المؤلفون: Mélanie Dipanda, Camille Baudin-Senegas, Valentine Nuss, Jérémie Vovelle, Anca-Maria Mihai, Alain Putot, Patrick Manckoundia, Jérémy Barben

المصدر: International Journal of Environmental Research and Public Health
Volume 18
Issue 18
International Journal of Environmental Research and Public Health, Vol 18, Iss 9735, p 9735 (2021)

مصطلحات موضوعية: myalgia, Adult, Male, medicine.medical_specialty, Geriatric rehabilitation, Coronavirus disease 2019 (COVID-19), Health, Toxicology and Mutagenesis, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Health Personnel, Article, self-declaration survey, Internal medicine, Pandemic, Medicine, Humans, Prospective Studies, Prospective cohort study, Pandemics, Aged, Geriatrics, geriatrics, business.industry, healthcare workers, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, Female, medicine.symptom, business, Nursing homes

الوصف: Healthcare workers (HCWs) are exposed to a higher risk of coronavirus disease (COVID-19) contamination. This prospective multicenter study describes the characteristics of HCWs tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) while working in a geriatric environment. We also compared HCWs with a positive reverse transcription polymerase chain reaction (RTPCR) assay (RTPCR+ group) and those with a negative test result (RTPCR− group). Between 15/5/2020 and 15/9/2020, 258 HCWs, employed in the acute geriatric unit (AGU), geriatric rehabilitation unit (GRU) or nursing home of three hospitals in Burgundy (France) were invited to complete an online survey. Among the 171 respondents, 83 participants, with mean age 42 years and 87.9% female, were tested for SARS-CoV-2 infection. Among these 83 participants, COVID-19 was confirmed in 38 cases (RTPCR+ group) of which 36 were symptomatic, and the RTPCR assay was negative in 45 cases (RTPCR− group) of which 20 participants were symptomatic. A total of 22.9% (of 83) had comorbidities, 21.7% were active smokers, and 65.1% had received the flu vaccine. A total of 37.3% worked in AGU, 19.3% in GRU and 16.9% in nursing homes. The most common symptom described was headache (23.2%), followed by fatigue or cough (12.5% each), and fever or myalgia (10.7% each). There were more participants with normal body mass index (p = 0.03) in the RTPCR+ group. In contrast, there were more users of non-steroidal anti-inflammatory drugs (p = 0.01), active smokers (p = 0.03) and flu vaccinated (p = 0.01) in the RTPCR− group. No difference was found between the two groups for the type of work (p = 0.20 for physicians and p = 0.18 for nurses). However, acquiring COVID-19 was significantly associated with working in AGU (p <
0.001) and nursing homes (p = 0.001). There were significantly more users of surgical masks (p = 0.035) in the RTPCR+ group and more filtering facepiece-2 mask users (p = 0.016) in the RTPCR− group. Our results reflect the first six months of the COVID-19 pandemic in France. Further studies are needed to evaluate and track the risks and consequences of COVID-19 in HCWs.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1b2a2920333521839210e02b1d1760f3Test

المؤلفون: Alain Putot, Patrick Manckoundia, Fabrice Larosa, Jérémy Barben, Valentine Nuss, Alexandre Mignot, Jérémie Vovelle, Geoffrey Odille, Noémie Girard, Sophie Putot, Sarah Lelarge, Stéphane Sanchez, Sofia Da Silva

المصدر: Journal of the American Medical Directors Association

مصطلحات موضوعية: Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.drug_class, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Antibiotics, Pneumonia, Viral, MEDLINE, Older patients, Internal medicine, medicine, Research Letter, Humans, Pandemics, General Nursing, Aged, business.industry, SARS-CoV-2, Health Policy, COVID-19, General Medicine, medicine.disease, Anti-Bacterial Agents, COVID-19 Drug Treatment, Pneumonia, Female, France, Geriatrics and Gerontology, business

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e69a4a3ac0a6f028f33c67b313bc1677Test

المؤلفون: Patrick Manckoundia, Valentine Nuss, Alain Putot, Philippe d’Athis, Clémentine Rosay, Jérémie Vovelle, Gilles Nuemi, Anca-Maria Mihai, Didier Menu, Jérémy Barben

المصدر: International Journal of Environmental Research and Public Health
Volume 17
Issue 18
International Journal of Environmental Research and Public Health, Vol 17, Iss 6685, p 6685 (2020)

