Aesthetic discomfort in hand osteoarthritis: results from the LIège Hand Osteoarthritis Cohort (LIHOC)

Characteristics of patients reporting high (HAD) or low (LAD) (aesthetic discomfort). (DOC 55 kb

Optimalisation de l'usage des anti-inflammatoires non stéroïdiens dans l'arthrose (une étude pragmatique)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Glucosamine sulphate in osteoarthritis: from symptoms to structure modification

Several chemical entities have been carefully investigated for the symptomatic and structural management of osteoarthritis. The most compelling evidence of a potential for inhibiting the structural progression of osteoarthritis has been obtained with glucosamine sulfate. At any rate, this compoind has clearly demonstrated a symptomatic action, mainly in osteoarthritis of the lower limbs, on pain relief an improvement of functional disability. An important issue is that all the conclusive studies with such chyemical entities resulted from the use of prescription medicines and not over-the-counter pills of food supplements

Cost-effectiveness of personalized supplementation with vitamin D-rich dairy products in the prevention of osteoporotic fractures

Summary: Titrated supplementations with vitamin D-fortified yogurt, based on spontaneous calcium and vitamin D intakes, can be cost-effective in postmenopausal women with or without increased risk of osteoporotic fractures. Introduction: The objective of this study is to assess the costeffectiveness of the vitamin D-fortified yogurt given to women with and without an increased risk of osteoporotic fracture. Methods: Avalidated cost-effectiveness microsimulation Markov model of osteoporosis management was used. Three personalized supplementation scenarios to reflect the Ca/Vit D needs taking into account the well-known variations in dietary habits and a possible pharmacological supplementation in Ca/ Vit D, given above or in combination with anti-osteoporosis medications: one yogurt per day, i.e., 400 mg of Ca+200 IU of Vit D (scenario 1 U), two yogurts per day, i.e., 800 mg of Ca+ 400 IU of Vit D (scenario 2 U), or three yogurts per day, i.e., 1, 200 mg of Ca+600 IU of Vit D (scenario 3 U). Results: One yogurt is cost-effective in the general population above the age of 70 years and in all age groups in women with low bone mineral density (BMD) or prevalent vertebral fracture (PVF). The daily intake of two yogurts is cost-effective above 80 years in the general population and above 70 years in the two groups of women at increased risk of fractures. However, an intake of three yogurts per day is only cost-effective above 80 years old in the general population, as well as in women with low BMD or PVF. Conclusions: Our study is the first economic analysis supporting the cost-effectiveness of dairy products, fortified with vitamin D, in the armamentarium against osteoporotic fractures

Additional file 1: of Public health impact and cost-effectiveness of dairy products supplemented with vitamin D in prevention of osteoporotic fractures

Results in women and men. (PDF 212 kb

Communicating Benefits from Vaccines Beyond Preventing Infectious Diseases

Abstract Despite immunisation being one of the greatest medical success stories of the twentieth century, there is a growing lack of confidence in some vaccines. Improving communication about the direct benefits of vaccination as well as its benefits beyond preventing infectious diseases may help regain this lost confidence. A conference was organised at the Fondation Merieux in France to discuss what benefits could be communicated and how innovative digital initiatives can used for communication. During this meeting, a wide range of indirect benefits of vaccination were discussed. For example, influenza vaccination can reduce hospitalisations and deaths in older persons with diabetes by 45% and 38%, respectively, but the link between influenza and complications from underlying chronic non-communicable diseases such as diabetes is frequently underestimated. Vaccination can reduce antimicrobial resistance (AMR), which is growing, by reducing the incidence of infectious disease (though direct and indirect or herd protection), by reducing the number of circulating AMR strains, and by reducing the need for antimicrobial use. Disease morbidity and treatment costs in the elderly population are likely to rise substantially, with the ageing global population. Healthy ageing and life-course vaccination approaches can reduce the burden of vaccine-preventable diseases, such as seasonal influenza and pneumococcal diseases, which place a significant burden on individuals and society, while improving quality of life. Novel disease surveillance systems based on information from Internet search engines, mobile phone apps, social media, cloud-based electronic health records, and crowd-sourced systems, contribute to improved awareness of disease burden. Examples of the role of new techniques and tools to process data generated by multiple sources, such as artificial intelligence, to support vaccination programmes, such as influenza and dengue, were discussed. The conference participants agreed that continual efforts are needed from all stakeholders to ensure effective, transparent communication of the full benefits and risks of vaccination

Cost-Effectiveness of Adjuvanted Quadrivalent Influenza Vaccine for Adults over 65 in France

Background: In France, influenza accounts for an average of over one million consultations with GPs, 20,000 hospitalizations, and 9000 deaths per year, particularly among the over-65s. This study evaluates the cost-effectiveness of the adjuvanted quadrivalent influenza vaccine (aQIV) compared to standard (SD-QIV) and high-dose (HD-QIV) quadrivalent influenza vaccines for individuals aged 65 and older in France. Methods: The age-structured SEIR transmission model, calibrated to simulate a mean influenza season, incorporates a contact matrix to estimate intergroup contact rates. Epidemiological, economic, and utility outcomes are evaluated. Vaccine effectiveness and costs are derived from literature and national insurance data. Quality of life adjustments for influenza attack rates and hospitalizations are applied. Deterministic and probabilistic analyses are also conducted. Results: Compared to SD-QIV, aQIV demonstrates substantial reductions in healthcare utilization and mortality, avoiding 89,485 GP consultations, 2144 hospitalizations, and preventing 1611 deaths. Despite an investment of EUR 110 million, aQIV yields a net saving of EUR 14 million in healthcare spending. Compared to HD-QIV, aQIV saves 62 million euros on vaccination costs. Cost-effectiveness analysis reveals an incremental cost-effectiveness ratio of EUR 7062 per QALY. Conclusions: This study highlights the cost-effectiveness of aQIV versus SD-QIV and HD-QIV, preventing influenza cases, hospitalizations, and deaths

La gestione post-frattura del paziente con frattura di femore: una visione prospettica

Background. La frattura di femore ha un impatto notevole su morbidità, mortalità e costi economici in tutto il mondo. Dopo il trattamento chirurgico, molti pazienti vanno incontro, come conseguenza della frattura, a disabilità protratta o al decesso. Una frattura è il maggior fattore di rischio per una successiva frattura, che può verificarsi anche entro breve tempo. Metodi. È stata realizzata, utilizzando il database Medline, una revisione della letteratura sulla gestione post-evento fratturativo dei pazienti con frattura di femore. Autorevoli esperti hanno concordato l’elaborazione di un documento di consenso. Evidenze. Per ottimizzare i risultati post-dimissione ospedaliera, la gestione dei pazienti con frattura di femore richiede una serie di interventi di assistenza, che debbono essere coordinati da un gruppo multidisciplinare, già da prima del ricovero e fino alla dimissione. Poiché attualmente è disponibile un solo studio di valutazione del trattamento farmacologico in pazienti con frattura recente del femore, ne sono necessari altri mirati alla prevenzione della frattura e alla gestione post-frattura di femore. Una corretta alimentazione è fondamentale per consentire la riparazione ossea e prevenire ulteriori cadute, in particolare nei pazienti malnutriti. Vitamina D, calcio e supplementi proteici sono associati a un incremento della BMD a livello dell’anca e a una riduzione delle fratture. La riabilitazione è essenziale per migliorare le disabilità funzionali e i tassi di sopravvivenza. Nelle strategie di prevenzione delle cadute e di recupero della funzionalità andrebbero integrati programmi di educazione del paziente ed esercizi di miglioramento dell’equilibrio e di incremento della forza muscolare e della mobilità. Una gestione appropriata previene ulteriori fratture, mentre sono di importanza critica l’identificazione e il trattamento dei pazienti ad alto rischio. Per favorire il raggiungimento di questi obiettivi, sono state definiti dei percorsi clinico-assistenziali di aiuto per i chirurghi ortopedici. Conclusione. Pur restando la frattura del femore associata a una prognosi non favorevole, una gestione appropriata è in grado di assicurare guarigione e sopravvivenza ottimali e deve essere considerata una priorità dopo l’evento fratturativo per evitare il peggioramento delle condizioni di salute e prevenire successive frattur