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8 results on '"Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF)"'

1. The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?

Author

Mathias Wargon, Agnès Ricard-Hibon, Enrique Casalino, Romain Hellmann, Donia Bouzid, Alain Michault, Anne-Laure Feral-Pierssens, Axelle Menu, Dominique Brun-Ney, Frédéric Adnet, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SAMU 93 [Bobigny], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire éducations et promotion de la santé (LEPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Nord, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier René Dubos [Pontoise], Centre Hospitalier de Saint-Denis [Ile-de-France], Observatoire Regional des Soins Non Programmés [ïle-de-France/Saint-Denis] (ORSNP), Malbec, Odile, Laboratoire Educations et Pratiques de Santé (LEPS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord

Subjects
Typology, medicine.medical_specialty, Healthcare use, Health geography, [SDV]Life Sciences [q-bio], Distribution (economics), Public Policy, Access to care, Vulnerable Populations, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Humans, 030212 general & internal medicine, Retrospective Studies, Frequent users, business.industry, Emergency department, Health Policy, 030503 health policy & services, Public health, Public Health, Environmental and Occupational Health, [SDV] Life Sciences [q-bio], Social deprivation, Biostatistics, Public aspects of medicine, RA1-1270, Emergency Service, Hospital, 0305 other medical science, business, Research Article, Demography
Abstract

Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories.

Published
2021
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2. Transition matrices model as a way to better understand and predict intra-hospital pathways of covid-19 patients

Author

Arnaud, Foucrier, Jules, Perrio, Johann, Grisel, Pascal, Crépey, Etienne, Gayat, Antoine, Vieillard-Baron, Frédéric, Batteux, Tobias, Gauss, Pierre, Squara, Seak-Hy, Lo, Matthias, Wargon, Romain, Hellmann, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Service de santé numérique [Paris] (SESAN), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Hôpital Lariboisière-Fernand-Widal [APHP], Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Ambroise Paré [AP-HP], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), CHU Grenoble, Clinique Ambroise Paré [Centres Médico-Chirurgicaux Ambroise Pré, Pierre Cherest, Hartmann], Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Observatoire Regional des Soins Non Programmés [ïle-de-France/Saint-Denis] (ORSNP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Jonchère, Laurent

Subjects
Hospitalization, [SDV] Life Sciences [q-bio], Intensive Care Units, Multidisciplinary, SARS-CoV-2, [SDV]Life Sciences [q-bio], Humans, COVID-19, Hospital Mortality, Pandemics, Hospitals, Retrospective Studies
Abstract

Since January 2020, the SARS-CoV-2 pandemic has severely affected hospital systems worldwide. In Europe, the first 3 epidemic waves (periods) have been the most severe in terms of number of infected and hospitalized patients. There are several descriptions of the demographic and clinical profiles of patients with COVID-19, but few studies of their hospital pathways. We used transition matrices, constructed from Markov chains, to illustrate the transition probabilities between different hospital wards for 90,834 patients between March 2020 and July 2021 managed in Paris area. We identified 3 epidemic periods (waves) during which the number of hospitalized patients was significantly high. Between the 3 periods, the main differences observed were: direct admission to ICU, from 14 to 18%, mortality from ICU, from 28 to 24%, length of stay (alive patients), from 9 to 7 days from CH and from 18 to 10 days from ICU. The proportion of patients transferred from CH to ICU remained stable. Understanding hospital pathways of patients is crucial to better monitor and anticipate the impact of SARS-CoV-2 pandemic on health system.

Published
2022
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3. Severe acute respiratory syndrome coronavirus 2-related multisystem inflammatory syndrome in children mimicking Kawasaki disease

Author

Isabelle Melki, Romain Basmaci, Luigi Titomanlio, Ulrich Meinzer, Naim Ouldali, Constance Beyler, Michael Levy, Jean-Christophe Mercier, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Hôpital Robert Debré Paris, Hôpital Robert Debré, Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [Paris] (Institut IMAGINE/RAISE), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Imagine [Paris Necker] (2I), Service de Pédiatrie-Urgences [Hopital Louis Mourier - APHP, Colombes], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Comets, Emmanuelle, Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [CHU Necker] (RAISE), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)

