A-MODY with F-YT2D, 65% of patients were classified in between these categories - in the zone of diagnostic uncertainty - even after adding hs-CRP to clinical parameters. CONCLUSION hs-CRP does not improve the differential diagnosis of HNF1A-MODY and F-YT2D.
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Affiliation(s)
- C Bellanné-Chantelot
- Department of Genetics, AP-HP, Hôpital Pitié-Salpétrière, Université Pierre-et-Marie-Curie, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - J Coste
- Unit of Biostatistics and Epidemiology, AP-HP, Hôtel Dieu; Unit Research APEMAC, EA 4360, Université Paris-Descartes, Sorbonne Paris Cité, Lorraine Université, 75004 Paris, France
| | - C Ciangura
- Department of Diabetology, AP-HP, Hôpital Pitié-Salpétrière, Université Pierre-et-Marie-Curie, 75013 Paris, France
| | - M Fonfrède
- Department of Medical Biochemistry, AP-HP, Hôpital Pitié-Salpétrière, 75013 Paris, France
| | - C Saint-Martin
- Department of Genetics, AP-HP, Hôpital Pitié-Salpétrière, Université Pierre-et-Marie-Curie, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - C Bouché
- Department of Diabetology, AP-HP, Hôpital Lariboisière, 75010 Paris, France
| | - E Sonnet
- Department of Endocrinology, CHU de Brest, 29609 Brest, France
| | - R Valéro
- Department of Nutrition, Metabolic diseases, Endocrinology, AP-HM, Hôpital de la Timone, Aix-Marseille Université, 13385 Marseille, France
| | - D-J Lévy
- Department of Diabetology, AP-HP, Hôpital Cochin, Université Paris-Descartes, 75014 Paris, France
| | - D Dubois-Laforgue
- Department of Diabetology, AP-HP, Hôpital Cochin, Université Paris-Descartes, 75014 Paris, France
| | - J Timsit
- Department of Diabetology, AP-HP, Hôpital Cochin, Université Paris-Descartes, 75014 Paris, France
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Lemaire JJ, Delom C, Coste A, Khalil T, Jourdy JC, Pontier B, Gabrillargues J, Sinardet D, Chabanne A, Achim V, Sakka L, Coste J, Chazal J, Salagnac A, Coll G, Irthum B. [Medico-economic analysis of a neurosurgery department at a university hospital]. Neurochirurgie 2015; 61:2-15. [PMID: 25665774 DOI: 10.1016/j.neuchi.2014.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/29/2014] [Accepted: 11/11/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. MATERIAL AND METHODS Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. RESULTS The average annual, analytic income statement was +1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. CONCLUSION Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value.
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Affiliation(s)
- J-J Lemaire
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France.
| | - C Delom
- Direction des finances, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - A Coste
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - T Khalil
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-C Jourdy
- Département d'information médicale, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Pontier
- Coordination soins de suite et réadaptation, agence régional de santé - Auvergne, 63057 Clermont-Ferrand, France
| | - J Gabrillargues
- Unité de neuroradiologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - D Sinardet
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - A Chabanne
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - V Achim
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - L Sakka
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J Coste
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J Chazal
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - A Salagnac
- Délégation à la recherche clinique & à l'innovation, direction générale adjointe, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - G Coll
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - B Irthum
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
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Roux C, Mazieres B, Rat AC, Fardellone P, Fautrel B, Pouchot J, Saraux A, Guillemin F, Euller-Ziegler L, Coste J. THU0199 Comparison of the Diagnostic Value of Schuss X Ray Alone, versus Schuss and Standard AP X Rays for the Diagnosis of Knee Osteoarthritis (OA) in the Khoala Cohort:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lemaire JJ, Pereira B, Derost P, Coste J, Ulla M, Morand D, Gabrillargues J, Coll G, Durif F. Étude rétrospective de la localisation des contacts effectifs sous-thalamiques chez 53 parkinsoniens sévères : analyse des couples de contacts par une approche unifiée (droit-gauche) et indépendante (droit et gauche). Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah A, Coste J, Schkommodau E, Lemaire JJ, Hemm-Ode S. Using acceleration sensors to quantify symptoms during deep brain stimulation surgery. ACTA ACUST UNITED AC 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-A/bmt-2013-4007/bmt-2013-4007.xml. [PMID: 24042602 DOI: 10.1515/bmt-2013-4007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Prions are unconventional infectious agents that cause fatal neurological illnesses such as Creutzfeldt-Jakob disease (CJD), bovine spongiform encephalopathy, and scrapie. Variant CJD can occur via blood transfusions. However, as no screening assay is available, uncertainties remain over the prevalence of vCJD in asymptomatic blood donors. Development of a diagnostic assay is therefore a primary objective. Little is known about the nature, distribution and level of infectivity in human blood and we have to rely on assumptions made from animal models. Ideally, two types of assays are required: a rapid high-throughput assay to routinely screen all blood donations and a confirmatory assay to ensure that all positive results from initial screening are true positives. Key event in prion disease is thought to be the conversion of normal cellular prion protein PrPc to a misfolded aggregated form termed PrP(TSE). This specific characteristic has been exploited to develop some tests.
