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Hernandez Poblete N, Gay F, Salvo F, Micoulaud-Franchi JA, Bienvenu T, Coelho J, Aupy J. Resective epilepsy surgery and its impact on depression in adults: a systematic review, meta-analysis, and implications for future research. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-333073. [PMID: 38443157 DOI: 10.1136/jnnp-2023-333073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND How epilepsy surgery influences the bidirectional relationship of epilepsy and depression remains poorly defined. METHOD For a better understanding of this question, we conducted a systematic review and meta-analysis of risk ratio on depression prevalence before and after epilepsy surgery, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Three databases were comprehensively screened for all studies assessing depression before and after resective surgery in adult epileptic patients until 8 October 2022. Studies were included if depression was assessed before and after epilepsy surgery regardless of the time of follow-up. A total of 1917 studies were screened for eligibility and 91 full-texts up for inclusion; 35 studies were finally included, 25 studies and 2563 patients were included in main meta-analysis and 10 for exploratory analysis. Risk of bias was assessed using Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) from Cochrane. To derive the pooled depression rates before and after surgery, a meta-analysis with inversed-variance was performed using random-effects logistic models with Peto's correction and a 95% CI. Heterogeneity was assessed with Cochran's Q-test along with its derived measure of inconsistency I2. RESULTS Overall, the depression rates before and after resective epilepsy surgery were 0.70 (0.53 to 0.91) 95% CI, suggesting that the rate of depression at last follow-up evaluation tends to decrease after Resective Epilepsy Surgery (RES). Subgroup analysis suggest a positive long-term effect appears with a significant lower rates of depression already 6 months (0.61 (0.38 to 0.98)), after surgery which is maintained over time after 1 year (0.53 (0.31 to 0.90)), and after 2 years (0.62 (0.42 to 0.92)). CONCLUSION This important finding should be taken in consideration before resective surgery for drug-resistant epilepsies. However, prospective studies should be conducted to characterise which patient, at the individual level, might be at risk of de novo or worsening of depression. PROSPERO REGISTRATION NUMBER CRD42022355386.
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Affiliation(s)
| | - Florian Gay
- CERPAD, CH Charles Perrens, Bordeaux, Aquitaine, France
| | - Francesco Salvo
- INSERM, Pharmaco-epidemiology Team, Université de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
- CNRS, SANPSY, Université de Bordeaux, Bordeaux, France
| | - Thomas Bienvenu
- CERPAD, CH Charles Perrens, Bordeaux, Aquitaine, France
- INSERM, Neurocentre Magendie, Université de Bordeaux, Bordeaux, France
| | - Julien Coelho
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
| | - Jerome Aupy
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
- CNRS, IMN, Université de Bordeaux, Bordeaux, France
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Micoulaud-Franchi JA, Coelho J, Boileau L, Quiles C, Geoffroy PA. [Pathophysiological hypothesis and diagnosis of insomnia disorder]. Rev Prat 2024; 74:275-280. [PMID: 38551867] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
PATHOPHYSIOLOGICAL HYPOTHESES AND DIAGNOSIS OF INSOMNIA DISORDER. All pathophysiological models place hyperarousal as a central process in the mechanisms of insomnia. These models differ, however, in terms of the importance and role of the variables explaining this hyperarousal. Behavioral and cognitive models describe self-maintenance behaviors and dysfunctional thoughts, such as worries and concerns about sleep and the consequences of insomnia. Alterations in cognitive functions related to hyperarousal in perceptual and memory processes can explain these behaviors and thoughts. Neurobiological models show instability in the sleepwake balance, with orexin possibly involved, but this remains to be confirmed. The diagnosis of insomnia must consider the semiology related to the mechanisms of insomnia, as well as co-morbidities.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France. CNRS UMR 6033 Sanpsy, CHU de Bordeaux, Bordeaux, France
| | - Julien Coelho
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France. CNRS UMR 6033 Sanpsy, CHU de Bordeaux, Bordeaux, France
| | - Léa Boileau
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France
| | - Clélia Quiles
- Centre hospitalier Charles-Perrens, Bordeaux, France. Université de Bordeaux, Inserm, Bordeaux. Population Health Research Center, team
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU neurosciences, hôpital Bichat-Claude-Bernard, Paris, France. GHU Paris psychiatrie et neurosciences, université de Paris, NeuroDiderot, Inserm, Paris, France. Université Paris-Cité, Inserm, NeuroDiderot, Paris, France
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Micoulaud-Franchi JA, Coelho J, Geoffroy PA, Vecchierini MF, Poirot I, Royant-Parola S, Hartley S, Cugy D, Gronfier C, Gauld C, Rey M. Eco-anxiety: An adaptive behavior or a mental disorder? Results of a psychometric study. Encephale 2024:S0013-7006(23)00173-2. [PMID: 38429155 DOI: 10.1016/j.encep.2023.08.009] [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] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Accepted: 08/05/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Eco-anxiety is a complex construct that has been created to grasp the psychological impact of the consequences of global warming. The concept needs a reliably valid questionnaire to better evaluate its impact on the risk of anxiety and depressive disorders. The Eco-Anxiety Questionnaire (EAQ-22) evaluates two dimensions: 'habitual ecological anxiety' and 'distress related to eco-anxiety'. However, a version in French, one of the world's widely spoken languages, was until now lacking. We aimed to translate and validate the French EAQ-22 and to evaluate the prevalence of the level of the two dimensions of eco-anxiety and the relationship with anxiety and depressive symptoms in a representative adult sample of the French general population. METHODS This study was performed under the auspices of the Institut national du sommeil et de la vigilance (INSV). Participants (18-65 years) were recruited by an institute specialized in conducting online surveys of representative population samples (quota sampling). Two native French speakers and two native English speakers performed a forward-backward translation of the questionnaire. The Hospital Anxiety and Depression scale (HAD) was administered to assess anxiety (HAD-A) and depressive (HAD-D) symptoms and for external validity. Internal structural validity and external validity were analysed. RESULTS Evaluation was performed on 1004 participants: mean age 43.47 years (SD=13.41, range: [19-66]); 54.1% (n=543) women. Using the HAD, 312 (31.1%) patients had current clinically significant anxiety symptoms (HAD-A>10) and 150 (14.9%) had current clinically significant depressive symptoms (HAD-D>10). Cronbach's alpha coefficient was 0.934, indicating very good internal consistency. Correlation between EAQ-22 and HAD scores was low (r[1004]=0.209, P<0.001), 'habitual ecological anxiety' was correlated less with HAD-A and HAD-D than 'distress related to eco-anxiety', indicating good external validity. CONCLUSION This study validates the French EAQ-22 and paves the way for using the EAQ-22 as a global tool for assessing eco-anxiety. Further prospective studies are now required to better evaluate the impact of eco-anxiety on the occurrence of anxiety and depressive disorder.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33076 Bordeaux, France; Institut national du sommeil et de la vigilance, Paris, France.
| | - Julien Coelho
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33076 Bordeaux, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU Neurosciences, hôpital Bichat - Claude-Bernard, AP-HP, 75018 Paris, France; GHU Paris - Psychiatry & Neurosciences, 1, rue Cabanis, 75014 Paris, France; Université Paris Cité, NeuroDiderot, Inserm, 75019 Paris, France
| | - Marie-Françoise Vecchierini
- Centre du sommeil et de la vigilance, hôpital Hôtel Dieu, AP-HP, Paris, France; Sorbonne Paris Cité, université Paris Descartes, Paris, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Isabelle Poirot
- Service de psychiatrie adulte, hôpital Fontan, CHU de Lille, Lille, France; Institut national du sommeil et de la vigilance, Paris, France
| | | | - Sarah Hartley
- Réseau Morphée, Garches, France; EA 4047, Sleep Center, Hôpital Raymond Poincaré, AP-HP, université de Versailles Saint-Quentin en Yvelines, Garches, France
| | - Didier Cugy
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Claude Gronfier
- Lyon Neuroscience Research Center (CRNL), Neurocampus, Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Lyon, France; Université Claude-Bernard Lyon 1, université de Lyon, 69000 Lyon, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Christophe Gauld
- Department of Psychiatry, University of Grenoble, avenue du Maquis du Grésivaudan, 38000 Grenoble, France; Institut des sciences cognitives Marc-Jeannerod, UMR 5229 CNRS & université Claude-Bernard Lyon 1, Lyon, France
| | - Marc Rey
- Institut national du sommeil et de la vigilance, Paris, France
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Gauld C, Baillieul S, Martin VP, Richaud A, Lopez R, Pelou M, Abi-Saab P, Coelho J, Philip P, Pépin JL, Micoulaud-Franchi JA. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med 2024. [PMID: 38420966 DOI: 10.5664/jcsm.11086] [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] [Indexed: 03/02/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a four-step approach: i) selection of OSA screening questionnaires; ii) item extraction and selection; iii) extraction of symptoms from items; iv) assessment of content overlap with the Jaccard Index (from 0: no overlap to 1: full overlap). RESULTS We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard Index 0.224, ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (e.g., snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only one questionnaire. CONCLUSIONS The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Sébastien Baillieul
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Vincent P Martin
- University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence, France
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | | | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Jean Louis Pépin
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
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Coelho J, Rey M, Labonne A, Adan A, Taillard J, Geoffroy PA, Cugy D, Dakar A, Philip P, Poirot I, Royant-Parola S, Hartley S, Vecchierini MF, Micoulaud-Franchi JA. Better characterizing sleep beliefs for personalized sleep health promotion: the French sleep beliefs scale validation study. Front Public Health 2024; 11:1293045. [PMID: 38274535 PMCID: PMC10808670 DOI: 10.3389/fpubh.2023.1293045] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
Background The Sleep Beliefs Scale (SBS) is a well-known tool to design and monitor personalized sleep health promotion at an individual and population level. The lack of an established French version limits the development of effective interventions targeting these populations. Thus, the aim of this study was to validate the French version of the SBS in a representative sample of the general population. Methods Quota sampling was used to recruit 1,004 participants (18-65 years, mean age: 43 years, 54% of female) who underwent an online survey to complete the SBS, and to assess sleep schedules, sleep quality and disorders, and mental health. Cronbach's α coefficient, confirmatory factor analysis, item-internal consistency (IIC), and item discriminant validity (IDV) of the SBS were computed to assess internal validity while bivariate associations with sleep schedules, sleep quality and disorders, and mental health were used to assess external convergent and discriminant validity. Results The mean score on the SBS was 12.3 ± 4.9. Item 19 ("Quiet & Dark") showed the highest rate of correct answers (n = 801, 79.8%), while item 20 ("Recovering sleep") showed the lowest rate of correct answers (n = 246, 24.5%). Overall, the SBS showed satisfactory internal consistency (α = 0.87) and confirmed the three-factor structure proposed by the original study. All items were found consistent (IIC > 0.4) and discriminant (IIC > IDV) except for item 20 ("recovering lost sleep by sleeping for a long time"). Females, older participants, and subjects with short time-in-bed, poor sleep quality, insomnia, and circadian rhythm disorder had higher SBS scores while participants with depressive symptoms had lower SBS scores. Conclusion We successfully translated and validated the French version of the SBS in a representative sample, making it a reliable instrument for researchers and clinicians to assess and target sleep beliefs. Correct answers vary from 25 to 80% which underlines the importance of continuing sleep health promotion campaigns by targeting poorly understood behaviors. Our findings also shed light on the fickleness of beliefs that are prone to vary within individuals across time, in step with societal changes. Several associated factors were identified, thus contributing to our understanding of sleep beliefs and offering insights for personalized approaches to enhance sleep health and overall well-being.
