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Verjat-Trannoy D, Merle V, Daniel C, Sambourg J, Astagneau P. Incorporation of skin preparation guidelines in local surgical facility protocols: what kind of barriers does it face? A multi-centre study in France. J Hosp Infect 2024; 145:203-209. [PMID: 38286240 DOI: 10.1016/j.jhin.2023.12.018] [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: 10/26/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Surgical site infection (SSI) is the most frequent and severe adverse event after surgery. Among preventive measures, the preoperative skin preparation (PSP) is known to be heterogeneously implemented in routine practice. A prerequisite would be the actual incorporation of guidelines in French surgical local protocols. AIM To assess whether PSP recommendations have been incorporated in local protocols and to identify the reasons for the non-incorporation. METHODS An online survey was proposed to all infection control teams (ICTs) in facilities participating in the French national surveillance and prevention of SSI network Spicmi. The reference recommendations were based on the French Society for Hospital Hygiene guidelines. FINDINGS In all, 485 healthcare facilities completed the questionnaire. The incorporation of recommendations in the facility protocol varied between 30% and 98% according to the recommendation. The measures most frequently incorporated were antisepsis with an alcoholic product and cessation of systematic hair removal. The least frequently incorporated were the use of plain soap for preoperative shower and the non-compulsory skin cleaning in the operating room. Barriers reported were either specific to PSP (e.g. 'Concern about an increase of SSI', 'Scepticism about recommendations', 'Force of habit') or non-specific (e.g. 'The protocol not yet due to be updated'). CONCLUSION We suggest that although some major prevention measures have been incorporated in the local protocol of most facilities, local protocols still frequently include some non-evidence based former recommendations. Communication about evolution of SSI rates, diffusion of guidelines by learned societies, and exchange with judiciary experts could make clear the conditions for applying recommendations.
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Affiliation(s)
- D Verjat-Trannoy
- Mission nationale Spicmi, Centre régional de prévention des infections associées aux soins (CPias) Ile-de-France, Paris, France.
| | - V Merle
- Direction de la qualité et de la gestion des risques, Groupe Hospitalier du Havre, Le Havre, France; Inserm U1086 Anticipe, Centre François Baclesse, Caen, France
| | - C Daniel
- Mission nationale Spicmi, Centre régional de prévention des infections associées aux soins (CPias) Ile-de-France, Paris, France
| | - J Sambourg
- Centre régional de prévention des infections associées aux soins (CPias) Ile-de-France, Paris, France
| | - P Astagneau
- Mission nationale Spicmi, Centre régional de prévention des infections associées aux soins (CPias) Ile-de-France, Paris, France; Sorbonne université, INSERM, Institut Pierre Louis d'Epidémiologie et de santé Publique, Paris, France
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Habihirwe P, Marini H, Wurtz B, Vermeulin T, Lottin M, Gehanno JF, Boulet L, Vergnes H, Edet S, Guet L, Le Roy F, Merle V. Compliance with good practice guidelines for the prevention of vascular access infections: the multi-centre PHYDEL survey in French haemodialysis units. J Hosp Infect 2023; 142:1-8. [PMID: 37734680 DOI: 10.1016/j.jhin.2023.09.007] [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: 05/05/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND French guidelines for the prevention of vascular access infections in a haemodialysis setting were released in 2005. Compliance with these guidelines is currently unknown. The aim of this study was to assess compliance with the guidelines for vascular access infection prevention in French haemodialysis units, and to describe the difficulties reported. METHODS A cross-sectional survey was conducted between March and December 2019 in 200 haemodialysis units in France, selected at random. Data were collected via questionnaire, completed by telephone interview with an infection control practitioner. A practice was deemed compliant when >85% of units declared that they always complied with the guidelines. RESULTS In total, 103 units (51.5%) agreed to participate. Most practices complied with the guidelines; however, some practices did not reach the 85% compliance threshold for working in pairs when connecting central venous catheter (CVC) lines, performing hand hygiene before disconnecting lines, rinsing antiseptic soap before painting CVC exit site or arteriovenous fistula (AVF) puncture site, allowing antiseptic paint to dry, handling CVC branches with antiseptic impregnated gauze, performing hand hygiene after AVF compression with gloves, wearing protective eyewear when connecting/disconnecting CVC or when puncturing AVF, and wearing a gown when puncturing AVF. The most frequently reported difficulties were understaffing, difficulties with skin preparation because of exit site skin damage, and lack of buttonhole technical expertise. CONCLUSIONS Despite good overall compliance, this survey highlights some shortcomings in compliance with infection prevention guidelines, which could be associated with either higher risk of vascular access infection or increased blood-borne virus transmission.
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Affiliation(s)
- P Habihirwe
- Department of Infection Control, CHU Rouen, Rouen, France
| | - H Marini
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | - B Wurtz
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; REIN Registry, Agence de Biomédecine, Paris, France
| | - T Vermeulin
- Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; Comprehensive Cancer Centre Henri Becquerel, UNICANCER, Rouen, France
| | - M Lottin
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | - J F Gehanno
- Department of Occupational Health, CHU Rouen, Rouen, France
| | - L Boulet
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | | | - S Edet
- REIN Registry, Agence de Biomédecine, Paris, France; Department of Nephrology and Haemodialysis, CHU Rouen, Rouen, France; ANIDER Rouen Normandie, Rouen, France
| | - L Guet
- CPIAS Normandie, Rouen, France
| | - F Le Roy
- Department of Nephrology and Haemodialysis, CHU Rouen, Rouen, France
| | - V Merle
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; REIN Registry, Agence de Biomédecine, Paris, France.
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Vermeulin T, Froment L, Merle V, Dormont B. Impact de la défavorisation sociale sur les hospitalisations non programmées en cancérologie : résultats d'une étude de cohorte rétrospective au CHU de Rouen. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gautier G, Lucas M, Vermeulin T, Di Fiore F, Merle V. Deprived social status is associated with decreased use of oral chemotherapy in patients with metastatic colorectal cancer: A retrospective cohort study on administrative databases in a French University Hospital. Pharmacol Res Perspect 2021; 9:e00888. [PMID: 34766736 PMCID: PMC8587174 DOI: 10.1002/prp2.888] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/02/2021] [Indexed: 11/15/2022] Open
Abstract
Factors associated with the choice of oral versus intravenous CT are not clearly established. Our purpose was to evaluate the influence of social status and home distance to hospital on the use of oral CT in patients with metastatic colorectal cancer (mCRC). This retrospective single-center study included mCRC patients between 2011 and 2017. Patient social status was assessed by European Deprivation Index (EDI) and home distance to the hospital was calculated. Univariable and multivariable logistic regression analyses were performed. One hundred and seventy-five mCRC patients were included, with 71 receiving oral CT. Most deprived patients received less oral CT (OR 0.5 [0.26, 0.96], p = .039). No association was found for road distance. Previous use of adjuvant oral CT was associated with oral CT in mCRC (OR 2.65 [1.06, 6.66], p = .038). Our results suggest that deprived social status is a factor associated with decreased use of oral CT in patients with mCRC. Clinical trial registration: no registration.
