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Saint-André-lez-Lille, France

Bernardini D.,Hopital Prive la Casamance | Heresbach D.,Center Hospitalier Of Redon | Bulois P.,Generale de Sante | Robaszkiewicz M.,Brest University Hospital Center | And 11 more authors.
Acta Endoscopica | Year: 2015

Introduction: Diagnosis or resection of colonic adenomas by colonoscopy can prevent the occurrence of colorectal cancer (CRC). We perform an annual prospective national survey of the practice of endoscopy, including colonoscopy in France. We report the main results and developments from 2011 to 2013. Methods: An online questionnaire conducted exclusively online since 2011 was sent to 2,600 gastroenterologists practicing endoscopy regularly. Data colonoscopies were collected prospectively for a week. These data were extrapolated to the total population of hepatogastroenterologists practicing regularly digestive endoscopy and then the whole year. The results of colonoscopies in France in terms of polyps diagnosis or cancer and the factors influencing the adenoma detection rate are reported (ADR). Results: In 2013, 383 gastroenterologists, representative of the overall population of French gastroenterologists have included 3,778 colonoscopies, corresponding to 1,150,268 exams reported for the year. In 21% of cases, it was performed gastroscopy at the same time. A pre-consultation colonoscopy was performed in 93.3% of cases and the consent was signed in 83.5%. Colonoscopy was complete in 89% of cases. The indications for colonoscopy were a CRC screening in 22%, a positive Hemoccult® in 4.4%, digestive symptoms in 51.3%. Polypectomy was performed in 28,5% of cases. ADR was 19.4%, the cancer detection rate was 2.4%. The main factors influencing the ADR were in 2013, male gender, age over 50 years (p <0.0001), personal or family history of CRC or colorectal polyps (p <0.001), a Hemoccult test positive (P=0.001), and surveillance postpolypectomy (p <0.001). Conclusion: In 2013 in France, this annual prospective study of colonoscopy practice, allows us to report a TDA of 19.4% vs 17.7% in 2011, a cancer diagnosis rate of 2.4% stable between the two investigations. The pre-consultation endoscopy was performed in 93.3% of cases and the consent was signed in 83.5%. © 2015, Springer-Verlag France. Source

Wijns W.,Cardiovascular Research Center Aalst | Suttorp M.J.,St Antonius Ziekenhuis | Zagozdzon L.,Orebro University | Morice M.-C.,Generale de Sante | And 5 more authors.
EuroIntervention | Year: 2016

Aims: Our aim was to evaluate the two-year clinical results of a new sirolimus-eluting stent (MiStent SES) with a bioabsorbable coating designed for rapid polymer dissolution but sustained drug delivery. Methods and results: Major adverse cardiac events (MACE), target lesion failure (TLF), target vessel failure (TVF), and stent thrombosis (ST) at two-year follow-up are reported for the DESSOLVE I and II trials. In DESSOLVE I, the MiStent SES (n=29) demonstrated a 3.4% two-year MACE rate without TLF or TVF. In DESSOLVE II, the MiStent group had a 6.7% (8/120) two-year MACE rate compared to 13.3% (8/60) for Endeavor (p=0.167). TLF was 5.0% in the MiStent and Endeavor groups (p=1.00). TVF was 5.0% for MiStent versus 11.7% for Endeavor (p=0.129). No probable or definite ST was reported with the MiStent up to two years. The median duration of dual antiplatelet therapy (DAPT) in DESSOLVE I and II was 364 and 366 days, respectively. Conclusions: The MiStent SES demonstrated good long-term safety and effectiveness with low two-year MACE, TLF, and TVF rates. © 2016 Europa Digital & Publishing. All rights reserved. Source

Kruse K.,Texas Orthopaedic Associates | Yalizis M.,Sydney Shoulder and Elbow Specialists | Neyton L.,Generale de Sante
Arthroscopy Techniques | Year: 2016

Arthroscopic distal clavicle resection has become an increasingly popular procedure in orthopaedics, and various techniques have been published. Many of the arthroscopic distal clavicle resection techniques that have been reported require visualization from the lateral portal with an anterior working portal to perform the resection. While these techniques have reported high success rates, there is often difficulty in viewing the entire acromioclavicular joint from the 2 standard arthroscopic portals (lateral and anterior). This is due to the medial edge of the acromion blocking the ability to visualize the most superior and posterior portions of the distal clavicle. We propose a technique for arthroscopic distal clavicle resection using an accessory anterior portal. © 2016 Arthroscopy Association of North America. Source

Katz G.,ESSEC Business School Paris | Romano O.,Generale de Sante | Foa C.,Generale de Sante | Vataire A.-L.,Creativ Ceutical | And 7 more authors.
PLoS ONE | Year: 2015

Background and Aims: The heterogeneous nature of breast cancer can make decisions on adjuvant chemotherapy following surgical resection challenging. Oncotype DX is a validated gene expression profiling test that predicts the likelihood of adjuvant chemotherapy benefit in early-stage breast cancer. The aim of this study is to determine the costs of chemotherapy in private hospitals in France, and evaluate the cost-effectiveness of Oncotype DX from national insurance and societal perspectives. Methods: A multicenter study was conducted in seven French private hospitals, capturing retrospective data from 106 patient files. Cost estimates were used in conjunction with a published Markov model to assess the cost-effectiveness of using Oncotype DX to inform chemotherapy decision making versus standard care. Sensitivity analyses were performed. Results: The cost of adjuvant chemotherapy in private hospitals was estimated at EUR 8,218 per patient from a national insurance perspective and EUR 10,305 from a societal perspective. Cost-effectiveness analysis indicated that introducing Oncotype DX improved life expectancy (+0.18 years) and quality-adjusted life expectancy (+0.17 QALYs) versus standard care. Oncotype DX was found cost-effective from a national insurance perspective (EUR 2,134 per QALY gained) and cost saving from a societal perspective versus standard care. Inclusion of lost productivity costs in the modeling analysis meant that costs for eligible patients undergoing Oncotype DX testing were on average EUR 602 lower than costs for those receiving standard care. Conclusions: As Oncotype DX was found both cost and life-saving from a societal perspective, the test was considered to be dominant to standard care. However, the delay in coverage has the potential to erode the quality of the French healthcare system, thus depriving patients of technologies that could improve clinical outcomes and allow healthcare professionals to better allocate hospital resources to improve the standard of care for all patients. © 2015 Katz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

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