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Introduction: Drug-related hospital admissions (DRAs) can account for 5%-40% of total hospital admissions in older adults, with a significant proportion deemed preventable. To increase the detection of DRAs, in 2021, a revised trigger tool listing 21 frequent causes of admissions and medications at risk was proposed. This study aimed to describe DRAs using this trigger tool in a French acute geriatric ward and to assess the performance of the tool., Methods: This was a retrospective cohort study in a 20-bed geriatric unit including all patients hospitalised in 2023. During the first quarter of 2024, each patient's chart was adjudicated by using a two-step standardised review procedure to assess whether the admission was a DRA. The potentially at cause medications and reasons for admission were also assessed., Results: During the study period, 483 patients were hospitalised in the acute-care geriatric ward (mean age 86.7 ± 6.15 years). After adjudication, 207 admissions (43%) were identified as DRAs; 70% were considered preventable. The main causes of DRAs were falls/fractures (33%), bleeding (23%) and delirium (14%). The drugs most frequently responsible were diuretics (21%), renin-angiotensin system inhibitors (20%) and direct oral anticoagulants (15%). The overall sensitivity and specificity of the tool for detecting DRAs was 90% (95% CI 88-93) and 72% (68-76), respectively. After adjudication, the trigger tool helped detect 83% more DRAs as compared with the attending geriatrician., Conclusion: DRAs are frequent in a geriatric population and often preventable. Their detection may be improved by the use of a trigger tool., (© The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Currently only 25-30% of patients with axonal forms of Charcot-Marie-Tooth disease (CMT) receive a genetic diagnosis. We aimed to identify the causative gene of CMT type 2 in 8 non-related French families with a distinct clinical phenotype. We collected clinical, electrophysiological, and laboratory findings and performed genetic analyses in four different French laboratories. Seventy-two patients with autosomal dominant inheritance were identified. The disease usually started in the fourth decade and the clinical picture was dominated by sensory ataxia (80%), neuropathic pain (38%), and length-dependent sensory loss to all modalities. Electrophysiological studies showed a primarily axonal neuropathy, with possible isolated sensory involvement in milder phenotypes. Disease severity varied greatly but the clinical course was generally mild. We identified 2 novel variants in LRSAM1 gene: a deletion of 4 amino acids, p.(Gln698_Gln701del), was found in 7 families and a duplication of a neighboring region of 10 amino acids, p.(Pro702_Gln711dup), in the remaining family. A common haplotype of ~450 kb suggesting a founder effect was noted around LRSAM1 in 4 families carrying the first variant. LRSAM1 gene encodes for an E3 ubiquitin ligase important for neural functioning. Our results confirm the localization of variants in its catalytic C-terminal RING domain and broaden the phenotypic spectrum of LRSAM1-related neuropathies, including painful and predominantly sensory ataxic forms.

Background: To evaluate the impact of the new IADPSG thresholds on gestational diabetes mellitus (GDM) prevalence., Methods: Universal screening for GDM was performed in 200 consecutive patients at 24 to 28 weeks with 75 g oral glucose tolerance test., Results: The prevalence of GDM was 14.0%. We observed that among the 28 patients with GDM, 16 (57.1%) had only one abnormal value, 10 (35.7%) two abnormal values and only two (7.2%) had three abnormal values. For the 16 patients with one abnormal value, 13 of them (81.2%) have an abnormal fasting plasma glucose (FPG). Patients with GDM had an increased body mass index (29.6 kg/m(2) vs 25.1 kg/m(2), P<0.001) and more important rates of familial history of type II diabetes (46.4% vs 21.5%, P<0.005) and history of GDM in a previous pregnancy (21.4% vs 2.9%, P<0.002) compared to non-GDM patients. Birth weight was increased in offspring of mothers with GDM (3451.3g vs 3387.4 g, P<0.05)., Conclusion: Our study found an increased rate of GDM with the new IADPSG criteria compared to previous published data. Higher rates of GDM represent a challenge for the organization of perinatal teams involved in GDM care., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

In 2002 the Gard was subjected to exceptional flooding, as much by their size as by the number of affected community victims, more than the Nimes floods in October 1988. No community was spared and more than 800 families had to be rapidly re-located. As the medical bibliography of the impact of the floods on respiratory heath was not conclusive we have proposed to the CHU of Nimes a hospital clinical research project undertaken by the members of RNSA, the Institute of Public Health of Brussels and the European Centre for Medical Bioclimate Research and Teaching, who have accepted to share their knowledge with the Gard. It seems to us to be indispensable, considering the certifications made by the professionals on the health on the department, to validate the study methods for the evaluation of the health impact of the floods, with regard to the development of moulds in the environment, so as to recognise the risk to health, in the very special circumstances, and so allow the mobilisabion of useful resources more rapidly than previously. The new floods to which the department was subjected in December 2003 made us regret that we had not developed this project more quickly.

Background: Since 2000, the incidence of syphilis has increased in France. The study objective was to estimate the frequency of syphilis in Languedoc Roussillon region in Southern France., Method: The prospective study was conducted between January 1, 2003 and June 30, 2003 in different medical wards in a French University Hospital, Nimes. The diseased patients in this study answered to a questionnaire, providing epidemiological and socio-economic data, symptomatology and treatment-seeking behaviour. Blood specimens were tested for syphilis by the serological methods (TPHA, VDRL, FTA)., Results: In 6 months, serologic evidence of syphilis infection was found in 30 patients. Men were more than twice as likely as women to be infected with syphilis. Most men (64.7%) acquired the infection homosexually. Four women acquired infection during pregnancy. The mean age of study population was 46.3 years. 40.7% were married. Out of 27 cases, 70.4% cases had an associated sexually transmitted infection (HIV, hepatitis, herpes, and gonorrhoea)., Conclusions: These data confirm the increase of syphilis in south of France and underline the importance of a permanent monitoring of sexually transmitted infection in target populations to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies.

Thirteen allergists reviewed 18 patients living and working in Vaucluse and Gard who suffered from ragweed from August 15 to October 15 2004. This preliminary study showed how difficult it is to realise a clinical data collection about pollinosis. It is entirely necessary to work together to build the protocol, with a clear and valid definition of inclusion and exclusion criteria.

Among fifty patients with bone metastases from breast cancer who were hospitalized between 1971 and 1980, 19 were given intermittent chemotherapy including both hormone-therapy (drostanolon propionate and tamoxifen) and a combination of cyclophosphamide, methotrexate, 5 FU, doxorubicin and vincristine (CMFDV). Comparison of these patients with two other groups given either miscellaneous chemotherapy programs (19 cases) or no chemotherapy (12 cases) exhibited the value of the standardized protocol, especially concerning median survival which exceeded three years (versus one year with the two other methods). Cobalt-therapy, chemotherapy and hormone-therapy in bone metastases from breast cancer are reviewed.