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Laurent M, Prodel M, Vainchtock A, Civet A, Chevrette A, Rousselle B, Moutet C, Dauphinot V, Krolak-Salmon P. 1Etude MEMORA-Learning: découverte de profils de patients à risque de conversion précoce vers le stade sévère de la maladie d'Alzheimer via des arbres de décision de survie. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.060] [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: 11/06/2022] Open
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Blanc E, Chaize G, Fievez S, Féger C, Herquelot E, Vainchtock A, Timsit JF, Gaillat J. The impact of comorbidities and their stacking on short- and long-term prognosis of patients over 50 with community-acquired pneumonia. BMC Infect Dis 2021; 21:949. [PMID: 34521380 PMCID: PMC8442401 DOI: 10.1186/s12879-021-06669-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prognosis of patients hospitalized with community-acquired pneumonia (CAP) with regards to intensive care unit (ICU) admission, short- and long-term mortality is correlated with patient's comorbidities. For patients hospitalized for CAP, including P-CAP, we assessed the prognostic impact of comorbidities known as at-risk (AR) or high-risk (HR) of pneumococcal CAP (P-CAP), and of the number of combined comorbidities. METHODS Data on hospitalizations for CAP among the French 50+ population were extracted from the 2014 French Information Systems Medicalization Program (PMSI), an exhaustive national hospital discharge database maintained by the French Technical Agency of Information on Hospitalization (ATIH). Their admission diagnosis, comorbidities (nature, risk type and number), other characteristics, and their subsequent hospital stays within the year following their hospitalization for CAP were analyzed. Logistic regression models were used to assess the associations between ICU transfer, short- and 1-year in-hospital mortality and all covariates. RESULTS From 182,858 patients, 149,555 patients aged ≥ 50 years (nonagenarians 17.8%) were hospitalized for CAP in 2014, including 8270 with P-CAP. Overall, 33.8% and 90.5% had ≥ 1 HR and ≥ 1 AR comorbidity, respectively. Cardiac diseases were the most frequent AR comorbidity (all CAP: 77.4%). Transfer in ICU occurred for 5.4% of CAP patients and 19.4% for P-CAP. Short-term and 1-year in-hospital mortality rates were 10.9% and 23% of CAP patients, respectively, significantly lower for P-CAP patients: 9.2% and 19.8% (HR 0.88 [95% CI 0.84-0.93], p < .0001). Both terms of mortality increased mostly with age, and with the number of comorbidities and combination of AR and HR comorbidities, in addition of specific comorbidities. CONCLUSIONS Not only specific comorbidities, but also the number of combined comorbidities and the combination of AR and HR comorbidities may impact the outcome of hospitalized CAP and P-CAP patients.
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Affiliation(s)
| | | | | | - C Féger
- EMIBiotech, Paris, France
- ICUREsearch, Paris, France
| | | | | | - J F Timsit
- Medical and Infectious Diseases ICU, Bichat-Claude Bernard Hospital, APHP, Paris, France
- UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases Control and Care INSERM/University of Paris, Paris, France
| | - J Gaillat
- Infectious Diseases Department, Annecy-Genevois Hospital, Annecy, France.
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Wyplosz B, Fernandes J, Goussiaume G, Moïsi J, Lortet-Tieulent J, Vainchtock A, Leboucher C, Raguideau F. Adults at risk of pneumococcal disease in France. Infect Dis Now 2021; 51:661-666. [PMID: 34343722 DOI: 10.1016/j.idnow.2021.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Immunocompromised patients and those with certain underlying medical conditions are at risk of pneumococcal disease, but in France their vaccine coverage is largely unknown. We aimed to assess the number of adult patients eligible for pneumococcal vaccination in France. METHODS We conducted an annual cross-sectional study based on retrospective data from the French National Health Data System. Over 2014-2018, we included all adults continuously affiliated to the General health insurance scheme (covering 76% of the population), at risk of pneumococcal disease. Patients were identified with published or newly developed algorithms using diagnoses and reimbursements for hospital stays, medical procedures, and specific treatments, laboratory tests, or medical devices. RESULTS On January 1, 2018, we identified 4,045,021 at-risk patients (11% increase since 2014). Mean age was 66.1years (55.1% were aged≥65), 51% were men, and 18% had at least two conditions. Of these, 3,634,594 had a chronic medical condition (including 2,617,921 patients treated for diabetes, 616,003 for chronic respiratory disease, 424,223 for heart failure, and 285,214 for chronic liver disease) and 570,035 were immunocompromised (of these, 191,527 were treated with immunosuppressive drugs or biotherapy, 152,255 with chemotherapy for cancer, and 100,604 for HIV). CONCLUSION These published or newly developed algorithms - which can be used to address other public health issues - identified more than 4 million adults eligible for pneumococcal vaccination in the main health insurance scheme (10% of the studied adult population). This is a first step towards ensuring patients get vaccinated as part of their chronic condition management.