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Affiliation(s)
- Gwendoline Gautier
- Department of HepatogastroenterologyRouen University HospitalUNIROUENRouenFrance
| | - Mélodie Lucas
- Department of Medical InformationLe Havre HospitalLe HavreFrance
- Dynamiques et Evènements des Soins et des Parcours Research GroupRouen University HospitalUNIROUENRouenFrance
| | - Thomas Vermeulin
- Dynamiques et Evènements des Soins et des Parcours Research GroupRouen University HospitalUNIROUENRouenFrance
- CLCC H. BecquerelUnicancerRouenFrance
- LEDA‐LEGOSUniversité Paris‐DauphineParisFrance
| | - Frederic Di Fiore
- Department of HepatogastroenterologyRouen University HospitalUNIROUENRouenFrance
- CLCC H. BecquerelUnicancerRouenFrance
| | - Veronique Merle
- Dynamiques et Evènements des Soins et des Parcours Research GroupRouen University HospitalUNIROUENRouenFrance
- Inserm U1086 ANTICIPECaenFrance
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Daubert G, Gillet G, Guet L, Marini H, Merle V. General Practitioners' Practice premises and Risk of Viral Cross-Transmission: A French Observational Multicenter Study. J Prim Care Community Health 2021; 12:21501327211043734. [PMID: 34486437 PMCID: PMC8424613 DOI: 10.1177/21501327211043734] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The common areas of general practitioners' practices (eg, reception, secretariat, waiting room, toilets) are places at risk of cross-transmission of viral diseases such as COVID-19, however risk is poorly documented. AIM To evaluate the risks of viral cross-transmission in general practitioners' practices based on the organization of the common areas of the premises. DESIGN AND SETTING Cross-sectional multicenter observational study in randomly selected general practitioners' practices in a French department (Seine-Maritime). The practices were included in 4 strata (1, 2, 3-5, or ≥6 general practitioners). METHOD Each practice was visited and a questionnaire describing practice organization, cleaning of the premises, screening of high-risk patients was completed on site and observation of the premises). RESULTS Data collection started in December 2019 and was discontinued due to the national lockdown related to the global SARS-CoV-2 pandemic. Eighty-two practices were analyzed. A hydroalcoholic solution was available in 7.3% of practices and surgical masks in 1.2%. In a majority of waiting rooms, the minimum distance between chairs facing each other was >2 m (78.0%), but was more frequently 1 m for chairs at 90° (53.7%). Overall, 79.3% of waiting rooms could be properly ventilated and waste bins were present in 23.9% of cases. A cleaning protocol was reported in 39.2% of practices. CONCLUSION The COVID-19 epidemic allowed the national dissemination of standard precautions. It will be interesting to monitor over the next few years whether the renewed consideration of standard precautions to prevent viral cross-contamination will be maintained over time.
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Affiliation(s)
- Guillaume Daubert
- Department of Family Medicine, Normandy Rouen University, Rouen, France
| | - Gregoire Gillet
- Department of Family Medicine, Normandy Rouen University, Rouen, France
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Boulet L, Vermeulin T, Vasiliu A, Gillibert A, Lottin M, Frébourg N, Boyer S, Merle V. Lack of effect of a poster-based intervention to reduce the number of blood culture samples collected. Med Mal Infect 2019; 50:78-82. [PMID: 31640881 DOI: 10.1016/j.medmal.2019.09.017] [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: 02/16/2019] [Accepted: 09/24/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To reduce the number of blood culture samples collected. PATIENTS AND METHOD We performed a cluster randomized controlled trial in adult acute care, and subacute care and rehabilitation wards in a university hospital in France. A poster associating an image of eyes looking at the reader with a summary of blood culture sampling guidelines was displayed in hospital wards in the intervention group. The incidence rate of blood cultures per 1000 days during pre- and post-intervention periods was calculated. RESULTS Thirty-one wards participated in the study. The median difference in blood cultures/1000 days between periods was -1.863 [-11.941; 1.007] in the intervention group and -5.824 [-14.763; -2.217] in the control group (P=0.27). CONCLUSION The intervention did not show the expected effect, possibly due to the choice of blood cultures as a target of good practice, but also to confounding factors such as the stringent policy of decreasing unnecessary costly testing.
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Affiliation(s)
- L Boulet
- Hospital Infection Control and Epidemiology Department, Rouen University Hospital, 76000 Rouen, France.
