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

Test Bench Of The Barrel Calorimeter Modules

A systematic procedure to qualify the barrel calorimeter modules is an essential step to guarantee a 0.7% constant term, which is the collaboration objective. The procedure detailed in this note consists of quality monitoring during mechanical assembling and of a set of electrical tests such as electrical continuity, cell and cross-talk capacitance measurement, and high-voltage behaviour. For the whole test, it has been necessary to develop dedicated electronic boards, to develop measurement methods, and the whole operation software. Making the procedure automatic will guarantee the quality of each module during assembling, cabling, and test in liquid argon

ATLAS liquid argon calorimeter front end electronics

The ATLAS detector has been designed for operation at CERN's Large Hadron Collider. ATLAS includes a complex system of liquid argon calorimeters. This paper describes the architecture and implementation of the system of custom front end electronics developed for the readout of the ATLAS liquid argon calorimeters

Performance of the ATLAS Electromagnetic Calorimeter End-cap Module 0

The construction and beam test results of the ATLAS electromagnetic end-cap calorimeter pre-production module 0 are presented. The stochastic term of the energy resolution is between 10% GeV^1/2 and 12.5% GeV^1/2 over the full pseudorapidity range. Position and angular resolutions are found to be in agreement with simulation. A global constant term of 0.6% is obtained in the pseudorapidity range 2.5 < eta < 3.2 (inner wheel)

L'« Evidence Based Medicine » (EBM) : utile reflet de la réalité ou dangereux miroir de sorcière ?

Modèle dominant actuel de la Médecine dans bon nombre de pays au monde, l’«Evidence Based Medicine » (EBM), dénommée ainsi, par Gordon Guyatt en 1992, a été difficilement traduite en français. On parlera surtout de Médecine fondée sur les preuves. Apparue au Canada, dans le sillage de l’épidémiologie clinique, l’EBM a été développée et promue tout d’abord comme outil d’apprentissage de la Médecine par le groupe de travail international « Evidence based working group ». Il s’agissait alors de procurer aux étudiants un outil capable de distinguer les études probantes au sein d’une littérature médicale qui commençait à foisonner et de développer du même coup leur esprit critique à partir des articles scientifiques (sources primaires d’information). Mais l’EBM est bien vite devenue la théorie d’une pratique, une façon d’exercer la médecine clinique. On est ainsi passé rapidement d’une méthode de tri de la littérature médicale « scientifique » selon un certain niveau de preuve, à l’exploitation des résultats des études issues de ce tri (source secondaire d’information) : revues systématiques de la littérature, recommandations de bonne pratique et autres documents en vue d'améliorer les décisions cliniques mais aussi en tant qu'instruments de régulation des pratiques, des produits et des actes

L'information sur le médicament en médecine générale

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF