33 results on '"Puisieux, François"'
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2. Plan antichute des personnes âgées France 2022-2024 : objectifs et méthodologie 1.
- Author
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Blain, Hubert, Annweiler, Cédric, Berrut, Gilles, Bernard, Pierre Louis, Bousquet, Jean, Dargent-Molina, Patricia, Friocourt, Patrick, Puisieux, François, Robiaud, Jean-Baptiste, and Rolland, Yves
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OLDER people ,WOUNDS & injuries ,AGING - Abstract
Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
3. Intérêt de l’ostéodensitométrie chez les sujets chuteurs
- Author
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Blain, Hubert, Rolland, Yves, Beauchet, Olivier, Annweiler, Cedric, Benhamou, Claude-Laurent, Benetos, Athanase, Berrut, Gilles, Audran, Maurice, Bendavid, Sauveur, Bousson, Valérie, Briot, Karine, Brazier, Michel, Breuil, Véronique, Chapuis, Laure, Chapurlat, Roland, Cohen-Solal, Martine, Cortet, Bernard, Dargent, Patricia, Fardellone, Patrice, Feron, Jean-Marc, Gauvain, Jean-Bernard, Guggenbuhl, Pascal, Hanon, Olivier, Laroche, Michel, Kolta, Sami, Lespessailles, Eric, Letombe, Brigitte, Mallet, Eric, Marcelli, Christian, Orcel, Philippe, Puisieux, François, Seret, Patrick, Souberbielle, Jean-Claude, Sutter, Bruno, Trémollières, Florence, Weryha, Georges, Roux, Christian, and Thomas, Thierry
- Published
- 2014
- Full Text
- View/download PDF
4. Synthèse en langue française des recommandations mondiales 2022 pour la prise en charge et la prévention des chutes chez les personnes âgées.
- Author
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Blain, Hubert, Annweiler, Cédric, Berrut, Gilles, Becker, Clemens, Bernard, Pierre-Louis, Bousquet, Jean, Dargent-Molina, Patricia, Friocourt, Patrick, Martin, Finbarr C., Masud, Tahir, Petrovic, Mirko, Puisieux, François, Robiaud, Jean-Baptiste, Ryg, Jesper, Van der Velde, Nathalie, Montero-Odasso, Manuel, and Rolland, Yves
- Subjects
OLDER people ,ACCIDENTAL fall prevention ,PATIENT preferences ,QUALITY of life ,PHYSICAL activity ,CAREGIVERS - Abstract
Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
5. Troubles cognitifs et insuffisance rénale: quels liens ?
- Author
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Gaxatte, Cédric, Daroux, Maïté, Bloch, Jennifer, Puisieux, François, Deramecourt, Vincent, and Boulanger, Eric
- Published
- 2011
- Full Text
- View/download PDF
6. Pneumopathies du sujet âgé: Évaluation d’un guide de prescription d’antibiothérapie probabiliste dans un service de médecine gériatrique
- Author
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Huvent-Grelle, Dominique, Puisieux, François, Tettart-Hevin, Kathleen, Tettart, Vincent, Bulckaen, Hélène, Simovic, Bénédicte, Leroy, Olivier, and Dewailly, Philippe
- Published
- 2004
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- View/download PDF
7. Rhumatismes inflammatoires induits par les médicaments
- Author
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Hachulla, Eric, Flipo, René-Marc, and Puisieux, François
- Published
- 2004
- Full Text
- View/download PDF
8. Évaluation des courbures rachidiennes après un tassement vertébral récent
- Author
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Cortet, Bernard, Roches, Elisabeth, Logier, Régis, Houvenagel, Eric, Gaydier-Souquières, Geneviève, Puisieux, François, and Delcambre, Bernard
- Published
- 2002
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- View/download PDF
9. Un plan national et des recommandations mondiales au service de la prévention des chutes chez les personnes âgées1.
- Author
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Blain, Hubert, Annweiler, Cédric, Berrut, Gilles, Bernard, Pierre Louis, Bousquet, Jean, Dargent-Molina, Patricia, Friocourt, Patrick, Puisieux, François, Robiaud, Jean-Baptiste, and Rolland, Yves