| | - T Vermeulin
- Clinique Mathilde, Department of Medical Information, 76000 Rouen, France
| | - A Vasiliu
- Hospital Infection Control and Epidemiology Department, Rouen University Hospital, 76000 Rouen, France
| | - A Gillibert
- Unit of Biostatistics, Rouen University Hospital, 76000 Rouen, France
| | - M Lottin
- Healthcare Associated Risk Department, Rouen University Hospital, 76000 Rouen, France
| | - N Frébourg
- Department of Microbiology, Rouen University Hospital, 76000 Rouen, France
| | - S Boyer
- Department of Microbiology, Rouen University Hospital, 76000 Rouen, France
| | - V Merle
- Hospital Infection Control and Epidemiology Department, Rouen University Hospital, 76000 Rouen, France; Dynamiques et Évènements des Soins et des Parcours research group, Rouen University Hospital, 76000 Rouen, France
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7
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Vermeulin T, Lucas M, Lahbib H, Froment L, Czernichow P, Josset V, Jusot F, Di Fiore F, Launoy G, Merle V. Conformité du délai d’initiation de la chimiothérapie adjuvante pour cancer du côlon : élaboration d’un indicateur qualité à partir du PMSI. ONCOLOGIE 2018. [DOI: 10.3166/onco-2018-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Lottin M, Fiaux E, Gouin P, Beduneau G, Braud H, Gastaldi G, Tiret I, Oudinot X, Merle V, Caron F. Pertinence de la prescription des antibiotiques actifs sur les staphylocoques résistant à la méticilline dans un CHU. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lucas M, Germain JM, Rémy E, Lottin M, Etienne M, Czernichow P, Merle V. Reassessment of antibiotic therapy in hospitals. Med Mal Infect 2017; 47:324-332. [PMID: 28550938 DOI: 10.1016/j.medmal.2017.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/08/2015] [Revised: 06/15/2016] [Accepted: 03/15/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION French national guidelines state that antibiotic therapies should be reassessed between 48 and 72hours after treatment initiation and that reassessment of antibiotic therapy (RA) must be recorded in patients' files. OBJECTIVE To determine whether RA is performed and recorded in patients' files in hospitals in a region of France. METHODS Setting: hospitals participating in the National nosocomial infection point- prevalence survey (NPS) in Upper-Normandy, France. Patients included those receiving antibiotic therapy (excluding antibiotic prophylaxis) on NPS day, started in the hospital in which the survey was conducted and ongoing for more than 72hours. Data collected included characteristics of participating hospitals and, for each included patient, characteristics of ward, infection and antibiotic therapy, and mention in the patients' files of explicit or implicit RA. The rate of explicit and implicit RA was calculated and factors associated with explicit or implicit RA were evaluated using a univariate analysis. RESULTS Thirty-three hospitals representing 87% of hospital beds region-wide were included in the study. In addition, 933 prescriptions were assessed for 724 infections in 676 patients. The overall rate of RA was 67.6% (49.3% of explicit RA and 18.3% of implicit RA). The rate of RA differed significantly according to infection and antibiotic class but not according to hospital or ward characteristics. CONCLUSION Our study provides new and reassuring results regarding reassessment of antibiotic therapy.
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Affiliation(s)
- M Lucas
- ARLIN Haute-Normandie, CCLIN Paris Nord, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.
| | - J-M Germain
- ARLIN Haute-Normandie, CCLIN Paris Nord, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France
| | - E Rémy
- OMEDIT Haute-Normandie, Rouen University Hospital, 76031 Rouen cedex, France
| | - M Lottin
- Department of Epidemiology and Public Health, Rouen University Hospital, 76031 Rouen cedex, France
| | - M Etienne
- Department of Infectious and Tropical Diseases, Rouen University Hospital, 76031 Rouen cedex, France
| | - P Czernichow
- Department of Epidemiology and Public Health, Rouen University Hospital, 76031 Rouen cedex, France
| | - V Merle
- Department of Epidemiology and Public Health, Rouen University Hospital, 76031 Rouen cedex, France
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Le Bourhis-Zaimi M, Marini H, Gueudry J, Calenda E, Vermeulin T, Frébourg N, Muraine M, Merle V. Incidence of postoperative nosocomial endophthalmitis: results of an eight-year prospective surveillance programme in a university hospital in France. J Hosp Infect 2017; 96:399-400. [PMID: 28527617 DOI: 10.1016/j.jhin.2017.05.008] [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: 04/06/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
Affiliation(s)
- M Le Bourhis-Zaimi
- Department of Infection Control, Rouen University Hospital, Rouen, France; Groupe "Dynamiques et Evènements des Soins et des Parcours", France.
| | - H Marini
- Department of Infection Control, Rouen University Hospital, Rouen, France; Groupe "Dynamiques et Evènements des Soins et des Parcours", France
| | - J Gueudry
- Department of Ophthalmology, Rouen University Hospital, Rouen, France
| | - E Calenda
- Department of Anesthesiology, Rouen University Hospital, Rouen, and EA3830, IRIB, Normandie Université, Rouen, France
| | - T Vermeulin
- Department of Infection Control, Rouen University Hospital, Rouen, France; Groupe "Dynamiques et Evènements des Soins et des Parcours", France
| | - N Frébourg
- Department of Microbiology, Rouen University Hospital, Rouen, France
| | - M Muraine
- Department of Ophthalmology, Rouen University Hospital, Rouen, France
| | - V Merle
- Department of Infection Control, Rouen University Hospital, Rouen, France; Groupe "Dynamiques et Evènements des Soins et des Parcours", France
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Basuyau F, Josset V, Merle V, Czernichow P. Case Fatality and Health Care Costs in HIV-Infected Patients: Evolution from 1992 to 2000 at Rouen University Hospital, France. Int J STD AIDS 2016; 15:679-84. [PMID: 15479505 DOI: 10.1177/095646240401501009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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
Vital prognosis in HIV-infected patients has been improved by new therapies, leading to an increase in treatment and outpatient costs but lower inpatient care costs. The aim of the study was to compare the health care costs between 1992–1996 (first half) and 1996–2000 (second half) in HIV-infected patients at Rouen University Hospital. Hospitalization costs (including inpatient and outpatient care), infectious complication treatment and antiretroviral therapy costs were evaluated from a National Health Insurance viewpoint. Between 1992 and 2000, 1212 patients were admitted at least once. Total expenditure increased between the two periods from €13,660 to €27,567, i.e., a two-fold increase. During the same period, 125 deaths were avoided, and 3602 years of life were gained. The cost of one avoided death was €108,320 and the cost per life-year gained was €3776.
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Affiliation(s)
- F Basuyau
- Department of Epidemiology and Public Health, Rouen University Hospital-Charles Nicolle, 1 rue de Germont, 76031 Rouen Cedex, France.
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Sainte-Marie A, Cuvelier A, Muir JF, Marini H, Merle V. Caractéristiques des pneumopathies nosocomiales au sein d’une unité de soins intensifs respiratoires (USIR). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.559] [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: 10/22/2022]
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Cossin S, Malavaud S, Jarno P, Giard M, L'Hériteau F, Simon L, Bieler L, Molinier L, Marcheix B, Venier AG, Simon L, Ali-Brandmeyer O, Neels C, Jarno P, Aupée M, Perennec M, Astagneau P, L'Hériteau F, Daniel F, Campion C, Giard M, Bernet C, Caillat-Vallet E, Venier AG, Bervas C, Reyreaud E, Baillet P, Costa Y, Jost JL, Merle V, Merlo L, Seguier JC, Malavaud S, Bruyere F, Thiolet JM, Barquin-Guichard S. Surgical site infection after valvular or coronary artery bypass surgery: 2008–2011 French SSI national ISO-RAISIN surveillance. J Hosp Infect 2015; 91:225-30. [DOI: 10.1016/j.jhin.2015.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 07/16/2015] [Indexed: 11/17/2022]
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Lottin M, Dufour M, Bourdenet G, Massy N, Dieu B, Varin R, Doucet J, Merle V. Signalement et analyse des erreurs médicamenteuses dans un CHU : méthode, résultats et intérêt. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.327] [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: 11/28/2022]
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15
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Fred A, Lucas M, Savalle C, Marini H, Froment L, Josset V, Merle V, Czernichow P. Médecins de santé publique en France 2006–2012 : et demain ? Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Lefebvre F, Merle V, Savoye G, Lemée V, Chapuzet C, Marini H, Géhanno JF, Chefson-Girault C, Gueit I, Freymuth F, Lerebours E, Czernichow P. Nosocomial transmission of measles: do we need extra precautions to avoid it? J Hosp Infect 2011; 79:185-7. [DOI: 10.1016/j.jhin.2011.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 05/25/2011] [Indexed: 11/15/2022]
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Buchbinder N, Dumesnil C, Pinquier D, Merle V, Filhon B, Schneider P, Vannier J. Pandemic A/H1N1/2009 influenza in a paediatric haematology and oncology unit: successful management of a sudden outbreak. J Hosp Infect 2011; 79:155-60. [DOI: 10.1016/j.jhin.2011.04.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
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Chouraki V, Savoye G, Dauchet L, Vernier-Massouille G, Dupas JL, Merle V, Laberenne JE, Salomez JL, Lerebours E, Turck D, Cortot A, Gower-Rousseau C, Colombel JF. The changing pattern of Crohn's disease incidence in northern France: a continuing increase in the 10- to 19-year-old age bracket (1988-2007). Aliment Pharmacol Ther 2011; 33:1133-42. [PMID: 21488915 DOI: 10.1111/j.1365-2036.2011.04628.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [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: 12/14/2022]
Abstract
BACKGROUND Crohn's disease incidence rates have stabilised in industrialised countries since the 1980s. Conversely, a continuing increase in childhood-onset Crohn's disease incidence has been reported. AIM To confirm trends in inflammatory bowel disease (IBD) incidence in northern France over an extended time period (1988-2007) with a focus on childhood-onset Crohn's disease. METHODS The IBD patients recorded in the EPIMAD registry between 1988 and 2007 were included. Standardised incidence rates were calculated for Crohn's disease and ulcerative colitis in the entire population, and separately according to age. Evolution of phenotypes at diagnosis was also studied. RESULTS A total of 12 084 incident IBD cases (7428 Crohn's disease and 4656 ulcerative colitis) were recorded. Crohn's disease incidence rates increased from 5.2 cases/100 000 persons in 1988-1990 to 6.7 in 2006-2007 (+29%), stabilising after a peak at 7.1 in 1997-1999. Crohn's disease incidence rates in the 10-19-year age category increased by 71%, from 6.5 (1988-1990) to 11.1 (2006-2007). The frequency of initial ileo-colonic localisation increased from 52.9% in 1988-1990 to 68.6% in 2006-2007 (P<0.0001). Ulcerative colitis incidence rates decreased during the same period. CONCLUSIONS From 1988 to 2007, Crohn's disease incidence increased by 29% in northern France and by 71% in the 10-19-year-old age group. Consequently, studies on Crohn's disease risk factors should focus on the population under 20 years of age.
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Affiliation(s)
- V Chouraki
- Registre des Maladies Inflammatoires Chroniques de l'Intestin du Nord Ouest de la France, Epidemiology Unit, Lille University Hospital, Lille Cedex, France
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Vasseur F, Gower-Rousseau C, Vernier-Massouille G, Dupas JL, Merle V, Merlin B, Lerebours E, Savoye G, Salomez JL, Cortot A, Colombel JF, Turck D. Nutritional status and growth in pediatric Crohn's disease: a population-based study. Am J Gastroenterol 2010; 105:1893-900. [PMID: 20145606 DOI: 10.1038/ajg.2010.20] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [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: 12/11/2022]
Abstract
OBJECTIVES Growth retardation and malnutrition are major features of pediatric Crohn's disease (CD). We examined nutritional and growth parameters from diagnosis to maximal follow-up in a population-based pediatric cohort, and we determined predictive factors. METHODS A total of 261 patients (156 boys, 105 girls) with onset of CD before the age of 17 were identified from 1988 to 2004 through the EPIMAD registry (Registre des Maladies Inflammatoires Chroniques de l'Intestin) in northern France. Median age at diagnosis was 13 years (11.2-15.4) and median follow-up was 73 months (46-114). Z-scores of height/age, weight/age, and body mass index (BMI)/age were determined. Multivariate stepwise regression analysis identified predictive factors for malnutrition and growth retardation at maximal follow-up. RESULTS At diagnosis, 25 children (9.5%) showed height less than -2 s.d., 70 (27%) weight less than -2 s.d., and 84 (32%) BMI less than -2 s.d. At maximal follow-up, growth retardation was present in 18 children (6.9%), whereas 40 (15%) had malnutrition. Nutritional status was more severely impaired in children with stricturing disease. Growth and nutritional retardation at diagnosis, young age, male gender, and extraintestinal manifestations at diagnosis were indicators of poor prognosis. A significant compensation was observed for weight and BMI in both genders and for height in girls. No treatment was associated with height, weight, or BMI at maximal follow-up. CONCLUSIONS In our pediatric population-based study, growth retardation and severe malnutrition were still present at maximal follow-up in 6.9 and 15% of CD children, respectively. Young boys with substantial inflammatory manifestations of CD have a higher risk of subsequent growth failure, especially when growth retardation is present at diagnosis.