مصطلحات موضوعية: Male, medicine.medical_specialty, anticoagulants, Vitamin K, Cross-sectional study, Health, Toxicology and Mutagenesis, Population, lcsh:Medicine, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Practice Patterns, Physicians', Medical prescription, education, Aged, Aged, 80 and over, education.field_of_study, Acenocoumarol, drug prescription, Fluindione, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Warfarin, aged 80 and over, outpatients, Cross-Sectional Studies, Prescriptions, chemistry, Ambulatory, Platelet aggregation inhibitor, Female, business, medicine.drug

الوصف: We compared very elderly people taking vitamin K antagonists (VKA) and those not taking VKA (noVKA). Individuals were included in the noVKA group if there was no VKA on their reimbursed prescriptions during the study period. We also compared three subgroups, constituted by VKA type (fluindione, warfarin, or acenocoumarol). We included individuals aged over 85 years, affiliated to Mutualité
Sociale Agricole of Burgundy, who were refunded for prescribed VKA in September 2017. The VKA and noVKA groups were compared in terms of demographic conditions, registered chronic diseases (RCD), number of drugs per prescription and cardiovascular medications. The three VKA subgroups were compared for the same items plus laboratory monitoring, novel and refill VKA prescriptions, and prescriber specialty. Of the 8696 included individuals, 1157 (13.30%) were prescribed VKA. Mean age was 90 years. The noVKA group had fewer women (53.67 vs 66.08%), more RCD (93.43 vs. 71.96%) and more drugs per prescription (6.65 vs. 5.18) than the VKA group (all p <
0.01). Except for direct oral anticoagulants and platelet aggregation inhibitors, the VKA group took significantly more cardiovascular medications. The most commonly prescribed VKA was fluindione (59.46%). Mean age was higher in the warfarin (90.42) than in the acenocoumarol (89.83) or fluindione (89.71) subgroups (p <
0.01). No differences were observed for sex (women were predominant) or RCD. 13% of subjects in this population had a VKA prescription. Fluindione was the most commonly prescribed VKA.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5cf1740cdda70efc79b2632d76c5a9c9Test

المؤلفون: Patrick Manckoundia, Arthur Hacquin, Valentine Nuss, Alain Putot, Amadou Konaté, Mélanie Dipanda, Anca-Maria Mihai, Jérémie Vovelle, Sophie Putot, Jérémy Barben

المصدر: Clinical Interventions in Aging

مصطلحات موضوعية: Male, medicine.medical_specialty, Anemia, Population, Transferrin receptor, Review, 03 medical and health sciences, Hemoglobins, 0302 clinical medicine, iron deficiency, Internal medicine, Receptors, Transferrin, medicine, Humans, iron metabolism, 030212 general & internal medicine, education, older adults, Aged, chemistry.chemical_classification, Inflammation, education.field_of_study, Anemia, Hypochromic, biology, Anemia, Iron-Deficiency, Transferrin saturation, business.industry, Oxygen transport, General Medicine, Iron deficiency, medicine.disease, Ferritin, Endocrinology, C-Reactive Protein, chemistry, Transferrin, Ferritins, biology.protein, Female, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Biomarkers

الوصف: Iron is involved in many types of metabolism, including oxygen transport in hemoglobin. Iron deficiency (ID), ie a decrease in circulating iron, can have severe consequences. We provide an update on iron metabolism and ID, highlighting the particularities in older adults (OAs). There are three iron compartments in the human body: 1) the functional compartment, which consists of heme proteins including hemoglobin, myoglobin and respiratory enzymes; 2) iron reserves (IR), which consist mainly of liver stocks and are stored as ferritin; and 3) transferrin. There are two types of ID. Absolute ID is characterized by a decrease in IR. Its main pathophysiological mechanism is bleeding, which is often digestive and can be due to neoplasia, frequent in OAs. Biological assessment shows low serum ferritin and transferrin saturation (TS) levels. Furthermore, hypochromic microcytic anemia is frequent, and the serum-soluble transferrin receptor (sTfR) level is high. Functional ID, in which IR are high or normal, is due to inflammation, which is also frequent in OAs, particularly in its chronic form. Biological assessments show high serum ferritin, normal or low TS, and normal sTfR levels. Moreover, C-reactive protein is elevated, and there is moderate non-regenerative non-macrocytic anemia. The main characteristics of iron metabolism anomalies in the elderly are the high frequency of ID (20% of ID with anemia in adults ≥85 years) and the severity of its consequences, which include cognitive impairment in case of ID or iron overload and decrease of physical activity in case of ID. In conclusion, causes of ID are frequently intertwined in OAs as a result of the polymorbidity that characterizes them. ID can have dramatic consequences, especially in frail OAs. Thus, measuring the appropriate biological markers prevents errors in the positive diagnosis of ID type, clarifies etiology, and informs treatment-related decision-making.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d2b4579da09789a33694d9ff97df2a3bTest
https://pubmed.ncbi.nlm.nih.gov/33116447Test