Subjects
Male, Pediatrics, Review, 030204 cardiovascular system & hematology, Procalcitonin, PCR, polymerase chain reaction, 0302 clinical medicine, Vasoplegia, 030212 general & internal medicine, Multisystem inflammatory syndrome temporally associated with SARS-CoV-2, Respiratory system, skin and connective tissue diseases, Child, Children, COVID-19, coronavirus disease 2019, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Immunoglobulins, Intravenous, TSS, toxic shock syndrome, General Medicine, KD, Kawasaki disease, Shock, Septic, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Rash, Systemic Inflammatory Response Syndrome, 3. Good health, Viral pneumonia, Shock (circulatory), Female, Disease Susceptibility, Symptom Assessment, medicine.symptom, PICU, paediatric intensive care unit, Cardiology and Cardiovascular Medicine, Syndrome inflammatoire multi-systémique temporellement associé à SARS-CoV-2, Enfant, medicine.medical_specialty, Adolescent, education, Shock, Cardiogenic, Mucocutaneous Lymph Node Syndrome, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, Diagnosis, Differential, 03 medical and health sciences, Diabetes mellitus, otorhinolaryngologic diseases, medicine, Humans, Immunologic Factors, PIMS-TS, paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2, KDSS, Kawasaki disease shock syndrome, Cardiogenic shock, IQR, interquartile range, SARS-CoV-2, business.industry, fungi, ComputingMilieux_PERSONALCOMPUTING, Syndrome de Kawasaki, COVID-19, Kawasaki syndrome, Length of Stay, medicine.disease, IL, interleukin, body regions, CI, confidence interval, IVIG, intravenous immunoglobulin, Kawasaki disease, MIS-C, multisystem inflammatory syndrome in children, business, ECMO, extracorporeal membrane oxygenation, Biomarkers, Choc cardiogénique
Abstract

Graphical abstract Schematic distribution of the clinical signs in multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2., The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been characterized by high transmission rates and high mortality in adults with predisposing factors, including age > 70 years, obesity, diabetes, systemic hypertension and other underlying diseases. During the second week of viral pneumonia, acute respiratory distress syndrome can occur and carries high mortality. Unlike most common respiratory viruses, children seem to be less susceptible to SARS-CoV-2 infection, and generally develop mild disease with low mortality. However, clusters of severe shock associated with high levels of cardiac biomarkers and unusual vasoplegia requiring inotropes, vasopressors and volume loading have recently been described. Both the clinical symptoms (i.e. high and persistent fever, gastrointestinal disorders, skin rash, conjunctival injection and dry cracked lips) and the biological signs (e.g. elevated C-reactive protein/procalcitonin and high levels of ferritinaemia) mimicked Kawasaki disease. In most cases, intravenous immunoglobin therapy improved cardiac function and led to full recovery within a few days. Adjunctive steroid therapy and sometimes biotherapy (e.g. anti-interleukin 1Ra and anti-interleukin 6 monoclonal antibodies) were often necessary. Although almost all children fully recovered within a week, some of them later developed coronary artery dilation or aneurysm. Thus, a new “multisystem inflammatory syndrome in children” related to SARS-CoV-2 has recently been described. Similarities with Kawasaki disease and the physiopathology of this syndrome still need further exploration.

Published
2021
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4. Results of the 2017 inspection campaign of French phase I/II research sites in Île-de-France following the BIA 10-2474 accident: Medical vs. regulatory relevance

Author

Bruno Lebourgeois, Franck Odoul, Coffi Megnigbeto, Christian Funck-Brentano, François Doz, Claire Henry, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Service départemental d’incendie et de secours de Loir-et-Cher (SDIS), Institut Curie [Paris], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CCSD, Accord Elsevier, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
medicine.medical_specialty, Pyridines, Pharmacist, Poison control, 030226 pharmacology & pharmacy, Suicide prevention, Occupational safety and health, Accreditation, Cyclic N-Oxides, Clinical trials as topic, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, medicine, Humans, Biomedical research, Pharmacology (medical), Adjudication, business.industry, Government regulation, Public health, Quality assurance, 3. Good health, Clinical trial, Accidents, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Family medicine, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, France, Public Health, business
Abstract

Summary Aims Following the serious adverse events that occurred in January 2016 during the BIA 10-2474 First-in-Human study, the French Ministry of Health asked the Regional Health Agencies to inspect operations at all research sites conducting phase I/II clinical trials of experimental drugs. The aim of this study was to assess the medical relevance of the inspections made in Ile-de-France (Paris region) in 2017. Methods All 30 sites of Ile-de-France region fully authorized to perform phase I/II trials were inspected by a public health physician and a public health pharmacist. Their reported list of observations was submitted to three physicians with longstanding experience of early pharmacology studies performed in academic or private research facilities. These physicians were asked to adjudicate each observation according to their perceived medical importance regarding safety. Adjudications were first performed separately and disagreements were later settled during a final adjudication meeting. Results At least one disagreement occurred initially among the 3 adjudicators for 84 of the 120 observations (70%) reported by the inspectors. Following reconciliation, the 3 physicians agreed that 20% of the observations were likely to have potentially serious medical consequences. These observations mainly concerned the management of emergencies and of serious adverse events and the continuity of care. Conclusions Maintenance of on-site inspections periodically carried out by regulatory authorities granting authorisations to perform phase I/II trials are justified. However, the medical relevance of these inspections can be improved with more emphasis on factors affecting the safety of research participants than on administrative or purely regulatory issues.