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Affiliation(s)
- Julien Coelho
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Marc Rey
- Institut National du Sommeil et de la Vigilance, Paris, France
| | | | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Jacques Taillard
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris-Psychiatry & Neurosciences, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, Paris, France
| | - Didier Cugy
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Institut National du Sommeil et de la Vigilance, Paris, France
| | - Alexandre Dakar
- Institut National du Sommeil et de la Vigilance, Paris, France
- Clinique Médicale et Cardiologique d’Aressy, Aressy, France
| | - Pierre Philip
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Isabelle Poirot
- Institut National du Sommeil et de la Vigilance, Paris, France
- Service de médecine physique et réadaptation pédiatrique, hospices civils de Lyon, Bron, France
| | - Sylvie Royant-Parola
- Institut National du Sommeil et de la Vigilance, Paris, France
- Réseau Morphée, Garches, France
| | - Sarah Hartley
- Institut National du Sommeil et de la Vigilance, Paris, France
- APHP, Hôpital Raymond Poincaré, Sleep Center, Université de Versailles Saint-Quentin en Yvelines, Garches, France
| | - Marie-Françoise Vecchierini
- Institut National du Sommeil et de la Vigilance, Paris, France
- AP-HP, Hôpital Hôtel Dieu, Centre du Sommeil et de la Vigilance, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- Institut National du Sommeil et de la Vigilance, Paris, France
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Pouvreau P, Coelho J, Rumeau C, Malard O, Garrel R, Michel J, Righini C, Vergez S, Baudouin R, Bastit V, Marie JP, Villepelet A, Moya-Plana A, Philouze P, Saroul N, Digue L, Daste A, Renard S, Moriniere S, Carsuzaa F, Verillaud B, Poissonnet G, Schultz P, Brenet E, Mouawad F, Thariat J, Vulquin N, Castain C, de Gabory L, Dupin C. Management of 80 sinonasal undifferentiated carcinomas. Retrospective multicentre study of the French Network of Rare Head and Neck Cancers (REFCOR). Eur J Surg Oncol 2023; 49:107108. [PMID: 37866154 DOI: 10.1016/j.ejso.2023.107108] [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: 05/26/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive disease requiring multimodal treatment, and multiple new entities once included in the spectrum of SNUC, such as SWI/SNF-deficient carcinomas, are emerging. We aimed to provide new data regarding the role of chemotherapy and surgery and the prognostic factors of disease-free survival. METHODS This study was based on data from the REFCOR database and included patients with SNUC treated with curative intent from 2007 to 2021 across 22 centres in France. RESULTS A total of 80 patients were included in the analysis. Among the entire cohort, the 5-year disease-free survival (DFS) and overall survival (OS) rates were 58% and 63%, respectively. Of 100% of the patients treated with irradiation, 29% underwent surgery, 56% neoadjuvant chemotherapy (82% had either a partial or a complete response) and 76% chemoradiotherapy. No treatment modality was associated with a better OS or DFS, including surgery (p = 0.34). There was a trend for a better DFS for the patients treated with chemotherapy (neoadjuvant or concomitant, p = 0.062). Overall survival at 3 years was 58% for SWI/SNF deficient group and 86% for non deficient group (p = 0.14). The locoregional relapse rate without distant metastases was 21% in the exclusive radiotherapy group and 26% in the surgery group. Grade 3 or higher toxicities concerned 9%, 32% and 29% of patients for surgery, radiotherapy and chemotherapy respectively. CONCLUSION In the management of localised SNUC among all patients treated with irradiation, surgery yielded no benefit, whereas the addition of chemotherapy tended to improve disease-free survival.
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Affiliation(s)
- Pierre Pouvreau
- Department of Radiation Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Julien Coelho
- Bordeaux University, na unit, UMR 6033, F-33000, Bordeaux, France
| | - Cécile Rumeau
- Department of Head and Neck Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France
| | - Olivier Malard
- Department of Head and Neck Surgery, Nantes University Hospital, Nantes, France
| | - Renaud Garrel
- Department of Head and Neck Surgery, Montpellier University Hospital, Montpellier, France
| | - Justin Michel
- Department of Head and Neck Surgery, La Conception University Hospital, Marseille, France
| | - Christian Righini
- Department of Head and Neck Surgery, Grenoble University Hospital, Grenoble, France
| | - Sebastien Vergez
- Department of Head and Neck Surgery, Toulouse University Hospital, Toulouse, France
| | - Robin Baudouin
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Vianney Bastit
- Department of Head and Neck Surgery, Caen University Hospital, Caen, France
| | - Jean-Paul Marie
- Department of Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Aude Villepelet
- Department of Head and Neck Surgery, Créteil Intercommunal Hospital, Créteil, France
| | - Antoine Moya-Plana
- Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
| | - Pierre Philouze
- Department of Head and Neck Surgery, Hospital Group of lyon, Lyon, France
| | - Nicolas Saroul
- Department of Head and Neck Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Laurence Digue
- Department of Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Amaury Daste
- Department of Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Sophie Renard
- Department of Head and Neck Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France
| | - Sylvain Moriniere
- Department of Head and Neck Surgery, Tours University Hospital, Tours, France
| | - Florent Carsuzaa
- Department of Head and Neck Surgery, Poitiers University Hospital, Poitiers, France
| | - Benjamin Verillaud
- Department of Head and Neck Surgery, Lariboisière Hospital, Paris, France
| | - Gilles Poissonnet
- Department of Head and Neck Oncologic Surgery, Antoine Lacassagne Center, Nice, France
| | - Philippe Schultz
- Department of Head and Neck Surgery, Strasbourg University Hospital, Strasbourg, France
| | - Esteban Brenet
- Department of Head and Neck Surgery, Reims University Hospital, Reims, France
| | - François Mouawad
- Department of Head and Neck Surgery, Lille University Hospital, Lille, France
| | - Juliette Thariat
- Department of Radiation Oncology, François Baclesse Center, Caen, France
| | - Noémie Vulquin
- Department of Radiation Oncology, Georges François Leclerc Center, Dijon, France
| | - Claire Castain
- Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - Ludovic de Gabory
- Department of Head and Neck Surgery, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Charles Dupin
- Department of Radiation Oncology, Bordeaux University Hospital, F33000, Bordeaux, France; Bordeaux University, na unit, UMR 6033, F-33000, Bordeaux, France; BRIC (BoRdeaux Institute of OnCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France.
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Coelho J, Sanchez-Ortuño MM, Martin VP, Gauld C, Richaud A, Lopez R, Pelou M, Abi-Saab P, Philip P, Geoffroy PA, Palagini L, Micoulaud-Franchi JA. Content analysis of insomnia questionnaires: A step to better evaluate the complex and multifaceted construct of insomnia disorder. Psychiatry Res 2023; 330:115584. [PMID: 37944205 DOI: 10.1016/j.psychres.2023.115584] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Insomnia disorder is a mental disorder that includes various types of symptoms (e.g., insomnia initiating, worries, mood disturbances) and impairments (e.g., distress related to sleep alterations). Self-report questionnaires are the most common method for assessing insomnia but no systematic quantified analysis of their content and overlap has been carried out. We used content analysis and a visualization method to better identify the different types of clinical manifestations that are investigated by nine commonly used insomnia questionnaires for adults and the Jaccard index to quantify the degree to which they overlap. Content analysis found and visualized 16 different clinical manifestations classified into five dimensions ("Insomnia symptoms", "Insomnia-related symptoms", "Daytime symptoms", "Insomnia-related impairments", "Sleep behaviors"). The average Jaccard Index was 0.409 (moderate overlap in content). There is a lack of distinction between symptoms and impairments, and the assessment of sleep duration and hyperarousal symptoms remains overlooked. This preliminary analysis makes it possible to visualize the content of each of the nine questionnaires and to select the most appropriate questionnaire based on the issue to be addressed. Suggestions are made regarding the development of future questionnaires to better distinguish symptoms and impairments, and the different phenotypes of insomnia disorder.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France.
