Benchmarking clinical management of spinal and non-spinal disorders using quality of life: results from the EPI3-LASER survey in primary care

Concerns have been raised regarding sub-optimal utilization of analgesics and psychotropic drugs in the treatment of patients with chronic musculoskeletal disorders (MSDs) and their associated co-morbidities. The objective of this study was to describe drug prescriptions for the management of spinal and non-spinal MSDs contrasted against a standardized measure of quality of life. A representative population sample of 1,756 MSDs patients [38.5% with spinal disorder (SD) and 61.5% with non-spinal MSDs (NS-MSD)] was drawn from the EPI3-LASER survey of 825 general practitioners (GPs) in France. Physicians recorded their diagnoses and prescriptions on that day. Patients provided information on socio-demographics, lifestyle and quality of life using the Short Form 12 (SF-12) questionnaire. Chronicity of MSDs was defined as more than 12 weeks duration of the current episode. Chronic SD and NS-MSD patients were prescribed less analgesics and non-steroidal anti-inflammatory drugs than their non-chronic counterpart [odds ratios (OR) and 95% confidence intervals (CI), respectively: 0.4, 0.2–0.7 and 0.5, 0.3–0.6]. They also had more anxio-depressive co-morbidities reported by their physicians (SD: 16.1 vs.7.4%; NS-MSD: 21.6 vs. 9.5%) who prescribed more antidepressants and anxiolytics with a difference that was statistically significant only for spinal disorder patients (OR, 95% CI: 2.0, 1.1–3.6). Psychotropic drugs were more often prescribed in patients in the lower quartile of SF-12 mental score and prescriptions of analgesics in the lower quartile of SF-12 physical score (P < 0.001). In conclusion, anxiety and depressive disorders were commonly reported by GPs among chronic MSD patients. Their prescriptions of psychotropic and analgesic drugs were consistent with patients’ self-rated mental and physical health

The ATLAS3D project - XXIX : The new look of early-type galaxies and surrounding fields disclosed by extremely deep optical images

Date of Acceptance: 25/09/2014Galactic archaeology based on star counts is instrumental to reconstruct the past mass assembly of Local Group galaxies. The development of new observing techniques and data reduction, coupled with the use of sensitive large field of view cameras, now allows us to pursue this technique in more distant galaxies exploiting their diffuse low surface brightness (LSB) light. As part of the ATLAS3D project, we have obtained with the MegaCam camera at the Canada-France-Hawaii Telescope extremely deep, multiband images of nearby early-type galaxies (ETGs). We present here a catalogue of 92 galaxies from the ATLAS3D sample, which are located in low- to medium-density environments. The observing strategy and data reduction pipeline, which achieve a gain of several magnitudes in the limiting surface brightness with respect to classical imaging surveys, are presented. The size and depth of the survey are compared to other recent deep imaging projects. The paper highlights the capability of LSB-optimized surveys at detecting new prominent structures that change the apparent morphology of galaxies. The intrinsic limitations of deep imaging observations are also discussed, among those, the contamination of the stellar haloes of galaxies by extended ghost reflections, and the cirrus emission from Galactic dust. The detection and systematic census of fine structures that trace the present and past mass assembly of ETGs are one of the prime goals of the project. We provide specific examples of each type of observed structures - tidal tails, stellar streams and shells - and explain how they were identified and classified. We give an overview of the initial results. The detailed statistical analysis will be presented in future papers.Peer reviewedFinal Accepted Versio

SDSS-IV MaStar : a large and comprehensive empirical stellar spectral library—first release

We present the first release of the MaNGA Stellar Library (MaStar), which is a large, well-calibrated, high-quality empirical library covering the wavelength range 3622–10354 Å at a resolving power of R ~ 1800. The spectra were obtained using the same instrument as used by the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) project, by piggybacking on the Sloan Digital Sky Survey (SDSS-IV)/Apache Point Observatory Galaxy Evolution Experiment 2-N (APOGEE-2N) observations. Compared to previous empirical libraries, the MaStar library will have a higher number of stars and a more comprehensive stellar-parameter coverage, especially of cool dwarfs, low-metallicity stars, and stars with different [α/Fe], achieved by a sophisticated target-selection strategy that takes advantage of stellar-parameter catalogs from the literature. This empirical library will provide a new basis for stellar-population synthesis and is particularly well suited for stellar-population analysis of MaNGA galaxies. The first version of the library contains 8646 high-quality per-visit spectra for 3321 unique stars. Compared to photometry, the relative flux calibration of the library is accurate to 3.9% in g − r, 2.7% in r − i, and 2.2% in i − z. The data are released as part of SDSS Data Release 15. We expect the final release of the library to contain more than 10,000 stars.Publisher PDFPeer reviewe

Analyse des attentes des médecins généralistes et hospitaliers dans la prise en charge conjointe des patients diabétiques de type 2

PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF

Pratiques de prescription du dosage des peptides natriurétiques en médecine ambulatoire

Le brain natriuretic peptide (BNP) et le N-terminal pro-brain natriuretic peptide (NTPROBNP) sont deux molécules pour lesquelles il existe un dosage ambulatoire. Ces examens complémentaires sont essentiels au diagnostic, suivi et pronostic de l'insuffisance cardiaque. Très largement étudiées en pratiques hospitalières, nous nous sommes intéressés à leur prescription en médecine ambulatoire. Notre étude prospective a exploré un groupe de prescripteurs urbain et un rural. On notait une fréquence de 1,4% de leur prescription en milieu rural correspondant à une surprescription de près de trois fois par rapport au milieu urbain. Les prescripteurs urbains étaient pour moitié des spécialistes alors qu'ils étaient pour 98% généralistes en milieu rural. Les indications de prescription étaient pour moitié à visée diagnostique et pour l'autre moitié s'inscrivaient dans le cadre du suivi thérapeutique sans influence du mode d'exercice ou de la spécialité du prescripteur. La nature du prescripteur n'influençait pas le résultat à visée diagnostique du dosage (10% positif, 40% négatif et 50% intermédiaire). Le dosage des peptides natriurétiques constitue donc un outil diagnostique et de suivi indispensable de l'insuffisance cardiaque en médecine ambulatoire et notamment rurale.PARIS6-Bibl. St Antoine CHU (751122104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Motivations et réticences des médecins généralistes à participer à un travail de pharmacovigilance (à propos d'un projet de réseau)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF

Evaluation de la qualité de tenue du carnet de santé de l'enfant (enquête transversale en médecine générale)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF

Controverse scientifique autour du dépistage de la prostate (influence sur l'attitude des médecins généralistes pour eux-mêmes et leur famille, enquête de pratique auprès des maîtres de stage)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF