Search results for "HUMAN HEALTH"
showing 10 items of 1622 documents
Chest trauma: First 48 hours management
2017
International audience; Chest trauma remains an issue for health services for both severe and apparently mild trauma management. Severe chest trauma is associated with high mortality and is considered liable for 25% of mortality in multiple traumas. Moreover, mild trauma is also associated with significant morbidity especially in patients with preexisting conditions. Thus, whatever the severity, a fast-acting strategy must be organized. At this time, there are no guidelines available from scientific societies. These expert recommendations aim to establish guidelines for chest trauma management in both prehospital an in hospital settings, for the first 48 hours. The ``Societe francaise d'ane…
A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes
2015
Contains fulltext : 152084.pdf (Publisher’s version ) (Open Access) BACKGROUND: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. MATERIALS AND METHODS: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of tre…
Childhood maltreatment and clinical severity of treatment‐resistant depression in a French cohort of outpatients (FACE‐DR): One‐year follow‐up
2020
International audience; Childhood maltreatment is associated with major depressive disorder (MDD). It not only increases the risk of lifetime MDD, but it also aggravates its course. Among depressed patients, 20-30% of them experience treatment-resistance depression (TRD). We aimed to assess the association between childhood maltreatment, severity of depression in a unipolar TRD sample, and patient outcomes after one-year of follow-up. Methods: Patients were recruited for a prospective cohort from the French network of TRD expert centers. Depressive symptom severity was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Quick Inventory of Depressive Symptomatology se…
Review of European and American guidelines for the diagnosis of Lyme borreliosis
2019
International audience; Lyme disease is a tick-borne bacterial disease with polymorphic clinical manifestations (cutaneous, rheumatological, and neurological). In recent years the issue of the diagnosis of this infection has been highly publicized on the Internet and other media in Europe and America. Some patients and physicians may share the perception that the diagnosis of the infection is not reliable in France. We reviewed current European and American guidelines on Lyme disease and performed a methodological evaluation of all guidelines. We retrieved 16 guidelines from seven countries. Our analysis revealed a global consensus regarding diagnosis at each stage of the infection. All gui…
Digoxin-related leukocytoclastic vasculitis in a very elderly woman: A case report
2016
International audience; Even though digoxin causes many side effects, few cases of skin involvement are recorded in the French Pharmacovigilance Database. We report a case of leukocytoclastic vasculitis (LV) very probably due to digoxin. A 91-year-old woman, hospitalized following a fall, presented cardiac decompensation in a context of rapid atrial fibrillation requiring treatment with digoxin. Eight days later, a rash appeared on her back and trunk. It was neither itchy, nor painful and persisted despite local treatment. There were no other clinical anomalies. After a few days, the rash spread with appearance of bullous lesions, ulcerations and a necrosis on lymphedema of the two legs. Am…
Prolonged-release buprenorphine formulations: Perspectives for clinical practice
2020
International audience; Buprenorphine and methadone are the two main opioid agonist treatments approved for opioid use disorder. Buprenorphine is a partial agonist of the mu opioid receptors, which has been merely available through sublingual form until now. In practice, the use of buprenorphine is smoother than that of methadone, and it induces reduced risks of overdose. However, sublingual buprenorphine also exposes to risks (e.g., withdrawal, misuse) and constraints (e.g., daily intake). Three new galenic formulations of prolonged-release buprenorphine (PRB) are being commercialized and should allow some improvements in patients' comfort and safety. This narrative review aims to describe…
Smartphone-based ecological momentary assessment (EMA) in psychiatric patients and student controls: A real-world feasibility study
2020
Abstract Background Smartphone-based ecological momentary assessment (EMA) is a promising methodology for mental health research. The objective of this study is to determine the feasibility of smartphone-based active and passive EMA in psychiatric outpatients and student controls. Methods Two smartphone applications —MEmind and eB2— were developed for behavioral active and passive monitoring. The applications were tested in psychiatric patients with a history of suicidal thoughts and/or behaviors (STB), psychiatric patients without a history of STB, and student controls. Main outcome was feasibility, measured as response to recruitment, retention, and EMA compliance. Secondary outcomes were…
0137 : Takotsubo cardiomyopathy following acute cerebral events
2016
International audience; ObjectiveTakotsubo cardiomyopathy is characterized by a transient apical ventricular dysfunction typically induced by an acute stress. Acute cerebral events including ischemic stroke (IS) or Epileptic Event (EE) may both be associated with massive catecholamine release. We aimed to identify the characteristics and outcomes of patients who experienced Takotsubo syndrome complicating an IS or EE.MethodsBetween 2008 and 2013, 87 patients were admitted in our Intensive Care Unit for suspected Takotsubo syndrome, of whom 6 previously experienced acute cerebral symptoms with either IS or EE, within two days. Takotsubo syndrome was diagnosed on Cardiac Magnetic Resonance, e…
Assessment and management of agitation in psychiatry: Expert consensus
2016
International audience; BACKGROUND:Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions.METHODS:An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items.RESULTS:Out of 2175 papers assessing psychomo…
Experience of medical students mentoring in an acute geriatric unit: Use of evidence-based medicine
2019
International audience; n a retrospective study, we studied the learning experience of second and third year undergraduate medical students in the acute geriatric unit of a University Hospital.Students who did not receive Evidence based medicine (EBM) classes had lower grades than those who did in the final theoretical and practical evaluations (p < .01).Our experience suggested that the implementation of EBM in the curriculum through small, structured semiology courses tailored to the specificities of the elderly improved Evidence based practices for undergraduate medical students. EBM should improve instruction and mentoring during undergraduate students' clinical rotation.