101 research outputs found

    J Clin Med

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    We aimed to describe the burden represented by potentially inappropriate medications (PIMs) in chronic polypharmacy in France. We conducted a nationwide cross-sectional study using data from the French National Insurance databases. The study period was from 1 January 2016 to 31 December 2016. Chronic drug use was defined as uninterrupted daily use lasting ?6 months. Chronic polypharmacy was defined as the chronic use of ?5 medications, and chronic hyperpolypharmacy as the chronic use of ?10 medications. For individuals aged ?65 (older adults), PIMs were defined according to the Beers and Laroche lists, and for individuals aged 45-64 years (middle-aged) PIMs were defined according to the PROMPT (Prescribing Optimally in Middle-aged People's Treatments) list. Among individuals with chronic polypharmacy, 4009 (46.2%) middle-aged and 18,036 (64.8%) older adults had at least one chronic PIM. Among individuals with chronic hyperpolypharmacy, these figures were, respectively, 570 (75.0%) and 2544 (88.7%). The most frequent chronic PIM were proton pump inhibitors (43.4% of older adults with chronic polypharmacy), short-acting benzodiazepines (older adults: 13.7%; middle-aged: 16.1%), hypnotics (6.1%; 7.4%), and long-acting sulfonylureas (3.9%; 12.3%). The burden of chronic PIM appeared to be very high in our study, concerning almost half of middle-aged adults and two-thirds of older adults with chronic polypharmacy. Deprescribing interventions in polypharmacy should primarily target proton pump inhibitors and hypnotics

    Targeted Therapy for Older Patients with Non-Small Cell Lung Cancer: Systematic Review and Guidelines from the French Society of Geriatric Oncology (SoFOG) and the French-Language Society of Pulmonology (SPLF)/ French-Language Oncology Group (GOLF)

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    Systematic molecular profiling and targeted therapy (TKI) have changed the face of Non-Small Cell Lung Cancer (NSCLC) treatment. However, there are no specific recommendations to address the prescription of TKI for older patients. A multidisciplinary task force from the French Society of Geriatric Oncology (SoFOG) and the French Society of Pulmonology/Oncology Group (SPLF/GOLF) conducted a systematic review from May 2010 to May 2021. Protocol registered in Prospero under number CRD42021224103. Three key questions were selected for older patients with NSCLC: (1) to whom TKI can be proposed, (2) for whom monotherapy should be favored, and (3) to whom a combination of TKI can be proposed. Among the 534 references isolated, 52 were included for the guidelines. The expert panel analysis concluded: (1) osimertinib 80 mg/day is recommended as a first-line treatment for older patients with the EGFR mutation; (2) full-dose first generation TKI, such as erlotinib or gefitinib, is feasible; (3) ALK and ROS1 rearrangement studies including older patients were too scarce to conclude on any definitive recommendations; and (4) given the actual data, TKI should be prescribed as monotherapy. Malnutrition, functional decline, and the number of comorbidities should be assessed primarily before TKI initiation. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

    Assessment of drug exposure in pharmacoepidemiology : comparison of interview data and reimbursement claims data from the French national healthcare insurance system