| | - Maria Montserrat Sanchez-Ortuño
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; Department of Nursing, School of Nursing, University of Murcia, Murcia, Spain
| | - Vincent P Martin
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence F-33400, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier 34000, France; Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier 34000, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, Paris 75018, France; GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, Université de Paris, NeuroDiderot, Inserm, Paris 75019, France
| | - Laura Palagini
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa 56126, Italy; Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara 44121, Italy
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
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Sanchez-Ortuno MM, Pecune F, Coelho J, Micoulaud-Franchi JA, Salles N, Auriacombe M, Serre F, Levavasseur Y, de Sevin E, Sagaspe P, Philip P. Predictors of users' adherence to a fully automated digital intervention to manage insomnia complaints. J Am Med Inform Assoc 2023; 30:1934-1942. [PMID: 37672004 PMCID: PMC10654843 DOI: 10.1093/jamia/ocad163] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/04/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE Fully automated digital interventions show promise for disseminating evidence-based strategies to manage insomnia complaints. However, an important concept often overlooked concerns the extent to which users adopt the recommendations provided in these programs into their daily lives. Our objectives were evaluating users' adherence to the behavioral recommendations provided by an app, and exploring whether users' perceptions of the app had an impact on their adherence behavior. MATERIAL AND METHODS Case series study of individuals completing a fully automated insomnia management program, conducted by a virtual agent, during December 2020 to September 2022. Primary outcome was self-reported adherence to the behavioral recommendations provided. Perceptions of the app and of the virtual agent were measured with the Acceptability E-Scale and ECA-Trust Questionnaire. Insomnia was evaluated with the Insomnia Severity Index at baseline (phase 1), after 7 days of sleep monitoring (phase 2) and post-intervention (phase 3). RESULTS A total of 824 users were included, 62.7% female, mean age 51.85 (±12.55) years. Of them, 32.7% reported having followed at least one recommendation. Users' trust in the virtual agent and acceptance of the app were related to a pre-intervention effect in insomnia severity (phase 2). In turn, larger pre-intervention improvements predicted better adherence. Mediational analyses showed that higher levels of trust in the virtual agent and better acceptance of the app exerted statistically significant positive effects on adherence (β = 0.007, 95% CI, 0.001-0.017 and β = 0.003, 95% CI 0.0004-0.008, respectively). DISCUSSION Users' adherence is motivated by positive perceptions of the app's features and pre-intervention improvements. CONCLUSIONS Determinants of adherence should be assessed, and targeted, to increase the impact of fully automated digital interventions.
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Affiliation(s)
- Maria Montserrat Sanchez-Ortuno
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- School of Nursing, Department of Nursing, University of Murcia, 30120 Murcia, Spain
| | - Florian Pecune
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
| | - Julien Coelho
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Sleep Medicine Service, University Hospital, 33076 Bordeaux, France
| | - Jean Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Sleep Medicine Service, University Hospital, 33076 Bordeaux, France
| | - Nathalie Salles
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Department of Clinical Gerontology, University Hospital, 33076 Bordeaux, France
| | - Marc Auriacombe
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Addiction Treatment Services, Charles Perrens Hospital, 33076 Bordeaux, France
| | - Fuschia Serre
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Addiction Treatment Services, Charles Perrens Hospital, 33076 Bordeaux, France
| | - Yannick Levavasseur
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
| | - Etienne de Sevin
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
| | - Patricia Sagaspe
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Sleep Medicine Service, University Hospital, 33076 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, University of Bordeaux, 33076 Bordeaux, France
- CNRS, SANPSY, UMR 6033, 33076 Bordeaux, France
- Sleep Medicine Service, University Hospital, 33076 Bordeaux, France
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9
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Coelho J, Lucas G, Micoulaud-Franchi JA, Tran B, Yon DK, Taillard J, D'Incau E, Philip P, Boyer L, Fond G. Sleep timing, workplace well-being and mental health in healthcare workers. Sleep Med 2023; 111:123-132. [PMID: 37769583 DOI: 10.1016/j.sleep.2023.09.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Healthcare workers face an elevated risk of burnout, sleep disorders, and mental health issues, potentially stemming from the misalignment of their circadian rhythm due to nonstandard work schedules. This cross-sectional survey aims to examine the connections between sleep timing, workplace well-being (including burnout and absenteeism), and mental health outcomes (specifically depression and poor sleep) in healthcare workers. Additionally, the survey takes into account individual and professional factors, as well as the interaction with work schedules. METHODS The study encompasses 4,971 healthcare workers from both public and private healthcare facilities in France, including nurses, nursing assistants, and physicians recruited during the third wave of the COVID-19 pandemic. The Maslach Burnout Inventory assesses burnout, the Center for Epidemiologic Studies Depression Scale measures depression, and the Pittsburgh Sleep Quality Index evaluates poor sleep. Sleep timing is categorized into morning, neutral, and evening timing, referred to as midsleep. Multivariate logistic regression analysis is conducted to explore the relationships between sleep timing and burnout, depression, and poor sleep, while adjusting for various factors. RESULTS The findings reveal that 56.5% of participants experience burnout, 29.8% report depression, and 64.5% report poor sleep. Nurses and nursing assistants exhibit a higher prevalence of poor sleep. Morning sleep timing is associated with burnout among those with fixed schedules and with depression among those with shift schedules. Among physicians, both morning and evening sleep timing are associated with depression, while morning sleep timing is linked to poor sleep across all subgroups. INTERPRETATION This study suggests that the misalignment between healthcare workers' internal circadian rhythm and their work schedules may contribute to an increased risk of burnout, depression, and poor sleep. Occupational health services and policymakers should recognize the potential for enhancing workplace well-being and mental health outcomes by enabling healthcare workers to maintain sleep schedules that accommodate their needs.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Bach Tran
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jacques Taillard
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France
| | - Emmanuel D'Incau
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Coelho J, Lucas G, Micoulaud-Franchi JA, Philip P, Boyer L, Fond G. Poor sleep is associated with work environment among 10,087 French healthcare workers: Results from a nationwide survey. Psychiatry Res 2023; 328:115448. [PMID: 37713924 DOI: 10.1016/j.psychres.2023.115448] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/17/2023]
Abstract
Poor sleep is a prevalent issue among healthcare workers and can have detrimental effects on their health. Various individual and professional factors, including the work environment, may contribute to poor sleep. However, only a limited number of studies have examined the simultaneous influence of these factors. Hence, we conducted a nationwide survey among graduated healthcare workers in both public and private healthcare facilities in France. The aim was to analyze the association between poor sleep, assessed using the Pittsburgh Sleep Quality Index (>5), and the work environment, evaluated using the Job Content Questionnaire. The study encompassed 10,087 healthcare workers, among whom 6,540 (64.8%) reported experiencing poor sleep. Nurses, health executives, nursing assistants, and other allied healthcare professionals were more likely to experience poor sleep compared to physicians. Through multivariate regression analysis, we identified several aspects of the work environment associated with an increased likelihood of poor sleep. These factors included high speed and quantity of work, high complexity and intensity, high fragmentation and unpredictability, limited decision-making latitude, underutilization of skills, lack of emotional support from colleagues, and sustained workplace bullying. These findings highlight the significance of considering the work environment in addressing sleep issues among healthcare professionals.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Coelho J, Pecune F, Levavasseur Y, De Sevin E, D'incau E, Sagaspe P, Sanchez-Ortuño MM, Micoulaud-Franchi JA, Philip P. From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent. Sleep 2023; 46:zsad165. [PMID: 37282717 DOI: 10.1093/sleep/zsad165] [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: 12/20/2022] [Revised: 04/28/2023] [Indexed: 06/08/2023] Open
Abstract
STUDY OBJECTIVES To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. METHODS A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. RESULTS The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21-1.30] for irregular TST and RR = 1.19 [1.15-1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10-1.52] and RR = 1.55 [1.13-1.98], respectively). CONCLUSIONS Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Florian Pecune
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Yannick Levavasseur
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Etienne De Sevin
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Emmanuel D'incau
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Patricia Sagaspe
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Maria-Montserrat Sanchez-Ortuño
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- School of Nursing, University of Murcia, Murcia, Spain
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Pierre Philip
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
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Philip P, Micoulaud-Franchi JA, Taillard J, Coelho J, Tisserand C, Dauvilliers Y, Sagaspe P. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med 2023; 19:957-965. [PMID: 36727504 PMCID: PMC10152350 DOI: 10.5664/jcsm.10470] [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: 08/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES Sleepiness is a well-known risk factor for traffic accidents. Our study presents a new questionnaire, the Bordeaux Sleepiness Scale (BOSS), specifically designed to evaluate sleep-related driving risk in patients with sleep disorders. METHODS The BOSS was designed by gathering data on sociodemographics, sleepiness, driving items, and traffic accident exposure (kilometers driven) in the past year of 293 patients followed for sleep disorders at a French sleep clinic. It was then validated on data from a large population-based cohort of 7,296 highway drivers. Its performance was compared to the Epworth sleepiness scale and to self-reported episodes of severe sleepiness at the wheel. Receiver operating characteristic curves were computed. RESULTS The sensitivity and specificity of the BOSS (cutoff = 3) to predict sleep-related near-misses or accidents was, respectively, 82% and 74%, with an area under the receiver operating characteristic curve of 0.83. In a cohort of patients and a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the Epworth sleepiness scale (P < .001). Although the areas under the curve were equivalent between the BOSS and sleepiness at the wheel, the specificity of the BOSS was higher. CONCLUSIONS The BOSS scale combining exposure (kilometers driven) and self-perception of situational sleepiness provides a simple and reliable evaluation of sleep-related driving risk. This short, specific questionnaire should be promoted as a first-line tool to evaluate the risk of traffic accidents in sleepy patients. CITATION Philip P, Micoulaud-Franchi J-A, Taillard J, et al. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med. 2023;19(5):957-965.