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Affiliation(s)
- B Wyplosz
- AP-HP, CHU Bicêtre, service de maladies infectieuses et tropicales, Le Kremlin-Bicêtre, France.
| | - J Fernandes
- CH Bayonne, département d'information médicale, Bayonne, France
| | | | - J Moïsi
- Pfizer vaccins, Paris, France
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Cash R, Cavillon M, Leboucher C, Jouaneton B, Vainchtock A, Aguadé A, Gomez E. Evaluation of “Sophia Diabetes”, a diabetic patient support programme, 8 years after its initiation. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
“Sophia Diabetes” is a personalized diabetic patient support program piloted by French National Health Insurance, launched experimentally in 10 primary health insurance funds in March 2008, extended in 2010 and then generalized to all of France in 2012-2013. A new evaluation was performed in 2018 to determine long-term (2008-2016) improvement of medical follow-up indicators, impact on morbidity, mortality and healthcare expenditure.
Methods
A sample of patients (n = 49,016) eligible for the programme in 2008, but also a sub-group of participating patients (n = 17,007), was matched, using propensity score, with controls randomly selected from the SNDS. Difference in difference method was applied for comparisons at each year of follow-up (Ti) while controlling for differences between populations.
Results
Sophia had a significant positive impact on recommended follow-up indicators, right from the first year. This improvement was maintained for most indicators even if compliance rates remained lower than targets. Sophia Diabetes does not appear to have a major impact on hospitalization rates in either eligible patients or participating patients. However, comparison between participants and controls revealed a less marked increase of hospitalizations for major cardiovascular events at T6 and T7. Compared to their controls, a better use of hospital emergency departments was observed for participants. Ambulatory care expenditure of participants increased more markedly between T4 and T7 (+€105 to €233), related to a better follow-up but in contrast, hospital expenditure increased less markedly during the first year of follow-up (-€139) and the last 2 years (-€360 to -€380).
Conclusions
For the first time in France, a disease management program has been evaluated over a long period. Globally, Sophia programresults in improved patient follow-up, decreased emergency visits, and a less marked increase of hospitalizations for major cardiovascular events at the end of period.
Key messages
First long term evaluation (8 years) of a disease management program in France. Sophia diabetes management program shows a positive impact on some follow-up and morbidity indicators.
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Affiliation(s)
- R Cash
- Les Asclépiades, Ardenais, France
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Prodel M, Leboucher C, Vainchtock A, Cavillon M, Cash R, Aguade AS, Gomez E. Étude des parcours de soins des patients diabétiques éligibles au programme « Sophia » par une technique de «Process Mining», à partir des données du Système national des données de santé. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Bylicki O, Prodel M, Blein C, Margery J, Vainchtock A, Chouaid C. Intérêt des techniques de Marching Learning pour évaluer les filières de prise en charge des patients atteints de cancer du poumon : application à l’agressivité des soins en fin de vie. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.279] [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]
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Girard N, Cozzone D, de Léotoing L, Tournier C, Vainchtock A, Tehard B, Cortot A. Extra-cost of brain metastases in patients with non-squamous non-small cell lung cancer (NSCLC): A French national hospital database analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.102] [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: 11/12/2022] Open
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Chouaïd C, Cotté FE, Jouaneton B, Vainchtock A, Gaudin AF. Utilisation de nivolumab dans le traitement du cancer du poumon avancé ou métastatique en France pendant les périodes d’autorisation temporaire d’utilisation (ATU) et post-ATU : suivi à partir des données hospitalières du PMSI. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.046] [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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De Oliveira H, Prodel M, Vainchtock A. Prédiction du coût hospitalier annuel pour des patients vivant avec le VIH : comparaison de 10 algorithmes de « Machine Learning » sur une cohorte identifiée dans les données PMSI. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.01.057] [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: 11/24/2022] Open
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Chouaïd C, Cotté F, Jouaneton B, Vainchtock A, Gaudin A. Nivolumab dans le traitement du cancer du poumon métastatique en France : analyse des 10 621 patients traités en 2015 et 2016 à partir des données du PMSI. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.224] [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]
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Prodel M, Lamarsalle L, Vainchtock A. Analyses de sensibilité des comorbidités sur le parcours de soin des patients implantés d’un défibrillateur cardiaque à partir des données PMSI. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.005] [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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Chouaïd C, Debieuvre D, Durand-Zaleski I, Fernandes J, Scherpereel A, Westeel V, Blein C, Gaudin A, Ozan N, Leblanc S, Vainchtock A, Cotté F, Souquet P. Disparités régionales et socio-économiques dans le cancer du poumon (étude TERRITOIRE). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.047] [Citation(s) in RCA: 3] [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] [Indexed: 11/29/2022]
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Souquet P, Debieuvre D, Westeel V, Durand-Zaleski I, Fernandes J, Scherpereel A, Blein C, Gaudin A, Ozan N, Vainchtock A, Saitta B, Cotté F, Chouaïd C. Délais d’accès à la chimiothérapie adjuvante après une chirurgie curative dans le cancer du poumon (étude TERRITOIRE). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Scotté F, Borget I, Martelli N, Vainchtock A. 1220 The cost of thromboembolic events in hospitalized patients: A study on four major cancer localizations. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30524-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: 11/28/2022]
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Rotily M, Abergel A, Branchoux S, De LL, Vainchtock A, Akremi R, Gaudin AF. Burden Of Hospitalizations Related To Chronic Hepatitis C In France: Evolution Between 2009 And 2012. Value Health 2014; 17:A364. [PMID: 27200755 DOI: 10.1016/j.jval.2014.08.808] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - A Abergel
- centre hospitalier universitaire CHU Estaing, Clermont-Ferrand, France
| | - S Branchoux
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | | | | | - R Akremi
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - A F Gaudin
- Bristol-Myers Squibb, Rueil-Malmaison, France
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Abergel A, Rotily M, Gaudin AF, De LL, Vainchtock A, Akremi R, Branchoux S. Mean Annual Cost Of Patients Hospitalized For Chronic Hepatitis C In France: The Hepc-Lone Study. Value Health 2014; 17:A364. [PMID: 27200756 DOI: 10.1016/j.jval.2014.08.809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Abergel
- centre hospitalier universitaire CHU Estaing, Clermont-Ferrand, France
| | | | - A F Gaudin
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | | | | | - R Akremi
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - S Branchoux
- Bristol-Myers Squibb, Rueil-Malmaison, France
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Scotte F, Martelli N, Vainchtock A, Borget I. Hospital Cost of Thromboembolic Events in Breast or Prostate Cancer Patients. Value Health 2014; 17:A625. [PMID: 27202208 DOI: 10.1016/j.jval.2014.08.2224] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Scotte
- Hopital Européen Georges Européen, Paris, France
| | - N Martelli
- Hopital Européen Georges Européen, Paris, France
| | | | - I Borget
- Institut Gustave Roussy, Villejuif, France
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Fauchier L, Samson A, Chaize G, Gaudin AF, Vainchtock A, Bailly C, Cotté FE. Burden Of Cardiovascular Complications In Patients With Atrial Fibrillation In France. Value Health 2014; 17:A483. [PMID: 27201414 DOI: 10.1016/j.jval.2014.08.1404] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Fauchier
- Service de Cardiologie B et Laboratoire d'Electrophysiologie Cardiaque, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, Chambray-les-Tours, France
| | - A Samson
- Paris-Dauphine University, Paris, France
| | | | - A F Gaudin
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | | | - C Bailly
- Bristol-Myers Squibb, Rueil Malmaison, France
| | - F E Cotté
- Bristol-Myers Squibb, Rueil Malmaison, France
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Scotte F, Vainchtock A, Borget I, Martelli N. Thromboembolic Events in French Breast and Prostate Cancer Patients Hospitalized in 2011 and 2012: Incidence and Costs. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu341.6] [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: 11/13/2022] Open
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Benjamin L, Cotté FE, Mercier F, Vainchtock A, Vidal-Trécan G, Durand-Zaleski I. Burden of breast cancer with brain metastasis: a French national hospital database analysis. J Med Econ 2012; 15:493-9. [PMID: 22304337 DOI: 10.3111/13696998.2012.662924] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Incidence of breast cancer with brain metastases (BCBM) is increasing, especially among patients over-expressing HER2. Epidemiology on this sub-type of cancer is scarce, since cancer registries carry no information on the HER2 status. A retrospective database analysis was conducted to estimate the burden of BCBM, especially among HER2-positive patients in a secondary objective. METHODS Patients with a new diagnosis of BCBM carried out between January and December 2008 were identified from the national hospital database using the International Disease Classification. Patients receiving a targeted anti-HER2 therapy were identified from the national pharmacy database. Hospital and pharmacy claims were linked to estimate the burden of HER2-positive patients. Data on hospitalizations were extracted to describe treatment patterns and healthcare costs during a 1-year follow-up. Predictors of treatment cost were analyzed through multi-linear regression analysis. RESULTS Two thousand and ninety-nine BCBM patients were identified (mean age (SD) = 57.8 (13.6)), of whom 12.2% received a targeted anti-HER2 therapy; 79% of patients had brain metastases associated with extracranial metastases, and the attrition rate reached 82%. Patients received mostly palliative care (47.4%), general medical care (40.6%), and chemotherapy (35.0%). The total annual hospital cost of treatment was 8,426,392€, representing a mean cost of 22,591€ (±14,726) per patient, mainly influenced by extracranial metastases, surgical acts, and HER2-overexpression (p < 0.0001). CONCLUSIONS The database linkage of hospital and pharmacy claims is a relevant approach to identify sub-type of cancer. Chemotherapy was widely used as a systemic treatment for breast cancer rather than for local treatment of brain metastases whose morbi-mortality remains high. The variability of treatment costs suggests clinical heterogeneity and, thus, extensive individualization of protocols.
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Affiliation(s)
- L Benjamin
- Epidémiologie, Evaluation et Politiques de santé (EA 4069), Université Paris Descartes, Sorbonne Paris Cité, France.
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Benjamin L, Cotté FE, Vainchtock A, Mercier F, Vidal-Trécan G, Durand-Zaleski I. Incidence du cancer du sein métastatique HER2+ en France : utilisation du chaînage patient à partir des bases médico-administratives de 2006 à 2009. Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.08.017] [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: 10/16/2022] Open
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Abramowitz L, Rémy V, Vainchtock A. Economic burden of anal cancer management in France. Rev Epidemiol Sante Publique 2010; 58:331-8. [DOI: 10.1016/j.respe.2010.06.165] [Citation(s) in RCA: 18] [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: 02/12/2009] [Revised: 01/14/2010] [Accepted: 06/03/2010] [Indexed: 12/01/2022] Open
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Flahault A, Monsonego J, Sultan S, Vernay C, Duru G, Vainchtock A, Decuypere L, Aractingi S. C5 - Fréquence et prise en charge des condylomes acuminés externes en consultation libérale ou hospitalière et dans les dispensaires anti-vénériens (DAV), en France. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79626-5] [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: 10/15/2022]
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Le Heuzey J, Lamarsalle L, Vainchtock A, Matalon C, Hazard J, Henric C. 430 Evaluation of medico-economic impact of new implantable defibrillators with a longer lifetime. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.95-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | | | - C. Matalon
- Guidant SAS, CRM, Rueil Malmaison, France
| | | | - C. Henric
- Guidant SAS, CRM, Rueil Malmaison, France
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