1
|
Martini K, Baillif S, Nahon-Esteve S, Denis P, Martel A. Intraoperative iStent versus postoperative selective laser trabeculoplasty in early glaucoma patients undergoing cataract surgery: A retrospective comparative study. J Fr Ophtalmol 2024; 47:103956. [PMID: 37783587 DOI: 10.1016/j.jfo.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To compare the efficacy and safety of iStent inject® versus 360° selective laser trabeculoplasty (SLT) in patients with early glaucoma undergoing cataract surgery. METHODS A retrospective non-randomized study was conducted in 73 eyes divided into two groups: cataract surgery+intraoperative iStent (n=40) versus cataract surgery+postoperative SLT at one month (n=33). The primary endpoint was intraocular pressure (IOP) lowering≥20% between baseline and 6 months postoperatively. The secondary endpoints were IOP lowering at 1, 6 and 12 months, and the mean number of IOP-lowering medications at 6 and 12 months. RESULTS The mean baseline IOP was 19.1 mmHg with no significant difference between groups. The mean baseline number of IOP-lowering medications was higher in the iStent group (n=1.95) compared to the SLT group (n=1.53; P=0.04). At 6 months, 18 (60%) patients in the SLT group and 20 (51%) patients in the iStent group achieved IOP lowering≥20% with no significant difference between groups (P=0.431). At 6 months, no difference in the mean number of IOP-lowering medications was found between groups (-0.92 and -0.89 in the iStent and SLT groups, respectively). Similar results were found at 12 months. CONCLUSION These results suggest similar safety and efficacy of intraoperative iStent and postoperative 360° SLT in lowering IOP and reducing glaucoma eye drops in early glaucoma patients undergoing cataract surgery. Treatment choice should be based on the ophthalmologist's experience and on the cost-benefit ratio.
Collapse
Affiliation(s)
- K Martini
- Ophthalmology Department, University Hospital of Nice, 30, voie Romaine, 06000 Nice, France.
| | - S Baillif
- Ophthalmology Department, University Hospital of Nice, 30, voie Romaine, 06000 Nice, France
| | - S Nahon-Esteve
- Ophthalmology Department, University Hospital of Nice, 30, voie Romaine, 06000 Nice, France
| | - P Denis
- Ophtalmology Department, University Hospital of La-Croix-Rousse, grande rue de la Croix-Rousse, Lyon, France
| | - A Martel
- Ophthalmology Department, University Hospital of Nice, 30, voie Romaine, 06000 Nice, France
| |
Collapse
|
2
|
Chacun S, Rezkallah A, Kodjikian L, Sève P, Mathis T, Denis P. Glaucoma and conjunctival fibrosis: A case report. J Fr Ophtalmol 2023; 46:e361-e364. [PMID: 37586900 DOI: 10.1016/j.jfo.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/05/2023] [Indexed: 08/18/2023]
Affiliation(s)
- S Chacun
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France.
| | - A Rezkallah
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| | - L Kodjikian
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France; UMR-CNRS 5510 Matéis, université de médicine Lyon 1, Lyon, France
| | - P Sève
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| | - T Mathis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France; UMR-CNRS 5510 Matéis, université de médicine Lyon 1, Lyon, France
| | - P Denis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| |
Collapse
|
3
|
Labbé A, Rousseau A, Denis P, Bresson-Dumont H, Baudouin C, Aptel F. [Review by the French Glaucoma Society on the roles of new surgical techniques in glaucoma]. J Fr Ophtalmol 2023; 46:1227-1231. [PMID: 37945427 DOI: 10.1016/j.jfo.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 11/12/2023]
Abstract
The surgical management of glaucoma has been enriched in recent years by the arrival of new surgical techniques as a group known as MIGS (minimally invasive glaucoma surgery). The objective of these new techniques is to reduce intraocular pressure (IOP) while limiting the risk of complications of conventional filtering surgery and allowing faster visual recovery. MIGS can be classified into three main categories depending on the route used to promote the outflow of aqueous humor: the trabecular route, the suprachoroidal route and the subconjunctival route. MIGS using the subconjunctival route are also called minimally invasive bleb surgery (MIBS). These new techniques do not replace conventional filtering surgery, which remains the gold standard technique, but now offer new alternatives for the surgical management of glaucoma patients in combination with cataract surgery or as stand-alone procedures.
Collapse
Affiliation(s)
- A Labbé
- Service d'ophtalmologie, CHNO des Quinze-Vingts, IHU FOReSight, Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, IHU FOReSIGHT, université de Versailles Saint-Quentin-en-Yvelines, Boulogne Billancourt, France.
| | - A Rousseau
- Service d'ophtalmologie, hôpital Bicêtre, AP-HP, IHU FOReSIGHT, université Paris Saclay, Le Kremlin-Bicêtre, France
| | - P Denis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, Lyon, France
| | | | - C Baudouin
- Service d'ophtalmologie, CHNO des Quinze-Vingts, IHU FOReSight, Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, IHU FOReSIGHT, université de Versailles Saint-Quentin-en-Yvelines, Boulogne Billancourt, France
| | - F Aptel
- Groupe Visis, médipôle Elsan, Perpignan, France
| |
Collapse
|
4
|
Denis P, Schmidely P, Nozière P, Gervais R, Fievez V, Gerard C, Ferlay A. Predicted essential fatty acid intakes for a group of dairy cows also apply at individual animal level. Animal 2023; 17:101005. [PMID: 37897870 DOI: 10.1016/j.animal.2023.101005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 10/30/2023] Open
Abstract
The ruminant requirements for essential fatty acids (EFAs), particularly linoleic acid (LA) and alpha-linolenic acid (ALA), have not been fully determined, although evidence suggests that an adequate supply of polyunsaturated fatty acids (FAs) could improve immunity and reproduction in transition cows. In previous studies, we predicted EFA intake for a group of cows based on animal characteristics and milk EFA secretions. However, to support precision livestock feeding, we need to match the nutrient requirements and intakes of each cow as closely as possible. Our group-level predictions may not be accurate enough to estimate the EFA intake of an individual cow, due to inter-individual variations in EFA digestion and metabolism related to differences in feed intake, intake patterns, and the composition and functioning of the rumen microbiota. To address this issue, here we set out to establish specific equations that predict EFA intake for an individual cow based on the difference (i.e. the residuals) between observed EFA intake and the predicted EFA intake based on our group-level equations. We studied a database of individual dairy cows (26 experiments; 503 datapoints from three research teams) and we predicted the residuals from (1) dietary and animal-related factors (i.e. full predictions) and (2) animal-related factors only (i.e. field predictions), which are considered more field-amenable. The variance of predicted LA and log ALA intake was explained to 68% by observed LA intake and 66% by observed log ALA intake, respectively. The residuals of LA intake were predicted by dietary ALA content, total FA intake, BW, milk yield and fat content in full predictions, and by BW, feeding level, milk yield and fat content, and sum of milk C4:0 to C14:0 FA in field predictions. The log residuals of ALA intake were predicted by dietary NDF and total FA contents, NDF intake, BW, milk protein, LA and ALA contents, and fat yield in full predictions, and by BW, DM intake, milk LA and ALA contents, and fat yield in field predictions. The field predictions showed a moderate loss of accuracy compared to full predictions based on RMSE of prediction (from 38 to 54 g/d for LA and from 0.090 to 0.12 log (g/d) for ALA). This work is the first to predict the EFA intake of an individual cow based on previously established group-level predictions of EFA intake adjusted for dietary and animal-related factors.