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- 2023
- Full Text
- View/download PDF
10. Traitement par anticoagulants chez les patients atteints de fibrillation atriale : un consensus.
- Author
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Hanon, Olivier, Jeandel, Claude, Jouanny, Pierre, Paccalin, Marc, Puisieux, François, Krolak-Salmon, Pierre, and Berrut, Gilles
- Abstract
Résumé: La fibrillation atriale (FA) est fréquente chez le sujet âgé. Son traitement repose sur les anticoagulants pour prévenir un accident vasculaire cérébral (AVC) et les emboles systémiques. Les antagonistes de la vitamine K (AVK) ont longtemps été les seuls anticoagulants disponibles pour la prise en charge de la FA. Leur maniement complexe en a fait une des principales causes de iatrogénie chez le sujet âgé. Depuis près de 10 ans, les anticoagulants oraux d'action directe (AOD) ont fait leur apparition et de grands essais randomisés (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) ont montré leur supériorité par rapport aux AVK dans la prise en charge de la FA. Ces essais ont été menés sur un très grand nombre de patients (n = 71 683), dont 27 500 ≥ 75 ans et près de 8 000 sujets > 80 ans. Les résultats de 11 méta-analyses récentes regroupant les données des essais randomisés et celles des études observationnelles de la « vraie vie » chez 660 896 personnes âgées indiquent que les AOD ont une meilleure efficacité que les AVK pour prévenir les accidents vasculaires cérébraux (AVC) (réduction du risque allant de 13 % à 26 %), et par rapport à ceux-ci présentent un moindre risque d'hémorragies cérébrales (réduction du risque de 50 %). Le risque d'hémorragie majeure apparaît lui, similaire ou moindre sous AOD que sous AVK (en fonction de la posologie, de la fonction rénale, du site hémorragique ou du type d'AOD). Par ailleurs, le bénéfice des AOD en comparaison aux AVK est retrouvé dans les analyses en sous-groupes chez les sujets de plus de 75 ans, chez les insuffisant rénaux (clairance créatine 30-50 mL/min) et chez les sujets chuteurs. Les analyses indiquent qu'en comparaison avec les AVK, les AOD apparaissent d'autant plus favorables que les patients sont âgés car ce sont eux qui présentent le plus haut risque d'AVC et d'hémorragies cérébrales. En résumé, les AOD présentent un profil efficacité/tolérance supérieur aux AVK, ce qui justifie leur utilisation en première intention chez le sujet âgé de plus de 75 ans. Atrial fibrillation (AF) is common in the elderly. The treatment of this condition is based on anticoagulation in preventing Stroke and systemic arterial embolism. Vitamin K antagonists (VKAs) have long been the only anticoagulants available for the management of AF. Difficulties handling VKAs have made them one of the main causes of iatrogenic disease in the elderly. In the last 10 years, direct-acting oral anticoagulants (DOACs) have emerged and large randomized trials (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) have demonstrated their superiority over VKAs in the management of AF. These trials were conducted with large numbers of patients (n=71,683), including 27,500 aged ≥75 years and nearly 8,000 subjects aged >80 years. Results from 11 recent meta-analyses of randomized trials and observational real-world studies of 660,896 elderly patient indicate that DOACs are more effective than VKA-based prophylaxis in preventing stroke (risk reduction ranging from 13% to 26%) and carry a lower risk of cerebral hemorrhage (risk reduction 50%). The risk of major hemorrhage appears to be similar to or lower with DOACs than with VKAs (depending on the dosage, renal function, hemorrhagic site or type of DOACs). Moreover, a greater benefit of DOACs over VKA therapy has been found in subgroup analyses in subjects aged over 75 years, in patients with renal insufficiency (creatinine clearance 30-50 mL/min) and in those with a history of falls. Analyses indicate that DOACs are a better choice than VKAs in the elderly because elderly patients are those with the highest risk of stroke and cerebral hemorrhages. In summary, DOACs have a better efficacy/tolerance profile than VKAs, which justifies their first-line use in subjects over 75 years of age. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
11. Activité physique et prévention des chutes chez les personnes âgées
- Author
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Blain, Hubert, Bloch, Frédéric, Borel, Liliane, Dargent-Molina, Patricia, Gauvain, Jean Bernard, Hewson, David, Orève, Marie-Joëlle, Kemoun, Gilles, Mourey, France, Puisieux, François, Rolland, Yves, Stephan, Yannick, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurosciences sensorielles et cognitives (NSC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional d'Orléans (CHRO), Laboratoire Modélisation et Sûreté des Systèmes (LM2S), Institut Charles Delaunay (ICD), Université de Technologie de Troyes (UTT)-Centre National de la Recherche Scientifique (CNRS)-Université de Technologie de Troyes (UTT)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Economie de Dauphine (LEDa), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Université de Poitiers, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle de gérontologie [CHRU de Lille], Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Institut national de la santé et de la recherche médicale(INSERM), Dupuis, Christine, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Hôpital Roger Salengro [Lille], CHU Toulouse [Toulouse], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional d'Orléans (CHR), Hôpital Roger Salengro-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UM3)-Université de Montpellier (UM), and Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Exercice physique ,Collection Expertise collective / ISBN 978-2-85598-920-5 ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Ostéoporose ,Faiblesse musculaire ,Prévention des accidents ,Chutes accidentelles ,Vieillissement ,Sujet âgé ,Espérance de vie ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Les chutes chez les personnes âgées sont fréquentes : près d’une personne de plus de 65 ans sur trois et une personne de plus de 80 ans sur deux chutent chaque année. L’état de santé, les capacités fonctionnelles, les facteurs comportementaux ou les caractéristiques de l’environnement constituent autant de facteurs de risque. Au-delà des traumatismes physiques et psychologiques tels que la peur de tomber qui en résultent, les chutes peuvent entraîner des limitations fonctionnelles, une diminution de la qualité de vie, une perte d’autonomie voire une entrée en institution.Dans un contexte de vieillissement de la population, la prévention des chutes et la préservation de l’autonomie dans les activités quotidiennes constituent des enjeux majeurs de santé publique. Sollicitée par le ministère de la Ville, de la Jeunesse et des Sports, cette expertise collective fait le point des connaissances actuelles sur les conditions d’efficacité de l’activité physique dans la prévention des chutes. Le groupe d’experts propose des pistes d’action qui devraient mobiliser non seulement les personnes âgées, les proches, les aidants, mais également tous les professionnels concernés.
