Actus Santé

Les certificats logiciels : au service de la protection des données de santé

ASIP Santé - jeu, 16/12/2021 - 10:38
Les certificats logiciels : au service de la protection des données de santé
Sous-titre
Professionnels de santé, authentifiez-vous en toute sécurité avec des certificats logiciels
photo_certificats_logiciels

Un certificat logiciel est un fichier informatique faisant fonction de pièce d'identité numérique. 
Il permet de garantir à distance l’identité d’une personne physique (un professionnel de santé par exemple) et/ou d’une personne morale (une structure de santé par exemple).

Un certificat logiciel contient des informations sur son propriétaire, certifiées par un tiers de confiance appelé "autorité de certification". Il permet 3 fonctionnalités principales :

  • l’authentification;
  • la signature électronique;
  • la sécurisation / le chiffrement des données.

L’Agence du Numérique en Santé est l’autorité de certification du domaine de la santé. Elle délivre des certificats logiciels pour sécuriser les échanges de données de santé informatisées entre les professionnels de santé exerçant en ville, à l’hôpital et dans les établissements médico-sociaux.

L’Agence du Numérique en Santé propose actuellement 4 offres de certificats logiciels :

  • Certificat de personne morale Serveur
  • Certificat de personne morale Organisation
  • Certificat de personne physique Professionnel
  • Certificat de personne physique Professionnel de Santé (PS)
     
Matrice des offres à commander en fonction des projets / usages */ /*-->*/ Projet / Usage Offre Certificat Logiciel DMP ORG AUTH_CLI
ORG SIGN MS Santé SERV SSL ROR (Répertoire Opérationnel des Ressources) ORG AUTH_CLI
OU SERV SSL PFLAU (Plateforme de Localisation des Appels d’Urgence) SERV SSL
ORG AUTH_CLI Annuaire AMC (Assurance Maladie Complémentaire) ORG AUTH_CLI RPPS (partenaires) ORG AUTH_CLI
ORG SIGN Annuaire Santé (RASS) ORG AUTH_CLI PRATIC ORG AUTH_CLI Dossier Pharmaceutique (DP) ORG AUTH_CLI Diapason SERV SSL
ORG AUTH_CLI ROC ORG SIGN PSIG (Portail des Signalements Sanitaires) SERV SSL
ORG AUTH_CLI SPEI (Prescription électronique)
GIE SESAM VITALE ORG SIGN eCRF (cahier d'observations électroniques) plateforme de recherches cliniques ORG AUTH_CLI France TAVI- Clingrid (implants Cardiologie) ORG AUTH_CLI Signature de flux de facturation ORG SIGN
Catégories: Actus Santé

Vaccination contre la Covid en France : au 29 novembre 2021, 105 209 650 injections ont été réalisées


1. Données de vaccination du jour et cumulées

Depuis le début de la campagne de vaccination en France, 51 933 749 personnes ont reçu au moins une injection (soit 77 % de la population totale) et 50 848 976 personnes ont désormais un schéma vaccinal complet (soit 75,4 % de la population totale).1

Depuis le début de la campagne de rappel, 7 299 378 personnes ont reçu une dose de rappel2.

[1] Avec l'ouverture de la vaccination aux 12-17 ans, le calcul du taux de vaccination de la population majeure évolue. Le nombre d'injections par classe d'âge n'étant disponible qu'à J+1, nous communiquerons désormais le taux de vaccination de la population majeure à J-1, de manière hebdomadaire chaque mardi. Le taux de vaccination de la population totale n'est pas impacté, il est toujours donné quotidiennement donné à J-J.

2 Le nombre d'injections de rappel n'étant disponible qu'à J+1, nous communiquerons désormais les nombres de rappel à J-1 de manière quotidienne.

2. Comment prendre rendez-vous pour se faire vacciner ?

Pour rappel, la prise de rendez-vous est possible :
• Via le site internet www.sante.fr
• Chez un pharmacien, un médecin de ville (médecin généraliste, médecin spécialiste, ou médecin du travail) ou une infirmière
• Via les dispositifs locaux mis à disposition pour aider à la prise de rendez-vous
• En cas de difficulté, via le numéro vert national (0 800 009 110) qui permet d'être redirigé vers le standard téléphonique d'un centre ou d'obtenir un accompagnement à la prise de rendez-vous.

Ouverture de la campagne de rappel depuis le 1er septembre

Suite aux annonces du Président de la République en août 2021, la campagne de rappel de vaccination anti-covid a débuté le 1er septembre 2021 pour certaines populations prioritaires particulièrement vulnérables.

Les populations éligibles à un rappel vaccinal dès le mois de septembre 2021 sont les suivantes :

  • Les résidents des EHPAD et des USLD ;
  • Les personnes de plus de 65 ans ;
  • Les personnes à très haut risque de forme grave ;
  • Les personnes présentant des pathologies facteurs de risque de forme grave, selon la classification établie par la Haute Autorité de Santé ;
  • Les personnes sévèrement immunodéprimées ;
  • Les personnes ayant reçu le vaccin Covid-19 Janssen.

Pour les quatre premiers groupes de personnes, le Conseil d'orientation de la stratégie vaccinale (COSV) dans son avis du 19 août 2021 et la Haute Autorité de Santé dans son avis du 23 août 2021 recommandent un délai d'au moins 6 mois entre la primo-vaccination complète et l'administration de la dose de rappel. Concrètement, les personnes ayant été primo vaccinées selon un schéma à deux doses, recevront leur dose de rappel (ou troisième dose) à partir de six mois après la deuxième dose.

Pour les patients sévèrement immunodéprimés, conformément à l'avis du COSV, l'administration d'une dose de rappel peut être réalisée dans un délai inférieur à 6 mois (mais d'au moins 3 mois), dès lors qu'il est jugé par l'équipe médicale que la quatrième dose permettrait d'améliorer la réponse immunitaire.

Pour les personnes ayant reçu le vaccin Covid-19 Janssen, la Haute Autorité de Santé recommande un délai minimal de 4 semaines entre la primo-vaccination et la dose de rappel.

A la suite de l'avis de la Haute Autorité de Santé du 5 octobre 2021, de nouvelles populations sont désormais concernées par le rappel vaccinal, 6 mois minimum après leur primo-vaccination complète :

  • les professionnels de santé, l'ensemble des salariés du secteurs de la santé et du secteur médico-social, les aides à domicile intervenant auprès de personnes vulnérables, les professionnels du transport sanitaire et les pompiers, quel que soit leur âge ;
  • les proches (de plus de 18 ans) de personnes immunodéprimées.

Le rappel doit être fait avec un vaccin à ARN messager (Pfizer ou Moderna) de manière indifférenciée quel que soit le vaccin utilisé pour la primovaccination

La vaccination pour le grand public
la vaccination obligatoire pour certaines professions
La dose de rappel, pour qui, quand et où ?

Contact presse : presse-dgs@sante.gouv.fr

docx cp-vaccination-covid-19-29-11-2021.docx Téléchargement (765.9 ko)
pdf cp-vaccination-covid-19-29-11-2021.pdf Téléchargement (755.4 ko)
Catégories: Actus Santé

Epidemiological update: Omicron variant of concern (VOC) – data as of 29 November 2021 (12:30)

As of 29 November 2021, 33 confirmed SARS-CoV-2 Omicron VOC cases have been reported by eight European Union and European Economic Area (EU/EEA) countries (Austria, Belgium, Czechia, Denmark, Germany, Italy, Netherlands, Portugal) according to information from public sources.

Catégories: Actus Santé

Variant omicron : Que sait-on à l’heure actuelle ?

INSERM - Salle de presse - il y a 8 heures 32 min
Le 26 novembre 2021, l’OMS a désigné un nouveau variant du SARS-CoV-2 – dit « omicron » - comme variant préoccupant (‘variant of concern’). Une décision qui s’appuie sur son groupe d’experts chargé de suivre l’évolution du virus (le Technical Advisory Group on Virus Evolution) qui s’est intéressé aux données disponibles à l’heure actuelle.
Catégories: Actus Santé

Vacciner les enfants pour lutter contre la pandémie de Covid-19, vraiment ?