Collapse
Affiliation(s)
- P Denis
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France
| | - P Schmidely
- Université Paris-Saclay, INRAE, AgroParisTech, UMR Modélisation Systémique Appliquée aux Ruminants, 75005 Paris, France
| | - P Nozière
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France
| | - R Gervais
- Département des Sciences Animales, Université Laval, 2425 rue de l'Agriculture, Québec G1V 0A6, Canada
| | - V Fievez
- Faculty of Bioscience Engineering, Laboratory for Animal Nutrition and Animal Product Quality, Ghent University, Ghent, Belgium
| | | | - A Ferlay
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France.
| |
Collapse
|
5
|
Dot C, Poli M, Aptel F, Labbe A, Kodjikian L, Baillif S, Bodaghi B, Denis P. Ocular hypertension and intravitreal steroids injections, update in 2023. French guidelines of the French glaucoma society and the French ophthalmology society. J Fr Ophtalmol 2023; 46:e249-e256. [PMID: 37302867 DOI: 10.1016/j.jfo.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
These guidelines are a consensus of French glaucoma and retina experts on the management of ocular hypertension (OHT) observed in a third of the cases after corticosteroid implant intravitreal injections. They update the first guidelines published in 2017. Two implants are marketed in France: the dexamethasone implant (DEXi) and the fluocinolone acetonide implant (FAci). It is essential to assess the pressure status before injecting a patient with a corticosteroid implant. A molecule-specific monitoring of the intraocular pressure is needed throughout the follow-up and at the time of reinjections. Real-life studies have allowed optimizing the management algorithm by significantly increasing the safety of these implants. Corticosteroid testing with DEXi should be performed before switching to FAci to optimize pressure tolerance of FAci. Beyond topical hypotensive treatments, selective laser trabeculoplasty may be considered in the therapeutic arsenal for the management of steroid-induced OHT and subsequent injections.
Collapse
Affiliation(s)
- C Dot
- HIA Desgenettes/CHU E. Herriot, Lyon, France.
| | - M Poli
- Pôle vision, Ecully, France
| | | | - A Labbe
- CHNO des XV-XX, Paris, France
| | | | | | - B Bodaghi
- CHU de Pitié Salpétrière, Paris, France
| | - P Denis
- CHU de Croix-Rousse, Lyon, France
| |
Collapse
|
6
|
Dot C, Poli M, Aptel F, Labbe A, Kodjikian L, Baillif S, Bodaghi B, Denis P. [Intraocular pressure elevation and intravitreal steroid implant injection: State of the art in 2023. Recommendations of the French Glaucoma Society and French Ophthalmology Society [French version]]. J Fr Ophtalmol 2023; 46:803-810. [PMID: 37481449 DOI: 10.1016/j.jfo.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
These are the recommendations of French glaucoma and retina experts on the management of ocular hypertension (OHT) observed in 1/3 of cases after intravitreal steroid implant injections. They are an update to the recommendations first published in 2017. There are two implants on the French market: the dexamethasone (DEXi) and fluocinolone acetonide (FAci) implants. It is important to know the pressure status before injecting a patient with a steroid implant. Monitoring of the IOP adapted to the specific drug is necessary throughout follow-up and reinjections. Real-life studies have made it possible to optimize the management algorithm by significantly increasing the safety of use of these implants. A corticosteroid test with DEXi is necessary before switching to FAci to optimize the pressure tolerance of the latter. In addition to topical glaucoma medications, SLT laser can be considered in the therapeutic arsenal for the management of steroid-induced OHT and future injections.
Collapse
Affiliation(s)
- C Dot
- HIA Desgenettes, CHU É.-Herriot, Lyon, France.
| | - M Poli
- Pôle vision, Écully, France
| | | | - A Labbe
- CHNO des XV-XX, Paris, France
| | | | | | - B Bodaghi
- CHU Pitié-Salpêtrière, Paris, France
| | - P Denis
- CHU Croix-Rousse, Lyon, France
| |
Collapse
|
7
|
Rezkallah A, Alyami A, Kodjikian L, Mathis T, Denis P. [Laser YAG iris cystotomy]. J Fr Ophtalmol 2023; 46:680-682. [PMID: 37087323 DOI: 10.1016/j.jfo.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 04/24/2023]
Affiliation(s)
- A Rezkallah
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France; UMR-CNRS 5510 Matéis, université de médicine Lyon 1, Lyon, France; Inserm U1208, Stem Cell and Brain Research Institue, université de médecine Lyon 1, Lyon, France.
| | - A Alyami
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| | - L Kodjikian
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France; UMR-CNRS 5510 Matéis, université de médicine Lyon 1, Lyon, France
| | - T Mathis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France; UMR-CNRS 5510 Matéis, université de médicine Lyon 1, Lyon, France
| | - P Denis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| |
Collapse
|
8
|
Ouazana-Vedrines C, Lesuffleur T, Denis P, Hoertel N, Limosin F, Rachas A, Tuppin P, Lemogne C. Using filled prescription sequences to rank antidepressants: A nationwide replication study. J Psychiatr Res 2023; 158:180-184. [PMID: 36587496 DOI: 10.1016/j.jpsychires.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 11/22/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Ranking antidepressants according to their acceptability (i.e., a combination of both efficacy and tolerability) in the general population may help choosing the best first-line medication. This study aimed to replicate the results of a proof-of-concept study ranking anti-depressants according to the proportion of filled prescription sequences consistent with a continuation of the first treatment versus those consistent with a change. We used a nationwide cohort from the French national health data system (SNDS) to support the use of this method as a widely available tool to rank antidepressant treatments in real life settings. About 1.2 million people were identified as new antidepressant users in the SNDS in 2011. The outcome was clinical acceptability as measured by the continuation/failure ratio over the six-month period following the introduction of the first-line treatment. Continuation was defined as at least two refills of the same treatment. Failure was defined as a psychiatric hospitalization, death or at least one filled prescription of another antidepressant, an antipsychotic medication, or a mood-stabilizer. Adjusted Odds Ratios (aOR) and 95% Confidence Interval (CI) were computed through multivariable binary logistic regressions. We ranked antidepressant medications according to clinical acceptability. Escitalopram again was the most acceptable option, and the five following antidepressants were the same as in the replication sample of the proof-of-concept study, in order Fluoxetine, Paroxetine, Sertraline, Citalopram and Venlafaxine with aOR (95% CI) for continuation ranging from 0.79 (0.77-0.81) to 0.66 (0.64-0.67). The present study provides evidence that filled prescription sequences is a widely available, robust and reproductible tool to rank antidepressant treatments in real life settings.
Collapse
Affiliation(s)
- Charles Ouazana-Vedrines
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014, Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.
| | - Thomas Lesuffleur
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Pierre Denis
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014, Paris, France; Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital Corentin-Celton, F-92130, Issy-les-Moulineaux, France
| | - Frédéric Limosin
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014, Paris, France; Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital Corentin-Celton, F-92130, Issy-les-Moulineaux, France
| | - Antoine Rachas
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Philippe Tuppin
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Cédric Lemogne
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014, Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| |
Collapse
|
9
|
Rodier-Bonifas C, Rochet E, Seve P, Duquesne A, Nguyen AM, Denis P, Kodjikian L, Mathis T. Uveitis in children: Epidemiological, clinical and prognostic characteristics. J Fr Ophtalmol 2023; 46:163-172. [PMID: 36642594 DOI: 10.1016/j.jfo.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/08/2022] [Revised: 08/20/2022] [Accepted: 08/26/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital. METHODS We performed a retrospective study of all cases of all pediatric uveitis seen at our institution over a 7-year period. RESULTS A total of 141 eyes of 86 children were included. The mean age was 10.7 years, and 61.6% were girls. The uveitis was bilateral in 64.0% of cases. Anterior uveitis (41.0%) and intermediate uveitis (32.0%) were the most frequent forms. The most frequent etiologies were idiopathic (27.9%), juvenile idiopathic arthritis (25.6%) and pars planitis (18.6%). During the follow-up period, systemic corticosteroids were received by 43.0% of children, immunosuppressive drugs by 31.4% and biological agents by 18.6%. At the final examination, complications were present in 67.0% of patients: 18.0% had cataracts, and 11.3% had intraocular hypertension. Posterior synechiae were present in 27.6% of eyes, optic disc edema in 10.5% and macular edema in 16.2%. At the last visit, visual acuity was better than 20/200 in 97.0% of cases. The presence of band keratopathy, cataract or glaucoma was an independent predictor of impaired visual outcomes at follow-up. CONCLUSION Juvenile idiopathic arthritis is one of the most frequent and severe pediatric uveitides. Close monitoring and early treatment could prevent complications.
Collapse
Affiliation(s)
- C Rodier-Bonifas
- Ophtalmologie rive gauche, department of ophthalmology, Clinique rive gauche, Toulouse 31076, France
| | - E Rochet
- Department of ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - P Seve
- Department of internal medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - A Duquesne
- Department of rheumatology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - A-M Nguyen
- Department of ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - P Denis
- Department of ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - L Kodjikian
- Department of ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France; CNRS UMR 5510 Mateis, Villeurbanne 69621, France.
| | - T Mathis
- Department of ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France; CNRS UMR 5510 Mateis, Villeurbanne 69621, France
| |
Collapse
|
10
|
Denis P, Ferlay A, Nozière P, Gerard C, Schmidely P. Quantitative relationships between ingested and intestinal flows of linoleic and alpha-linolenic acids, body weight and milk performance in mid-lactation dairy cows. Animal 2022; 16:100661. [DOI: 10.1016/j.animal.2022.100661] [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] [Received: 05/18/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 11/01/2022] Open
|
11
|
Ouazana-Vedrines C, Lesuffleur T, Denis P, Hoertel N, Olekhnovitch R, Olfson M, Blanco C, Limosin F, Rachas A, Tuppin P, Lemogne C. Acceptability of Second-Line Antidepressant Medications Using Filled Prescription Sequences in a Nationwide Cohort Study. J Clin Psychiatry 2022; 83. [PMID: 36264106 DOI: 10.4088/jcp.21m14248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 10/24/2022]
Abstract
Background: Although about half of patients do not respond to a first-line antidepressant medication, there is no consensus on the best second-line option. The aim of this nationwide population-based study was to rank antidepressants according to their relative acceptability (ie, efficacy and tolerability) using filled prescription sequences after failure of first treatment. Methods: About 1.2 million people were identified as new antidepressant users in the French national health data system in 2011. The inclusion criterion was having at least 2 filled prescriptions of a second-line treatment after a filled prescription of a first-line treatment, resulting in 63,726 participants. The outcome was clinical acceptability as measured by the continuation/change ratio for second-line treatment. Continuation sequence was defined as at least 2 refills of the same treatment. Change sequence was defined as at least 1 filled prescription of another antidepressant. Adjusted odds ratios (aORs) were computed through multivariable binary logistic regressions. Results: Intraclass switch had a better acceptability than interclass switch (aOR [95% CI]: 1.23 [1.20-1.28]). According to the first-line treatment, intraclass switch remained more acceptable for selective serotonin reuptake inhibitors only (1.37 [1.31-1.42]). For α2 blockers and tricyclic agents, combination antidepressant therapy was the most acceptable second-line option (1.59 [1.27-2.01] and 2.53 [1.53-4.04], respectively), whereas for serotonin-norepinephrine reuptake inhibitors there was no significant difference between the strategies. For other antidepressants, intraclass switch had lower acceptability than interclass switch (0.70 [0.51-0.95]). Conclusions: Administrative claim databases may help with ranking acceptability of second-line treatments in real world settings and complement randomized controlled trials in informing clinicians about the most acceptable second-line options according to the first-line treatment.
Collapse
Affiliation(s)
- Charles Ouazana-Vedrines
- Université Paris Cité, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,Corresponding author: Charles Ouazana-Vedrines, MD, Service de Psychiatrie de l'Adulte, Hôpital Hôtel-Dieu, 1 Place du Parvis Notre-Dame, 75004 Paris, France
| | - Thomas Lesuffleur
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Pierre Denis
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et d'Addictologie de l'Adulte et du Sujet Âgé, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S126, Issy-les-Moulineaux, France
| | - Romain Olekhnovitch
- Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, New York
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
| | - Frédéric Limosin
- Université Paris Cité, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et d'Addictologie de l'Adulte et du Sujet Âgé, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S126, Issy-les-Moulineaux, France
| | - Antoine Rachas
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Philippe Tuppin
- Department of Pathologies and Patients, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Cédric Lemogne
- Université Paris Cité, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| |
Collapse
|
12
|
Rachas A, Gastaldi-Ménager C, Denis P, Barthélémy P, Constantinou P, Drouin J, Lastier D, Lesuffleur T, Mette C, Nicolas M, Pestel L, Rivière S, Tajahmady A, Gissot C, Fagot-Campagna A. The Economic Burden of Disease in France From the National Health Insurance Perspective: The Healthcare Expenditures and Conditions Mapping Used to Prepare the French Social Security Funding Act and the Public Health Act. Med Care 2022; 60:655-664. [PMID: 35880776 PMCID: PMC9365254 DOI: 10.1097/mlr.0000000000001745] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Identifying the most frequently treated and the costliest health conditions is essential for prioritizing actions to improve the resilience of health systems. OBJECTIVES Healthcare Expenditures and Conditions Mapping describes the annual economic burden of 58 health conditions to prepare the French Social Security Funding Act and the Public Health Act. DESIGN Annual cross-sectional study (2015-2019) based on the French national health database. SUBJECTS National health insurance beneficiaries (97% of the French residents). MEASURES All individual health care expenditures reimbursed by the national health insurance were attributed to 58 health conditions (treated diseases, chronic treatments, and episodes of care) identified by using algorithms based on available medical information (diagnosis coded during hospital stays, long-term diseases, and specific drugs). RESULTS In 2019, €167.0 billion were reimbursed to 66.3 million people (52% women, median age: 42 y). The most prevalent treated diseases were diabetes (6.0%), chronic respiratory diseases (5.5%), and coronary diseases (3.2%). Coronary diseases accounted for 4.6% of expenditures, neurotic and mood disorders 3.7%, psychotic disorders 2.8%, and breast cancer 2.1%. Between 2015 and 2019, the expenditures increased primarily for diabetes (+€906 million) and neurotic and mood disorders (+€861 million) due to the growing number of patients. "Active lung cancer" (+€797 million) represented the highest relative increase (+54%) due to expenditures for the expensive drugs and medical devices delivered at hospital. CONCLUSIONS These results have provided policy-makers, evaluators, and public health specialists with key insights into identifying health priorities and a better understanding of trends in health care expenditures in France.
Collapse
Affiliation(s)
- Antoine Rachas
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Christelle Gastaldi-Ménager
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Pierre Denis
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Pauline Barthélémy
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Panayotis Constantinou
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Jérôme Drouin
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Dimitri Lastier
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Thomas Lesuffleur
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Corinne Mette
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Muriel Nicolas
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Laurence Pestel
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Sébastien Rivière
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Ayden Tajahmady
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Claude Gissot
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| | - Anne Fagot-Campagna
- Direction de la stratégie, des études et des statistiques, Caisse Nationale d’Assurance Maladie, Paris, France
| |
Collapse
|
13
|
Rezkallah A, Denis P. [Editorial]. J Fr Ophtalmol 2022; 45:493-494. [PMID: 35559730 DOI: 10.1016/j.jfo.2022.04.001] [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: 11/26/2022]
Affiliation(s)
- A Rezkallah
- Service d'ophtalmologie, Hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69004 Lyon, France.
| | - P Denis
- Service d'ophtalmologie, Hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69004 Lyon, France
| |
Collapse
|
14
|
Rezkallah A, Leroux P, Mathis T, Kodjikian L, Denis P. [Soemmering's ring on swept-source OCT]. J Fr Ophtalmol 2021; 44:1445-1446. [PMID: 34364697 DOI: 10.1016/j.jfo.2021.03.013] [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] [Received: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 10/20/2022]
Affiliation(s)
- A Rezkallah
- Service d'ophtalmologie, hospices civils de Lyon, CHU de la Croix-Rousse, université de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - P Leroux
- Service d'ophtalmologie, hospices civils de Lyon, CHU de la Croix-Rousse, université de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - T Mathis
- Service d'ophtalmologie, hospices civils de Lyon, CHU de la Croix-Rousse, université de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Faculté de médecine Lyon 1, UMR-CNRS 5510 Matéis, Lyon, France
| | - L Kodjikian
- Service d'ophtalmologie, hospices civils de Lyon, CHU de la Croix-Rousse, université de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Faculté de médecine Lyon 1, UMR-CNRS 5510 Matéis, Lyon, France
| | - P Denis
- Service d'ophtalmologie, hospices civils de Lyon, CHU de la Croix-Rousse, université de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
| |
Collapse
|
15
|
Chirpaz N, Kerever S, Gavoille A, Kodjikian L, Bernier R, Gerfaud-Valentin M, Denis P, Mathis T, Jamilloux Y, Sève P. Relevance of Brain MRI in Patients with Uveitis: Retrospective Cohort on 402 Patients. Ocul Immunol Inflamm 2021; 30:1109-1115. [PMID: 33826481 DOI: 10.1080/09273948.2020.1870145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim: To assess the diagnostic value of brain magnetic resonance imaging (bMRI) for the etiological diagnosis of uveitis and to establish predictive factors associated with its advantageous use.Methods: Retrospective study on all patients with de novo uveitis who were referred to our tertiary hospital and who underwent a bMRI between 2003 and 2018.Results: bMRI was contributive in 19 out of 402 cases (5%), among patients with a contributive bMRI, 68% had neurological signs. Univariate analysis established that neurological signs (p < .001), granulomatous uveitis (p = .003), retinal vasculitis (p = .002), and intermediate uveitis (p < .001) were all significantly associated with a contributive bMRI. Multivariate analysis confirms the significant association of neurological signs (p < .001) and intermediate uveitis (p = .01).Conclusion: bMRI appears to be a relevant exam in specific cases; intermediate/posterior uveitis or panuveitis accompanied by neurological signs, retinal vasculitis, or in patients older than 40, to rule out an oculocerebral lymphoma.Abbreviations: ACE: Angiotensin-Converting Enzyme; bMRI: Magnetic Resonance Imaging; CBC: Complete Blood cell Count; BMRI: Brain Magnetic Resonance Imaging; CT: Computerized Tomography; MS: Multiple Sclerosis; NS: Neurological Signs; OCL: Oculocerebral Lymphoma; RIS: Radiologically Isolated Syndrome.
Collapse
Affiliation(s)
- N Chirpaz
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.,Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France
| | - S Kerever
- University of Paris France, Paris, France
| | - A Gavoille
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - L Kodjikian
- Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France.,UMR-CNRS 5510 Matéis, Villeurbanne, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - R Bernier
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.,Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France
| | - M Gerfaud-Valentin
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - P Denis
- Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France
| | - T Mathis
- Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France
| | - Y Jamilloux
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - P Sève
- Department of Internal Medicine, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.,UMR-CNRS 5510 Matéis, Villeurbanne, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Hospices Civils de Lyon, Pôle IMER, Lyon, France.,University Lyon, University Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
16
|
Tanguy-Melac A, Denis P, Fagot-Campagna A, Gastaldi-Ménager C, Laurent M, Tuppin P. Intensity of Care, Expenditure, and Place of Death in French Women in the Year Before Their Death From Breast Cancer: A Population-Based Study. Cancer Control 2020; 27:1073274820977175. [PMID: 33356850 PMCID: PMC8480356 DOI: 10.1177/1073274820977175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/15/2022] Open
Abstract
Health care utilization of women with breast cancer (BC) during the last year of life, together with the causes and place of death and associated expenditure have been poorly described. Women treated for BC (2014-2015) with BC as a cause of death in 2015 and covered by the national health insurance general scheme (77% of the population) were identified in the French health data system (n = 6,696, mean age: 68.7 years, SD ± 15). Almost 70% died in short-stay hospitals (SSH), 4% in hospital-at-home (HaH), 9% in Rehab, 5% in skilled nursing homes (SNH) and 12% at home. One-third presented cardiovascular comorbidity. During the last year, 90% were hospitalized at least once in SSH, 25% in Rehab, 13% in HaH and 71% received hospital palliative care (HPC), but only 5% prior to their end-of-life stay. During the last month, 85% of women were admitted at least once to a SSH, 42% via the emergency department, 10% to an ICU, 24% received inpatient chemotherapy and 18% received outpatient chemotherapy. Among the 83% of women who died in hospital, independent factors for HPC use were cardiovascular comorbidity (adjusted odds ratio, aOR: 0.83; 95%CI: 0.72-0.95) and, in the 30 days before death, at least one SNH stay (aOR: 0.52; 95%CI: 0.36-0.76), ICU stay (aOR: 0.36; 95%CI: 0.30-0.43), inpatient chemotherapy (aOR: 0.55; 95%CI: 0.48-0.63), outpatient chemotherapy (aOR: 0.60; 95%CI: 0.51-0.70), death in Rehab (aOR: 1.4; 95%CI: 1.05-1.86) or HAH (aOR: 4.5; 95%CI: 2.47-8.1) vs SSH. Overall mean expenditure reimbursed per woman was €38,734 and €42,209 for those with PC. Women with inpatient or outpatient chemotherapy during the last month had lower rates of HPC, suggesting declining use of HPC before death. This study also indicates SSH-centered management with increased use of HPC in HaH and Rehab units and decreased access to HPC in SNH.
Collapse
Affiliation(s)
| | - Pierre Denis
- 27054Caisse Nationale d'Assurance Maladie (CNAM), Paris, France
| | | | | | | | - Philippe Tuppin
- 27054Caisse Nationale d'Assurance Maladie (CNAM), Paris, France
| |
Collapse
|
17
|
Amadou C, Denis P, Cosker K, Fagot-Campagna A. Less amputations for diabetic foot ulcer from 2008 to 2014, hospital management improved but substantial progress is still possible: A French nationwide study. PLoS One 2020; 15:e0242524. [PMID: 33253241 PMCID: PMC7703996 DOI: 10.1371/journal.pone.0242524] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the improvement in the management of diabetes and its complications based on the evolution of hospitalisation rates for diabetic foot ulcer (DFU) and lower extremity amputation (LEA) in individuals with diabetes in France. Methods Data were provided by the French national health insurance general scheme from 2008 to 2014. Hospitalisations for DFU and LEA were extracted from the SNIIRAM/SNDS French medical and administrative database. Results In 2014, 22,347 hospitalisations for DFU and 8,342 hospitalisations for LEA in patients with diabetes were recorded. Between 2008 and 2014, the standardised rate of hospitalisation for DFU raised from 508 to 701/100,000 patients with diabetes. In the same period, the standardised rate of LEA decreased from 301 to 262/100,000 patients with diabetes. The level of amputation tended to become more distal. The proportion of men (69% versus 73%) and the frequency of revascularization procedures (39% versus 46%) increased. In 2013, the one-year mortality rate was 23% after hospitalisation for DFU and 26% after hospitalisation for LEA. Conclusions For the first time in France, the incidence of a serious complication of diabetes, i.e. amputations, has decreased in relation with a marked improvement in hospital management.