- Published
- 2015
12. Gériatrie (collection Le livre de l'interne)
- Author
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PUISIEUX François and PUISIEUX François
- Subjects
- Geriatrics
- Abstract
La gériatrie est devenue une préoccupation forte des hôpitaux confrontés aux difficultés de prise en charge des patients âgés, de plus en plus nombreux et aux besoins spécifiques. En ville, une part grandissante de l'activité des médecins libéraux, en premier lieu des médecins généralistes, est consacrée aux personnes âgées. Composé de cinq parties, l'ouvrage présente successivement : - les particularités du patient âgé - notions de fragilité, de polypathologie, d'autonomie, de dépendance, d'aidant, - les moyens dont dispose le gériatre - l'équipe pluridisciplinaire, les composantes de la filière gériatrique, les partenaires extra-hospitaliers, les outils notamment ceux de l'évaluation gériatrique, - la pratique gériatrique - l'examen clinique, la consultation, les thérapies médicamenteuses et non médicamenteuses, les soins palliatifs -, les syndromes gériatriques - altération de l'état général, chutes, confusion, dénutrition, déshydratation et enfin les autres situations couramment rencontrées en gériatrie : - addictions, anémie, constipation, convulsions, déficiences visuelles et auditives. Ces deux dernières parties sont organisées sous la forme d'un répertoire d'une cinquantaine de situations cliniques et propose pour chacune d'elles des conduites pratiques diagnostiques et thérapeutiques. Au total, un volume très complet dans lequel tous les praticiens amenés à prendre en charge des personnes âgées, à l'hôpital mais aussi en ville, pourront trouver des informations particulièrement utiles dans leur pratique quotidienne.
- Published
- 2012
13. [Swallowing disorders, pneumonia and respiratory tract infectious disease in the elderly] : Troubles de la déglutition du sujet âgé et pneumopathies en 14 questions/réponses
- Author
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Puisieux, François, D'Andrea, Cristiano, Baconnier, P., Bui-Dinh, D., Castaings-Pelet, S., Crestani, Bruno, Desrues, B., Ferron, C., Franco, Alain, Gaillat, J., Guenard, Hervé, Housset, Bruno, Jeandel, Claude, Jebrak, G., Leymarie-Selles, A., Orvoen-Frija, Elisabeth, Piette, François, Pinganaud, Geneviève, Salle, Jean-Yves, Strubel, D., Vernejoux, J.-M., De Wazières, Benoît, Weil-Engerer, S., Service de gériatrie, Hôpital des bateliers-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gérontologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de physiologie respiratoire, CHU Grenoble, Service SSR, CHU Bordeaux [Bordeaux], Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pneumologie A, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service de pneumologie, Service de médecine gériatrique, CHU de Saint-Etienne, Centre de gérontologie, Service des maladies infectieuses, Hôpital d'Annecy, EFR, Service de Pneumologie et de Pathologie Professionnelle, CHI Créteil, Centre de gérontologie clinique, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'ORL, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Charles Foix [AP-HP], Service de Médecine Physique et de Réadaptation [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Service de gérontologie et de prévention du vieillissement, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service des maladies respiratoires, Unité de gériatrie aigüe, Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Subjects
MESH: Aged ,MESH: Humans ,MESH: Deglutition Disorders ,MESH: Anti-Bacterial Agents ,[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology ,MESH: Respiratory Tract Infections ,otorhinolaryngologic diseases ,MESH: Pneumonia, Aspiration ,MESH: Fluoroscopy - Abstract
International audience; Swallowing disorders (or dysphagia) are common in the elderly and their prevalence is often underestimated. They may result in serious complications including dehydration, malnutrition, airway obstruction, aspiration pneumonia (infectious process) or pneumonitis (chemical injury caused by the inhalation of sterile gastric contents). Moreover the repercussions of dysphagia are not only physical but also emotional and social, leading to depression, altered quality of life, and social isolation. While some changes in swallowing may be a natural result of aging, dysphagia in the elderly is mainly due to central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors. To be effective, management requires a multidisciplinary team approach and a careful assessment of the patient's oropharyngeal anatomy and physiology, medical and nutritional status, cognition, language and behaviour. Clinical evaluation can be completed by a videofluoroscopic study which enables observation of bolus movement and movements of the oral cavity, pharynx and larynx throughout the swallow. The treatment depends on the underlying cause, extent of dysphagia and prognosis. Various categories of treatment are available, including compensatory strategies (postural changes and dietary modification), direct or indirect therapy techniques (swallow manoeuvres, medication and surgical procedures).
