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University of Technology of Compiègne, France

Allaert F.A.,CENBIOTECH | Quantin C.,University Hospital Dijon
Studies in Health Technology and Informatics | Year: 2010

Giving patients power over their personal health record is an unavoidable evolution in all industrialized countries which will reflect their active participation in the management of their own health. This would lead to patients sharing management with health professionals, which would need traceability of the data provider to maintain trust and transparency. The systematic use of electronic signatures by medical practitioners will be essential to provide sufficient guarantees and to clearly determine who has added what in the PEHR. © 2010 European Federation for Medical Informatics. All rights reserved.

Sattar N.A.,University of Glasgow | Ginsberg H.,University College West | Ray K.,St Georges, University of London | Chapman M.J.,French Institute of Health and Medical Research | And 26 more authors.
Atherosclerosis Supplements | Year: 2014

Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines. © 2014.

Loos H.M.,University of Burgundy | Loos H.M.,Friedrich - Alexander - University, Erlangen - Nuremberg | Loos H.M.,Fraunhofer Institute for Process Engineering and Packaging | Doucet S.,University of Burgundy | And 9 more authors.
Chemical Senses | Year: 2014

The odorous steroid 5α-androst-16-en-3-one (AND) occurs in numerous biological fluids in mammals, including man, where it is believed to play a chemocommunicative role. As AND was recently detected in milk and amniotic fluid, sensitivity and hedonic responses to this substance were assessed in human neonates. To this aim, respiration and facial expressions were recorded in 3-day-old newborns in response to aqueous solutions of AND, ranging from 500 ng/mL to 0.5 fg/mL. Although analyses of respiratory rate did not lead to clear-cut results, the newborns changed their facial expressions at concentrations not detected by adults in a triangle test. Newborns displayed negative facial actions of longer duration to AND relative to an odorless control. Thus, AND may be considered to be offensive to newborns, which is a counterintuitive outcome as they are exposed to this compound in the womb (and it should therefore be familiar), in milk, and on the mother's skin surface (and it should therefore be conditioned as positive). Multiple reasons for this perceptual-behavioral paradox are discussed. © The Author 2014.

Le Ven F.,University Hospital Brest | Tribouilloy C.,University Hospital Amiens | Habib G.,University Hospital Marseille | Gueffet J.-P.,University of Nantes | And 7 more authors.
European Journal of Echocardiography | Year: 2011

Aims The aim of this paper is to report clinical characteristics, consequences, echocardiographic features, and pathological findings encountered in patients suffering from valvular disease associated with benfluorex exposure in a multicentre French registry. Methods and results Forty patients suffering from unexplained restrictive valvular disease with a previous exposition to benfluorex, a fenfluramine derivative, were identified from eight French university hospitals. Patients were mostly women (87.5) with a mean age of 57 ± 9 years and high body mass index of 30 ± 7 kg/m; 37.5 of them presented with severe heart failure symptoms (NYHA class III and IV). Benfluorex mean daily dose was 415 ± 131 mg with total therapy duration of 72 ± 53 months. Resulting cumulative dose was 910 ± 675 g. Common echocardiographic findings were leaflets and sub-valvular apparatus thickening and retraction. Aortic and mitral valve regurgitations resulting from leaflets loss of coaptation were the most frequent findings (87.5 and 82.5) and were severe in 29 patients (72.5). Multiple valve involvements were present in 31 cases (77.5). Pulmonary arterial hypertension was identified in 20 cases (50). Histopathological examination demonstrated abundant extra cellular matrix encasing the leaflets without modification of valve architecture. Fifteen patients (37.5) underwent valvular surgery. Conclusion Benfluorex-related valvulopathy shares numerous characteristics with other drug-induced valvular disease. Clinical consequences may be serious with severe heart failure symptoms that may lead to surgical treatment. © 2011 The Author.

Bron A.M.,University Hospital Dijon | Viswanathan A.C.,University College London | Thelen U.,Private Practice | de Natale R.,Ospedale Civile di Monselice | And 4 more authors.
Clinical Ophthalmology | Year: 2010

Objective: Low vision that causes forfeiture of driver's licenses and collection of disability pension benefits can lead to negative psychosocial and economic consequences. The purpose of this study was to review the requirements for holding a driver's license and rules for obtaining a disability pension due to low vision. Results highlight the possibility of using a milestone approach to describe progressive eye disease. Methods: Government and research reports, websites, and journal articles were evaluated to review rules and requirements in Germany, Spain, Italy, France, the UK, and the US. Results: Visual acuity limits are present in all driver's license regulations. In most countries, the visual acuity limit is 0.5. Visual field limits are included in some driver's license regulations. In Europe, binocular visual field requirements typically follow the European Union standard of ≥120°. In the US, the visual field requirements are typically between 110° and 140°. Some countries distinguish between being partially sighted and blind in the definition of legal blindness, and in others there is only one limit. Conclusions: Loss of driving privileges could be used as a milestone to monitor progressive eye disease. Forfeiture could be standardized as a best-corrected visual acuity of <0.5 or visual field of <120°, which is consistent in most countries. However, requirements to receive disability pensions were too variable to standardize as milestones in progressive eye disease. Implementation of the World Health Organization criteria for low vision and blindness would help to establish better comparability between countries. © 2010 Bron et al.

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