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Sabate JM, Deutsch D, Melchior C, Entremont A, Mion F, Bouchoucha M, Façon S, Raynaud JJ, Zerbib F, Jouët P. COVID-19 pandemic and lockdown stress consequences in people with and without Irritable Bowel Syndrome. ACTA ACUST UNITED AC 2021; 18:100660. [PMID: 34150971 PMCID: PMC8206631 DOI: 10.1016/j.jemep.2021.100660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/21/2021] [Indexed: 12/19/2022]
Abstract
Background While all resources have been mobilized to fight COVID-19, this study aimed to analyze the consequences of lockdown and pandemic stress in participants with and without Irritable Bowel Syndrome (IBS). Methodology An online survey was proposed to people with or without IBS during the exponential phase of the pandemic in France. The questionnaire included questions about socio-demographic data, conditions of confinement, activities carried out, IBS characteristics, measurement of stress level, consequences on sleep, fatigue, anxiety and depression, and quality of life (both perceived non-specific and specific for IBS). Results/Discussion From March 31 to April 15, 2020, 304 participants, 232 with IBS and 72 without were included in the survey (mean age: 46.8 ± 16.8 years, female gender: 75.3%). Age, level of education, financial resources, living space per person and activities performed during confinement were identical in both groups. Stress linked to fear of COVID-19, lockdown and financial worries was at the same level in both groups, but the psychological consequences and deterioration of quality of life (QOL) were both higher in IBS participants. In a univariate analysis, teleworking, solitary confinement, and low household resources had a variable impact on the scores of depression, anxiety, fatigue and non-specific perceived QOL, but in a multivariate analysis, the only factor explaining a deterioration of non-specific QOL was the fact of suffering from IBS. Conclusion/Perspectives Stress linked to the COVID-19 pandemic and confinement is high and equivalent in both IBS and non-IBS participants, with higher psychological and QOL consequences in IBS patients who have altered coping capacities.
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Affiliation(s)
- J-M Sabate
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France.,INSERM U-987, Pathophysiology and Clinical Pharmacology of pain, Ambroise-Paré Hospital, 92100 Boulogne-Billancourt, France
| | - D Deutsch
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - C Melchior
- Gastroenterology Department and INSERM CIC-CRB 1404, Rouen University Hospital and INSERM UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy University, 76031 Rouen, France
| | - A Entremont
- 28, place du marché Saint-Honoré, 75001 Paris, France
| | - F Mion
- Gastroenterology Department, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon, France
| | - M Bouchoucha
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - S Façon
- Association des patients souffrant du syndrome de l'intestin irritable (APSSII, www.apsssi.org), hôpital Avicenne, 125, rue de Stalingrad, Bobigny, France
| | - J-J Raynaud
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - F Zerbib
- Gastroenterology Department, hôpital Haut-Lévêque, 1, avenue Magellan, 33604 Pessac cedex, France
| | - P Jouët
- INSERM U-987, Pathophysiology and Clinical Pharmacology of pain, Ambroise-Paré Hospital, 92100 Boulogne-Billancourt, France.,Gastroenterology Department, hôpital Ambroise-Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
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Veziant J, Raspado O, Entremont A, Joris J, Pereira B, Slim K. Large-scale implementation of enhanced recovery programs after surgery. A francophone experience. J Visc Surg 2016; 154:159-166. [PMID: 27638322 DOI: 10.1016/j.jviscsurg.2016.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 12/11/2022]
Abstract
INTRODUCTION Enhanced recovery after surgery program (ERP) has now surpassed the stage of clinical research in certain specialties and currently poses the problematic of large-scale implementation. The goal of this study was to report the experience during the first year of implementation in three French-speaking countries. MATERIAL AND METHODS This is a prospective study in which 67 healthcare centers, all registered in the Grace-Audit databank, participated. Included were patients undergoing colorectal (CRS), bariatric (BS) and orthopedic hip and knee surgery (OS), performed within an ERP. The main endpoints were duration of hospital stay, postoperative morbidity, the degree of compliance with the elements of the ERP, the relation between the extent of