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Affiliation(s)
- Francis Vasseur
- Pôle de Santé Publique, Parc Eurasanté, University Hospital, Université de Lille 2 EA2694, Lille Cedex, France
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Marini H, Merle V, Derrey S, Maréchal I, Froment L, Lebaron C, Fréger P, Czernichow P. Surveillance des événements indésirables graves (EIG) en neurochirurgie : utilisation du PMSI pour identifier les retours au bloc opératoire (RBO). Rev Epidemiol Sante Publique 2010. [DOI: 10.1016/j.respe.2010.02.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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21
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Pioc S, Merle V, Marini H, Josset V, Froment L, Czernichow P. Les droits des usagers du système de santé sont-ils respectés ? L’apport de la certification des établissements de santé : étude pilote en Haute-Normandie. Rev Epidemiol Sante Publique 2010. [DOI: 10.1016/j.respe.2010.02.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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22
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Audureau E, Merle V, Kerleau K, Dollois B, Baugé-Rousseau M, Théry S, Tavolacci MP, Dubreuil N, Thillard D, Gasparin-Grisel S, Mathieu M, Augé C, Czernichow P. [Information for patients about hospital infections in psychiatry: An assessment of healthcare professionals' knowledge, opinion and attitude]. Encephale 2009; 36:132-8. [PMID: 20434630 DOI: 10.1016/j.encep.2009.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 06/22/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION French legislation makes mandatory for healthcare providers the disclosure of hospital infection (HI) risk and actual occurrence to the patient. Given the specific diseases encountered in psychiatry, some difficulties may be expected in practical application of this regulation. OBJECTIVES The aim of our study was to describe the knowledge, declared practices and opinions of healthcare workers (HCW) in psychiatry concerning information for patients about HI. METHODS We randomly selected doctors, nurses and head nurses from four hospitals with psychiatric activity in Normandy. The HCW were asked to self-complete an anonymous questionnaire, including data describing the responding HCW and questions aiming at describing his/her knowledge, attitude in routine daily practice and opinion about information to patients about HI. RESULTS One hundred and forty-one HCW were initially selected, of which 114 (80.9%) eventually agreed to complete the questionnaire. Only eight HCW (7.0%) were considered to have a correct overall knowledge of legal obligations. Main errors concerned the obligation to inform the patient of the HI risk according to the medical procedures that are to be performed (43.9% of correct answers) and the obligation to inform the patient of the HI risk according to his/her medical condition (46.5%). The obligation to inform the patient of the occurrence of a HI was largely known (84.2%). HCW usually giving information about the risk of HI to patients without HI accounted for 5.3%. Main reasons advocated for not informing patients were a low level risk of HI in psychiatry (80.4%) and the lack of patients' demand (59.8%). In the case of HI occurrence, the percentage of HCW routinely informing patients was 13.2%. HCW systematically informing the patient's family about the occurrence of HI accounted for 9.6%. A large proportion of HCW supported delivering information to patients about HI (86.0%). HCW expected from information better approval of prevention programs by the patients (87.7%) but feared an increased anxiety in patients (75.4%) and a higher rate of care refusal (48.2%). CONCLUSION Whereas a very large proportion of HCW in psychiatry support delivering information to patients about HI, our study shows HCW's lack of awareness of regulations and lack of declared practices. Among factors explaining this contrast, a lower perceived HI risk and severity level are to be mentioned. Training programs focusing on risk and mechanisms of HI could be offered to professionals in psychiatry. The issue of specific communication difficulties with psychiatric patients should be addressed as well. In order to develop information on HI, specific methods suited to those patients should be developed.
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Affiliation(s)
- E Audureau
- Département d'épidémiologie et de santé publique, CHU de Rouen, France
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Etancelin P, Silly S, Merle V, Bonmarchand G, Richard JC, Vannier JP, Nouvellon M. Efficacité des mesures environnementales dans la prévention de l’aspergillose invasive nosocomiale liée aux travaux : bilan de cinq années d’expérience. ACTA ACUST UNITED AC 2009; 57:71-5. [DOI: 10.1016/j.patbio.2008.07.004] [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] [Received: 06/27/2008] [Accepted: 07/03/2008] [Indexed: 10/21/2022]
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Merle V, Germain JM, Tavolacci MP, Brocard C, Chefson C, Cyvoct C, Edouard S, Guet L, Martin E, Czernichow P. Influence of infection control report cards on patients' choice of hospital: pilot survey. J Hosp Infect 2009; 71:263-8. [PMID: 19147258 DOI: 10.1016/j.jhin.2008.11.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 11/25/2008] [Indexed: 11/19/2022]
Abstract
The impact on patients' attitudes of quality report cards on infection control in hospitals has never previously been studied. In 2006, the French government implemented a mandatory report card on infection control activity (ICALIN) in all hospitals. This approach was aimed at encouraging professionals to change their routine practices in case they should lose patients due to a low ICALIN score. Our objective was to assess what impact ICALIN could have on patients' attitude as regards hospital choice. We performed a survey of patients and visitors in 14 randomly selected hospitals of various ICALIN scores. A convenience sample of 381 patients and visitors completed an anonymous questionnaire on ICALIN, their reasons for choosing a hospital and attitude in the event of a low ICALIN score. Factors associated with interest in ICALIN and impact of ICALIN on hospital choice were assessed by logistic regression. Our results showed that 77% of participants were interested in ICALIN. ICALIN was ranked sixth as a reason for choosing a hospital. In the case of a low ICALIN, 24.1% of participants would refuse admission and 54.9% would seek advice from their general practitioner. Sociodemographic factors had no influence on patients' attitude. In conclusion, our survey suggests that patients take note of poor performance on infection control report cards. As most patients rely on their general practitioner to interpret these report cards, there is a definite need for further communication with general practitioners on this issue.
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Affiliation(s)
- V Merle
- Department of Epidemiology and Public Health, Rouen University Hospital, Rouen, France.