المؤلفون: Jérémie Vovelle, Alain Putot, Philippe d’Athis, Anca-Maria Mihai, Valentine Nuss, Jérémy Barben, Didier Menu, Patrick Manckoundia, Clémentine Rosay

المساهمون: Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Mutualité Sociale Agricole - Caisse de Dijon (MSA de Dijon), Caisse Centrale de la Mutualité Sociale Agricole (CCMSA), Service Biostatistiques et Informatique Médicale (CHU de Dijon) (DIM), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)

المصدر: International Journal of Clinical Practice
International Journal of Clinical Practice, Wiley, 2020, 74 (1), pp.e13420. ⟨10.1111/ijcp.13420⟩

مصطلحات موضوعية: Male, Administration, Oral, 030204 cardiovascular system & hematology, Kidney Function Tests, 0302 clinical medicine, Rivaroxaban, Medicine, Disease, 030212 general & internal medicine, Prospective Studies, Practice Patterns, Physicians', Aged, 80 and over, education.field_of_study, Frailty, Venous Thromboembolism, General Medicine, Metaanalysis, Management, 3. Good health, Dabigatran, Health, Creatinine, Ambulatory, Platelet aggregation inhibitor, Apixaban, Female, Blood Coagulation Tests, France, Safety, medicine.drug, medicine.medical_specialty, Pyridones, Population, Drug Prescriptions, 03 medical and health sciences, Internal medicine, Humans, Medical prescription, education, Antihypertensive Agents, Aged, business.industry, Warfarin, Anticoagulants, Blood Cell Count, Atrial-Fibrillation, Chronic Disease, Pyrazoles, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Platelet Aggregation Inhibitors

الوصف: International audience; Objective Direct oral anticoagulants (DOACs) are increasingly prescribed to elderly people, but the epidemiologic data for this population remains scarce. We compared the elderly population taking DOACs and those not taking DOACs (noDOAC). Method We included individuals over 75 years old, affiliated to Mutualite Sociale Agricole of Burgundy (a French regional health insurance agency), who had been refunded for a prescribed DOAC between 1st and 30th September 2017. The DAOC group (DAOCG) and noDOAC group (noDOACG) were compared in terms of demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs. In the DOACG, we compared the type of prescribing physician and laboratory monitoring for novel prescriptions (initial) and prescription refills (>= 3 months). Results Of the 19 798 included patients, 1518 (7.7%) were prescribed DAOCs and 18 280 (92.3%) were not. Mean and median age was 85 years in the 2 groups (DOACG and noDOACG). In the DOACG, there were more men (50% vs 40.2%), more RCD (88.9% vs 68.7%) and more drugs per prescription (6 +/- 2.8 vs 5 +/- 2.9) (All P < .01). The DOACG also took more antihypertensive drugs. The most commonly prescribed DOACs were apixaban (42.9%) followed by rivaroxaban (38.4%) and dabigatran (18.6%). Complete blood count, serum creatinine and coagulation function tests were requested for 69.4%, 75% and 22.2%, respectively, of patients prescribed DAOCs. Conclusions The DOACG had more RCD and drugs per prescription than the noDOACG; routine laboratory monitoring was insufficient. What's knownPlatelet aggregation inhibitors (low-dose) are recommended for secondary prevention of cardiovascular events in patients suffering from symptomatic atherosclerosis. The main risk of this treatment is bleeding.A prescription for platelet aggregation inhibitors was found in 34% of geriatric inpatients in this prospective study. Compliance to guidelines was better for symptomatic peripheral artery disease than for primary prevention in accordance with recent publications. Geriatric comorbidities had no impact on the prescription of platelet aggregation inhibitors. Underuse of platelet aggregation inhibitors was observed in 11.3% of cases and overuse in 13.7% of cases.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0000ec9411a5193ba59bd985b2de4b1dTest
https://pubmed.ncbi.nlm.nih.gov/31532052Test