application of the elements and postoperative hospital stay, and finally the completeness of data inclusions in the databank. RESULTS A total of 1904 patients were included in the Grace-Audit databank between January 1, 2015 and January 31, 2016, undergoing CRS (n=490), BS (n=431), and OS (n=983). The mean implementation rate was 83.7±10.0% for CRS, 75.0±23.7% for BS, and 83.5±14.9% for OS. The duration of hospital stay was 6.5 days for CRS, 2.6 days for BS and 3.4 days for OS. Overall postoperative morbidity (onset of postoperative undesirable event), surgical morbidity (superficial or deep organ space surgical site complications such as bleeding, infection or defective healing) and readmission rates were 20.6%, 7.5%, and 5.7% for CRS; 2.5%, 1.4%, and 1.6% for BS and 2.9%, 0.2%, and 2% for OS, respectively. A statistically significant relationship was found between the degree of compliance of the elements of ERP and the duration of hospital stay for CRS and BS; hospital stay was reduced when at least 15 of the 22 elements of the program were applied (P<0.001). The patients included in the Grace-Audit databank represented less than 20% of the patients undergoing operation in the same establishments during the study period for all three specialties. CONCLUSIONS This study shows that large-scale ERPs are feasible and safe in French-speaking countries. Nonetheless, although encouraging, these preliminary results highlight that implementation must be improved in specialties such as bariatric surgery and that more complete data collection is needed.
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Affiliation(s)
- J Veziant
- Service de chirurgie digestive, CHU Estaing, 63003 Clermont-Ferrand, France; Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France
| | - O Raspado
- Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France; Infirmerie protestante, 69300 Caluire, France
| | - A Entremont
- Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France
| | - J Joris
- Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France; Service d'anesthésie et de réanimation, CHU de Liège, 4000 Liège, Belgium
| | - B Pereira
- Département de statistiques, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - K Slim
- Service de chirurgie digestive, CHU Estaing, 63003 Clermont-Ferrand, France; Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France.
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- Groupe francophone de réhabilitation améliorée après chirurgie, 63110 Beaumont, France
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Borie D, Frileux P, Levy E, Entremont A, Berger A, Ollivier JM, Drevillon C, Cugnenc P, Parc R. [Surgery of acute necrotizing pancreatitis. Active prolonged drainage in 157 consecutive patients]. Presse Med 1994; 23:1064-8. [PMID: 7971817] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Conventional surgery and non-surgical methods have given unsatisfactory results for the treatment of acute necrotic pancreatitis. We therefore adoptive active prolonged drainage with the aim of controlling both acute enzyme toxicity and secondary necrosis. METHODS One hundred fifty-seven patients with necrotic pancreatitis defined as the presence of extensive pancreatic or peripancreatic necrosis at laparotomy were divided into three groups according to previous care: group 1 no prior medical or surgical treatment (n = 46, 29%), group 2 prior medical but no surgical treatment (n = 48, 31%) and group 3 prior medical and surgical treatment (n = 63, 40%). Spiral drains were placed in the drainage grooves after necrosectomy and post-operative drainage with Mikulicz bags. Continuous lavage-drainage was then maintained for 45 days. Enteral nutrition was initiated on day 7 (mean) and increased progressively to 75 kcal/kg/day so parenteral nutrition could be interrupted 8 days later. RESULTS There were 28 deaths (18%) including 6 in group 1, 10 in group 2 and 12 in group 3 (13, 21 and 19% respectively). Deaths were due to early multiple organ failure (n = 16), progressive degradation of the clinical situation (n = 8) and sudden death despite improvement (n = 4). Complications requiring re-operation occurred in 44 patients (28%). Among the 129 survivors, mean duration of hospitalization was 70 days including 60 days in the intensive care unit. CONCLUSIONS Compared with results from former series, active prolonged drainage appears to be more adapted to the natural history and anatomic presentation of acute necrotic pancreatitis.
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Affiliation(s)
- D Borie
- Service de Chirurgie digestive, Hôpital Saint-Antoine, Paris
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