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Tavolacci MP, Griffon N, Richard JC, Merle V, Czernichow P. Surgical hand rubbing: knowledge and declared use of health care workers. Am J Infect Control 2008; 36:606-7. [PMID: 18926321 DOI: 10.1016/j.ajic.2008.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 02/27/2008] [Accepted: 02/29/2008] [Indexed: 11/17/2022]
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26
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Chouraki V, Dauchet L, Merle V, Dupas JL, Lerebours E, Vernier-Massouille G, Marti R, Salomez JL, Cortot A, Gower-Rousseau C, Colombel JF. Incidence de la maladie de Crohn et de la rectocolite hémorragique dans le nord de la France de 1988 à 2005 : résultats du registre EPIMAD. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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27
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Czernichow P, Mercierb A, Kerhuelb N, Hallais C, Merle V, Bécretb F. Pourquoi la prise en charge des patients dépressifs est-elle difficile ? Perceptions comparées des médecins généralistes en France et en Angleterre. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.045] [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: 11/29/2022] Open
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28
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Merle V, Hallais C, Savoye G, Scotté M, Wurtz B, Blot J, Froment L, Lerebours E, Czernichow P. La revue des réadmissions imprévues permet-elle d’améliorer la qualité des soins ? Étude pilote de faisabilité dans deux services cliniques. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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29
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Hallais C, Bailly L, Coussens E, Mercier A, Froment L, Merle V, Godard J, Czernichow P. Comment assurer la qualité de surveillance des patients traités pour cancer de la prostate ? Enquête en Haute-Normandie. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.202] [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: 10/21/2022] Open
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30
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Hallais C, Moreau A, Merle V, Guitard PG, Haghighat S, Thillard D, Tavolacci MP, Veber B, Czernichow P. Évaluation coût–efficacité de l’utilisation de sondes d’intubation à aspiration sous-glottique pour la prévention des pneumopathies sous ventilation. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Merle V, Marini H, Rongère J, Scotté M, Tavolacci MP, Czernichow P. Une plaquette d’information sur les infections du site opératoire (ISO) permet-elle d’améliorer le souvenir de l’information et la satisfaction des patients ? Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.209] [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: 11/29/2022] Open
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32
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Marini H, Merle V, Frébourg N, Godier S, Bastit D, Benadiba L, Menguy E, Quesney M, Plissonnier D, Czernichow P. Mycoplasma hominis wound infection after a vascular allograft. J Infect 2008; 57:272-4. [PMID: 18649944 DOI: 10.1016/j.jinf.2008.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Revised: 05/14/2008] [Accepted: 06/06/2008] [Indexed: 10/21/2022]
Abstract
Cases of Mycoplasma hominis infections after allograft are rare. We report a case of M. hominis wound infection after a vascular allograft. The allograft was positive before having any contact with the recipient, and our investigation suggests that M. hominis may have been transmitted from the donor to the recipient. It is not clear, however, whether specific diagnosis of M. hominis should be performed on tissue before grafting in order to prevent such donor-to-host transmission.
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Affiliation(s)
- H Marini
- Department of Epidemiology and Public Health, Rouen University Hospital, Rouen, France.
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Merle V, Hallais C, Wurtz B, Blot J, Daubert H, Froment L, Josset V, Savoye G, Scotté M, Czernichow P. La création du dossier informatisé de séjour avant l’admission est-elle un bon marqueur de programmation des réadmissions ? Étude dans un pôle médical d’activité de CHU. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.02.064] [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: 10/22/2022] Open
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34
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Merle V, Tavolacci MP, Moreau A, Dubreuil N, Dollois B, Gray C, Kerleau K, Théry S, Czernichow P. What factors influence healthcare professionals' opinion and attitude regarding information for patients about hospital infection? J Hosp Infect 2007; 66:269-74. [PMID: 17574303 DOI: 10.1016/j.jhin.2007.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2006] [Accepted: 04/26/2007] [Indexed: 11/28/2022]
Abstract
Although informing patients about medical risks is said to decrease the number of malpractice claims, most inpatients receive no information about hospital infection. Using a self-administered questionnaire, we surveyed 1270 healthcare workers randomly selected from 22 French hospitals to assess their opinion on information for patients about hospital infection risks, and their practice of informing patients with, or without, hospital infection. The influence of healthcare worker characteristics on opinion and practice was assessed using logistic regression. Response rate was 87.2%. Although 85.4% supported giving more information, only 17.0% routinely informed non-infected patients and 31.6% informed infected patients about infection. Attitudes were influenced by healthcare worker characteristics and environmental factors. Knowledge of obligations influenced practice when informing non-infected patients, but not those with hospital-acquired infection. Further research is needed to help healthcare professionals improve risk communication and disclosure of hospital infection.
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Affiliation(s)
- V Merle
- Réseau CoCLINNOR, Rouen University Hospital, Rouen, France.
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35
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Tavolacci MP, Marini H, Vanheste S, Merle V, Coulon AM, Micaud G, Czernichow P. A voluntary ingestion of alcohol-based hand rub. J Hosp Infect 2007; 66:86-7. [PMID: 17350719 DOI: 10.1016/j.jhin.2007.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 01/17/2007] [Indexed: 11/23/2022]
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36
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Lerebours E, Gower-Rousseau C, Merle V, Brazier F, Debeugny S, Marti R, Salomez JL, Hellot MF, Dupas JL, Colombel JF, Cortot A, Benichou J. Stressful life events as a risk factor for inflammatory bowel disease onset: A population-based case-control study. Am J Gastroenterol 2007; 102:122-31. [PMID: 17100973 DOI: 10.1111/j.1572-0241.2006.00931.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Stress is often perceived by patients with inflammatory bowel disease (IBD) as the leading cause of their disease. The aim of this study was to assess whether stress, evaluated through life event (LE) occurrence, is associated with IBD onset. METHODS Incident cases of IBD, including 167 patients with Crohn's disease (CD) and 74 with ulcerative colitis (UC), were compared with two control groups, one of 69 patients with acute self-limited colitis (ASLC) and another of 255 blood donors (BDs). Stress was assessed using Paykel's self-questionnaire of LEs. Only LEs occurring within 6 months before the onset of symptoms in IBD cases and ASLC controls and before blood donation in BD controls were registered. Anxiety and depression were assessed using Bate's and Beck's questionnaires, respectively. RESULTS In univariate analysis, occurrence of LEs was more frequent in the 6-month period prior to diagnosis in CD cases than in UC cases or either control group. After adjustment for depression and anxiety scores as well as other characteristics such as smoking status and sociodemographic features, this association appeared no longer significant. No associations were noted between occurrence of LEs and onset of UC relative to controls. CONCLUSIONS Despite its separate association with CD, LE occurrence does not appear to be an independent risk factor for IBD onset.
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Affiliation(s)
- Eric Lerebours
- Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, CHU de Lille, 59037 Lille Cedex, France
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Tavolacci MP, Merle V, Pitrou I, Thillard D, Serra V, Czernichow P. Alcohol-based hand rub: influence of healthcare workers' knowledge and perception on declared use. J Hosp Infect 2006; 64:149-55. [PMID: 16891041 DOI: 10.1016/j.jhin.2006.05.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2005] [Accepted: 05/26/2006] [Indexed: 10/24/2022]
Abstract
Handrubbing with alcohol-based hand rub (AHR) is a validated alternative to handwashing. The aims of this study were to compare knowledge and declared use of AHR between different categories of healthcare worker (HCW), and to assess factors associated with the use of AHR. A standardized questionnaire was sent to all HCWs in a tertiary care university hospital. The following data were collected for each HCW: job title (physician, nurse, nursing assistant or other), sources of information about AHR; knowledge and perception of AHR and declared use of AHR in daily practice instead of unmedicated or antiseptic soap. Of 5238 questionnaires, 1811 were returned. Physicians had better knowledge about AHR than other HCWs. HCWs' knowledge of AHR efficacy and skin tolerance were independently associated with the use of AHR instead of unmedicated or antiseptic soap. The declared use of AHR differed according to professional category.