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Affiliation(s)
- J Coste
- Laboratoire R&D sécurité transfusionnelle et innovation diagnostique (TransDiag), établissement français du sang de Pyrénées-Méditerranée, 392, avenue du Professeur-Jean-Louis-Viala, 34184 Montpellier cedex 3, France.
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Plichart M, Orvoen G, Jourdain P, Escande M, Friocourt P, Coste J, Quinquis L, Chedhomme FX, Vidal JS, Hanon O. BNP usefulness in very elderly dyspneic patients. The BED Study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ségarra C, Bougard D, Béringue V, Coste J. Détection du prion dans le sang de mouton infecté au stade pré-symptomatique. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bougard D, Bélondrade M, Béringue V, Coste J, Lehmann S. Nouvelle approche pour l’évaluation des procédures de décontamination du prion : amplification in vitro du prion associé à des fils d’acier. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Segarra C, Coste J. La maladie d’Alzheimer est-elle une maladie à prion ? Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vossier L, Leon F, Coste J, Fournier-Wirth C. Production de peptides antimicrobiens naturels actifs par recyclage biologique. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cottu PH, Laroche F, Pierga JY, Coste J, Medkour T, Lotz JP, Beerblock K, Tournigand C, Chauvenet L, Decleves X, Boussahira D, Batteux F, Borderie F, Perrot S. Aromatase inhibitor pain syndromes: Classification and determination of specific risk factors—A prospective multicenter cohort study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
569 Background: Pain is frequent during Aromatase Inhibitors (AIs) treatment for breast cancer and several pain syndromes have been reported but not precisely defined. We developed a prospective multicentre study aiming at classifying AIs-related pain syndromes, comparing their impact on daily life, and identifying their specific determinants for a more targeted prevention approach. Methods: A one-year multicenter cohort prospective study, with 5 pre-scheduled visits, was carried out in early stage breast cancer women, free of pain, starting an AI treatment, recruited from 4 oncology centres. At baseline, clinical data (demography and psychosocial, cancer characteristics and treatments, pain, sleep, rheumatologic examination, cancer-related quality of life), biological data (sex hormones, vitamin D, bone biomarkers, oxidative stress, immunological and inflammatory markers), and genetic polymorphism for pain mechanisms (opioid and serotonin pathways) were recorded. Results: A cohort of 135 women was evaluated. Among them, 77 (57%) developed a pain syndrome along the study period, leading to AIs discontinuation in 12 cases. Five main different types of pain syndromes were identified: joint pain, in 48 women overall over the follow-up (36%), diffuse pain, in 30 women (22%), tendinitis, in 29 women (22%), and neuropathic pain, in 12 women (9%) and mixed types, which were frequent and often transient. Analyses demonstrated that risk factors for developing pain syndromes were baseline anxiety and impaired quality of life, while cancer features, genetic background, inflammation, immunological and sex hormone levels were not involved. Conclusions: In pain-free women with breast cancer starting an AI, risks for developing pain during the first year of treatment are slightly greater than 50%. We identified 5 main pain syndromes, joint and widespread pain being the most frequent. In all instances, initial psychological dimensions (personality, impaired quality of life and anxiety) are identified as major risk factors for pain development.
