0000000000140841
AUTHOR
Philippe D’athis
Age–Period–Cohort Analysis of Stroke Incidence in Dijon From 1985 to 2005
Background and Purpose— Variations in stroke incidence could be explained by changes in vascular and environmental factors that affect the risk of stroke and changes in risk factors that are present in early life. The aim of this study was to identify and measure the effects of 3 interrelated factors, age, calendar period of stroke onset, and birth year cohort, on the incidence rates of stroke from 1985 through 2005. Methods— Age–period–cohort models were used to analyze stroke incidence in Dijon from 1985 to 2005 from a population-based registry that collects data on all stroke patients whatever the type of management, in the public hospital, private hospitals, or at home, in the populati…
Impact of an ambulatory physical activity program on balance and motor abilities of retirees: a prospective study
International audience; BACKGROUND:Given the public health problem generated by posture and gait disorders, a preventive approach is essential.OBJECTIVE:We investigated the impact of an ambulatory physical activity program (APAP) on the motor skills of retirees.METHOD:Retirees ≥ 60 years were recruited in this prospective study. The APAP was supported by a French regional health insurance plan. Between inclusion (T0) and 12 weeks (T1), subjects participated in an APAP (1 hour/week) that included strengthening muscular exercises, balance work, joint flexibility exercises, one-leg-balance test (OLB), stimulation of the foot arch, and rise-from-the-floor (RFF). Timed-up-and-go test (TUG) durat…
Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population
Platelet aggregation inhibitors (PAI) have widely proven their efficiency for the prevention of ischemic cardiovascular events. We aimed to describe PAI prescription in an elderly multimorbid population and to determine the factors that influence their prescription, including the impact of age, comorbidities and frailty, evaluated through a comprehensive geriatric assessment. This cross-sectional study included all patients admitted to the acute geriatric department of a university hospital from November 2016 to January 2017. We included 304 consecutive hospitalized patients aged 88.7 ±
Blood group related antigens in ocular cicatricial pemphigoid
Aim: To study the MUC5AC and the blood group related antigen expression in ocular cicatricial pemphigoid (OCP) according to the distribution of Lewis and secretor phenotypes in OCP patients compared to normal subjects. Methods: Immunostaining was performed on conjunctival biopsy specimens from 22 consecutive patients suffering from OCP, using monoclonal antibodies (Mabs) directed against the peptidic core MUC5AC mucin (anti-M1/MUC5AC Mabs) and against the saccharide moieties (anti-blood group related antigens). These latter included anti-Lea, anti-Leb, anti-sialyl Lea, and H type 2 Mabs, which immunoreact with Lewis positive and non-secretor (Lea), Lewis positive and secretor (Leb), Lewis p…
Caractéristiques et motivations des médecins français ayant choisi d’émigrer en Grande-Bretagne
Abstract Background As member states in the European Union now recognize the national qualifications of other member states, doctors will be able to move more freely within Europe according to the opportunities on offer and the constraints imposed by the different health-care systems. The aim of this study is to understand the reasons why French doctors choose to work in Great Britain. Method A self-completed questionnaire was used to conduct a survey among French doctors registered with the British Medical Council in 2005 who had done their studies in France and for whom the address was correct. Results The response rate, which was difficult to assess (impossible to distinguish between inc…
Potentially inappropriate use of furosemide in a very elderly population: An observational study
International audience; ObjectiveLittle is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients.MethodsAll patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included.ResultsAmong 15 141 patients with a median age of 86 years, comprising 61.3% of women, 3937 patients (26%) had a prescription for furosemide. Severe heart failure was the most common chronic comorbidity (27.7%). Furosemide was considered a long-term therapy for almost all patients (98.7% with prescripti…
Assessment of induced corneal hypoxia in diabetic patients
Comparative Study Address correspondence and reprint requests to Dr. C. Creuzot-Garcher, Service d'Ophtalmologie, CHU, Hopital Général, 3 Rue du Faubourg Raines, BP 1519, 21033 Dijon, France. E-mail: Catherine.creuzot-garcher@chu-dijon.fr; To assess the control of corneal hydration in patients with diabetes during a contact lens-induced hypoxia. Corneal stress was induced in 15 patients with diabetes and 23 healthy patients by having them wear contact lenses for 2 hours. Pachymetries were measured and corneal parameters (percentage recovery per hour [PRPH], time for deswelling [T99%] and induced swelling [IS]) were calculated. In the mean time, tears were collected to assess the activity of…
Évaluation de la prescription des inhibiteurs de la pompe à protons chez la personne âgée de 75 ans et plus dans un service de gériatrie aiguë