INSERM - Salle de presse - il y a 11 heures 19 min
Alors que les débats sur la vaccination des enfants et la transmission en milieu scolaire se poursuivent, Canal Détox fait le point sur l'état des connaissances et les décisions qui ont été prises jusqu'ici.
Catégories: Actus Santé

Deficits in planned hospital care for vulnerable adolescents in England during the COVID-19 pandemic: analysis of linked administrative data

Planned hospital care (outpatient attendances and planned hospital admissions) was disrupted during the pandemic, but we lack evidence on which groups of young people were most impacted. We aimed to describe differences in planned care for vulnerable adolescents receiving children's social care (CSC) services or special educational needs (SEN) support during the pandemic, relative to their peers. Using the ECHILD Database (linked de-identified administrative health, education and social care records for all children in England), we examined changes in planned hospital care from 23 March to 31 December 2020 for secondary school pupils in Years 7 to 11 (N=3,030,235). There were large deficits in planned care for adolescents overall, which disproportionately affected the 21% receiving SEN support or CSC services who bore 25% of the outpatient attendance deficit and 37% of the planned admissions deficit. These findings indicate a need for targeted catch-up funding and resources, particularly for vulnerable groups.
Catégories: Actus Santé

A case series of SARS-CoV-2 reinfections caused by the variant of concern Gamma in Brazil

The rapid spread of the SARS-CoV-2 Variant of Concern (VOC) Gamma during late 2020 and early 2021 in Brazilian settings with high seroprevalence raised some concern about the potential role of reinfections in driving the epidemic. Very few cases of reinfection associated with the VOC Gamma, however, have been reported. Here we describe 25 cases of SARS-CoV-2 reinfection confirmed by real-time RT-PCR twice within months apart in Brazil. SARS-CoV-2 genomic analysis confirmed that individuals were primo-infected between March and December 2020 with distinct viral lineages, including B.1.1, B.1.1.28, B.1.1.33, B.1.195 and P.2, and then reinfected with the VOC Gamma between 3 to 12 months after primo-infection. The overall mean cycle threshold (Ct) value of the first (25.7) and second (24.5) episodes were roughly similar for the whole group and 14 individuals displayed mean Ct values < 25.0 at reinfection. Sera of 14 patients tested by plaque reduction neutralization test after reinfection displayed detectable neutralizing antibodies against Gamma and other SARS-CoV-2 variants (B.1.33, B.1.1.28 and Delta). All individuals have milder or no symptoms after reinfection and none required hospitalization. The present study demonstrates that the VOC Gamma was associated with reinfections during the second Brazilian epidemic wave in 2021 and raised concern about the potential infectiousness of reinfected subjects. Although individuals here analyzed failed to mount a long-term sterilizing immunity, they developed a high anti-Gamma neutralizing antibody response after reinfection that may provide some protection against severe disease.
Catégories: Actus Santé

Diagnostic performance of attenuated total reflection Fourier-transform infrared spectroscopy for detecting COVID-19 from routine nasopharyngeal swab samples

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing global COVID-19 pandemic since 2019 has led to increasing amount of research to study how to do fast screening and diagnosis to efficiently detect COVID-19 positive cases, and how to prevent spreading of the virus. Our research objective was to study whether SARS-CoV-2 could be detected from routine nasopharyngeal swab samples by using attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy coupled with partial least squares discriminant analysis (PLS-DA). The advantage of ATR-FTIR is that measurements can be conducted without any sample preparation and no reagents are needed. Our study included 558 positive and 558 negative samples collected from Northern Finland. Overall, we found moderate diagnostic performance for ATR-FTIR when polymerase chain reaction (PCR) was used as the gold standard: the average area under the receiver operating characteristics curve (AUROC) was 0.67-0.68 (min. 0.65, max. 0.69) with 20, 10 and 5 k-fold cross validations. Mean accuracy, sensitivity and specificity was 0.62-0.63 (min. 0.60, max. 0.65), 0.61 (min. 0.58, max. 0.65) and 0.64 (min. 0.59, max. 0.67) with 20, 10 and 5 k-fold cross validations. As a conclusion, our study with relatively large sample set clearly indicate that measured ATR-FTIR spectrum contains specific information for SARS-CoV-2 infection (P<0.001 in label permutation test). However, the diagnostic performance of ATR-FTIR remained only moderate, potentially due to low concentration of viral particles in the transport medium. Further studies are needed before ATR-FTIR can be recommended for fast screening of SARS-CoV-2 from routine nasopharyngeal swab samples.
Catégories: Actus Santé