- Published
- 2009
14. Private practice-hospital patient pathways for elderly people with falls or at risk of falls: A study in Lille (northern France)
- Author
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Beaucamp, Florence, Pardessus, Vinciane, Pollez, Bruno, Marissal, Jean-Pierre, Puisieux, François, and Thevenon, André
- Published
- 2016
- Full Text
- View/download PDF
15. [Anti-fall plan for the elderly in France 2022-2024: objectives and methodology].
- Author
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Blain H, Annweiler C, Berrut G, Bernard PL, Bousquet J, Dargent-Molina P, Friocourt P, Puisieux F, Robiaud JB, and Rolland Y
- Subjects
- Humans, Aged, Aged, 80 and over, Exercise, France, Accidental Falls prevention & control, Hospitalization
- Abstract
Background: Falls and fall-related injuries are a major public health problem in industrialized countries. Faced with this challenge, a French national plan was launched in 2022 aiming to reduce by 20% the incidence of falls-related hospitalizations or deaths., Objectives: To describe the main pillars of the 2022-2024 French national plan against falls in older persons. Methods and assessment: The six pillars of the plan are: 1) screening and monitoring risks of falls and alert health and care workers; 2) home safety assessment and getting out safely; 3) developing technical aids for mobility and the use of assistive technologies at home; 4) appropriate physical activity, best weapon against falls; 5) tele-assistance devices for all older persons; 6) a cross-cutting pillar: Informing, raising awareness, training, and involving local actors. The plan, deployed in the 18 French regions, will provide a unique opportunity to determine the best strategies to achieve the objectives and the barriers encountered., Conclusions: The deployment of the French national plan will bring useful data for considering a long-term strategy in France and helping countries or regions wishing to implement a fall prevention plan on their territory.
- Published
- 2023
- Full Text
- View/download PDF
16. [A national plan and global recommendations for the prevention of falls in the elderly].
- Author
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Blain H, Annweiler C, Berrut G, Bernard PL, Bousquet J, Dargent-Molina P, Friocourt P, Puisieux F, Robiaud JB, and Rolland Y
- Subjects
- Aged, Humans, Risk Factors, Accidental Falls prevention & control
- Published
- 2023
- Full Text
- View/download PDF
17. [Synthesis in French of the 2022 global recommendations for the management and prevention of falls in the elderly].
- Author
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Blain H, Annweiler C, Berrut G, Becker C, Bernard PL, Bousquet J, Dargent-Molina P, Friocourt P, Martin FC, Masud T, Petrovic M, Puisieux F, Robiaud JB, Ryg J, Van der Velde N, Montero-Odasso M, and Rolland Y
- Abstract
Background: Falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs., Objective: To synthesize evidence-based and expert consensus-based 2022 world guidelines for the management and prevention of falls in older adults. These recommendations consider a person-centred approach that includes the preferences of the patient, caregivers and other stakeholders, gaps in previous guidelines, recent developments in e-health and both local context and resources., Recommendations: All older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for communitydwelling older adults. An algorithm is proposed to stratify falls risk and interventions for persons at low, moderate or high risk. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations., Conclusions: The core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.
- Published
- 2023
- Full Text
- View/download PDF
18. [Anticoagulant treatment in elderly patients with atrial fibrillation: position paper].
- Author
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Hanon O, Jeandel C, Jouanny P, Paccalin M, Puisieux F, Krolak-Salmon P, and Berrut G
- Subjects
- Aged, Atrial Fibrillation complications, Humans, Stroke etiology, Factor Xa Inhibitors therapeutic use, Stroke prevention & control
- Abstract
Atrial fibrillation (AF) is common in the elderly. The treatment of this condition is based on anticoagulation in preventing Stroke and systemic arterial embolism. Vitamin K antagonists (VKAs) have long been the only anticoagulants available for the management of AF. Difficulties handling VKAs have made them one of the main causes of iatrogenic disease in the elderly. In the last 10 years, direct-acting oral anticoagulants (DOACs) have emerged and large randomized trials (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) have demonstrated their superiority over VKAs in the management of AF. These trials were conducted with large numbers of patients (n=71,683), including 27,500 aged ≥75 years and nearly 8,000 subjects aged >80 years. Results from 11 recent meta-analyses of randomized trials and observational real-world studies of 660,896 elderly patient indicate that DOACs are more effective than VKA-based prophylaxis in preventing stroke (risk reduction ranging from 13% to 26%) and carry a lower risk of cerebral hemorrhage (risk reduction 50%). The risk of major hemorrhage appears to be similar to or lower with DOACs than with VKAs (depending on the dosage, renal function, hemorrhagic site or type of DOACs). Moreover, a greater benefit of DOACs over VKA therapy has been found in subgroup analyses in subjects aged over 75 years, in patients with renal insufficiency (creatinine clearance 30-50 mL/min) and in those with a history of falls. Analyses indicate that DOACs are a better choice than VKAs in the elderly because elderly patients are those with the highest risk of stroke and cerebral hemorrhages. In summary, DOACs have a better efficacy/tolerance profile than VKAs, which justifies their first-line use in subjects over 75 years of age.
- Published
- 2019
- Full Text
- View/download PDF
19. [Therapeutic education of the elderly].
