Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

Les conseillers d’orientation professionnelle

Benassy-Chauffard C., Bacquet R. Les conseillers d’orientation professionnelle. In: Bulletin de psychologie, tome 11 n°140, 1957. XVème Congrès International de Psychologie : symposium sur l'émotion. pp. 167-170

E. S. R. OF Gd3+ IN La2O3 AND ITS SOLID SOLUTIONS WITH CeO2

Les spectres de RPE des ions Gd3+ présents à l'état de traces dans La2O3 et (La2O3)1-x-(CeO2)x sont caractéristiques d'une symétrie axiale suivant l'axe et correspondent à un clivage en champ nul très important (~ 1,61 cm-1). L'addition d'oxyde de cérium crée des distorsions aléatoires de la symétrie axiale. Par rapport aux spectres enregistrés avec La2O3,cela se traduit par un fort élargissement de certaines raies de résonance.In La2O3 and in its solid solutions with CeO2, the ESR spectra of Gd3+ ions present as traces in sites of axial symmetry are characterized by a strong zero-field splitting (~ 1.61 cm-1). With respect to the La2O3 patterns, the random distorsions of the axial symmetry due to the introduction of Ceria, cause an important broadening of some lines

Pheromone variability and evolution in the butterfly genus Bicyclus, and implication in its diversification

The evolution of olfactive communication in generating reproductive isolation among species remains poorly understood (Smadja & Butlin 2009). In Lepidoptera, studies have mainly focused on long-distance pheromones produced by moths. Moth sex pheromones have been shown to display inter-population variation (e.g. Tòth et al. 1992, McElfresh & Millar 2008 and ref. within, Groot et al. 2009) and to be involved in interspecific isolation (e.g. Löfstedt et al. 1991, Groot et al. 2006). In butterflies, the few existing studies on sex pheromones have mainly focused on the identification of the male specific compounds and the demonstration of their behavioural activity in courtship (e.g. Grula et al. 1980, Nieberding et al. 2008, Yildizhan et al. 2009), but have failed so far to highlight a role in reproductive isolation (Friberg et al. 2008). In the species-rich Bicyclus genus Kirby, 1871 (Nymphalidae, Satyrinae) the structures producing the pheromones, i.e. the androconia, are key characters to discriminate among species (Condamin 1973). In B. anynana (Butler, 1879), the male sex pheromone (MSP) has been shown to play a role in mate choice (Costanzo & Monteiro 2007, Nieberding et al. 2008), to be heritable, and particular ratios of the pheromone components are under strong sexual selection (Nieberding et al, unpubl. data). Therefore, we expect that pheromone evolution is responsible for reproductive isolation and diversification in this butterfly group. In this framework, our research project aims at understanding the evolution of MSP at the interspecific level across the Bicyclus genus and specifically at testing their potential role in the speciation process. Potential MSP of several species across the Bicyclus genus have been identified by gas chromatography and mass spectrometry. Observed differences in pheromone composition between species are compared in a phylogenetic framework to the molecular tree of the species (following Oliver et al. 2009). We expect the evolutionary rate of MSP to be unlinked to the molecular tree if MSP are under sexual selection across the genus (i.e. saltational evolution following Symonds & Elgar 2004, Shirangi et al. 2009). Moreover, if MSP generated reproductive isolation between species in a “reinforcement” process, we expect higher differences of MSP composition between sympatric species than between allopatric species and an increase of this pattern for younger species compared to older species (Lukhtanov et al. 2006)

PARAMAGNETIC POINT DEFECTS IN ZIRCONIA

Nous avons étudié par RPE des ions d'impuretés trivalentes dans des monocristaux de zircone monoclinique et de zircone stabilisé à la chaux. Nos résultats montrent que ces impuretés n'ont jamais de lacune d'oxygène associée en position de plus proches voisins. Nous avons aussi confirmé, par des expériences de recuit, l'existence d'une transition désordre-ordre pour le réseau anionique de la zircone stabilisée à la chaux. Une telle transition n'a pu être mise en évidence dans la zircone yttriée.By means of the ESR technique we studied trivalent impurity ions in single crystals of monoclinic zirconia as well as of calcia stabilized zirconia. Our results show that these impurities never have an associated O2 vacancy in a nearest neighbour position. We also confirmed the existence of a disorder-order transformation of the anion lattice of calcia stabilized zirconia under annealing. Such a transformation cannot be observed in Yttria stabilized zirconia

Étude par R. P. E. de la variation thermique du couplage hyperfin de Mn2+ dans CdF2

The temperature dependence of hyperfine coupling constant of Mn2+ in CdF2 was measured by E. S. R. techniques. This dependence has been interpreted using the Simanek-Orbach theory.Nous avons étudié par R. P. E. la variation, en fonction de la température, de la constante de couplage hyperfin de Mn2+ dans CdF2. Cette variation a été interprétée à l'aide de la théorie de Simanek et Orbach

E.S.R. of CO3-3-Li+ centre in irradiated synthetic single crystal calcite

An E.S.R. spectrum of effective spin S = 1/2 exhibiting a hyperfine structure quadruplet has been observed in synthetic single crystal calcite X-irradiated at 20 °C. From the g values it is deduced that this spectrum is due to a CO3- 3 molecular ion which is charge stabilized by an interstitial Li + ion. This defect which is axially symmetric along the crystalline c axis is very stable at room temperature.Dans des monocristaux de calcite synthétique irradiés aux rayons X à la température ambiante, on observe le spectre de résonance d'un électron célibataire piégé sur un ion carbonate et couplé à un noyau de lithium. Ce défaut qui a été identifié comme étant un ion moléculaire CO3-3 stabilisé par un ion Li+ en position interstitielle, présente une symétrie axiale suivant l'axe c. Il est très stable à la température ambiante