Collapse
Affiliation(s)
- Coralie Amadou
- Paris-Saclay University, Corbeil-Essonnes, France
- Department of Diabetes and Endocrinology, Sud-Francilien Hospital, Corbeil-Essonnes, France
- * E-mail:
| | - Pierre Denis
- Caisse Nationale d'Assurance Maladie (CNAM), French National Health Insurance, Paris, France
| | - Kristel Cosker
- Caisse Nationale d'Assurance Maladie (CNAM), French National Health Insurance, Paris, France
| | - Anne Fagot-Campagna
- Caisse Nationale d'Assurance Maladie (CNAM), French National Health Insurance, Paris, France
| |
Collapse
|
18
|
Kern M, Douma I, Denis P. Fracture de Xen®. J Fr Ophtalmol 2020; 43:972-973. [DOI: 10.1016/j.jfo.2019.11.032] [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] [Received: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022]
|
19
|
Arndt C, Audrun F, Bodaghi B, Caujolle JP, Cassoux N, Defoort S, Delyfer MN, Denis P, Doan S, Fenolland JR, Giraud JM, Kodjikian L, Labetoulle M, Lasudry J, Leveziel N, Rousseau A, Saadoun D, Speeg-Schatz C, Touhami S, Touitou V, Vignal C, Zech C. [Categorization of the degree of urgency according to ophthalmology procedures or situations]. J Fr Ophtalmol 2020; 43:525-528. [PMID: 32409227 DOI: 10.1016/j.jfo.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 11/19/2022]
Affiliation(s)
- C Arndt
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - F Audrun
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - B Bodaghi
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-P Caujolle
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - N Cassoux
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Defoort
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - M-N Delyfer
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - P Denis
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Doan
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-R Fenolland
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-M Giraud
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - L Kodjikian
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France.
| | - M Labetoulle
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J Lasudry
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - N Leveziel
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - A Rousseau
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - D Saadoun
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Speeg-Schatz
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Touhami
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - V Touitou
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Vignal
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Zech
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| |
Collapse
|
20
|
Tanguy-Melac A, Denis P, Pestel L, Fagot-Campagna A, Gastaldi-Ménager C, Tuppin P. Intensity of care, expenditure, place and cause of death people with lung cancer in the year before their death: A French population based study. Bull Cancer 2020; 107:308-321. [PMID: 32035648 DOI: 10.1016/j.bulcan.2019.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/28/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Health care utilization of people with lung cancer (LC) the last year of life, their causes of death and place of death and the associated expenditure have been poorly described together. Then we conducted an observational study. METHODS People with LC covered by the French health Insurance general scheme (77% of the population) who died in 2015 were identified in the national health data system, together with their health care utilization and, in 95% of cases, their causes of death. RESULTS A total of 22,899 individuals were included (mean age: 68 years, SD±11.4), 72% of whom died in short-stay hospitals (SSH), 4% in hospital-at-home, 8% in Rehab hospital, 2% in skilled nursing homes and 14% at home. One-half of these people had also a chronic respiratory tract disease and 18% another cancer. Hospital palliative care (HPC) was identified for 65% of people, but for only 9% prior to their end-of-life stay. During the last month of life, 49% of people had two or more SSH stays, 15% were admitted to an intensive care unit, 23% received a chemotherapy session (13% during the last 14 days). The main cause of death was cancer for 92% of individuals (LC for 82%) The mean expenditure during the last year of life was €43,329 per individual. DISCUSSION This study indicates high rates of intensive care unit admissions and chemotherapy during the last month of life and a SSH hospital-centered management with intensive use of HPC mainly during the end-of-life stay.
Collapse
Affiliation(s)
- Audrey Tanguy-Melac
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France
| | - Pierre Denis
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France
| | - Laurence Pestel
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France
| | - Anne Fagot-Campagna
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France
| | - Christelle Gastaldi-Ménager
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France
| | - Philippe Tuppin
- Caisse nationale d'assurance maladie (CNAM), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André-Lemierre, 75986 Paris cedex 20, France.
| |
Collapse
|
21
|
Denis P, Aguadé A, Lesuffleur T, Pestel L, Nicolas M, Rachas A, Gastaldi-Menager C. Economic burden of diabetes in France between 2012 and 2017 based on French national claim database. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.068] [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: 11/12/2022] Open
Abstract
Abstract
Background
The aim of this study is to assess the economic burden of diabetes in France based on a top-down allocation of health care expenditure, and to analyze structure and trends of expenditure between 2012 and 2017.
Methods
Using information about 57 millions of individuals from the general scheme insurance database (87% of the French population), we applied algorithms based on ICD-10 diagnoses, long-term diseases, and specific treatments. All reimbursed expenditure (drugs, medical visit and other ambulatory care, hospitalization, disability/sickness benefits) were extracted for each individual. A top-down method was used to allocate expenditure to diabetes. To analyze trends, we applied the same methodology from 2012 through 2017.
Results
In 2016 (results for 2017 will be available for the conference), among the 137 billion euros reimbursed, 6.8 billion (5%) were attributed to diabetes and 3.2 million people were concerned (5.5% of the population). Drugs represented the main expenditure item (31% of the average annual expenditure per patient related to diabetes), followed by nursing (18%) and medical devices (17.5%). From 2012 to 2016, the number of people with diabetes increased by 11.4% (+322 700) with an increase by 2.7%/year, the expenditure attributed to diabetes increased by 2.3%/year. The average expenditure per patient in 2016 was about €2150, slightly decreasing from 2012, mainly due to price controls on antidiabetics drugs which permits to limit expenditure growth.
Conclusions
Our study shows the high economic burden of diabetes in France with a detailed analysis of expenditures and their main drivers. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority. The developed tool will help decision makers to monitor the burden of diabetes but also to provide stakeholders with a better understanding of trends and regulating actions.
Key messages
Diabetes represents a high proportion of healthcare expenditure in France. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority.
Collapse
|
22
|
Bertrand P, Jamilloux Y, Ecochard R, Richard-Colmant G, Gerfaud-Valentin M, Guillaud M, Denis P, Kodjikian L, Sève P. Épidémiologie des uvéites du point de vue de l’interniste : étude rétrospective de 912 cas. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.009] [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]
|
23
|
Cotte P, Jamilloux Y, Gerfaud-Valentin M, Weber E, Francois M, Grumet P, Planchette J, Denis P, Mathis T, Kodjikian L, Sève P. Intérêt de l’association ECA élevée–lymphopénie pour le diagnostic des uvéites sarcoïdosiques. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.089] [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]
|
24
|
Mathis T, Lereuil T, Bruneteau L, Apoustoulo C, Vartin C, Chambard C, Denis P, Kodjikian L. [Performance of ultra-wide field retinophotography for screening of diabetic retinopathy]. J Fr Ophtalmol 2019; 42:572-578. [PMID: 31104875 DOI: 10.1016/j.jfo.2019.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/02/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Early diagnosis of diabetic retinopathy is a public health issue. Fundus retinophotography (FRP) is widely used for the detection of the disease. Recently, ultra-wide field retinophotography (WFRP) device allows imaging of approximately 80% of the retinal surface in a single image. The goal of the present study was to evaluate the efficacy of WFRP in the diagnosis and gradation of diabetic retinopathy compared to the gold standard of FRP. METHODS The non-mydriatic Optos P200Tx was used for WFRP imaging. FRP in the 9 positions of gaze was then acquired with the Topcon TRC-NW6S after pupillary dilation. The processing time for each imaging modality was recorded. RESULTS One hundred and sixteen eyes of 58 patients were included in this study. Fourteen eyes were excluded from the analysis due to insufficient imaging quality. WFRP sensitivity was 96% and specificity was 92%. Only 6 eyes received a higher severity grade of diabetic retinopathy by WFRP compared to FRP. In these cases, when the WFRP was analyzed in the same field as the FRP, the severity grade was similar for 5 of the 6 eyes. The mean time of acquisition was significantly lower for WFRP compared to FRP. CONCLUSION WFRP is fast and effective in screening for diabetic retinopathy. The severity grade of the disease was similar to the gold standard of FRP in most cases. WFRP could thus be used in mass screening for diabetic retinopathy.