- Author
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Puisieux F
- Subjects
- Aged, Humans, Patient Education as Topic
- Abstract
Competing Interests: F. Puisieux déclare n’avoir aucun lien d’intérêts.
- Published
- 2018
20. [Hallucinations and Parkinson's disease in the elderly: Pitfalls and medical care].
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Leroy A, Roche J, Dujardin K, Duthoit D, Puisieux F, Pins D, Jardri R, and Boulanger E
- Subjects
- Algorithms, Hallucinations diagnosis, Humans, Practice Guidelines as Topic, Hallucinations etiology, Hallucinations therapy, Parkinson Disease complications
- Abstract
Hallucinations are common neuropsychiatric symptoms in Parkinson's disease (PD), with a significant prognosis impact. It is necessary to rule out other diagnoses that can be mentioned when hallucinations occur in old patients with PD. The various etiological factors must be systematically checked and can help for diagnosis. Medical care will be focused on treating the primary cause (medical or iatrogenic origin) and will privilege non-pharmacological strategies. Due to their frequent adverse effects, antipsychotic medication should be limited and started at low dose in old patients with multiple comorbidities. Clozapine and quetiapine have the highest level of recommendation in this indication. In the future, defining fMRI-based targets for noninvasive brain stimulation tools should pave the way for innovative non-pharmacological treatment of hallucinations., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
21. [How the Congolese young people consider their elderly].
- Author
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Bikouta F, Bileckot R, Cauli M, Massamba H, and Puisieux F
- Subjects
- Adolescent, Adult, Aged, 80 and over, Attitude, Congo epidemiology, Cross-Sectional Studies, Elder Abuse statistics & numerical data, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Young Adult, Aged psychology
- Abstract
The traditional image of the African family that has long grant a place of choice to the elderly does match maybe any more the reality of today. The WHO report on violence and health 2002 and some studies carried out in other African countries suggest that elder abuse also exists in sub-Saharan Africa. To describe how the young Congolese adults consider their elderly and mistreatments that can result. A cross sectional study was realized between January and April, 2008 with 300 youth and adults aged 15 to 55 years (203 ≤ 25 years old), living in Brazzaville or in Pointe-Noire. The sample of 300 people was constituted according to the method of non-probability sampling. The data collection was made on the ground by state employees of the Ministry of Health, social affairs and family by means of a pre-established questionnaire containing open and closed questions. Youth and adults have contrasted and contradictory representations of the elderly. In 70% of the cases they said have good relationships with the elderly and qualified them as wise persons and as models but, conversely, more than 50% of them found them unwanted and disturbing. Witchcraft accusations are frequent with often serious consequences. Social transformations dispossess little by little the elderly people of their status and their prerogatives in Congo-Brazzaville. They come along with a change of look and behavior of the young adults towards them. Elder abuse in Congo-Brazzaville is an underestimated problem insufficiently denounced and fought.
- Published
- 2015
- Full Text
- View/download PDF
22. [French geriatric day hospitals managing falls].
- Author
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Robinet P and Puisieux F
- Subjects
- Aged, France, Geriatric Assessment statistics & numerical data, Health Care Surveys, Humans, Patient Care Team statistics & numerical data, Referral and Consultation statistics & numerical data, Surveys and Questionnaires, Accidental Falls statistics & numerical data, Day Care, Medical statistics & numerical data, Delivery of Health Care statistics & numerical data, Health Services for the Aged statistics & numerical data
- Abstract
Introduction: Falling is a serious hazard for the elderly that may lead to severe injury, loss of independence, and death. The aim of the study was to describe the resources devoted by French geriatric day hospitals for the assessment and care of elderly fallers, by differentiating medicine day hospitals and rehabilitation day hospitals., Method: Department heads listed in the directory of the Association for the Promotion of the Day Hospitals for Elderly people (APHJPA) were contacted by email and invited to answer a questionnaire online., Results: Among the 162 doctors contacted, 135 filled in the questionnaire (82.3%). Care of fallers was an important activity for responding departments. However, it represented less than 20% of the total activity for 80% of respondents. It involved the systematic or occasional participation of numerous medical and paramedical personnel. The majority of teams systematically performed complementary investigations in all fallers. Primary care physicians requested one half of all day hospitalization. A standardized file was used by 55 to 64.3% of respondents, while computerized files were still not widely used. Home assessment was proposed by only 17 medicine day hospitals. 85% of rehabilitation day hospitals proposed a personalized care project, spread out over several sessions, associated with educational intervention. One half of respondents carried out a preliminary consultation and/or a follow-up consultation., Conclusion: Although the fall was not the leading activity in terms of volume of geriatric day hospitals, the majority of these units devoted considerable resources to this activity and ensures personalized evaluation and care of elderly fallers.
- Published
- 2014
23. [Discharge from hospital into nursing home: conditions and quality of transmissions].