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Affiliation(s)
- M P Tavolacci
- Department of Epidemiology and Public Health, Rouen University Hospital, Rouen, France.
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Merle V, Germain J, Tavolacci M, Brocard C, Chefson-Girault C, Cyvoct C, De Quin-Gorce M, Édouard S, Guet L, Martin E, Czernichow P. C1-3 - L’indice composite des activités de lutte contre les infections nosocomiales (ICALIN): connaissances et attitude des patients et des usagers. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76815-8] [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: 11/17/2022] Open
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Germain J, Merle V, Tavolacci M, Astagneau P, Czernichow P. C1-2 - Qualité des données servant au calcul de l’Indice composite des activités de lutte contre les infections nosocomiales (ICALIN). Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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40
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Josset V, Riou F, Moret L, Beuret-Blanquart F, Pascal M, Ferreol S, van Doren C, Berard M, Micaud G, Marc F, Gallien P, Merle V, Petit J, Lombrail P, Czernichow P. P3-5 - Comparaison de « performances » entre équipes d’établissements de santé : exemple des patients admis en soins de suite et de réadaptation (SSR) — Projet INPEC (H). Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76901-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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41
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Merle V, Tavolacci M, Moreau A, Dubreuil N, Dollois B, Gray C, Kerleau K, Théry S, Czernichow P. C1-4 - Information des patients sur les infections nosocomiales : connaissances, attitudes et opinions des professionnels de santé. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76816-x] [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: 11/17/2022] Open
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42
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Ladner J, Delbos V, Dauchet L, Tavolacci M, Merle V, Czernichow P. P9-8 - Un enseignement d’épidémiologie basé sur la lecture critique d’article (LCA) dans le second cycle des études médicales : Expérience à l’UFR de Médecine de Rouen, 2003-2005. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76932-2] [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: 11/16/2022] Open
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Tavolacci M, Merle V, Thillard D, Czernichow P. E1-5 - Connaissances et pratiques d’utilisation des Produits hydro-alcooliques (PHA) pour l’hygiène des mains chez les médecins et les soignants dans un Centre Hospitalier Universitaire. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76856-0] [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: 10/22/2022] Open
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Tavolacci MP, Pitrou I, Merle V, Haghighat S, Thillard D, Czernichow P. Surgical hand rubbing compared with surgical hand scrubbing: comparison of efficacy and costs. J Hosp Infect 2006; 63:55-9. [PMID: 16517006 DOI: 10.1016/j.jhin.2005.11.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Accepted: 11/22/2005] [Indexed: 11/16/2022]
Abstract
The aim of this study was to compare the efficacy of surgical hand rubbing (SHR) with the efficacy of surgical hand scrubbing (SHS), and to determine the costs of both techniques for surgical hand disinfection. A review of studies reported in the literature that compared the efficacy of SHS and SHR was performed using MEDLINE. The costs of SHR and SHS were estimated based on standard hospital costs. The literature showed that SHR had immediate efficacy that was similar to that of SHS, but SHR had a more lasting effect. SHR reduced costs by 67%. In conclusion, SHR is a cost-effective alternative to SHS.
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Affiliation(s)
- M P Tavolacci
- Department of Epidemiology and Public Health, Rouen University Hospital, France.
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Merle V, Van Rossem V, Tavolacci MP, Czernichow P. Knowledge and opinions of surgical patients regarding nosocomial infections. J Hosp Infect 2005; 60:169-71. [PMID: 15866016 DOI: 10.1016/j.jhin.2004.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2004] [Accepted: 09/09/2004] [Indexed: 11/16/2022]
Abstract
UNLABELLED Sixty-five inpatients in various surgery departments were questioned about their knowledge and opinions regarding nosocomial infection, the information they were given on nosocomial infection, and their supposed attitude should they contract a nosocomial infection. RESULTS Seventeen (26%, [16-39%]) were able to describe nosocomial infections as infections acquired in hospital. Identification of nosocomial infections as hospital-acquired infections was significantly associated with a high educational level and with having a member of their own family working in a health-related field. Fifty-two patients (80.0%, [68.2-88.9%]) stated that during their hospitalization they had received no information concerning nosocomial infections and 50 patients (76.9% [64.8-86.5]) mentioned that patients would welcome information about nosocomial infections. Thirty-three patients [50.8, 95% CI(38.6-62.9%)] declared that they would seek legal action against the hospital should they contract a nosocomial infection. There was a trend toward a higher probability of legal action in patients who rated their own risk of nosocomial infection as low or absent versus those who rated their own risk of nosocomial infection as medium or high (58.0% vs. 28.6%, p=0.051). The intention of seeking legal action against the hospital in case of nosocomial infection was not significantly influenced by patients' opinion regarding nosocomial infection preventability.
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Affiliation(s)
- V Merle
- Department of Epidemiology and Public Health, Rouen University Hospital, Rouen, France.
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Baron S, Turck D, Leplat C, Merle V, Gower-Rousseau C, Marti R, Yzet T, Lerebours E, Dupas JL, Debeugny S, Salomez JL, Cortot A, Colombel JF. Environmental risk factors in paediatric inflammatory bowel diseases: a population based case control study. Gut 2005; 54:357-63. [PMID: 15710983 PMCID: PMC1774426 DOI: 10.1136/gut.2004.054353] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.2] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Environmental exposures in early life have been implicated in the aetiology of inflammatory bowel disease. OBJECTIVE To examine environmental risk factors prior to the development of inflammatory bowel disease in a paediatric population based case control study. METHODS A total of 222 incident cases of Crohn's disease and 60 incident cases of ulcerative colitis occurring before 17 years of age between January 1988 and December 1997 were matched with one control subject by sex, age, and geographical location. We recorded 140 study variables in a questionnaire that covered familial history of inflammatory bowel disease, events during the perinatal period, infant and child diet, vaccinations and childhood diseases, household amenities, and the family's socioeconomic status. RESULTS In a multivariate model, familial history of inflammatory bowel disease (odds ratio (OR) 4.3 (95% confidence interval 2.3-8)), breast feeding (OR 2.1 (1.3-3.4)), bacille Calmette-Guerin vaccination (OR 3.6 (1.1-11.9)), and history of eczema (OR 2.1 (1-4.5)) were significant risk factors for Crohn's disease whereas regular drinking of tap water was a protective factor (OR 0.56 (0.3-1)). Familial history of inflammatory bowel disease (OR 12.5 (2.2-71.4)), disease during pregnancy (OR 8.9 (1.5-52)), and bedroom sharing (OR 7.1 (1.9-27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor (OR 0.06 (0.01-0.36)). CONCLUSIONS While family history and appendicectomy are known risk factors, changes in risk based on domestic promiscuity, certain vaccinations, and dietary factors may provide new aetiological clues.