Published
2020
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5. Linked transmission chains of imported SARS-CoV-2 variant B.1.351 across mainland France, January 2021

Author

Diane Descamps, Arnaud Tarantola, Lucile Trutt, Josselin Vincent, Aurélien Zhu-Soubise, Lisa King, Olivier Catelinois, Colin Deschanvres, Olivier Glass, Vincent Enouf, Mounira Smati-Lafarge, Marilyne Gojon, Delphine Barataud, Jacques Izopet, Florence Daubresse, Valérie Lebaillif, Sylvie Behillil, Anne Guinard, Valérie Garrait, Sylvie van der Werf, Guillaume Spaccaferri, Etienne Simon-Loriere, Amine Si Ali, Sibylle Bernard-Stoecklin, Simon Ribes, Blandine De Kerros, Esra Morvan, Muriel Beliah-Nappez, Karine Vilhes, Clémentine Calba, Alexandra Mailles, Sarah Mahdjoub-Assaad, Damien Mouly, Aurélie Misme, Berenice Villegas-Ramirez, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Prévention et contrôle des infections (PCI ), Hôpitaux Universitaires de Genève (HUG), Centre Hospitalier Intercommunal de Créteil (CHIC), Hôpital Lariboisière-Fernand-Widal [APHP], Agence régionale de Santé Pays de la Loire [Nantes], Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre hospitalier universitaire de Nantes (CHU Nantes), Agence Régionale de Santé Occitanie (ARS Occitanie), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Génomique évolutive des virus à ARN - Evolutionary genomics of RNA viruses, Institut Pasteur [Paris] (IP), Pasteur International Bioresources network (PIBNet), and Plateforme de Microbiologie Mutualisée (PIBnet) - Mutualized Platform for Microbiology (P2M)

Subjects
Adult, Male, Adolescent, Epidemiology, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Black People, law.invention, Young Adult, law, Communicable Diseases, Imported, Virology, Humans, Child, SARS-CoV-2 variants 20H/501Y.V2, Mozambique, Aged, Travel, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, Middle Aged, Geography, Transmission (mechanics), Cluster, COVID-19 Nucleic Acid Testing, Mainland, Incubation, Female, France, Rapid Communication
Abstract

International audience; Two cases of confirmed SARS-CoV-2 infection with the B.1.351 variant were reported in France in mid-January, 2020. These cases attended a gathering in Mozambique in mid-December 2020. Investigations led to the identification of five imported cases responsible for 14 transmission chains and a total 36 cases. Epidemiological characteristics seemed comparable to those described before the emergence of the South African variant B.1.351. The lack of tertiary transmission outside of the personal sphere suggests that distancing and barrier measures were effective.

Published
2021
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6. Hystérectomie : évolution des pratiques entre 2009 et 2019 en France

Author

F. Margueritte, Annie Serfaty, Xavier Fritel, Cyrille Huchon, Arnaud Fauconnier, Audrey Chevrot, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Service de gynécologie et obstétrique [Hopital Lariboisière - Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Gynecology, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Medical Information Systems Program, Philosophy, [SDV]Life Sciences [q-bio], Surgical approach, Obstetrics and Gynecology, Assessment, Hysterectomy, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, medicine, 030212 general & internal medicine
Abstract

Resume Objectifs L’hysterectomie est l’intervention la plus pratiquee chez une femme. Nous avons souhaite realiser un etat des lieux de l’hysterectomie en France en 2019. Nous avons egalement evalue les variations au cours du temps des indications et des voies d’abord de l’hysterectomie, ceci au regard des differents evenements ayant pu etre a l’origine de la modification des pratiques. Methodes Nous avons utilise le Programme de Medicalisation des Systemes d’Information en medecine, chirurgie, obstetrique et odontologie afin d’extraire l’ensemble des actes relatifs a une hysterectomie quelle que soit sa voie d’abord de 2009 a 2019. Resultats Environ 60 000 hysterectomies ont ete realisees en France en 2019. La voie d’abord chirurgicale la plus frequemment utilisee est desormais la cœlioscopie, realisee dans 30 % des hysterectomies, suivie des voies d’abord laparotomique (29 %), puis vaginale (26 %) et coelio-vaginale (15 %). Les procedures cœlioscopiques sont realisees plus souvent en structures hospitalieres publiques que privees. Une annexectomie est associee a 41 % des hysterectomies. Une diminution du nombre d’hysterectomie a ete observee entre 2008 et 2019, passant d’environ 72 000 en 2008 a environ 60 000 en 2019. Cette diminution survient au cours d’une periode au cours de laquelle sont apparue de nouvelles therapeutiques ainsi que de nouvelles recommandations. Conclusion L’evolution du nombre d’hysterectomies est correlee au developpement d’alternatives therapeutiques pour les pathologies pour lesquelles etait classiquement realisee une hysterectomie.

Published
2021
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7. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020

Author

Daniel Lévy-Bruhl, Sylvie Behillil, Clément Bassi, Alexandra Mailles, Anne Simondon, Yassoungo Silue, P. Rolland, François Xavier Lescure, Matthieu Mechain, Morgane Stempfelet, Anouk Tabaï, Clément Lazarus, Bruno Coignard, C Campese, Investigation team, Sophie Ismael, Sibylle Bernard Stoecklin, Denis Malvy, Vincent Enouf, Mathieu Nguyen, Laure Meurice, Estelle Yamani, Duc Minh Nguyen, Scarlett Georges, Santé publique France - French National Public Health Agency, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Agence Régionale de la Santé (ARS), Centre National de Référence des virus des infections respiratoires (dont la grippe) [Paris] (CNR), Institut Pasteur [Paris], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Bordeaux GeoSentinel Site [Bordeaux], Service des maladies infectieuses et tropicales [Bordeaux], CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Laboratoire de Biotechnologie et Microbiologie Appliquée (LBMA), Université Bordeaux Segalen - Bordeaux 2-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Direction Générale de la Santé [Paris] (DGS), Ministère des Solidarités et de la Santé [Paris, France], Santé publique France [Saint-Maurice, France] (French National Public Health Agency), parent-French National Public Health Agency, Investigation Team: Laurent Filleul, Stéphanie Vandentorren, Guillaume Spaccaferri, Hélène Prouvost, Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf, Alexis Ardoin, Marion Dreyer, Karim Tararbit, Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold, Didier Che, Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah, Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier, Pauline Mathieu., Direction des maladies infectieuses - Infectious Diseases Division [Saint-Maurice], Santé publique France - French National Public Health Agency [Saint-Maurice, France], Direction des régions [Saint-Maurice], Cellule Régionale Ile-de-France [Paris], Santé publique France - French National Public Health Agency [Saint-Maurice, France]-Santé publique France - French National Public Health Agency [Saint-Maurice, France], Agence Régionale de Santé Nouvelle-Aquitaine [Bordeaux] (ARS NA), Cellule Régionale Nouvelle-Aquitaine [Bordeaux], Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre opérationnel de réception et de régulation des urgences sanitaires et sociales [Paris], Ministère des Solidarités et de la Santé [Paris, France]-Ministère des Solidarités et de la Santé [Paris, France], Direction alerte et crise [Saint-Maurice], Investigation Team : Laurent Filleul, Stéphanie Vandentorren, Guillaume Spaccaferri, Hélène Prouvost, Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf, Alexis Ardoin, Marion Dreyer, Karim Tararbit, Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold, Didier Che, Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah, Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier, Pauline Mathieu, Bodescot, Myriam, and Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR)

Subjects
0301 basic medicine, Male, Epidemiology, MESH: Coronavirus Infections, [SDV]Life Sciences [q-bio], coronavirus, medicine.disease_cause, MESH: Risk Assessment, contact tracing, containment, MESH: Infection Control, 0302 clinical medicine, COVID-19, France, 2019-nCov, Surveillance, SARS-CoV-2, Coronavirus, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infection control, MESH: COVID-19, 030212 general & internal medicine, MESH: Travel, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Travel, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, biology, Transmission (medicine), Middle Aged, MESH: China, 3. Good health, Population Surveillance, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Betacoronavirus, Risk assessment, Coronavirus Infections, Adult, medicine.medical_specialty, China, Pneumonia, Viral, Disease cluster, Risk Assessment, MESH: Population Surveillance, MESH: Contact Tracing, 03 medical and health sciences, Betacoronavirus, Virology, medicine, Humans, MESH: SARS-CoV-2, Infection Control, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, biology.organism_classification, medicine.disease, MESH: Male, MESH: France, Pneumonia, 030104 developmental biology, MESH: Pneumonia, Viral, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Contact tracing
Abstract

Investigation Team : Santé publique France, Direction des régions, Cellule Régionale Nouvelle Aquitaine, Bordeaux, France: Laurent Filleul, Stéphanie Vandentorren.Santé publique France, Direction des régions, Cellule Régionale Auvergne-Rhône-Alpes, Lyon, France: Guillaume Spaccaferri.Santé publique France, Direction des régions, Cellule Régionale Hauts-de-France, Lille, France: Hélène Prouvost.Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France: Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf.Agence Régionale de Santé Ile-de-France, Paris, France: Alexis Ardoin, Marion Dreyer, Karim Tararbit.Agence Régionale de Santé Nouvelle-Aquitaine, Bordeaux, France: Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold.Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France: Didier Che.AP-HP, Hôpital Bichat, Service des maladies infectieuses et tropicales, Paris, France: Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah.Centre Hospitalier Universitaire de Bordeaux, Bordeaux GeoSentinel Site, Bordeaux, France: Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier.Direction Générale de la Santé, Ministère des solidarités et de la santé, Centre opérationnel de réception et de régulation des urgences sanitaires et sociales, Paris, France: Pauline Mathieu; International audience; A novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) causing a cluster of respiratory infections (coronavirus disease 2019, COVID-19) in Wuhan, China, was identified on 7 January 2020. The epidemic quickly disseminated from Wuhan and as at 12 February 2020, 45,179 cases have been confirmed in 25 countries, including 1,116 deaths. Strengthened surveillance was implemented in France on 10 January 2020 in order to identify imported cases early and prevent secondary transmission. Three categories of risk exposure and follow-up procedure were defined for contacts. Three cases of COVID-19 were confirmed on 24 January, the first cases in Europe. Contact tracing was immediately initiated. Five contacts were evaluated as at low risk of exposure and 18 at moderate/high risk. As at 12 February 2020, two cases have been discharged and the third one remains symptomatic with a persistent cough, and no secondary transmission has been identified. Effective collaboration between all parties involved in the surveillance and response to emerging threats is required to detect imported cases early and to implement adequate control measures.

Published
2020
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8. Main barriers to effective implementation of stroke care pathways in France: a qualitative study

Author

Kristel Gache, Henri Leleu, Gérard Nitenberg, France Woimant, Marie Ferrua, Etienne Minvielle, COordination pour la Mesure de la Performance et l'Amélioration de la Qualité ( Hôpital, Patient, Sécurité, Territoire) (COMPAQ(HSPT) - U988), École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), UMR CNRS 8179, Centre National de la Recherche Scientifique (CNRS)-Université de Lille, Sciences et Technologies, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Institut Gustave Roussy (IGR), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), EHESP, SCD, Institut Gustave Roussy (IGR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Lille, Sciences et Technologies-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Quality management, Axial coding, Health Personnel, Health informatics, Health administration, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Nursing, Clinical pathways, Care coordination, Health care, Humans, Medicine, 030212 general & internal medicine, Implementation barriers, Program Development, Health Education, Qualitative Research, Quality of Health Care, business.industry, Nursing research, Public health, Health Policy, Quality of care, Continuity of Patient Care, 3. Good health, Stroke, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Critical Pathways, Health Resources, [SHS.GESTION]Humanities and Social Sciences/Business administration, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, [SHS.GESTION] Humanities and Social Sciences/Business administration, 030217 neurology & neurosurgery, Research Article, Qualitative research
Abstract

Background Stroke Care Pathways (SCPs) aim to improve quality of care by providing better access to stroke units, rehabilitation centres, and home care for dependent patients. The objective of this study was to identify the main barriers to effective implementation of SCPs in France. Methods We selected 4 types of SCPs currently implemented in France that differed in terms of geographical location, population size, socio-economic conditions, and available health care facilities. We carried out 51 semi-structured interviews of 44 key health professionals involved in these SCPs and used the interview data to (i) create a typology of the organisational barriers to effective SCP implementation by axial coding, (ii) define barrier contents by vertical coding. The typology was validated by a panel of 15 stroke care professionals. Results Four main barriers to effective SCP implementation were identified: lack of resources (31/44 interviewees), coordination problems among staff (14/44) and among facilities (27/44), suboptimal professional and organisational practices (16/44), and inadequate public education about stroke (13/44). Transposition of the findings onto a generic SCP highlighted alternative care options and identified 10 to 17 barriers that could disrupt continuity of care. Conclusion Lack of resources was considered to be the chief obstacle to effective SCP implementation. However, the main weakness of existing SCPs was poor communication and cooperation among health professionals and among facilities. We intend to use this knowledge to construct a robust set of quality indicators for use in SCP quality improvement initiatives, in comparisons between SCPs, and in the assessment of the effective implementation of clinical practice guidelines.

Published
2014
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