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Affiliation(s)
- Pierre Philip
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
- INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Julien Coelho
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | | | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France
- PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Patricia Sagaspe
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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Coelho J, Montagni I, Micoulaud-Franchi JA, Plancoulaine S, Tzourio C. Study of the association between cannabis use and sleep disturbances in a large sample of University students. Psychiatry Res 2023; 322:115096. [PMID: 36842936 DOI: 10.1016/j.psychres.2023.115096] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Sleep complaints and cannabis use are common among University students and are related to detrimental effects on health. The aim of this study was to explore their association. This cross-sectional study based on the i-Share e-cohort included French students between 18 and 30 years old (n = 14,787). Frequency of cannabis use was categorized into daily, weekly, monthly, and never/rarely use. Sleep complaints were defined using four items (i.e., insomnia, sleepiness, poor sleep quality, and sleep deprivation). In the whole sample (mean age: 20.4 years, 75.5% of females), 22.7% had insomnia, 18.3% had sleepiness, 22.4% had poor sleep quality, 52.5% had sleep deprivation, and 5.8% used cannabis weekly or daily. After adjustment, the likelihood of insomnia was significantly higher by 45% in cannabis users compared to non-users. The estimates steadily increased with frequency of use, reaching a 2.0-fold higher likelihood of insomnia in daily users compared to never/rarely users. Results were similar for the other sleep complaints. These findings provide support for an association between cannabis use and sleep complaints, particularly insomnia, among University students. Though direction and causality cannot be established in this setting, these results suggest warning students and health professionals about the association between cannabis use and sleep complaints.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France.
| | - Ilaria Montagni
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
| | - Jean-Arthur Micoulaud-Franchi
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, Place Amélie Raba Léon, 33000, Bordeaux, Nouvelle-Aquitaine, France
| | - Sabine Plancoulaine
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Epidémiologie et StatistiquesS (CRESS), F-75004 Paris, France
| | - Christophe Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
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Bandarra MCF, Escoval A, Lopes A, Abreu C, Simões J, Brito M, Dinis R, Alves S, Póvoa S, Oliveira SD, Simão D, Nogueira-Costa G, Coelho J, Montenegro M, Ramos M, Meireles P, Magno S, Pedro S, da Costa LM. P137 PERSONA study: Optimization of the value-based healthcare as for the follow-up of women with breast cancer- A portrait of breast cancer survivor’s follow-up in Portugal. Breast 2023. [DOI: 10.1016/s0960-9776(23)00254-0] [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: 03/17/2023] Open
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Coelho J, Taillard J, Bernard A, Lopez R, Fond G, Boyer L, Lucas G, Alla F, Buysse DJ, Wallace ML, Verdun-Esquer C, Geoffroy PA, d’Incau E, Philip P, Micoulaud-Franchi JA. Emotional Exhaustion, a Proxy for Burnout, Is Associated with Sleep Health in French Healthcare Workers without Anxiety or Depressive Symptoms: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12051895. [PMID: 36902682 PMCID: PMC10004252 DOI: 10.3390/jcm12051895] [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: 12/22/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout among healthcare workers while considering anxiety and depressive symptoms. A cross-sectional Internet-based survey of French healthcare workers was conducted in summer 2020, at the end of the first COVID-19 lockdown in France (March to May 2020). Sleep health was assessed using the RU-SATED v2.0 scale (RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration). Emotional exhaustion was used as a proxy for overall burnout. Of 1069 participating French healthcare workers, 474 (44.3%) reported good sleep health (RU-SATED > 8) and 143 (13.4%) reported emotional exhaustion. Males and nurses had a lower likelihood of emotional exhaustion than females and physicians, respectively. Good sleep health was associated with a 2.5-fold lower likelihood of emotional exhaustion and associations persisted among healthcare workers without significant anxiety and depressive symptoms. Longitudinal studies are needed to explore the preventive role of sleep health promotion in terms of the reduction in burnout risk.
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Affiliation(s)
- Julien Coelho
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-64570-6212
| | - Jacques Taillard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
| | - Adèle Bernard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, F-34000 Montpellier, France
- Inserm, U1061, Université Montpellier 1, F-34000 Montpellier, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Guillaume Lucas
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
| | - François Alla
- Pôle de Santé Publique, CHU Bordeaux, F-33000 Bordeaux, France
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | | | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, F-75018 Paris, France
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, F-75014 Paris, France
- Inserm, FHU I2-D2, Université de Paris, NeuroDiderot, F-75019 Paris, France
| | - Emmanuel d’Incau
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
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Silveira F, Seixas J, Tauile M, Teixeira G, Meirelles L, Alvim M, Coelho J. 100 Lipschütz ulcer in teenagers – Case report. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.129] [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]
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Peixoto C, Rego D, Cruz M, Peixoto B, Bicho M, Coelho J, Medeiros H. Challenges of ageing in prisons and forensic psychiatric settings. Eur Psychiatry 2022. [PMCID: PMC9567742 DOI: 10.1192/j.eurpsy.2022.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction There is a current trend towards an increase in the number of elderly prisoners due to the increase in life expectancy and the change in the attitude of society and the judicial system. The cut-off for “older offender” is defined from the age of 50, due to the lifestyle previous to prision and premature ageing. Objectives The authors intend to understand the challenges of aging in prison and forensic services, highlighting the psychiatric comorbidities of inmates and how these services can adapt to the needs of this population. Methods Non-systematic review of the literature. Results Studies of elderly in prisons and elderly forensic psychiatric patients are limited. Prisoners have increased physical and psychiatric morbidity and early mortality as they are more exposed to risk factors and more likely to have at least one health problem compared to older adults in the community. Compared to older people in the community, older prisoners are at higher risk for most psychiatric disorders including depression, psychosis, bipolar disorder, cognitive impairment, personality disorder and anxiety. Suicide rates are also higher among elderly prisoners. The inadequacy of the prison system to respond to the unique needs of elderly prisoners has a detrimental impact on their overall experience of incarceration. The development of specific services for elderly prisoners or the adaptation of mixed units for the elderly population is proposed. Conclusions The elderly population in prisons is growing and has higher risk of psychiatric pathology compared to community elders. Prison services with difficulties in identifying and meeting these needs. Disclosure No significant relationships.
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Coelho J, Micoulaud-Franchi JA, Nguyen D, Wiet AS, Taillard J, Philip P. 0046 Circadian misalignment is associated with Covid-19 infection. Sleep 2022. [PMCID: PMC9384125 DOI: 10.1093/sleep/zsac079.044] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Sleep disturbances are frequently reported in patients infected by Covid-19, but the role of sleep-wake behaviors as a risk factor to contract Covid-19 has up to now poorly been studied. The aim of this study was to explore the relationship between usual sleep-wake behaviors and the risk of Covid-19 infection in a population of subjects suspect of contact or infection with SARS-CoV-2. Methods Cross-sectionnal monocentric study set during a non-confined period in winter 2021. Recruitment took place in a Covid-19 ambulatory screening platform. Subjects between 18 and 45 years old were included whether they were symptomatic or not, healthcare workers or not, in contact with a Covid-19 case or not. They were asked about their usual sleep-wake behaviors. Usual sleep duration and sleep timing were explored during workdays and free days. Circadian misalignment was defined as at least 2 hours shift of circadian alignment (defined as the difference between mid‐sleep during workdays and mid‐sleep during free days, mid sleep as the middle between bedtime and getting up time). Results One thousand eighteen subjects were included in our study (acceptance rate: 10.8%, 39% of men, mean age of 28±8). Habitual mean sleep duration was equivalent in both groups (7h47 vs 7h49, p=0.733). Circadian misalignment greater than 2 hours concerned 33% of subjects in the Covid-19 group versus 20% of the control group (p=0.026). After adjustment on age, gender, BMI and work schedules, subjects presenting a circadian misalignment superior to 2 hours had 2.07 more chances to be tested positive than subjects which respected on identical sleep-wake timing between workdays and free days (OR=2.07, 95%CI= [1.12-3.80], p=0.024). Conclusion Altered sleep not only is present in subjects infected by Covid-19 but could be responsible of a higher change to be infected. Chronobiological impact on immune system and higher chances to be exposed to social contacts could explain our findings which deserve to be confirmed through a future large cohort study. Ultimately regular sleep-wake pattern could constitute a privileged prevention target to fight Covid-19 infection. Support (If Any)
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Debedde E, Felber M, Coelho J, Fabiano E, Durdux C, Timsit MO, Méjean A, Audenet F. Management and outcomes of non-muscle invasive bladder recurrence after complete response to trimodality therapy for muscle-invasive bladder cancer: A monocentric experience. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00841-7] [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: 11/04/2022]
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Coelho J, Lopez R, Richaud A, Buysse DJ, Wallace ML, Philip P, Micoulaud-Franchi JA. Toward a multi-lingual diagnostic tool for the worldwide problem of sleep health: The French RU-SATED validation. J Psychiatr Res 2021; 143:341-349. [PMID: 34563876 DOI: 10.1016/j.jpsychires.2021.09.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sleep health is "a multidimensional pattern of sleep-wakefulness, adapted to individual, social, and environmental demands, that promotes physical and mental well-being". The RU-SATED is a short practical self-reported symptom scale that is a reliable valid tool for the rapid evaluation of sleep health. This study sought to examine the psychometric validity of the French version. METHODS We conducted an observational cross-sectional study. All professionals working in Bordeaux University Hospital were asked to answer an internet-based questionnaire assessing sleep, mental and physical health outcomes. Sleep health was measured using the French RU-SATED scale obtained by a rigorous reverse translation process. Psychometric validity included factor structure, internal structural validity, concurrent validity and external validity of the measure, with sleep, mental and physical health outcomes. RESULTS A total of 1,562 participants were included with 80.5% of women and a mean age of 40.0 (±11.2). Sleep health was within the average range (M = 8.2, SD = 2.4) on the RU-SATED. Confirmatory factor analyses showed acceptable model fit measures. Cronbach's alpha coefficient was 0.57 and ranged from 0.46 to 0.58 when removing each item. The correlation between items with the overall corrected scores ranged from 0.19 to 0.43. The "Efficiency" item showed poor psychometric properties. Most items were highly correlated with their appropriate sleep outcome. All items showed a strong association with positive mental and physical health outcomes. DISCUSSION The French RU-SATED scale is a reliable valid tool for measuring sleep health in adults. Nevertheless, future studies should better evaluate the reliability and validity of the "Efficiency" item. It is also important to explore how the RU-SATED can be used to evaluate the impact of sleep hygiene strategies in promoting public health in accordance with models of sleep behavior change.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France.