- Author
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Delabrière I, Delzenne E, Gaxatte C, and Puisieux F
- Subjects
- Aged, Aged, 80 and over, Female, France, Humans, Male, Prospective Studies, Hospitalization statistics & numerical data, Length of Stay statistics & numerical data, Nursing Homes statistics & numerical data, Patient Discharge statistics & numerical data
- Abstract
Context: Nursing home residents are very old, with multiple comorbidities and disabled for activities of daily living (ADLs). Therefore, they have a higher risk of accidents as falls or fractures or acute diseases as infections, which require hospitalization. Care's coordination and sharing of informations between hospitals and nursing homes are often insufficient even with agreements. Thus, discharge to nursing homes after hospitalization may be difficult for old patients because of incomplete oral or written transmissions., Objective: To examine both protocols and the quality of the return to the nursing homes after an hospitalization for old residents., Method: A prospective multicenter study done by collecting data about consecutive returns into their nursing home after an hospitalization of more than 24 hours of nursing home residents aged 65 years and more., Results: Twenty-eight nursing homes of the North of France were enrolled in the study. During the 3 months period of the study, 246 discharges after an hospitalization of 24 hours or more were registered. 225 residents (165 women and 60 men), mean age 85.0 ± 7.2, were concerned. Most of them were ADLs disabled, with a dementia for 47.1% of them. The average length of hospitalization was 11.6 days. At the end of hospitalization, the notification of return, which was made only in 82% of cases, was announced in average 1.3 days before the discharge. Unfortunately, in 32% of cases, the notification was made the day of the discharge. Residents went back home indifferently any day of the week but more often the Friday and less often the weekend. The day and the hour of the planned discharge were respected in 79.1% of cases. In most cases, nursing home caregivers have considered that the clinical status was stable or improved compared to the previous one. However in 28% of cases, a loss of autonomy was found. Medical doctors wrote a letter of discharge in 85.8% of cases. Nurses gave written transmissions only in 41.9% of cases., Conclusion: Many points concerning discharge from hospital, about old people living in nursing home, have to be improved: oral transmissions about patient's status, notification of the return, discharge's letter, nurse's transmissions and assessment of the loss of autonomy., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
24. [Sleep complaints and disorders in residential home patients taking hypnotic drugs].
- Author
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Delzenne E, Pesch S, Martin I, Di Pompeo C, Huvent D, Boulanger É, Puisieux F, and Roche J
- Subjects
- Activities of Daily Living classification, Aged, Aged, 80 and over, Female, France, Geriatric Assessment, Humans, Male, Mental Status Schedule, Prospective Studies, Sleep Initiation and Maintenance Disorders diagnosis, Surveys and Questionnaires, Homes for the Aged, Hypnotics and Sedatives adverse effects, Hypnotics and Sedatives therapeutic use, Nursing Homes, Sleep Initiation and Maintenance Disorders chemically induced, Sleep Initiation and Maintenance Disorders drug therapy
- Abstract
Objective: To analyze sleep of residential home patients taking hypnotic drugs., Patients and Method: This prospective, observational and multicentric study was performed a given day in nursing homes. Residents over than 65, having MMSE ≥ 15 and coherence A or B (for the AGGIR scale) were included. Aphasic residents or having acute pathology were excluded. Sleep complain was expressed by the resident himself and sleep disorder was observed by care givers. Sleep qualitative (complain versus disorder, difficulty to fall asleep and night awakenings) and quantitative (sleep duration) aspects were compared to residents who take or not hypnotic treatments., Results: 635 residents were included. 28.2% of the residents expressed sleep complains whereas care givers reported that only 11.4% of resident presented real sleep disorders (p<0.001). Compared to the residents who take hypnotic drugs (55.6%), residents without such treatment had shown less sleep complaints (31.2 versus 24.8%; p<0.05), less difficulties to fall asleep (38.6 versus 26.5%; p<0.001), and less night awakenings (69.5 versus 60.9%; p<0.05). No sleep duration difference was found according to hypnotic drugs., Discussion: Institutionalized geriatric patients who take hypnotic drugs seem to have a significant lower quality of sleep.
- Published
- 2012
- Full Text
- View/download PDF
25. [Cognitive impairment and chronic kidney disease: which links?].
- Author
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Gaxatte C, Daroux M, Bloch J, Puisieux F, Deramecourt V, and Boulanger E
- Subjects
- Chronic Disease, Humans, Kidney Failure, Chronic therapy, Renal Dialysis, Cognition Disorders etiology, Kidney Diseases complications, Kidney Failure, Chronic complications
- Abstract
Ageing of the population leads to an increase of cognitive disorders and chronic renal failure incidence. Compared to the general population, prevalence of cognitive impairment is more important in renal failure patients, especially in dialyzed patients. No direct link has been established between renal failure and cognitive impairment. The care of older and older patients and the high frequency of vascular risk factors, in particular hypertension and diabetes, partially explain the prevalence of vascular dementia and Alzheimer disease in this population. Other factors as the anemia, phosphocalcic metabolism disorders facilitate the cognitive impairment. The present work reviews the links existing between chronic renal failure and cognitive impairment., (Copyright © 2010 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
26. [Alcohol consumption patterns in older people living in nursing homes].