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    En pharmaco-Ă©pidĂ©miologie, la mesure de l’exposition mĂ©dicamenteuse est fondamentale. Des donnĂ©es dĂ©claratives recueillies par interrogatoire des sujets ou des donnĂ©es extraites des bases de remboursement de l’Assurance Maladie peuvent ĂȘtre utilisĂ©es. Les objectifs de ce travail Ă©taient de comparer l’exposition mesurĂ©e Ă  partir de ces deux sources de donnĂ©es et d’évaluer l’impact du choix de l’une ou l’autre source sur les mesures de risque dans les Ă©tudes Ă©tiologiques. Les travaux ont Ă©tĂ© conduits au sein de l’étude des Trois-CitĂ©s, cohorte de sujets ĂągĂ©s pour laquelle Ă©taient disponibles des donnĂ©es dĂ©claratives et de remboursement. La concordance entre les expositions issues des deux sources ou la validitĂ© de l’exposition issue de l’une par rapport Ă  celle issue de l’autre ont Ă©tĂ© Ă©valuĂ©es dans diffĂ©rents contextes. La survenue d’évĂ©nements a Ă©tĂ© simulĂ©e dans la population et des Ă©tudes cas-tĂ©moins nichĂ©es ont Ă©tĂ© conduites pour Ă©valuer l’association entre l’exposition issue de chaque source et chaque Ă©vĂ©nement. Pour les mĂ©dicaments cardiovasculaires, les mesures d’exposition Ă©taient peu diffĂ©rentes entre les deux sources. L’impact du choix de l’une ou l’autre source sur les mesures d’association entre l’exposition et un Ă©vĂ©nement Ă©tait faible. Pour les benzodiazĂ©pines ou les anti-inflammatoires non stĂ©roĂŻdiens, des diffĂ©rences Ă©taient observĂ©es entre les expositions issues des deux sources. Pour ces mĂ©dicaments, l’association avec un Ă©vĂ©nement pouvait varier selon la source utilisĂ©e. Pour des mĂ©dicaments pris de maniĂšre irrĂ©guliĂšre ou intermittente, le choix de la source de donnĂ©es pour la mesure de l’exposition peut donc ĂȘtre un Ă©lĂ©ment dĂ©terminant.In pharmacoepidemiology, assessment of drug exposure is fundamental. It can rely on data collected through patient interviews or extracted from healthcare insurance system databases recording reimbursement claims. This work aimed to compare drug exposure measured from these two data sources and to evaluate the impact of choosing one source or the other on risk estimates in etiological studies. It was conducted as part of the Three-City Study, a cohort of French elderly persons for which both interview and reimbursement data were available. Agreement between exposures measured from both sources or validity of exposure measured from one source with reference to that measured from the other were evaluated in different backgrounds. Simulated outcomes were generated in the study population and nested case-control studies were conducted in order to estimate the association between the drug exposure measured from each source and each simulated outcome. For cardiovascular system drugs, exposure measured from interview data was close to that measured from reimbursement data. The choice of one source or the other had few impact on the estimated associations between the exposure and an outcome. For benzodiazepines or non-steroidal anti-inflammatory drugs, exposure measured from both sources could differ. For these drugs, the association between the exposure measured from each source and an outcome could vary. For drugs that can be used irregularly or intermittently, the choice of the source of data for drug exposure assessment could thus be of great importance

    Noize Michel. Dom Jean Albert Belin et l'Alchimie chrétienne.

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    Noize Michel. Noize Michel. Dom Jean Albert Belin et l'Alchimie chrĂ©tienne. In: École pratique des hautes Ă©tudes, 5e section, Sciences religieuses. Annuaire. Tomes 80-81, Fascicule II. Vie de la Section : annĂ©es 1971-1972 et 1972-1973. 1971. pp. 82-83

    Assessment of drug exposure in pharmacoepidemiology : comparison of interview data and reimbursement claims data from the French national healthcare insurance system

    No full text
    En pharmaco-Ă©pidĂ©miologie, la mesure de l’exposition mĂ©dicamenteuse est fondamentale. Des donnĂ©es dĂ©claratives recueillies par interrogatoire des sujets ou des donnĂ©es extraites des bases de remboursement de l’Assurance Maladie peuvent ĂȘtre utilisĂ©es. Les objectifs de ce travail Ă©taient de comparer l’exposition mesurĂ©e Ă  partir de ces deux sources de donnĂ©es et d’évaluer l’impact du choix de l’une ou l’autre source sur les mesures de risque dans les Ă©tudes Ă©tiologiques. Les travaux ont Ă©tĂ© conduits au sein de l’étude des Trois-CitĂ©s, cohorte de sujets ĂągĂ©s pour laquelle Ă©taient disponibles des donnĂ©es dĂ©claratives et de remboursement. La concordance entre les expositions issues des deux sources ou la validitĂ© de l’exposition issue de l’une par rapport Ă  celle issue de l’autre ont Ă©tĂ© Ă©valuĂ©es dans diffĂ©rents contextes. La survenue d’évĂ©nements a Ă©tĂ© simulĂ©e dans la population et des Ă©tudes cas-tĂ©moins nichĂ©es ont Ă©tĂ© conduites pour Ă©valuer l’association entre l’exposition issue de chaque source et chaque Ă©vĂ©nement. Pour les mĂ©dicaments cardiovasculaires, les mesures d’exposition Ă©taient peu diffĂ©rentes entre les deux sources. L’impact du choix de l’une ou l’autre source sur les mesures d’association entre l’exposition et un Ă©vĂ©nement Ă©tait faible. Pour les benzodiazĂ©pines ou les anti-inflammatoires non stĂ©roĂŻdiens, des diffĂ©rences Ă©taient observĂ©es entre les expositions issues des deux sources. Pour ces mĂ©dicaments, l’association avec un Ă©vĂ©nement pouvait varier selon la source utilisĂ©e. Pour des mĂ©dicaments pris de maniĂšre irrĂ©guliĂšre ou intermittente, le choix de la source de donnĂ©es pour la mesure de l’exposition peut donc ĂȘtre un Ă©lĂ©ment dĂ©terminant.In pharmacoepidemiology, assessment of drug exposure is fundamental. It can rely on data collected through patient interviews or extracted from healthcare insurance system databases recording reimbursement claims. This work aimed to compare drug exposure measured from these two data sources and to evaluate the impact of choosing one source or the other on risk estimates in etiological studies. It was conducted as part of the Three-City Study, a cohort of French elderly persons for which both interview and reimbursement data were available. Agreement between exposures measured from both sources or validity of exposure measured from one source with reference to that measured from the other were evaluated in different backgrounds. Simulated outcomes were generated in the study population and nested case-control studies were conducted in order to estimate the association between the drug exposure measured from each source and each simulated outcome. For cardiovascular system drugs, exposure measured from interview data was close to that measured from reimbursement data. The choice of one source or the other had few impact on the estimated associations between the exposure and an outcome. For benzodiazepines or non-steroidal anti-inflammatory drugs, exposure measured from both sources could differ. For these drugs, the association between the exposure measured from each source and an outcome could vary. For drugs that can be used irregularly or intermittently, the choice of the source of data for drug exposure assessment could thus be of great importance

    Le Grand ƒuvre, liturgie de l'alchimie chrĂ©tienne

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    L'auteur, s'appuyant sur des textes reprĂ©sentatifs de ce courant de pensĂ©e, montre que bon nombre d'alchimistes de confession catholique Ă©tablissaient et dĂ©veloppaient des analogies trĂšs prĂ©cises entre leur foi et les thĂšmes alchimiques. L'Ă©tude de ces comparaisons le conduit Ă  conclure que l'alchimie sublime en christophanie ses mythes, sa spiritualitĂ© et ses pratiques. AnamnĂšse et eschatologie, cĂ©lĂ©bration sacrificielle, rĂ©conciliation et sanctification universelles, le grand Ɠuvre est l'accoucheur des achĂšvements mĂ©talliques comme la Messe est actualisation de la RĂ©demption pascale. Une attention particuliĂšre est portĂ©e au rĂŽle du mouvement spatio-temporel qui permet Ă  l'adepte, comme au chrĂ©tien, de s'affranchir des entraves du temps. L'alchimie Ă©tait peut-ĂȘtre et involontairement une chimie embryonnaire et une mĂ©tallurgie empirique. Bien plus et dĂ©libĂ©rĂ©ment, elle fut une doctrine philosophique, une sotĂ©riologie, une ascĂšse spirituelle et un ensemble de pratiques rituelles faisant de l'Artifex un Hierourgos, analogue et confrĂšre du cĂ©lĂ©brant eucharistique. Elle fut, enfin, une liturgie et un essai de connaissance de Dieu Ă  partir de ce monde, complĂ©mentaire de la thĂ©ologie qui interprĂ©tait le cosmos Ă  partir de la RĂ©vĂ©lation.Noize Michel. Le Grand ƒuvre, liturgie de l'alchimie chrĂ©tienne. In: Revue de l'histoire des religions, tome 186, n°2, 1974. pp. 149-183