Resume Introduction et objectifs Les inhibiteurs de la pompe a protons (IPP) sont tres prescrits en France et seraient responsables d’effets indesirables non negligeables surtout chez la personne âgee (PA). Afin de limiter leur mesusage et un surcout pour la securite sociale, la Haute Autorite de sante (HAS) a edite des recommandations de prescription strictes. Nous avons conduit une etude chez la PA dont l’objectif principal etait d’evaluer le taux de prescription d’IPP hors recommandations de la HAS. Methode Il s’agissait d’une etude prospective, monocentrique et observationnelle portant sur des PA de 75 ans et plus admises dans un service de geriatrie aigue, sur une periode de 6 mois. La…
Multidisciplinary management in geriatric day-hospital is beneficial for elderly fallers: A prospective study of 28 cases
We determined whether management including medical, psychological, and physiotherapeutic approaches, over a period of 6 weeks, has a beneficial effect on motor abilities, psychological status, and independence of elderly fallers with psychomotor disadaptation syndrome (PDS). We included 28 subjects (mean age 81.4 years). They were assessed from a medical, motor, and psychological point of view at both the inclusion and the end of the multidisciplinary intervention. A follow-up was conducted with multidisciplinary assessment at 6 and 9 months after the beginning of the study in order to evaluate duration of benefits of the management. The statistical analysis concerned only subjects who took…
The Prescription of Vitamin K Antagonists in a Very Old Population: A Cross-Sectional Study of 8696 Ambulatory Subjects Aged Over 85 Years
We compared very elderly people taking vitamin K antagonists (VKA) and those not taking VKA (noVKA). Individuals were included in the noVKA group if there was no VKA on their reimbursed prescriptions during the study period. We also compared three subgroups, constituted by VKA type (fluindione, warfarin, or acenocoumarol). We included individuals aged over 85 years, affiliated to Mutualité
Falsely elevated intraocular pressure due to increased central corneal thickness
PURPOSE: To evaluate whether ocular hypertensive subjects have a higher central corneal thickness than other individuals. METHODS: In this prospective study, 48 subjects with ocular hypertension, 63 patients with open-angle glaucoma, 56 nonglaucomatous patients with diabetes mellitus, and 106 control subjects were evaluated. Corneal thickness was measured by ultrasound pachymetry, and intraocular pressure was determined by Goldmann applanation tonometry. RESULTS: Central corneal thickness was significantly higher in the ocular hypertensive subjects, mean +/- S.D., 592+/-39 microm, than in the patients with glaucoma (536+/-34 microm), the nonglaucomatous patients with diabetes mellitus (550+…
Comparaison des caractéristiques et des motivations des médecins expatriés français et britanniques
Resume Position du probleme Les phenomenes migratoires dans les populations de medecins etant encore peu etudies, malgre l’importante de connaitre la demographie medicale, cette etude vise a determiner les caracteristiques et les motivations des medecins francais installes au Royaume-Uni et des medecins britanniques installes en France. Methodes Il s’agit d’une etude transversale par auto-questionnaire adresse en 2005 a tous les medecins francais exercant en Grande-Bretagne et en 2009 a tous les medecins britanniques exercant en France, en utilisant les donnees officielles des conseils nationaux de medecins. Ce questionnaire, developpe pour l’etude et envoye par courrier, explorait les moti…
The prescription of direct oral anticoagulants in the elderly: An observational study of 19 798 Ambulatory subjects.
International audience; Objective Direct oral anticoagulants (DOACs) are increasingly prescribed to elderly people, but the epidemiologic data for this population remains scarce. We compared the elderly population taking DOACs and those not taking DOACs (noDOAC). Method We included individuals over 75 years old, affiliated to Mutualite Sociale Agricole of Burgundy (a French regional health insurance agency), who had been refunded for a prescribed DOAC between 1st and 30th September 2017. The DAOC group (DAOCG) and noDOAC group (noDOACG) were compared in terms of demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs. In the DOACG, we compared the…
Changes in blood pressure in a large cohort of elderly individuals: Study 3C
Summary Objective Analysis of changes in blood pressure with a two-year interval, and of factors associated with this change, in a large cohort of elderly individuals. Methods Follow-up of a cohort of 9294 individuals aged 65 years and over recruited from the general population for Study 3C. Changes in blood pressure are defined as the difference in its averages between the inclusion visit and the follow-up visit at 2 years. The factors associated with changes in systolic blood pressure were identified by univariate and multivariate analyses. Results Systolic and diastolic blood pressure decreased on average by 7.60 mmHg and 4.45 mmHg respectively in 7659 individuals included in the study b…