Collapse
Affiliation(s)
- T Mathis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gaston-Berger, 69100 Villeurbanne, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France.
| | - T Lereuil
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - L Bruneteau
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - C Apoustoulo
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - C Vartin
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - C Chambard
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - P Denis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - L Kodjikian
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, université Lyon 1, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gaston-Berger, 69100 Villeurbanne, France; Institut des sciences et techniques de réadaptation, université Lyon 1, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| |
Collapse
|
25
|
Mathis T, Levron A, Pommier P, Denis P, Thariat J, Kodjikian L. Intra- and subretinal neovascularization following radiation therapy: Contribution of OCT-angiography. J Fr Ophtalmol 2018; 41:e481-e483. [DOI: 10.1016/j.jfo.2018.04.007] [Citation(s) in RCA: 3] [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] [Received: 02/06/2018] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 10/27/2022]
|
26
|
Xue Y, Scaglione F, Celegato F, Denis P, Fecht HJ, Rizzi P, Battezzati L. Shape controlled gold nanostructures on de-alloyed nanoporous gold with excellent SERS performance. Chem Phys Lett 2018. [DOI: 10.1016/j.cplett.2018.08.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
27
|
Mathis T, Rauber H, Sautivet L, Chambard C, Denis P, Danaila T, Kodjikian L. [Screening for reading difficulties in Parkinson's disease: An evaluation of the Alouette test]. J Fr Ophtalmol 2018; 41:718-724. [PMID: 30150017 DOI: 10.1016/j.jfo.2018.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/15/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Reading disorders in Parkinson's disease (PD) are poorly evaluated due to the lack of validated tests to screen for them. They are often attributed to hand tremors associated with the disease. In this study, we evaluated the "alouette test" validated for dyslexia screening, in PD by comparing the results to healthy patients. METHODS The "alouette test" was conducted on a fixed surface to avoid errors related to tremor. A fixation and tracking test were then performed. All the tests were filmed to be analyzed later by 2 examiners blinded to the neurological diagnosis. RESULTS Thirty-eight patients were included, 19 with PD, and 19 healthy age-matched patients. PD patients read on average 250.9±13.7 words correctly vs. 260.3±2.7 words for healthy patients (P=0.008). This difference was greatest for the older patient subgroup (>65 years), who had the disease longer (P=0.014). Tracking and fixation tests were more impaired in PD patients compared to healthy patients. CONCLUSION This study highlighted many reading disorders in PD. The use of the "alouette test" which can easily be implemented in clinical practice, could help to diagnose these disorders. Better evaluation of these difficulties would allow for better medical care of these patients.
Collapse
Affiliation(s)
- T Mathis
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gasto-Berger, 69100 Villeurbane, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France.
| | - H Rauber
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - L Sautivet
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - C Chambard
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - P Denis
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - T Danaila
- Service de neurologie, troubles du mouvement et pathologies neuromusculaires, université Lyon 1, hôpital Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France
| | - L Kodjikian
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gasto-Berger, 69100 Villeurbane, France
| |
Collapse
|
28
|
Poli M, Cornut PL, Nguyen AM, De Bats F, Denis P. Accuracy of peripapillary versus macular vessel density in diagnosis of early to advanced primary open angle glaucoma. J Fr Ophtalmol 2018; 41:619-629. [PMID: 30150018 DOI: 10.1016/j.jfo.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate macular and peripapillary vessel density (mVD, pVD) using optical coherence tomography angiography (OCT-A) in healthy subjects, patients with ocular hypertension (OHT) and primary open-angle glaucoma (POAG) patients. METHODS In this prospective observational study, OCT-A images were obtained from 60 eyes of 36 healthy, ocular hypertension (OHT), preperimetric glaucoma (PPG), early glaucoma (EG) and moderate and advanced POAG subjects. Superficial mVD was acquired over a 6×6-mm cube centered on the foveal avascular zone and pVD over a 4.5×4.5-mm cube centered on the optic disc. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCC) thickness was calculated using spectral-domain OCT. Correlations between vascular, structural and Humphrey VF indices were evaluated (Spearman's rank correlation coefficient). RESULTS Median pVD and mVD in the PPG eyes were lower than in healthy eyes (51.87% and 47.23% versus 55.70% and 53.61%, respectively; P<0.001 and P=0.003), but higher than in mild glaucoma eyes (46.21% and 41.98%, P<0.001 compared to normal eyes) and moderate to advanced glaucoma eyes (37.45% and 39.89%, P<0.0001 compared to normal eyes). The highest correlations were found between structural parameters and pVD (r=0.87 and 0.86 for pRNFL and GCC, P<0.0001), followed by mVD (r=0.69 for both pRNFL and GCC, P<0.0001). Correlations with mean VF sensitivity were similar for pVD and mVD (r=0.61 and 0.56) and for GCC and pRNFL (r=0.60 and 0.52, P<0.0001 for all). CONCLUSIONS VD measured with OCT-A shows reduction in POAG. Detection of this damage differentiates PPG from normal and perimetric POAG eyes with a high correlation with structural parameters. Peripapillary VD accuracy is higher than mVD in detecting the disease. These results suggest that OCT-A could improve POAG diagnosis and understanding of the pathophysiologic mechanisms behind glaucoma.
Collapse
Affiliation(s)
- M Poli
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Lyon Sud University Hospital, 69310 Pierre-Bénite, France.
| | - P-L Cornut
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France
| | - A-M Nguyen
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - F De Bats
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - P Denis
- Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| |
Collapse
|
29
|
Briet C, Piffaretti C, Fosse S, Denis P, Allix I, Campagna AF, Coutant R. [Epidemiology of type 1 diabetes and its complications]. Rev Prat 2018; 68:607-610. [PMID: 30869246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Epidemiology of type 1 diabetes and its complications. The prevalence of type 1 diabetes in adult is estimated at 0.3 to 0.5%, or 10% of all types of diabetes. In youth less than 15 years, in France, the incidence of type 1 diabetes is 18 per 100,000 over the period 2013-2015 (based on the National Health Data System), corresponding to an approximate prevalence of 1.3 per 1000. The incidence of diabetes in youth increases by 3 to 4% per year, an increase seen in France since 1988. With the intensification of treatment (resulting in HbA1c around 8% on average over the entire follow-up), after 30 years of progression of diabetes (in subjects aged 50 years on average), it was observed that the prevalence of severe retinopathy (requiring laser treatment) was nearly 15%, microalbuminuria 15%, macroproteinuria 4%, advanced renal failure less than 2%, clinical neuropathy 24%, and macrovascular complications around 5%.
Collapse
Affiliation(s)
| | - Clara Piffaretti
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), Paris, France
| | | | | | | | | | - Régis Coutant
- Endocrinologie diabétologie pédiatrique, CHU Angers, Angers, France
| |
Collapse
|
30
|
Nordmann JP, Denis P, Nguer Y, Mouton-Chopin D, Saraux H. Static Threshold Visual Field in Glaucoma with the Fastpac™ Algorithm of the Humphrey Field Analyser is the Gain in Examination Time Offset by Any Loss of Information? Eur J Ophthalmol 2018; 4:105-10. [PMID: 7950333 DOI: 10.1177/112067219400400205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A new algorithm (Fastpac™) has been designed to speed up full threshold tests with the Humphrey Field Analyser. We studied the utility of this algorithm by comparing central 24-2 threshold programs obtained with standard and Fastpac™ algorithms in 43 hypertensive or glaucomatous eyes. The Fastpac™ reduced testing time by 35% to 45%. In glaucomatous eyes, the time spared was inversely correlated with the degree of visual field impairment. Global indices were used to compare visual fields. Mean absolute differences in indices did not exceed 0.98 dB. Correlations between indices in glaucoma patients with standard and Fastpac™ strategy were respectively 0.99 and 0.98 for mean deviation and pattern standard deviation. The intra-test variability (short-term fluctuation) was slightly higher with Fastpac™ with a lower correlation between algorithms (r=0.62). The use of Fastpac™ achieves a mean time reduction of 40% and does not significantly modify global indices obtained with the Humphrey perimeter in hypertensive and glaucomatous eyes.
Collapse
Affiliation(s)
- J P Nordmann
- Department of Ophthalmology, Hôpital Tenon, Paris, France
| | | | | | | | | |
Collapse
|
31
|
Bron A, Denis P, Hoang-Xuan TC, Boureau-Andrieux C, Crozafon P, Hachet E, Medhorn E, Akingbehin A. The Effects of Rimexolone 1% in Postoperative Inflammation after Cataract Extraction. A Double-Masked Placebo-Controlled Study. Eur J Ophthalmol 2018; 8:16-21. [PMID: 9590590 DOI: 10.1177/112067219800800105] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim A multicentre, randomized, placebo-controlled double-masked study was conducted to assess the efficacy and safety of Rimexolone 1% eye drops in reducing inflammation after cataract surgery and intra-ocular lens implantation. Methods Rimexolone 1% (124 patients) or placebo (58 patients) was given, four times a day for 14 days starting 22-34 hours after surgery. All patients also received tobramycin 0.3% four times a day for 7 days. The clinical signs of ocular inflammation were recorded on days 1, 3, 8, 15 and 17 or 18. Results Rimexolone 1% markedly decreased the mean inflammation severity scores, and the sum of clinical assessments of cells and flare in the anterior chamber compared with placebo at each assessment. In addition, the percentage of patients with no anterior chamber inflammation was significantly higher with Rimexolone 1% than with the placebo at each assessment. All these results were statistically significant. Intra-ocular pressure did not rise after treatment with Rimexolone 1%. Conclusions The results suggest that Rimexolone 1% ophthalmic solution is an effective and safe steroidal anti-inflammatory agent for topical use following cataract surgery and intraocular lens implantation.
Collapse
Affiliation(s)
- A Bron
- Department of Ophthalmology, Faubourg Raines Hospital, Dijon, France
| | | | | | | | | | | | | | | |
Collapse
|
32
|
de Lagasnerie G, Aguadé AS, Denis P, Fagot-Campagna A, Gastaldi-Menager C. The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. Eur J Health Econ 2018; 19:189-201. [PMID: 28190188 PMCID: PMC5813074 DOI: 10.1007/s10198-017-0873-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/24/2017] [Indexed: 05/04/2023]
Abstract
A better understanding of the economic burden of diabetes constitutes a major public health challenge in order to design new ways to curb diabetes health care expenditure. The aim of this study was to develop a new cost-of-illness method in order to assess the specific and nonspecific costs of diabetes from a public payer perspective. Using medical and administrative data from the major French national health insurance system covering about 59 million individuals in 2012, we identified people with diabetes and then estimated the economic burden of diabetes. Various methods were used: (a) global cost of patients with diabetes, (b) cost of treatment directly related to diabetes (i.e., 'medicalized approach'), (c) incremental regression-based approach, (d) incremental matched-control approach, and (e) a novel combination of the 'medicalized approach' and the 'incremental matched-control' approach. We identified 3 million individuals with diabetes (5% of the population). The total expenditure of this population amounted to €19 billion, representing 15% of total expenditure reimbursed to the entire population. Of the total expenditure, €10 billion (52%) was considered to be attributable to diabetes care: €2.3 billion (23% of €10 billion) was directly attributable, and €7.7 billion was attributable to additional reimbursed expenditure indirectly related to diabetes (77%). Inpatient care represented the major part of the expenditure attributable to diabetes care (22%) together with drugs (20%) and medical auxiliaries (15%). Antidiabetic drugs represented an expenditure of about €1.1 billion, accounting for 49% of all diabetes-specific expenditure. This study shows the economic impact of the assumption concerning definition of costs on evaluation of the economic burden of diabetes. The proposed new cost-of-illness method provides specific insight for policy-makers to enhance diabetes management and assess the opportunity costs of diabetes complications' management programs.
Collapse
Affiliation(s)
- Grégoire de Lagasnerie
- Strategy and Research Department, National Health Insurance (CNAMTS), 50 Avenue du Pr André Lemierre, 75986, Paris Cedex 20, France
| | - Anne-Sophie Aguadé
- Strategy and Research Department, National Health Insurance (CNAMTS), 50 Avenue du Pr André Lemierre, 75986, Paris Cedex 20, France
| | - Pierre Denis
- Strategy and Research Department, National Health Insurance (CNAMTS), 50 Avenue du Pr André Lemierre, 75986, Paris Cedex 20, France
| | - Anne Fagot-Campagna
- Strategy and Research Department, National Health Insurance (CNAMTS), 50 Avenue du Pr André Lemierre, 75986, Paris Cedex 20, France
| | - Christelle Gastaldi-Menager
- Strategy and Research Department, National Health Insurance (CNAMTS), 50 Avenue du Pr André Lemierre, 75986, Paris Cedex 20, France.
| |
Collapse
|
33
|
Lefevre A, Mathis T, Denis P, Kodjikian L. Hémangioblastomes rétiniens : stratégie thérapeutique et suivi à long terme dans une cohorte rétrospective. J Fr Ophtalmol 2018; 41:164-169. [DOI: 10.1016/j.jfo.2017.07.004] [Citation(s) in RCA: 2] [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] [Received: 06/14/2017] [Revised: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 11/30/2022]
|
34
|
Denis P, Andrew R, Wells D, Friren B. A Comparison of Morning and Evening Instillation of a Combination Travoprost 0.004%/Timolol 0.5% Ophthalmic Solution. Eur J Ophthalmol 2018. [DOI: 10.1177/112067210601600308] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P. Denis
- Hôpital Edouard Herriot, Lyon - France
| | - R. Andrew
- Alcon Research Ltd., Fort Worth, TX - USA
| | - D. Wells
- Alcon Research Ltd., Fort Worth, TX - USA
| | - B. Friren
- Laboratoires Alcon, Rueil-Malmaison - France
| |
Collapse
|
35
|
Abstract
Purpose As pregnancy is liable to modify immune response, the authors explored the immune functions of a pregnant patient with acute retinal necrosis (ARN) to ascertain whether pregnancy may promote the onset of infection. Methods Polymerase chain reaction (PCR) was used for the detection of herpes simplex virus (HSV) DNA in ocular, uterus cervix, and cerebrospinal fluid samples. Peripheral blood mononuclear cells were cultured for 72 hours with mitogens and cellular proliferation was assessed using (methyl-3H) thymidine incorporation. Flow cytometry was performed for T, B, and NK cell count using CD2, CD3, CD4, CD8 (T cells), CD19, CD20 (B cells), and a combination of CD3–CD16 and CD56 monoclonal antibodies (NK cells). Results Unilateral ARN, with a confluent peripheral necrotizing retinitis extending throughout the entire retina, was diagnosed clinically. The herpetic infection (herpes simplex virus 1) was confirmed using PCR of aqueous humor specimen. The immunologic study performed during and after pregnancy showed that T and B lymphocytes were quantitatively normal and responses to concanavalin A, phytohemagglutinin, and pokeweed mitogens were weaker during pregnancy. Conclusions A reduced response to mitogens, with postdelivery normalization, was noted in a pregnant woman with an ARN syndrome. Further studies are needed to explore the antigen-specific immune deviation in pregnant patients with ARN.
Collapse
Affiliation(s)
- C Chiquet
- Department of Ophthalmology, Edouard Herriot Hospital, Lyon, France.
| | | | | | | | | | | |
Collapse
|
36
|
Denis P, Le Pen C, Umuhire D, Berdeaux G. Treatment Carryover Impacts on Effectiveness of Intraocular Pressure Lowering Agents, Estimated by a Discrete Event Simulation Model. Eur J Ophthalmol 2018; 18:44-51. [DOI: 10.1177/112067210801800108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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]
Abstract
Purpose To compare the effectiveness of two treatment sequences, latanoprost–latanoprost timolol fixed combination (L-LT) versus travoprost–travoprost timolol fixed combination (T-TT), in the treatment of open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods A discrete event simulation (DES) model was constructed. Patients with either OAG or OHT were treated first-line with a prostaglandin, either latanoprost or travoprost. In case of treatment failure, patients were switched to the specific prostaglandin-timolol sequence LT or TT. Failure was defined as intraocular pressure higher than or equal to 18 mmHg at two visits. Time to failure was estimated from two randomized clinical trials. Log-rank tests were computed. Linear functions after log-log transformation were used to model time to failure. The time horizon of the model was 60 months. Outcomes included treatment failure and disease progression. Sensitivity analyses were performed. Results Latanoprost treatment resulted in more treatment failures than travoprost (p<0.01), and LT more than TT (p<0.01). At 60 months, the probability of starting a third treatment line was 39.2% with L-LT versus 29.9% with T-TT. On average, L-LT patients developed 0.55 new visual field defects versus 0.48 for T-TT patients. The probability of no disease progression at 60 months was 61.4% with L-LT and 65.5% with T-TT. Conclusions Based on randomized clinical trial results and using a DES model, the T-TT sequence was more effective at avoiding starting a third line treatment than the L-LT sequence. T-TT treated patients developed less glaucoma progression.