    EFFETS SECONDAIRES DES CORTICOIDES SUR LE COLON

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    DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

    SARCOIDOSE NASALE (ETUDE DE LA LITTERATURE A PROPOS D'UN CAS)

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    DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

    Mesure de l'exposition médicamenteuse en pharmaco-épidémiologie (étude comparative de données issues des bases de remboursement de l'Assurance Maladie française et de données déclaratives)

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    En pharmaco-Ă©pidĂ©miologie, la mesure de l exposition mĂ©dicamenteuse est fondamentale. Des donnĂ©es dĂ©claratives recueillies par interrogatoire des sujets ou des donnĂ©es extraites des bases de remboursement de l Assurance Maladie peuvent ĂȘtre utilisĂ©es. Les objectifs de ce travail Ă©taient de comparer l exposition mesurĂ©e Ă  partir de ces deux sources de donnĂ©es et d Ă©valuer l impact du choix de l une ou l autre source sur les mesures de risque dans les Ă©tudes Ă©tiologiques. Les travaux ont Ă©tĂ© conduits au sein de l Ă©tude des Trois-CitĂ©s, cohorte de sujets ĂągĂ©s pour laquelle Ă©taient disponibles des donnĂ©es dĂ©claratives et de remboursement. La concordance entre les expositions issues des deux sources ou la validitĂ© de l exposition issue de l une par rapport Ă  celle issue de l autre ont Ă©tĂ© Ă©valuĂ©es dans diffĂ©rents contextes. La survenue d Ă©vĂ©nements a Ă©tĂ© simulĂ©e dans la population et des Ă©tudes cas-tĂ©moins nichĂ©es ont Ă©tĂ© conduites pour Ă©valuer l association entre l exposition issue de chaque source et chaque Ă©vĂ©nement. Pour les mĂ©dicaments cardiovasculaires, les mesures d exposition Ă©taient peu diffĂ©rentes entre les deux sources. L impact du choix de l une ou l autre source sur les mesures d association entre l exposition et un Ă©vĂ©nement Ă©tait faible. Pour les benzodiazĂ©pines ou les anti-inflammatoires non stĂ©roĂŻdiens, des diffĂ©rences Ă©taient observĂ©es entre les expositions issues des deux sources. Pour ces mĂ©dicaments, l association avec un Ă©vĂ©nement pouvait varier selon la source utilisĂ©e. Pour des mĂ©dicaments pris de maniĂšre irrĂ©guliĂšre ou intermittente, le choix de la source de donnĂ©es pour la mesure de l exposition peut donc ĂȘtre un Ă©lĂ©ment dĂ©terminant.In pharmacoepidemiology, assessment of drug exposure is fundamental. It can rely on data collected through patient interviews or extracted from healthcare insurance system databases recording reimbursement claims. This work aimed to compare drug exposure measured from these two data sources and to evaluate the impact of choosing one source or the other on risk estimates in etiological studies. It was conducted as part of the Three-City Study, a cohort of French elderly persons for which both interview and reimbursement data were available. Agreement between exposures measured from both sources or validity of exposure measured from one source with reference to that measured from the other were evaluated in different backgrounds. Simulated outcomes were generated in the study population and nested case-control studies were conducted in order to estimate the association between the drug exposure measured from each source and each simulated outcome. For cardiovascular system drugs, exposure measured from interview data was close to that measured from reimbursement data. The choice of one source or the other had few impact on the estimated associations between the exposure and an outcome. For benzodiazepines or non-steroidal anti-inflammatory drugs, exposure measured from both sources could differ. For these drugs, the association between the exposure measured from each source and an outcome could vary. For drugs that can be used irregularly or intermittently, the choice of the source of data for drug exposure assessment could thus be of great importance.BORDEAUX2-Bib. Ă©lectronique (335229905) / SudocSudocFranceF
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