- Author
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Leurs P, Huvent-Grelle D, Lelievre-Leroy S, Roche J, and Puisieux F
- Subjects
- Age of Onset, Aged, Aged, 80 and over, Alcoholic Intoxication epidemiology, Alcoholism epidemiology, Comorbidity, Cross-Sectional Studies, Female, France, Health Status, Health Surveys, Humans, Male, Mental Status Schedule, Socioeconomic Factors, Alcohol Drinking adverse effects, Alcohol Drinking epidemiology, Frail Elderly statistics & numerical data, Homes for the Aged statistics & numerical data, Nursing Homes statistics & numerical data
- Abstract
Background: Although frail elderly people are particularly vulnerable to the adverse effects of alcohol, very little work on alcohol consumption patterns in older people living in nursing homes has been undertaken., Objective: To determine alcohol consumption patterns among the residents of 8 nursing homes of the Nord Pas-de-Calais in France, and the characteristics associated with heavy drinking (≥ 3 glasses of wine or equivalent/day)., Methods: All residents were invited to participate in the study on condition that they satisfied the inclusion criteria (age ≥ 60 years, Mini Mental State of Folstein (MMSE) > 15, agreement) and the exclusion criteria (no oral communication, end of life). Two questionnaires were used, one for the residents and the other for the personnel nursing., Results: Three hundred and sixty-eight residents [242 females (65.8%) and 126 males (34.2%); mean age, 80.5 ± 8.9 years] participated in the study. Among them, 98 (26.6%) reported no consumption of alcohol and 21 (5.7%) reported occasional consumption. The 249 (67.7%) others reported every-day consumption, principally in the restaurant at the time of the meals. Sixty-seven (18.2%), were heavy drinkers with an early-onset alcoholism for two out of three. Compared with the other residents participating in the study, the at-risk alcohol drinkers were younger and more likely to be a man., Conclusion: The study confirms that the prevalence of chronic at risk consumption is high in nursing homes. More efforts are needed to identify and improve management of alcohol disorders in this particular setting., (Copyright © 2010. Published by Elsevier Masson SAS.)
- Published
- 2010
- Full Text
- View/download PDF
27. [Renal aging: risk factors and nephroprotection].
- Author
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Daroux M, Gaxatte C, Puisieux F, Corman B, and Boulanger E
- Subjects
- Aged, Aging physiology, Humans, Kidney physiology, Renal Insufficiency epidemiology, Risk Factors, Renal Insufficiency etiology, Renal Insufficiency prevention & control
- Abstract
Renal failure in the elderly is currently underestimated and presents a real challenge for the public health system. Kidney function must be routinely assessed by creatinine clearance, estimated with either the Cockcroft and Gault formula or the simplified MDRD formula, which appears especially appropriate for the elderly. Normal kidney aging is related to tissue and functional changes that make older patients very vulnerable to environmental modifications. Numerous factors can accelerate the impairment of rental function during aging. Some of them cannot be modified: sex, genome, and initial kidney disease. Most of them can be managed or treated: hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, proteinuria, and the presence of oxidation and glycation products. Chronic renal failure in the elderly must be managed early with strict treatment targets to avoid the development of end-stage renal disease. Inhibitors of the renin-angiotensin-aldosterone system play an essential role in optimizing nephroprotection: control of hypertension, diabetes complications, and proteinuria. They should be prescribed very carefully in older patients. Age is not a prerequisite for consultations with nephrologists, which should take place early so that nephroprotection can still be useful.
- Published
- 2009
- Full Text
- View/download PDF
28. [Relation between Pisa syndrome and choline esterase inhibitors in a cohort of Alzheimer's disease patients].
- Author
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Huvent-Grelle D, Roche J, Gaxatte C, Dewailly P, and Puisieux F
- Subjects
- Aged, 80 and over, Cohort Studies, Donepezil, Galantamine adverse effects, Humans, Indans adverse effects, Male, Piperidines adverse effects, Syndrome, Alzheimer Disease drug therapy, Cholinesterase Inhibitors adverse effects, Dystonia chemically induced
- Published
- 2009
- Full Text
- View/download PDF
29. [A study on the management of short term care for elderly patients aged 75 and over in the Nord-Pas de Calais region].
- Author
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Defebvre MM, Cerf E, Fournier P, Puisieux F, and Loens I
- Subjects
- Aged, Cross-Sectional Studies, Delivery of Health Care, France, Geriatric Assessment, Hospital Administration, Hospitalization, Hospitals, District organization & administration, Hospitals, Private organization & administration, Hospitals, Public organization & administration, Humans, Outcome Assessment, Health Care, Health Services for the Aged organization & administration
- Abstract
The development of the geriatrics portion of the third national health plan in the Nord-Pas de Calais presented an interesting opportunity to analyse the management of health care for an ageing population in one of France's youngest regions. This work served as a means to establish recommendations for the improvement of the organisation and planning of health care services for this particular population group in the region. In this article reporting on the study's outcomes, the authors present the results on the management of health care for elderly people in hospitals and other short term medical care facilities.
- Published
- 2007
- Full Text
- View/download PDF
30. [Dementia and falls: two related syndromes in old age].
- Author
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Puisieux F, Pardessus V, and Bombois S
- Subjects
- Cognition Disorders epidemiology, Cognition Disorders psychology, Dementia epidemiology, Dementia psychology, Humans, Risk Factors, Accidental Falls statistics & numerical data, Aged psychology, Cognition Disorders complications, Dementia complications
- Abstract
Dementia and cognitive impairment are known as a major risk for falls and subsequent adverse events in the elderly. In addition to result in serious injury, including fractures, falls lead to functional decline due to fear of falling again and self limitation of activity in older adults. All types of dementia and all degrees of severity are involved. Rather than resulting from a single cause, falls are the result of a combination of intrinsic, situational, and environmental factors. The most common risk factors for falls in patients with cognitive impairment and dementia are gait and balance disturbances, behavioral disorders, visual problems, malnutrition, adverse effects of drugs, fear of falling, neurocardiovascular instability (particularly orthostatic hypotension), and environmental hazards. Based on data from studies in cognitively normal people who fall, a multifaceted intervention, including a physical exercise programme and modification of the risk factors may prevent falls in older people with cognitive impairment and dementia. Preliminary research suggests that physiotherapy may have a role for falls prevention in these patients. However, randomized studies need to be performed.
- Published
- 2005
31. [Lung diseases in the elderly. Assessment of guidelines for the probabilistic prescription of antibiotics in a department of geriatric care].
- Author
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Huvent-Grelle D, Puisieux F, Tettart-Hevin K, Tettart V, Bulckaen H, Simovic B, Leroy O, and Dewailly P
- Subjects
- Aged, Aged, 80 and over, Drug Administration Schedule, Female, Hospitals, Humans, Male, Nursing Homes, Retrospective Studies, Treatment Outcome, Aging, Anti-Bacterial Agents therapeutic use, Cross Infection drug therapy, Geriatric Assessment, Guideline Adherence, Pneumonia drug therapy, Practice Guidelines as Topic, Practice Patterns, Physicians' statistics & numerical data
- Abstract
Objective: We developed a prescribing guideline containing recommendations for the initial empirical antibiotic therapy in community or nosocomial pneumonia. The aim of the present study was to examine the impact of this measure., Method: The prescribing guideline was implemented in May 1999. We retrospectively reviewed the charts of all patients>65 years with community-, or nursing home- or hospital-acquired pneumonia hospitalised in our department of acute geriatric care between May 1999 and November 2000. The criteria assessed were: consistence with the guideline, clinical effectiveness within 72 hours, adequation with the isolated germs and intra-hospital mortality., Results: Data were collected on 112 patients (63 women et 49 men; mean age=80 +/- 8 Years). The pneumonia was community-acquired in 52 cases (46%), nursing home acquired in 25 cases (22%) and hospital-acquired in 35 cases (31%). Antibiotic prescription was consistent with the guideline in 64 cases (57%). When the antibiotic therapy was consistent, the patients were more likely to improve within 72 hours (45/64 versus 23/48; p=0.01). Despite a tendency, the number of antimicrobial treatments adapted to the isolated microorganisms was not significantly higher in the consistent group (22/36 adapted treatments versus 10/20). The intra-hospital mortality (25%) was similar in the two groups consistent and not consistent with the guideline. SARM was the most frequent multiresistant bacteria that was isolated., Conclusion: The use of a prescribing guideline might improve the efficiency of empirical probabilistic antibiotic therapies. The impact of the guideline use on overall antibiotic costs and microbiological flora remains to be determined.
- Published
- 2004
- Full Text
- View/download PDF
32. [Postprandial hypotension in the elderly].
- Author
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Puisieux F
- Subjects
- Accidental Falls, Aged, Eating, Humans, Hypotension therapy, Risk Factors, Vascular Resistance, Aging, Blood Pressure physiology, Hypotension complications, Hypotension etiology, Postprandial Period, Syncope etiology
- Abstract
A FREQUENT BLOOD PRESSURE DISORDER: Falls and syncope are frequent accidents in the elderly and may be caused by a large variety of disorders. Over the past decade, postprandial hypotension (PPH), which is defined as a decrease in systolic blood pressure of 20 mmHg or more within two hours of ingestion of the meal, has been recognised as a common cause of syncope and falls in this population. It should therefore be searched for systematically in any assessment of syncope and falls. The PPH mechanism is not fully understood, but PPH is probably the consequence of an alteration in the compensatory mechanisms for meal-induced splanchnic blood pooling and the lowering of peripheral vascular resistance following ingestion of food. REGARDING TREATMENT: Treatment of PPH, which may be non pharmacologic and pharmacologic, is not well codified, because too few rigorous studies has been conducted on symptomatic patients.
- Published
- 2003
33. [ Movement and balance disorders. Falls in the elderly].
- Author
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Puisieux F
- Subjects
- Aged, Algorithms, France epidemiology, Geriatrics, Hip Fractures prevention & control, Humans, Osteoporosis prevention & control, Posture, Risk Factors, Accidental Falls prevention & control, Accidental Falls statistics & numerical data, Movement Disorders complications, Movement Disorders diagnosis, Movement Disorders epidemiology, Postural Balance
- Published
- 2002
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