Collapse
Affiliation(s)
| | | | | | - G. Berdeaux
- Alcon France, Rueil-Malmaison
- Conservatoire National des Arts et Métiers, Paris - France
| |
Collapse
|
37
|
Denis P, Duch S. First real-life data of use of the new PF-MD glaucoma device (EasyGrip ®
): results of the ISY study from Spain and France. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s062] [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: 11/27/2022]
Affiliation(s)
- P. Denis
- Service d'ophtalmologie; Hôpital de la Croix Rousse; Lyon Cedex 04 France
| | - S. Duch
- Glaucoma Unit; ICO Barcelona; Barcelona Spain
| |
Collapse
|
38
|
Rezkallah A, Malcles A, Dot C, Voirin N, Agard E, Vie A, Denis P, Kodjikian L. Evaluation of efficacy and safety of dexamethasone intravitreal implants between vitrectomized and non-vitrectomized eyes in a real-life study. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01115] [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: 11/29/2022]
Affiliation(s)
- A. Rezkallah
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - A. Malcles
- Ophthalmology; Hôpitaux Universitaires de Genève; Geneve Switzerland
| | - C. Dot
- Ophthalmology; Hôpital d'instruction des armées Desgenettes; Lyon France
| | - N. Voirin
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - E. Agard
- Ophthalmology; Hôpital d'instruction des armées Desgenettes; Lyon France
| | - A.L. Vie
- NeuroOphthalmology; Hôpital Neurologique; Lyon France
| | - P. Denis
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - L. Kodjikian
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| |
Collapse
|
39
|
Simon L, Trévidic P, Denis P, Vignes S. Vulvar lymphangioma circumscriptum: comparison of primary and acquired forms in a cohort of 57 patients. J Eur Acad Dermatol Venereol 2017; 32:e56-e58. [PMID: 28758249 DOI: 10.1111/jdv.14497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- L Simon
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France
| | | | - P Denis
- Cabinet d'Histopathologie, Paris, France
| | - S Vignes
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France
| |
Collapse
|
40
|
Tuppin P, Pestel L, Samson S, Cuerq A, Tala S, Rivière S, Denis P, Gastaldi-Ménager C, Gissot C, Fagot-Campagna A. Poids des cancers sur la population et le système de soins en France en 2014, les données du Sniiram. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.036] [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
|
41
|
Tuppin P, Pestel L, Samson S, Cuerq A, Rivière S, Tala S, Denis P, Drouin J, Gissot C, Gastaldi-Ménager C, Fagot-Campagna A. [The human and economic burden of cancer in France in 2014, based on the Sniiram national database]. Bull Cancer 2017; 104:524-537. [PMID: 28285755 DOI: 10.1016/j.bulcan.2017.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 10/25/2016] [Revised: 12/06/2016] [Accepted: 01/26/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The national health insurance information system (Sniiram) can be used to estimate the national medical and economic burden of cancer. This study reports the annual rates, characteristics and expenditure of people reimbursed for cancer. METHODS Among 57 million general health scheme beneficiaries (86% of the French population), people managed for cancer were identified using algorithms based on hospital diagnoses and full refund for long-term cancer. The reimbursed costs (euros) related to the cancer, paid off by the health insurance, were estimated. RESULTS In 2014, 2.491 million people (4.4%) covered by the general health scheme had a cancer managed (men 1.1 million, 5.1%; women 1.3 million, 4.9%). The annual (2012-2014) average growth rate of patients was 0.8%. The spending related to the cancer was 13.5 billion: 5 billion for primary health care (drugs 2.3 billion), 7.5 billion for the hospital (drugs 1.3 billions) and 900 million for sick leave and invalidity pensions. Spending annual average growth rate (2012-2014) was 4% (drugs 2%). The rates of patients and the relative spending were 1.8% and 2.5 billion for the breast cancer (women), 1.5% and 1.0 billion for prostate cancer, 0.9% and 1.5 billion for the colon cancer, and 0.19% and 1.3 billion for lung cancer. DISCUSSION Cancers establish one of the first groups of chronic diseases pathologies in terms of patients and spending. If the numbers of patients remain stables, the spending increases, mainly for medicines.
Collapse
Affiliation(s)
- Philippe Tuppin
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France.
| | - Laurence Pestel
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Solène Samson
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Anne Cuerq
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Sébastien Rivière
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Stéphane Tala
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Pierre Denis
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Jérôme Drouin
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Claude Gissot
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Christelle Gastaldi-Ménager
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| | - Anne Fagot-Campagna
- Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris, France
| |
Collapse
|
42
|
Denis P, Pisella PJ. Risque d’hypertonie oculaire (HTO) après injection intravitréenne, avant-propos. J Fr Ophtalmol 2017; 40:237-238. [DOI: 10.1016/j.jfo.2017.02.001] [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] [Received: 01/31/2017] [Accepted: 02/09/2017] [Indexed: 10/19/2022]
|
43
|
Poli M, Denis P, Dot C, Nordmann JP. Conduite à tenir face au risque d’hypertonie oculaire après injection intra-vitréenne. J Fr Ophtalmol 2017; 40:e77-e82. [DOI: 10.1016/j.jfo.2017.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 11/27/2022]
|
44
|
Guillaud M, Richard-Colmant G, Gerfaud-valentin M, Denis P, Broussolle C, Kodjikian L, Sève P. Aspects cliniques, étiologiques et prise en charge des uvéites : étude rétrospective de 957 patients. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.045] [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]
|
45
|
Richard-Colmant G, Guillaud M, Gerfaud-Valentin M, Denis P, Broussolle C, Kodjikian L, Sève P. Caractéristiques cliniques, évolutives et thérapeutiques des uvéites d’origine indéterminée : analyse d’une cohorte rétrospective de 355 patients. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.047] [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: 10/20/2022]
|
46
|
Bernard A, Tigaud S, Roure-Sobas C, Boibieux A, Denis P, Broussolle C, Kodjikian L, Sève P. Diagnostic des uvéites associées à la maladie de Lyme : expérience d’un centre tertiaire. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.048] [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]
|
47
|
Aptel F, Rouland J, Stalmans I, Denis P. Ultrasound treatment in patients with Primary Open-Angle Glaucoma with a second generation probe: Results of a Multicenter Clinical Trial. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0447] [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: 11/27/2022]
|
48
|
Denis P. Apport clinique du latanoprost sans conservateur dans le traitement du glaucome à angle ouvert et de l’hypertension oculaire. Étude multicentrique randomisée contrôlée. J Fr Ophtalmol 2016; 39:622-30. [DOI: 10.1016/j.jfo.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/18/2016] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
|
49
|
Domingues-Faria C, Salles J, Goncalves-Mendes N, Berry A, Denis P, Giraudet C, Patrac V, Le Bacquer O, Chanet A, Combe K, Guillet C, Farges MC, Bonhomme C, Vasson MP, Boirie Y, Walrand S. La carence en vitamine D diminue les capacités de régénération musculaire chez le rat âgé. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.09.022] [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: 10/20/2022]
|
50
|
Dulnik J, Denis P, Sajkiewicz P, Kołbuk D, Choińska E. Biodegradation of bicomponent PCL/gelatin and PCL/collagen nanofibers electrospun from alternative solvent system. Polym Degrad Stab 2016. [DOI: 10.1016/j.polymdegradstab.2016.05.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|