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Affiliation(s)
| | | | | | - J Coste
- Biostatistics, Hôtel Dieu University Hospital, Paris, France
| | - T Medkour
- Pain Clinic, Hotel Dieu University Hospital, Paris, France
| | | | | | | | - Laure Chauvenet
- Medical Oncology Department, Hopital Hotel Dieu, Paris, France
| | | | | | - F Batteux
- Biology and Immunology Department, Cochin Hospital, Paris, France
| | - F Borderie
- Biology and Immunology Department, Cochin Hospital, Paris, France
| | - Serge Perrot
- Pain Clinic and Internal Medicine Department, Hôtel Dieu Hospital, & Inserm U987, Paris, France
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Hemm-Ode S, Wettmann P, Kistler B, Behm P, Schkommodau E, Coste J, Lemaire J, Shah A. Intraoperative optical flow based tremor evaluation - a feasibility study. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-A/bmt-2013-4008/bmt-2013-4008.xml. [DOI: 10.1515/bmt-2013-4008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Coste J, Carel JC, Autier P. [The grey realities of population screening]. Rev Epidemiol Sante Publique 2012; 60:163-5. [PMID: 22682096 DOI: 10.1016/j.respe.2012.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 05/07/2012] [Indexed: 10/28/2022] Open
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Coste J, Prowse C, Grabmer C, Schennach H, Santos Prado Scuracchio P, Wendel SN, Germain M, Delage G, Krusius T, Ekblom-Kullberg S, Tiberghien P, O’Riordan J, Murphy WG, Flesland Ø, Turner M, Williamson L, Gregori L, Epstein J, Asher D, Panzer S, Reesink HW. Prion reduction of red-blood-cells. Vox Sang 2012; 103:260-72. [DOI: 10.1111/j.1423-0410.2012.01597.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Guillemin F, Rat AC, Mazieres B, Pouchot J, Fautrel B, Euller-Ziegler L, Fardellone P, Morvan J, Roux CH, Verrouil E, Saraux A, Coste J. Prevalence of symptomatic hip and knee osteoarthritis: a two-phase population-based survey. Osteoarthritis Cartilage 2011; 19:1314-22. [PMID: 21875676 DOI: 10.1016/j.joca.2011.08.004] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 07/23/2011] [Accepted: 08/03/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) epidemiologic data are scarce in Europe. To estimate the prevalence of symptomatic knee and hip OA in a multiregional sample in France. DESIGN A two-phase population-based survey was conducted in six regions in 2007-2009. On initial phone contact using random-digit dialing, subjects 40-75 years old were screened with a validated questionnaire. Subjects screened positive were invited for ascertainment: physical examination and hip and/or knee radiography (Kellgren-Lawrence grade≥2). Multiple imputation for data missing not-at-random was used to account for refusals. RESULTS Of 63,232 homes contacted, 27,632 were eligible, 9621 subjects screened positive, 3707 participated fully in the ascertainment phase, and 1010 had symptomatic OA: 317 hip, 756 knee. Hip OA prevalence according to age class ranged from 0.9% to 3.9% for men and 0.7-5.1% for women. Knee OA ranged from 2.1% to 10.1% for men and 1.6-14.9% for women. Both differed by geographical region. The hip and knee standardized prevalence was 1.9% and 4.7% for men and 2.5% and 6.6% for women, respectively. CONCLUSIONS This confirmed the feasibility of using a screening questionnaire for eliciting population-based estimates of OA. In France, it increases with age and is greater among women above the age of 50. The geographical disparity of hip and knee OA parallels the distribution of obesity. Study registration ID number 906297 at http://www.clinicaltrials.gov/.
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Affiliation(s)
- F Guillemin
- Nancy-Université, Paul Verlaine Metz, Paris Descartes, EA 4360 Apemac, Nancy, France.
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Lemaire JJ, Pontier B, Coste J, Gillart T, Sakka L, Feschet F, Gabrillargues J, Coudeyre E, Luauté J. Comportements conscients après cérébrolésions : support anatomofonctionnel et perspectives thérapeutiques. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lemaire JJ, Pontier B, Coste J, Gillart T, Sakka L, Feschet F, Gabrillargues J, Coudeyre E, Luauté J. Conscious behavior after traumatic brain injury: Anatomo-functional support and therapeutic prospects. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Petrik J, Coste J, Fournier-Wirth C. Advances in transfusion medicine in the first decade of the 21st century: Advances in miniaturized technologies. Transfus Apher Sci 2011; 45:45-51. [PMID: 21715229 DOI: 10.1016/j.transci.2011.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several miniaturized high throughput technologies have been developed in the last decade, primarily to study genomic structures and gene expression patterns under various conditions. At the same time, the microarrays, biosensors, integrated microfluidic lab-on-a-chip devices, next generation sequencing or digital PCR are gradually finding their diagnostic applications, although their suitability for specialised diagnostic fields has still to be assessed. In this review we discuss the potential applications of the new technologies to blood testing.
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Affiliation(s)
- J Petrik
- Scottish National Blood Transfusion Service, Edinburgh, UK.
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