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Affiliation(s)
- S Baron
- Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, Lille, France
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Josset V, Chamouni P, Tavolacci MP, Merle V, Delbos V, Froment L, Ladner J, Ounnoughene N, Czernichow P. [Efficiency of hepatitis C virus screening before and after blood transfusion]. Transfus Clin Biol 2004; 11:186-91. [PMID: 15564099 DOI: 10.1016/j.tracli.2004.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED Efficiency of a viral hepatitis C screening strategy before and after blood transfusion has to be evaluated. METHODS Four screening strategies were virtually applied to the population of transfused patients at Rouen University Hospital during 1996 and then compared : the first without any systematic HCV screening test; the second with systematic testing both before and 3 months after transfusion; the third with systematic testing both before and 6 months after transfusion ; the last defined as systematic testing before transfusion only. The efficacy (i.e. number of positive tests), the efficiency (i.e. average cost per positive test) and the marginal costs of moving from a strategy to another one were assessed using decision analysis. RESULTS The efficacy of systematic screening test before transfusion only (361 per positive test), systematic testing both before and three months after (523 per positive test) or six months after (488 per positive test) transfusion was similar, but the efficacy of the strategy without any systematic screening test (385 per positive test) was lower. The systematization of screening test both before, and three months, or 6 months after transfusion lead to a marginal cost of 619 , and 559 per positive test respectively. The systematization of testing before transfusion only lead to a marginal cost of 343 per positive test. Adding systematic testing after transfusion lead to a marginal cost of 5824 per positive test. CONCLUSION Systematic screening tests before transfusion only can be considered as the most efficient strategy.
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Affiliation(s)
- V Josset
- Département d'épidémiologie et de santé publique, Unité d'information médicale, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
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Josset V, Chamouni P, Merle V, Tavolacci MP, Froment L, Daubert H, Ladner J, Czernichow P. [Survival after blood transfusion: a study at Rouen university hospital]. Transfus Clin Biol 2004; 11:199-204. [PMID: 15564101 DOI: 10.1016/j.tracli.2004.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/26/2022]
Abstract
UNLABELLED The aim of this study was to estimate short term survival rate after blood transfusion according to various criteria. PATIENTS AND METHODS Patients admitted and transfused from January, 1 until June, 30 1996 at Rouen university hospital were retrospectively included, and their status (alive or dead) was determined. The characteristics of patients admitted and transfused were compared to the overall population of inpatients. Independent factors associated with mortality six months after blood transfusion were evaluated using Cox model. RESULTS During the study period, 1887 patients were transfused. These patients were older, more often admitted in surgical or in intensive care units, and had a longer duration of stay, than the overall inpatients population. The survival rate at six months in transfused patients was 76.1%. Mortality rate at six months was independently higher in patients aged 75 and older, in men, in patients admitted in intensive care units, or transfused with homologous fresh-frozen plasma or packed platelet blood cells. Mortality rate was lower in patients who underwent a surgical procedure, in children under 16, and in patients whose stay was classified in "Circulatory system disorders", "Musculoskeletal system and connective tissues disorders or trauma", or "Injuries, allergy or poisoning". CONCLUSION In this study implemented in a teaching hospital inpatients receiving blood transfusion, the survival was mainly associated with the severity and characteristics of the diseases requiring transfusion.
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Affiliation(s)
- V Josset
- Département d'épidémiologie et de santé publique, CHU--Hôpitaux de Rouen, 1, rue de Germont, 76031 Rouen, France.
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Merle V, Moret L, Josset V, Pidhorz L, Piétu G, Gouin F, Riou F, Chassagne P, Petit J, Lombrail P, Czernichow P, Dujardin F. Facteurs de qualité de la prise en charge des sujets âgés opérés d’une fracture de l’extrémité supérieure du fémur. ACTA ACUST UNITED AC 2004; 90:504-16. [PMID: 15672917 DOI: 10.1016/s0035-1040(04)70424-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/28/2022]
Abstract
Hip fractures are one of the leading causes for admission of elderly subjects to healthcare facilities. Because of population aging, the incidence of hip fractures has increased considerably over the last years and will continue to increase in industrialized countries. Hip fracture in an elderly subject may be life threatening and has a significant functional and social impact not only because of the fracture itself, but also because of the risk of complications related to the patient's health status and the long hospital stay. The purpose of this work was to identify in the published literature professional practices, excepting the surgical procedure, associated with better early and long-term outcome in elderly patients with hip fracture. Questions raised concerning the patient's hospital stay include factors related to the preoperative phase (time to surgery, usefulness of traction), the operation itself (antibiotic prophylaxis, anesthesia technique), and the postoperative phase (prevention of venous thrombosis, malnutrition, episodes of confusion, duration of indwelling bladder catheter, correction of anemia, geriatric care during the stay in the orthopedic ward, early and intense rehabilitation, prevention of recurrence). Among these factors, several appear to be associated with better outcome, including long-term outcome--surgery as early as possible in light of the patient's general status, antibiotic prophylaxis in accordance with standard recommendations (SFAR), prevention of venous thrombosis with low-molecular-weight heparin initiated at admission and associated with elastic contention. Oral nutritional support is probably beneficial and should be proposed for all patients. Particular attention must be given to prevention of confusion in order to reduce the rate of institutionalization. The rythm of rehabilitation exercises should be at least five sessions per week. Finally, there are several methods, which are effective in preventing recurrence, taking into account osteoporosis, risk of falls. Preventive measures should be instituted for all patients undergoing surgery for hip fracture.
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Affiliation(s)
- V Merle
- Département d'Epidémiologie et de Santé Publique, CHU de Rouen, Hôpitaux de Rouen, 1, rue de Germont, 76031 Rouen Cedex
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Basuyau F, Josset V, Merle V, Czernichow P. Case fatality and health care costs in HIV-infected patients: evolution from 1992 to 2000 at Rouen University Hospital, France. Int J STD AIDS 2004. [DOI: 10.1258/0956462041944420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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