| | - Régis Lopez
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Inserm, U1061, Université Montpellier 1, Montpellier, France
| | - Alexandre Richaud
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Pierre Philip
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
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22
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Lamagni T, Wloch C, Broughton K, Collin SM, Chalker V, Coelho J, Ladhani SN, Brown CS, Shetty N, Johnson AP. Assessing the added value of group B Streptococcus maternal immunisation in preventing maternal infection and fetal harm: population surveillance study. BJOG 2021; 129:233-240. [PMID: 34324252 PMCID: PMC9291181 DOI: 10.1111/1471-0528.16852] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the incidence of maternal group B Streptococcus (GBS) infection in England. DESIGN Population surveillance augmented through data linkage. SETTING England. POPULATION All pregnant women accessing the National Health Service (NHS) in England. METHODS Invasive GBS (iGBS) infections during pregnancy or within 6 weeks of childbirth were identified by linking Public Health England (PHE) national microbiology surveillance data for 2014 to NHS hospital admission records. Capsular serotypes of GBS were determined by reference laboratory typing of clinical isolates from women aged 15-44 years. Post-caesarean section surgical site infection (SSI) caused by GBS was identified in 21 hospitals participating in PHE SSI surveillance (2009-2015). MAIN OUTCOME MEASURES iGBS rate per 1000 maternities; risk of GBS SSI per 1000 caesarean sections. RESULTS Of 1601 patients diagnosed with iGBS infections in England in 2014, 185 (12%) were identified as maternal infections, a rate of 0.29 (95% CI 0.25-0.33) per 1000 maternities and representing 83% of all iGBS cases in women aged 18-44 years. Seven (3.8%) were associated with miscarriage. Fetal outcome identified excess rates of stillbirth (3.4 versus 0.5%) and extreme prematurity (<28 weeks of gestation, 3.7 versus 0.5%) compared with national averages (P < 0.001). Caesarean section surveillance in 27 860 women (21 hospitals) identified 47 cases of GBS SSI, with an estimated 4.24 (3.51-5.07) per 1000 caesarean sections, a median time-to-onset of 10 days (IQR 7-13 days) and ten infections that required readmission. Capsular serotype analysis identified a diverse array of strains with serotype III as the most common (43%). CONCLUSIONS Our assessment of maternal GBS infection in England indicates the potential additional benefit of GBS vaccination in preventing adverse maternal and fetal outcomes.
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Affiliation(s)
- T Lamagni
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - C Wloch
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - K Broughton
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - S M Collin
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - V Chalker
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - J Coelho
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - S N Ladhani
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - C S Brown
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - N Shetty
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - A P Johnson
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
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Prével R, Coelho J, Orieux A, Philip P, Gruson D, Bioulac S. Psychological evaluation and support in COVID-19 critically ill patients: a feasibility study. Crit Care 2021; 25:218. [PMID: 34167549 PMCID: PMC8223189 DOI: 10.1186/s13054-021-03642-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/11/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Renaud Prével
- Medical Intensive Care Unit, CHU Bordeaux, 33000, Bordeaux, France. .,Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France.
| | - Julien Coelho
- Service Universitaire Médecine du Sommeil, CHU Bordeaux, 33000, Bordeaux, France
| | - Arthur Orieux
- Medical Intensive Care Unit, CHU Bordeaux, 33000, Bordeaux, France
| | - Pierre Philip
- Service Universitaire Médecine du Sommeil, CHU Bordeaux, 33000, Bordeaux, France.,CNRS SANPSY (Sommeil Addiction et Neuropsychiatrie), USR 3413, Univ. Bordeaux, 33000, Bordeaux, France
| | - Didier Gruson
- Medical Intensive Care Unit, CHU Bordeaux, 33000, Bordeaux, France.,Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | - Stéphanie Bioulac
- Service Universitaire Médecine du Sommeil, CHU Bordeaux, 33000, Bordeaux, France.,CNRS SANPSY (Sommeil Addiction et Neuropsychiatrie), USR 3413, Univ. Bordeaux, 33000, Bordeaux, France
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Peixoto C, Rego D, Bicho M, Coelho J, Medeiros H. Psychiatric symptoms in huntington’s disease. Eur Psychiatry 2021. [PMCID: PMC9528255 DOI: 10.1192/j.eurpsy.2021.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder, that typically manifests in adulthood, clinically characterized by progressive motor, cognitive and psychiatric/behavioural symptoms. Psychiatric symptoms are common in HD. The presentation of these symptoms is highly variable, and their course does not correlate with motor or cognitive disease progression. Psychiatric symptoms often precede motor onset by many years.ObjectivesThe authors intend to review the literature the most frequent psychiatric disorders in patients with HD.MethodsNon-systematic review of the literature.ResultsPsychiatric symptoms have been a core feature of HD. Pre-symptomatic HD patients exhibit a greater prevalence of psychiatric symptoms, particularly affective disorders. This symptoms are presenting symptoms of HD in up to half of all people. In symptomatic HD patients, it is estimated that up to 73–98% of patients will have a major psychiatric disorder or psychiatric symptoms. Psychiatric manifestations in HD include depression, irritability, apathy, anxiety, mania, perseverations, obsessions and psychosis. Cognitive changes include progressive deficits in attention, learning, executive and sensory functions, resulting in dementia. Depression, diagnosed in half of patients with HD, is the most common and earliest symptoms prior to the motor onset. There are likely multiple causes of the psychiatric symptoms, with underlying factors including a combination of neurobiological, cognitive, psychological, social and environmental factors.ConclusionsPatients with HD have high psychiatric comorbidity, that causes significant functional impairment and affect quality of life. Thus, they require a multidisciplinary approach in the recognition and treatment of psychiatric symptoms.
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Bicho M, Coelho J, Peixoto C, Fontes H. Pisa syndrome – a case report. Eur Psychiatry 2021. [PMCID: PMC9480287 DOI: 10.1192/j.eurpsy.2021.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Pisa Syndrome or pleurothotonus is a form of dystonia and often can arise as a side effect of antipsychotic treatment conditioning high morbidity and limiting management options. Despite the fact that the precise mechanism remains unclear, a neurochemical imbalance in dopaminergic and cholinergic transmission but also in serotoninergic and noradrenergic transmission can be a possible pathophysiologic mechanism, which can lead to changes in the axial axis with abnormal posture and marked lateral trunk flexion and abnormal gait. Objectives Regarding a clinical case, the authors intend to review the relevant and current literature on the relationship between psychotropic drugs and Pisa Syndrome. Methods Description of a clinical case by consulting databases of current and scientifically relevant articles. Results The clinical case reports a 48-year-old woman with a history of HIV and Substance Use Disorder, hospitalized for unspecific behavioral changes, characterized by mood changes, self-referential, persecutory and somatic delusional ideas, and delusions of the control of thought. She was medicated with antipsychotics and mood stabilizers, with subsequent development of an acute-onset dystonic condition, characterizing the Pisa Syndrome. In this context, the dose of antipsychotics was lowered and anticholinergics were introduced, with progressive improvement of the clinical picture. Conclusions Pisa Syndrome, previously seen as a rare adverse effect, can occur as a dystonic reaction related to the use of psychotropic drugs, so its use should be judicious. Further studies are needed to understand the extent of this association and its pathophysiological mechanisms in order to guide more rigorous therapeutic lines. Disclosure No significant relationships.
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Degala S, Puleston R, Bates R, Borges-Stewart R, Coelho J, Kapatai G, Chalker V, Mair-Jenkins J. A protracted iGAS outbreak in a long-term care facility 2014-2015: control measures and the use of whole-genome sequencing. J Hosp Infect 2021; 105:70-77. [PMID: 32386676 DOI: 10.1016/j.jhin.2019.12.004] [Citation(s) in RCA: 1] [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: 09/13/2019] [Accepted: 12/04/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND In 2014, two residents of a long-term care facility (LTCF) developed invasive group A streptococcal (iGAS) infections with identical typing (emm 11), resulting in one death. The second resident recovered but had a subsequent episode of emm 11 iGAS infection 10 months later. This second episode was linked to a third case, within 12 days, leading to a further outbreak investigation. AIM To combine different techniques to establish whether this was a protracted outbreak, understand transmission pathways and inform appropriate control measures. METHODS Following a routine response to the first cluster, the second investigation included a care record review. This informed network analysis of case interactions with staff and visitors during 10 days prior to infection. These data were combined with post-outbreak whole-genome sequencing (WGS) using isolates from cases, and staff and resident screening (44 GAS isolates: 11 outbreak-related and 33 sporadic isolates). FINDINGS Two of the three confirmed iGAS cases died (one suffered two episodes). All iGAS cases, and six non-invasive isolates from 2015, were emm 11 (monophylogenetic WGS clade). Network analysis highlighted only indirect contact through staff-visitor interactions between iGAS cases in 2015. This suggested a common source and transmission propagation through carriage and/or environmental contamination over an 11-month period. CONCLUSIONS This outbreak highlighted benefits of staff/resident screening and typing as part of routine response. Network analysis and highly discriminatory WGS clarified the protracted nature of the outbreak, supporting findings of hygiene and infection control issues and adding to our understanding of the epidemiology.
