Prise en charge et coûts de la bronchopneumopathie chronique obstructive en France en 2011

RésuméIntroductionCette étude vise à estimer une prévalence de la bronchopneumopathie chronique obstructive (BPCO) traitée et les coûts associés par degré de sévérité.MéthodeElle a été conduite sur les données 2011 de l’échantillon généraliste de bénéficiaires (EGB). Cet échantillon représente 1/97e des bénéficiaires des principaux régimes d’assurance maladie obligatoire. Les cas et leur sévérité ont été identifiés à partir d’algorithmes originaux. Les coûts ont été établis dans une perspective collective.RésultatsLe taux de prévalence minimale de la BPCO traitée a été estimé à 3,8 % dans la population âgée de 40ans et plus, et 1,9 % tous âges confondus. La population (58,2 % d’hommes) avait 68,8±12,7ans d’âge moyen. Au total, 6,2 % des patients ont eu des consommations de soins évocatrices d’un stade très sévère, 8,1 %, 13,8 % et 71,9 % d’un stade sévère, modéré ou peu sévère. Sur une année, 28,8 % ont consulté un pneumologue, 5,0 % ont été hospitalisés (≥24h) pour BPCO et 6,7 % sont décédés. En moyenne, les patients ont eu 1,7±1,5 exacerbations/an et seulement 61,4 % ont reçu un traitement médicamenteux spécifique. La consommation annuelle moyenne de soins d’un patient a été estimée à 9382€ dont 5516€ attribuable à la BPCO.ConclusionCette étude utilisant des bases de données médico-administratives confirme l’importance du fardeau épidémiologique et économique de la BPCO en France.SummaryObjectivesTo estimate the prevalence of treated chronic obstructive pulmonary disease (COPD) and its associated costs by stage of severity.MethodsThe study was conducted on the 2011 data of the french general beneficiary sample database (EGB). EGB is a 1/97th sample of the whole population of the beneficiaries of the main compulsory national health insurances. COPD cases and the level of severity of the disease have been identified using new algorithms established from the available parameters in EGB. Costs were estimated using a collective perspective.ResultsThe minimal prevalence of treated COPD was estimated at 3.8% in patients of 40 years and older and 1.9% regardless of the age of individuals. This population was predominantly male (58.2%) with a mean age of 68.8 years (±12.7). A total of 6.2% of patients had a health-care utilization suggestive of a very severe stage of COPD and 8.1%, 13.8% and 71.9% suggestive of severe, moderate and mild stages respectively. Over one year, 28.8% of patients visited a specialist respiratory physician, 5.0% were hospitalized (≥24h) for COPD and 6.7% died. Patients experienced an average of 1.7 (±1.5) exacerbations per year and only 61.4% received specific pharmacological treatment for COPD during the year. The average yearly health-care cost of a patient with COPD was estimated at €9382, with €5342 directly related to COPD.ConclusionThis study based on medico-administrative databases confirms the high epidemiological and economic burden of COPD in France

On Broken Triangles

A binary CSP instance satisfying the broken-triangle property (BTP) can be solved in polynomial time. Unfortunately, in practice, few instances satisfy the BTP. We show that a local version of the BTP allows the merging of domain values in binary CSPs, thus providing a novel polynomial-time reduction operation. Experimental trials on benchmark instances demonstrate a significant decrease in instance size for certain classes of problems. We show that BTP-merging can be generalised to instances with constraints of arbitrary arity. A directional version of the general-arity BTP then allows us to extend the BTP tractable class previously defined only for binary CSP

The Impact of AND/OR Search Spaces on Constraint Satisfaction and Counting

The contribution of this paper is in demonstrating the impact of AND/OR search spaces view on solutions counting. In contrast to the traditional (OR) search space view, the AND/OR search space displays independencies present in the graphical model explicitly and may sometimes reduce the search space exponentially. Empirica

Comparison of non histone proteins selectively associated with nucleosomes with proteins released during limited DNase digestions.

Cultured mammary cells from GR mouse were used to analyse proteins associated with the mononucleosomes and released by a short micrococcal DNase treatment of nuclei. On metrizamide density gradients, mononucleosomes appear to be heterogeneous according to their content of associated non-histone proteins. Proteins associated with the denser fraction (1.22 - 1.24 g/ml) were analysed by two dimensional electrophoresis and compared to the proteins released by DNase I treatment. All the proteins associated with mononucleosomes were also released by DNase I treatment. It could then be assumed that these proteins are associated with the active part of the genome. Additional proteins were released by micrococcal DNase treatment of the nuclei. They could be involved in a higher order organization of chromatin

On Broken Triangles ⋆

Abstract. A binary CSP instance satisfying the broken-triangle property (BTP) can be solved in polynomial time. Unfortunately, in practice, few instances satisfy the BTP. We show that a local version of the BTP allows the merging of domain values in arbitrary instances of binary CSP, thus providing a novel polynomial-time reduction operation. Extensive experimental trials on benchmark instances demonstrate a significant decrease in instance size for certain classes of problems. We show that BTP-merging can be generalised to instances with constraints of arbitrary arity and we investigate the theoretical relationship with resolution in SAT. A directional version of the general-arity BTP then allows us to extend the BTP tractable class previously defined only for binary CSP

Observance du traitement de fond dans l’asthme persistant de l’adulte en pratique courante

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