Risk of herpes zoster in patients prescribed inhaled corticosteroids: a cohort study

<p>Abstract</p> <p>Background</p> <p>Little is known concerning risk factors for herpes zoster in the general population. We hypothesised that inhaled corticosteroids (ICS) are a risk factor for herpes zoster especially among users of inhibitors of cytochrome P450 enzymes involved in their metabolism.</p> <p>Methods</p> <p>We identified a cohort of adult users of respiratory medications in the General Practice Research Database and carried out a nested case control analysis of inhaled corticosteroid use among 8900 new cases of herpes zoster and 88032 controls matching on age and calendar time.</p> <p>Results</p> <p>The adjusted odds ratio for the relationship between current use of ICS and the occurrence of herpes zoster was 1.00 (95% confidence interval (CI), 0.94-1.07). There was no increase in risk of herpes zoster even at higher ICS doses; odds ratio 1.05 (95% CI, 0.96-1.14). Among subjects with concomitant prescriptions for an ICS and an inhibitor of cytochrome P450 3A4, the point estimate for the association between herpes zoster and the use of higher doses of inhaled corticosteroids was 1.23 (95% CI, 0.81-1.88).</p> <p>Conclusions</p> <p>The use of inhaled corticosteroids, even at high doses and in conjunction with inhibitors of their metabolism, was not a significant risk factor for the occurrence of herpes zoster in adults.</p

Atteintes démyélinisantes aigües inflammatoies du système nerveux central chez l'enfant (facteurs pronostiques d'évolution vers la sclérose en plaques et le handicap)

Notre objectif était de préciser les facteurs pronostiques cliniques et en imagerie IRM de rechute (qualifiant pour le diagnostic de sclérose en plaques) et de handicap sévère après un premier épisode démyélinisant aigû inflammatoire du système nerveux central avant 16 ans. Nous avons mis en place d'une cohorte incluant tout patient avec ces critères d'inclusion dans les centres neuropédiatriques français à partir de 1985 et étudié des variables standardisées avec des modèles d'analyse de survie. Selon l'analyse multivariée, le risque de rechute (50% des patients à 3 ans de suivi) était plus élevé chez les patients ayant débuté après 10 ans et si l'IRM montrait des lésions perpendiculaires au corps calleux ou exclusivement bien limitées. Il était plus bas en cas de myélite ou de troubles de conscience. Le risque d'atteindre un handicap sévère (10% des patients à 3 ans de suivi) était plus élevé en cas de début polysymptomatique, de séquelles du premier épisode, de rechutes ou d'une évolution progressive.LYON1-BU.Sciences (692662101) / SudocSudocFranceF

L'acquisition des connaissances temporelles et leurs relations avec les compétences numériques chez des enfants entre 6 et 11 ans

International audienceAcquisition of time knowledge (TK; the correct representation and use of time units) is linked to the development of numerical abilities,but this relationship has not been investigated in children. The current study examined the acquisition of TK and its association with numerical skills. A total of 105 children aged 6 to 11 years were interviewed with our Time Knowledge Questionnaire (TKQ), developed for purposes of this study, and the Zareki-R, a battery for the evaluation of number processing and mental calculation.The TKQ assessed conventional time knowledge (temporal orientation, temporal sequences, relationships between time units, and telling the time on a clock), estimation of longer durations related to birthday and life span, and estimation of the duration of the interview. Time knowledge increased with age, especially from 6 to 8 years, and was strongly linked to numerical skills.Regression analyses showed that four numerical components were implicated in TK: academic knowledge of numbers and numberfacts (e.g., reading Arabic numerals, mental calculation), number line estimation (e.g., correspondence between a number and a distance),contextual estimation (e.g., many/few leaves on a tree, children in a family), and numerical tasks involving verbal working memory (e.g., comparison of numbers presented orally).Numerical correlations with TK varied according to children’s age; subtests based on academic knowledge of numbers, workingmemory, and number line estimation were linked with TK in the younger children, but only contextual estimation was associatedwith TK in the older children

e-Table 3 - RUDANT-884684

E-table 3. Association between Guillain-Barré syndrome (GBS) and surgery during the previous 60 days (case-crossover design), according to the presence of infection during hospitalization for each main group of surgery, and association with each subgroup of organs and tissues targeted by the procedure

e-Table 2 - RUDANT-884684

e-table 2. Procedures performed during the case and referent windows among the 8,364 GBS cases included in the present stud

e-Table 4 - RUDANT-884684

E-table 4. Association between surgery during the previous 60 days and GBS (case-crossover design), according to the standard duration of the procedure, for each main group of surgery

e-Table 5 - RUDANT-884684

E-Table 5: Association between Guillain-Barré syndrome (GBS) and surgery during the previous 60 days (case-crossover design), among patients treated with immunoglobulins or plasma exchange

Data from: Surgery and risk of Guillain-Barré syndrome: a French nationwide epidemiologic study

Objectives: To assess the association between Guillain-Barre syndrome (GBS) and recent surgery based on French nationwide data. Methods: Data were extracted from the French health administrative databases (SNIIRAM / PMSI). All patients hospitalized for GBS between 2009 and 2014 were identified by ICD-10 code G61.0 as main diagnosis. Patients previously hospitalized for GBS in 2006, 2007 and 2008 were excluded. Surgical procedures were identified from the hospital database. Hospitalizations for surgery with no infection diagnosis code entered while the hospital stay were also identified. The association between GBS and a recent surgical procedure was estimated using a case-crossover design. Case and referent windows were defined as 1–60 days and 366–425 days before GBS hospitalization, respectively. Analyses were adjusted for previous episodes of gastroenteritis and respiratory tract infection, identified by drug dispensing data. Results: Out of the 8,364 GBS cases included, 175 and 257 patients had undergone a surgical procedure in the referent and case windows, respectively (adjusted odds ratio (OR) =1.54, 95% confidence interval (CI): 1.26, 1.88). A slightly weaker association was observed for surgical procedures with no identified infection during the hospitalization (OR=1.40, 95%CI: 1.12, 1.73). In terms of the type of surgery, only surgical procedures on bones and digestive organs were significantly associated with GBS (OR and 95%CI=2.81 (1.70, 4.65) and 2.37 (1.32, 4.23), respectively). Conclusion: In this large nationwide epidemiological study, GBS was moderately associated with any type of recent surgery, and was more strongly associated with bone and digestive organ surgery

Do children with mathematical learning disabilities use the inversion principle to solve three-term arithmetic problems?: The impact of presentation mode

International audienc

Maltraitance envers les enfants et Covid-19

En France, au début de l’année 2020, environ 690 000 vies ont pu être épargnées grâce au confinement général de la population et aux mesures restrictives de lutte contre la Covid-19. Conséquence inattendue, ces mesures ont eu un impact sur une autre frange vulnérable de la population : celle des jeunes enfants, pour lesquels il a été démontré une augmentation des maltraitances subies à cette période. À partir de données de la littérature et de l’apport de nos travaux de recherche dans le domaine, nous proposons une documentation de cette crise des violences intra-familiales, intriquée dans la crise sanitaire de la Covid-19