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Affiliation(s)
- S Degala
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Nottingham, UK.
| | - R Puleston
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Nottingham, UK
| | - R Bates
- Local Knowledge and Intelligence Service, Public Health England, Nottingham, UK
| | | | - J Coelho
- Respiratory and Systemic Bacteria Section, Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, Nottingham, UK
| | - G Kapatai
- Respiratory and Systemic Bacteria Section, Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, Nottingham, UK
| | - V Chalker
- Respiratory and Systemic Bacteria Section, Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, Nottingham, UK
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Coelho J, Divernet-Queriaud M, Roy PM, Penaloza A, Le Gal G, Trinh-Duc A. Comparison of the Wells score and the revised Geneva score as a tool to predict pulmonary embolism in outpatients over age 65. Thromb Res 2020; 196:120-126. [PMID: 32862033 DOI: 10.1016/j.thromres.2020.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/11/2019] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
Abstract
TITLE Comparison of the Wells score and the revised Geneva score as a tool to predict pulmonary embolism in outpatients over 65 years of age. INTRODUCTION The incidence and mortality of pulmonary embolism (PE) is high in the elderly. The Wells score (SW) and the revised Geneva score (RGS) have been validated in patient populations with a large age range. The aim of this study was to compare the predictive accuracy of these two scores in diagnosis of PE in patients over 65 years of age. METHOD A prospective multicentre study (nine French and three Belgian centres) was conducted at the same time as the PERCEPIC study. A total of 1757 patients admitted with suspected PE were included and divided into two groups according to age (≥65 years or <65 years). The pre-test probability of PE was assessed prospectively for the RGS. The SW was calculated retrospectively. The predictive accuracy of the two scores was compared by the area under the curve (AUC) of the ROC curves. RESULTS The overall prevalence of PE was 11.3%. The prevalence among patients aged ≥65 in the low, moderate and high pre-test probability groups, evaluated using the WS and was respectively 13.5% (CI 95%: CI 9.9-17.3), 28.2% (CI 22.1-34.3), 50% (CI 26-74) and 8.1% (CI 3.2-12.9), 22.3% (CI 18.2-26.3), 43.7% (CI 25.6-61.9) using the RGS. The AUC for the WS and RGS for patients aged ≥65 was 0.632 (CI 0.574-0.691) and 0.610 (CI 0.555-0.666). The difference between the AUCs was not statistically significant (p = .441). CONCLUSION In the population for this study, the WS and RGS have the same PE diagnostic accuracy in patients over age 65. This result should be validated in a prospective study that directly compares these scores.
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Affiliation(s)
- Julien Coelho
- Centre Hospitalier d'Agen-Nérac, Site St Esprit, 21 route de Villeneuve, 47923 Agen, France.
| | | | - Pierre-Marie Roy
- Emergency Department, Centre Hospitalier Universitaire Angers, Institut Mitovasc, Université d'Angers, Angers, France
| | - Andréa Penaloza
- Emergency Department, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Grégoire Le Gal
- Division of Hematology-Thrombosis Program, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Albert Trinh-Duc
- Centre Hospitalier d'Agen-Nérac, Site St Esprit, 21 route de Villeneuve, 47923 Agen, France
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28
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Certenais T, Manangama G, Coelho J, Brochard P, Sentilhes L, Teysseire R, Delva F. Expositions à des facteurs de risque sur la reproduction en milieu professionnel. ARCH MAL PROF ENVIRO 2019. [DOI: 10.1016/j.admp.2019.09.004] [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: 10/25/2022]
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29
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Werutsky G, Cardona A, Kaen D, Arrieta O, Gelatti A, Mathias C, Zukin M, Cronemberger E, Mascarenhas E, Campos C, De Lima VC, Borges G, Coelho J, Oliveira F, Silva A, Araújo L, Quiroba A, Andrade H, Morbeck I, Lobaton J, Dias J, Zarba J, Fein L, Salman P, Trejo R, Barrios C. EP1.16-39 Prospective Epidemiological Study of Metastatic Non-Small Cell Lung Cancer (NSCLC) in Latin America – LATINO Lung (LACOG 0116). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2404] [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: 10/25/2022]
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30
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Sharma H, Ong MR, Ready D, Coelho J, Groves N, Chalker V, Warren S. Real-time whole genome sequencing to control a Streptococcus pyogenes outbreak at a national orthopaedic hospital. J Hosp Infect 2019; 103:21-26. [PMID: 31283948 DOI: 10.1016/j.jhin.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/10/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Whole genome sequencing (WGS) of Streptococcus pyogenes linked to invasive disease has been used to identify and investigate outbreaks. The clinical application of WGS in real-time for outbreak control is seldom employed. AIMS A fatal case of bacteraemia at a national orthopaedic hospital prompted an outbreak investigation to identify carriers and halt transmission using real-time WGS. METHODS Retrospective surveillance was conducted to identify patients with Streptococcus pyogenes infections in the last year. Upon contact tracing, four patients and 179 staff were screened for Streptococcus pyogenes carriage. All isolates identified were emm-typed. WGS was performed in real-time on a subset of isolates. FINDINGS Twelve isolates of Streptococcus pyogenes from the index case, two patients and eight staff were identified. Six isolates were emm 1.0, including the index case and five staff isolates. The remaining isolates belonged to distinct emm types. WGS analysis was undertaken on the six emm 1.0 isolates. Five were indistinguishable by single nucleotide polymorphism (SNP) analysis, with 0 SNP distance, and one had one SNP difference, supporting the hypothesis of recent local transmission. All screen-positive healthcare workers were offered treatment with penicillin or clindamycin. No further cases were identified. CONCLUSION The increased molecular discrimination of WGS confirmed the clustering of these cases and the outbreak was contained. This demonstrates the clinical utility of WGS in managing outbreaks of invasive Streptococcus pyogenes in real-time and we recommend its implementation as a routine clinical service.
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Affiliation(s)
- H Sharma
- Bone Infection Unit, The Royal National Orthopaedic Hospital, Stanmore, UK.
| | - M R Ong
- Bone Infection Unit, The Royal National Orthopaedic Hospital, Stanmore, UK
| | - D Ready
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, London, UK
| | - J Coelho
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, London, UK
| | - N Groves
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, London, UK
| | - V Chalker
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, London, UK
| | - S Warren
- Bone Infection Unit, The Royal National Orthopaedic Hospital, Stanmore, UK
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31
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Coelho J, Cruz R. Identification and characterization of drug interactions reported in Portugal between 2008 and 2018. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.013] [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: 11/15/2022] Open
Affiliation(s)
- J Coelho
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - R Cruz
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
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32
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Espiga M, Mauvoisin S, Teysseire R, Manangama G, Coelho J, Brochard P, Sentilhes L, Delva F. L’entretien infirmier protocolisé au centre ARTEMIS. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2018.03.215] [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]
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33
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Coelho J, Manangama G, Teysseire R, Mauvoisin S, Espiga M, Brochard P, Sentilhes L, Delva F. Expositions professionnelles péri-conceptionnelles à des facteurs de risque sur la reproduction chez les couples du centre ARTEMIS. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2018.03.213] [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]
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34
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Jones CS, Nowers J, Smart NJ, Coelho J, Watts A, Daniels IR. Pelvic floor reconstruction with bilateral gracilis flaps following extralevator abdominoperineal excision - a video vignette. Colorectal Dis 2017; 19:1120-1121. [PMID: 29053218 DOI: 10.1111/codi.13933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 09/12/2017] [Indexed: 02/08/2023]
Affiliation(s)
- C S Jones
- University of Exeter Medical School, Exeter, UK
| | - J Nowers
- Exeter Surgical Health Services Research Unit (HESRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N J Smart
- Exeter Surgical Health Services Research Unit (HESRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - J Coelho
- Plastic and Reconstructive Surgery Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - A Watts
- Plastic and Reconstructive Surgery Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - I R Daniels
- Exeter Surgical Health Services Research Unit (HESRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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35
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Schmidt C, Goncalves N, Silva A, Coelho J, Fontoura D, Leite S, Miranda-Silva D, Falcao-Pires I, Lourenco A, Oliveira J, Leite-Moreira A, Moreira-Goncalves D. P452Chronic exercise training modulates inflammation and reduces left ventricle stiffness in heart failure with preserved ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p452] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Matos-Pires A, Canelas P, Coelho J, Gaspar C, Cavagliá R. Ulsba's Epva hospital team's first year of activity. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Domestic violence (DV) against women still lacks rigor in its identification and denouncement, which makes it an under diagnosed condition.Physical and psychic well-being of women who are victims of DV is threatened hence it is essential to discuss this subject as a health matter. Furthermore, health professionals are usually DV victims’ first contact. In 2009, Margaret Chan from WHO stated that “Preventing violence against women requires a multi-sectoral approach, and in this context the health sector has a central role to play which includes helping to identify abuse early, providing victims with the necessary treatment, and referring women to appropriate and informed care.”Portuguese Health Ministry has created, through the legal dispatch No. 6378/2013 of may 16, an integrated intervention model on interpersonal violence throughout life, entitled Ação de Saúde sobre Género, Violência e Ciclo de Vida (ASGVCV), made operational by Equipas para a Prevenção da Violência em Adultos (EPVA) teams.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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37
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Meireles A, Goldsmith C, El-Ghrably I, Erginay A, Habib M, Pessoa B, Coelho J, Patel T, Tadayoni R, Massin P, Atorf J, Augustin AJ. Efficacy of 0.2 μg/day fluocinolone acetonide implant (ILUVIEN) in eyes with diabetic macular edema and prior vitrectomy. Eye (Lond) 2017; 31:684-690. [PMID: 28085139 PMCID: PMC5437318 DOI: 10.1038/eye.2016.303] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/15/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose Limited data are available on the efficacy of the 0.2 μg/day fluocinolone acetonide (FAc) implant in eyes with prior vitrectomy. Here, we present a collection of 26 vitrectomized eyes treated with the 0.2 μg/day FAc implant. Methods Retrospective study involving six centers from four European countries analyzing the safety and efficacy data from patients (26 eyes from 25 patients) with DME and a prior vitrectomy that had been treated with one 0.2 μg/day FAc implant. Results Prior intravitreal therapies included anti-VEGF (mean, 3.8 injections) and steroids (mean, 1.9 injections). Pars plana vitrectomy (PPV) was performed in these eyes primarily for abnormalities of vitreoretinal interface, followed by proliferative diabetic retinopathy and vitreous hemorrhage. The 0.2 μg/day FAc implant was injected 24.2 months, on average, after PPV and the mean duration of follow-up after injection was 255 days (range, 90 to 759 days). The mean change in BCVA was +11.7 ETDRS letters (range, −19 to +40 letters; P<0.0004) and the mean change in central foveal thickness (CFT) was −233.5 μm (range, −678 to 274 μm; P<0.0001). The mean change in IOP from baseline at the last visit was +1.4 mm Hg (range, −9 to +8 mm Hg; P=0.0090). Eight eyes initiated or continued IOP lowering medications. Conclusions These data suggest the 0.2 μg/day FAc implant is effective in vitrectomized patients with an acceptable safety profile. Further studies are still required to confirm the current findings and to assess the effect of the 0.2 μg/day FAc implant over a longer period of follow-up.
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Affiliation(s)
- A Meireles
- Unit of Ophthalmology, CHP-Hospital Santo António, Porto, Portugal.,Unit of Ophthalmology, Universidade do Porto-Instituto Ciências Biomédicas Abel Salazar, Porto, Portugal
| | - C Goldsmith
- Unit of Ophthalmology, James Paget University Hospital, Great Yarmouth, UK
| | - I El-Ghrably
- Unit of Ophthalmology, James Cook University Hospital, Middlesbrough, UK
| | - A Erginay
- Unit of Ophthalmology, Lariboisiere University hospital, Paris, France
| | - M Habib
- Unit of Ophthalmology, Sunderland Eye Hospital, Sunderland, UK
| | - B Pessoa
- Unit of Ophthalmology, CHP-Hospital Santo António, Porto, Portugal
| | - J Coelho
- Unit of Ophthalmology, CHP-Hospital Santo António, Porto, Portugal
| | - T Patel
- Unit of Ophthalmology, James Paget University Hospital, Great Yarmouth, UK
| | - R Tadayoni
- Unit of Ophthalmology, Lariboisiere University hospital, Paris, France
| | - P Massin
- Unit of Ophthalmology, Lariboisiere University hospital, Paris, France
| | - J Atorf
- Department of Ophthalmology, Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - A J Augustin
- Department of Ophthalmology, Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
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38
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Perera KS, Vanassche T, Bosch J, Swaminathan B, Mundl H, Giruparajah M, Barboza MA, O’Donnell MJ, Gomez-Schneider M, Hankey GJ, Yoon BW, Roxas A, Lavallee P, Sargento-Freitas J, Shamalov N, Brouns R, Gagliardi RJ, Kasner SE, Pieroni A, Vermehren P, Kitagawa K, Wang Y, Muir K, Coutinho JM, Connolly SJ, Hart RG, Czeto K, Kahn M, Mattina K, Ameriso S, Pujol-Lereis V, Hawkes M, Pertierra L, Perera N, De Smedt A, Van Dyck R, Van Hooff R, Yperzeele L, Gagliardi V, Cerqueir L, Yang X, Chen W, Amarenco P, Guidoux C, Ringleb P, Bereczki D, Vastagh I, Canavan M, Toni D, Anzini A, Colosimo C, De Michele M, Di Mascio M, Durastanti L, Falcou A, Fausti S, Mancini A, Mizumo S, Uchiyama S, Kim C, Jung S, Kim Y, Kim J, Jo J, Arauz A, Quiroz-Compean A, Colin J, Nederkoorn P, Marianito V, Cunha L, Santo G, Silva F, Coelho J, Kustova M, Meshkova K, Williams G, Siegler J, Zhang C, Gallatti N, Kruszewski M. Global Survey of the Frequency of Atrial Fibrillation–Associated Stroke. Stroke 2016; 47:2197-202. [DOI: 10.1161/strokeaha.116.013378] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/27/2016] [Indexed: 12/22/2022]
Abstract
Background and Purpose—
Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features.
Methods—
Consecutive patients hospitalized for ischemic stroke in 2013 to 2014 were surveyed from 19 stroke research centers in 19 different countries. Data were analyzed by global regions and World Bank income levels.
Results—
Of 2144 patients with ischemic stroke, 590 (28%; 95% confidence interval, 25.6–29.5) had AF-associated stroke, with highest frequencies in North America (35%) and Europe (33%) and lowest in Latin America (17%). Most had a history of AF before stroke (15%) or newly detected AF on electrocardiography (10%); only 2% of patients with ischemic stroke had unsuspected AF detected by poststroke cardiac rhythm monitoring. The mean age and 30-day mortality rate of patients with AF-associated stroke (75 years; SD, 11.5 years; 10%; 95% confidence interval, 7.6–12.6, respectively) were substantially higher than those of patients without AF (64 years; SD, 15.58 years; 4%; 95% confidence interval, 3.3–5.4;
P
<0.001 for both comparisons). There was a strong positive correlation between the mean age and the frequency of AF (
r
=0.76;
P
=0.0002).
Conclusions—
This cross-sectional global sample of patients with recent ischemic stroke shows a substantial frequency of AF-associated stroke throughout the world in proportion to the mean age of the stroke population. Most AF is identified by history or electrocardiography; the yield of conventional short-duration cardiac rhythm monitoring is relatively low. Patients with AF-associated stroke were typically elderly (>75 years old) and more often women.
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Affiliation(s)
- Kanjana S. Perera
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Thomas Vanassche
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Jackie Bosch
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Balakumar Swaminathan
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Hardi Mundl
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Mohana Giruparajah
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Miguel A. Barboza
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Martin J. O’Donnell
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Maia Gomez-Schneider
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Graeme J. Hankey
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Byung-Woo Yoon
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Artemio Roxas
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Philippa Lavallee
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Joao Sargento-Freitas
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Nikolay Shamalov
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Raf Brouns
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Rubens J. Gagliardi
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Scott E. Kasner
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Alessio Pieroni
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Philipp Vermehren
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Kazuo Kitagawa
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Yongjun Wang
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Keith Muir
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Jonathan M. Coutinho
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Stuart J. Connolly
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Robert G. Hart
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - K. Czeto
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - M. Kahn
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - K.R. Mattina
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - S.F. Ameriso
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - V. Pujol-Lereis
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - M. Hawkes
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - L. Pertierra
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - N. Perera
- School of Medicine & Pharmacology, University of Western Australia and Sir Charles Gairdner Hospital, Perth, Australia
| | - A. De Smedt
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - R. Van Dyck
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - L. Yperzeele
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - L.G. Cerqueir
- Santa Casa de São Paulo, Medical School, Sao Paulo, Brazil
| | - X. Yang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - W. Chen
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | | | - P.A. Ringleb
- University Hospital Heidelberg, Heidelberg, Germany
| | | | - I. Vastagh
- Semmelweis University, Budapest, Hungary
| | - M. Canavan
- Galway University Hospitals, Galway, Ireland
| | - D. Toni
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Anzini
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - C. Colosimo
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - M. De Michele
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - M.T. Di Mascio
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - L. Durastanti
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Falcou
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - S. Fausti
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Mancini
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - S. Mizumo
- Tokyo Women’s Medical University, Tokyo, Japan
| | - S. Uchiyama
- Tokyo Women’s Medical University, Tokyo, Japan
| | - C.K. Kim
- Seoul National University Hospital, Seoul, Korea
| | - S. Jung
- Seoul National University Hospital, Seoul, Korea
| | - Y. Kim
- Seoul National University Hospital, Seoul, Korea
| | - J.A. Kim
- Seoul National University Hospital, Seoul, Korea
| | - J.Y. Jo
- Seoul National University Hospital, Seoul, Korea
| | - A. Arauz
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | - A. Quiroz-Compean
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | - J. Colin
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | | | | | - L. Cunha
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - G. Santo
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F. Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J. Coelho
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M. Kustova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - K. Meshkova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - G. Williams
- Institute of Neuroscience and Physiology, University of Glasgow, Queen Elizabeth Hospital, Glasgow, United Kingdom
| | - J. Siegler
- Hospital of the University of Pennslyvania, Philadelphia
| | - C. Zhang
- Hospital of the University of Pennslyvania, Philadelphia
| | - N. Gallatti
- Hospital of the University of Pennslyvania, Philadelphia
| | - M. Kruszewski
- Hospital of the University of Pennslyvania, Philadelphia
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Marconi A, Di Marcantonio P, D'Odorico V, Cristiani S, Maiolino R, Oliva E, Origlia L, Riva M, Valenziano L, Zerbi FM, Abreu M, Adibekyan V, Allende Prieto C, Amado PJ, Benz W, Boisse I, Bonfils X, Bouchy F, Buchhave L, Buscher D, Cabral A, Canto Martins BL, Chiavassa A, Coelho J, Christensen LB, Delgado-Mena E, de Medeiros JR, Di Varano I, Figueira P, Fisher M, Fynbo JPU, Glasse ACH, Haehnelt M, Haniff C, Hansen CJ, Hatzes A, Huke P, Korn AJ, Leão IC, Liske J, Lovis C, Maslowski P, Matute I, McCracken RA, Martins CJAP, Monteiro MJPFG, Morris S, Morris T, Nicklas H, Niedzielski A, Nunes NJ, Palle E, Parr-Burman PM, Parro V, Parry I, Pepe F, Piskunov N, Queloz D, Quirrenbach A, Rebolo Lopez R, Reiners A, Reid DT, Santos N, Seifert W, Sousa S, Stempels HC, Strassmeier K, Sun X, Udry S, Vanzi L, Vestergaard M, Weber M, Zackrisson E. EELT-HIRES the high-resolution spectrograph for the E-ELT. ACTA ACUST UNITED AC 2016. [DOI: 10.1117/12.2231653] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - V. D'Odorico
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | - S. Cristiani
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | | | - E. Oliva
- INAF - Osservatorio Astrofisico di Arcetri (Italy)
| | - L. Origlia
- INAF - Osservatorio Astronomico di Bologna (Italy)
| | - M. Riva
- INAF - Osservatorio Astronomico di Brera (Italy)
| | | | | | | | | | | | - P. J. Amado
- Instituto de Astrofísica de Andalucía (Spain)
| | | | - I. Boisse
- Lab. d'Astrophysique de Marseille (France)
| | - X. Bonfils
- Observatoire de Science de l'Univ. de Grenoble (France)
| | | | | | | | | | | | - A. Chiavassa
- Lab. Lagrange, Univ. Côte d'Azur, Observatoire de la Côte d'Azur (France)
| | | | | | | | | | - I. Di Varano
- Leibniz-Institut für Astrophysik Potsdam (Germany)
| | | | | | | | | | | | | | | | - A. Hatzes
- Thüringer Landessternwarte Tautenburg (Germany)
| | - P. Huke
- Univ. of Göttingen (Germany)
| | | | - I. C. Leão
- Federal Univ. of Rio Grande do Norte (Brazil)
| | | | | | | | | | | | | | | | | | | | | | | | | | - E. Palle
- Instituto de Astrofísica de Canarias (Spain)
| | | | - V. Parro
- Instituto Mauá de Tecnologia (Brazil)
| | - I. Parry
- Univ. of Cambridge (United Kingdom)
| | - F. Pepe
- Univ. de Genève (Switzerland)
| | | | | | | | | | | | | | | | | | | | | | | | - X. Sun
- Univ. of Cambridge (United Kingdom)
| | - S. Udry
- Univ. de Genève (Switzerland)
| | - L. Vanzi
- Pontificia Univ. Católica de Chile (Chile)
| | | | - M. Weber
- Leibniz-Institut für Astrophysik Potsdam (Germany)
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Morais DS, Coelho J, Lopes MA, Ferraz MP, Gomes P, Fernandes MH, Santos JD, Sooraj Hussain N. Microanalysis of Bioactive Samarium Doped Glass-Reinforced Hydroxyapatite. Microsc Microanal 2015; 21 Suppl 5:31-32. [PMID: 26227696 DOI: 10.1017/s1431927615013963] [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: 06/04/2023]
Affiliation(s)
- D S Morais
- 1CEMUC,Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia,Universidade do Porto (FEUP),Rua Dr. Roberto Frias,Porto,Portugal
| | - J Coelho
- 2INESC Porto,Rua do Campo Alegre,Porto,Portugal
| | - M A Lopes
- 1CEMUC,Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia,Universidade do Porto (FEUP),Rua Dr. Roberto Frias,Porto,Portugal
| | - M P Ferraz
- 3CEBIMED - Centro de Estudos em Biomedicina, Faculdade de Ciências da Saúde,Universidade Fernando Pessoa (FCS-UFP),Porto,Portugal
| | - P Gomes
- 4Faculdade de Medicina Dentária,Universidade do Porto (FMDUP),Rua Dr. Manuel Pereira da Silva,Porto,Portugal
| | - M H Fernandes
- 4Faculdade de Medicina Dentária,Universidade do Porto (FMDUP),Rua Dr. Manuel Pereira da Silva,Porto,Portugal
| | - J D Santos
- 1CEMUC,Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia,Universidade do Porto (FEUP),Rua Dr. Roberto Frias,Porto,Portugal
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Guy R, Williams C, Irvine N, Reynolds A, Coelho J, Saliba V, Thomas D, Doherty L, Chalker V, von Wissmann B, Chand M, Efstratiou A, Ramsay M, Lamagni T. Increase in scarlet fever notifications in the United Kingdom, 2013/2014. ACTA ACUST UNITED AC 2014; 19:20749. [PMID: 24698137 DOI: 10.2807/1560-7917.es2014.19.12.20749] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Increases in scarlet fever above usual seasonal levels are currently being seen across the United Kingdom. Medical practitioners have been alerted to the exceptional increase in incidence. Given the potential for this to signal a population increase in invasive group A streptococcal disease, close monitoring of invasive disease is essential.
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Affiliation(s)
- R Guy
- Public Health England, London, United Kingdom
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Guyot A, Coelho J, Ziol M, Caux F, Laroche L. Pseudo-cirrhose par métastases hépatiques diffuses d’un mélanome choroïdien. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.307] [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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Neves A, Coelho J, Couto L, Roncon-Albuquerque R. PP226-SUN METABOLIC ENDOTOXEMIA AS A MODULATOR OF METABOLIC RISK IN OBESITY: A TRANSLATIONAL STUDY. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60271-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: 10/26/2022]
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Zoysa AD, Coelho J, Daniel R, Dhami C, Kafatos G, Lamagni T, Efstratiou A. P159 Invasive group A streptococcal disease in the UK, 2008–2012 and molecular characterisation of isolates during enhanced surveillance. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70402-3] [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: 11/17/2022]
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Gomes-Filho I, Coelho J, Seixas S, Passos J, Hintz A, Cerqueira E, Barreto M. SP1-108 Periodontal disease and acute myocardial infarction: community controls vs hospital controls. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976n.85] [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: 11/04/2022]
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Santos C, Marcelino P, Carvalho T, Coelho J, Bispo M, Mourão L, Perdigoto R, Barroso E. The Value of Tubular Enzymes for Early Detection of Acute Kidney Injury After Liver Transplantation: An Observational Study. Transplant Proc 2010; 42:3639-43. [DOI: 10.1016/j.transproceed.2010.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 05/31/2010] [Accepted: 06/10/2010] [Indexed: 11/28/2022]
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Lima D, Coelho J, Pereira A, Silvestre M, Nelson D. Chemical and functional characterization of bovine blood globin obtained by the acidified acetone method. Acta Alimentaria 2010. [DOI: 10.1556/aalim.39.2010.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Borgström F, Ström O, Coelho J, Johansson H, Oden A, McCloskey EV, Kanis JA. The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX. Osteoporos Int 2010; 21:495-505. [PMID: 19565175 DOI: 10.1007/s00198-009-0989-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [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] [Received: 01/15/2009] [Accepted: 04/23/2009] [Indexed: 11/24/2022]
Abstract
SUMMARY The study estimated the cost-effectiveness of risedronate compared to no treatment in UK women using the FRAX algorithm for fracture risk assessment. A Markov cohort model was used to estimate the cost-effectiveness. Risedronate was found cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of 30,000 pounds. INTRODUCTION The aim of this study was to assess the cost-effectiveness of risedronate for the prevention and treatment in a UK setting using the FRAX algorithm for fracture risk assessment. A further aim was to establish intervention thresholds with risedronate treatment. METHODS The cost-effectiveness of risedronate was compared to no treatment in post-menopausal women with clinical risk factors for fracture using a Markov cohort model populated with data relevant for the UK. The model incorporated the features of FRAX (the WHO risk assessment tool). The analysis had a health care perspective and quality adjusted life years was used as the main outcome measure. RESULTS Treatment was cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of 30,000 pounds. Treatment was also cost-effective at all ages in women who had previously sustained a fragility fracture or in women with a parental history of hip fracture with a bone mineral density set at the threshold of osteoporosis. At the 30,000 pounds threshold value for a QALY, risedronate was on average found to cost-effective below the 10-year probability of a major osteoporotic fractures of 13.0%. CONCLUSIONS Risedronate is a cost-effective agent for the treatment of established osteoporosis (osteoporosis and a prior fragility fracture) in women from the age of 50 years and older and above 65 years in women with osteoporosis alone. The results support the treatment recommendations in recent UK guidelines for osteoporosis.
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Affiliation(s)
- F Borgström
- Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
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49
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Borgström F, Ström O, Coelho J, Johansson H, Oden A, McCloskey E, Kanis JA. The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis. Osteoporos Int 2010; 21:339-49. [PMID: 19513577 DOI: 10.1007/s00198-009-0971-5] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 04/17/2009] [Accepted: 04/21/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED The cost-effectiveness of strontium ranelate was compared to no treatment in UK women using the FRAX algorithm for fracture risk assessment. At a willingness-to-pay of pound 30,000 per quality-adjusted life-year (QALY), strontium ranelate was generally cost-effective in women with prior fracture at the threshold of osteoporosis from an age of 65 years. INTRODUCTION The objectives of the study were to estimate the cost-effectiveness of strontium ranelate in the UK for the treatment of osteoporosis and to establish intervention thresholds for treatment using the FRAX tool. METHODS The cost-effectiveness of strontium ranelate was compared to no treatment in postmenopausal women with clinical risk factors for fracture using a lifetime simulation model based on Markov cohort methodology that incorporated the features of FRAX. RESULTS At a threshold of pound 30,000 per QALY, strontium ranelate was generally cost-effective in women from an age of 65 years with prior fracture at the threshold of osteoporosis (i.e., a T-score of -2.5 SD) and in women with a prior fracture (and no information on bone mineral density) from the age of 65 years. At a threshold of pound 20,000, strontium ranelate became cost-effective at a 10-year fracture probability of 25.7% and at 16.9% with a threshold of pound 30,000 for a QALY. CONCLUSIONS Strontium ranelate is a cost-effective agent for the treatment of established osteoporosis in women over the age of 65 years. Cost-effective scenarios were also found for the prevention and treatment of fractures associated with osteoporosis, in younger women with additional clinical risk factors.
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Affiliation(s)
- F Borgström
- Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
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50
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Coelho J, Soyer P, Pautrat K, Boudiaf M, Vahedi K, Reignier S, Valleur P, Marteau P. [Management of ileal stenosis in patients with Crohn's disease]. ACTA ACUST UNITED AC 2009; 33:F75-81. [PMID: 19733458 DOI: 10.1016/j.gcb.2009.07.024] [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] [Indexed: 12/14/2022]
Abstract
Stenosis is the most frequent complication during Crohn's disease. The lesion can be inflammatory, or due to a fibrosing or neoplastic process. The medical treatment with anti-inflammatory drugs is usually sufficient as first line treatment; fibrous lesions require endoscopic or surgical procedures while neoplastic lesions require surgery. A multidisciplinary approach (radiologic, medical, surgical and endoscopic) is needed. In a first part, we discuss the definition of stenosis and the modalities of imaging (particularly MRI) and of treatment (particularly with TNFalpha antagonists). Then we expose the strategy for the management of the most frequent clinical situations: occlusion, ileal inflammatory stenosis, stenosis of an ileocolonic anastomosis and chronic fibrous stenosis. The treatment decision takes into account the results of radiological assessment, CRP level and the effects of the previous treatments.
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Affiliation(s)
- J Coelho
- Département médicochirurgical de pathologie digestive, hôpital Lariboisière, 2 rue Ambroise-Paré, Paris, France
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