A cross-sectional study exploring the justification of opportunistic breast cancer screening in Thailand

Objective: Breast cancer is currently the most common malignant disease in Thailand. The present study aims to evaluate the most beneficial method of breast cancer screening in different breast densities by analyzing the benefits of screening mammography with additional breast ultrasonography classified by breast density. Method: 49 middle-aged and elderly Bangkokian women who had undergone both mammography and ultrasonography were picked at random for analysis. BI-RADS scores were assigned based on mammography results alone and based on combined mammography and ultrasonography results. Concordance/discordance rates between the 2 radiographic techniques were compared in women stratified based on their breast densities. Results: All of our participants were given a score between BIRADS 1 and 3, while over 40% of participants are in the BIRADS 2 category. 60% of subjects with extremely dense breasts benefit from screening mammography with additional breast ultrasonography, while only 50% of samples with heterogeneous density and 34.21% samples with heterogeneous fibroglandular breasts benefit from the extra intervention. Conclusion: Our study concludes that women with higher breast density are more likely to benefit from screening using ultrasonography in addition to mammography as opposed to mammography screening alone. We recommend both mammography and ultrasonography for initial breast cancer screening. For follow-up visits, we suggest the screening method in accordance with breast density, using ultrasonography alone for women with high breast densities and mammography for women with heterogeneously dense breasts.
Catégories: Actus Santé

Impact of the COVID-19 pandemic on the malaria burden in northern Ghana: Analysis of routine surveillance data

Introduction: The COVID-19 pandemic and its collateral damage severely impact health systems globally and risk to worsen the malaria situation in endemic countries. Malaria is a leading cause of morbidity and mortality in Ghana. This study aims to analyze routine surveillance data to assess possible effects on the malaria burden in the first year of the COVID-19 pandemic in the Northern Region of Ghana. Methods: Monthly routine data from the District Health Information Management System II (DHIMS2) of the Northern Region of Ghana were analyzed. Overall outpatient department visits and malaria incidence rates from the years 2015 to 2019 were compared to the corresponding data of the year 2020. Results: Compared to the corresponding periods of the years 2015 to 2019, overall visits and malaria incidence in pediatric and adult outpatient departments in northern Ghana decreased in March and April 2020, when major movement and social restrictions were implemented in response to the pandemic. Incidence slightly rebounded afterwards in 2020 but stayed below the average of the previous years. Data from inpatient departments showed a similar but more pronounced trend when compared to outpatient departments. In pregnant women, however, malaria incidence in outpatient departments increased after the first COVID-19 wave. Discussion: The findings from this study show that the COVID-19 pandemic affects the malaria burden in health facilities of Ghana, with declines in in- and outpatient rates. Pregnant women may experience reduced access to intermittent preventive malaria treatment and insecticide treated nets, resulting in subsequent higher malaria morbidity. Further data from other African countries, particularly on community-based studies, are needed to fully determine the impact of the pandemic on the malaria situation.
Catégories: Actus Santé

COVID-19 trends and severity among symptomatic children aged 0 to 17 years in ten EU countries, 3 August 2020 to 3 October 2021

To guide evidence-based prevention of COVID-19 in children, we estimated risks of severe outcomes in 820,404 symptomatic paediatric cases reported by 10 EU Member States between August 2020 and October 2021. Case and hospitalisation rates rose as overall transmission increased but severe outcomes were rare: 9,611 (1.2%) were hospitalised, 640 (0.08%) required intensive care and 84 (0.01%) died. Despite increased individual risk (aOR; 95% CI for hospitalisation: 7.3; 3.3 - 16.2, ICU: 8.7; 6.2 - 12.3) in cases with comorbidities such as cancer, diabetes, cardiac or lung disease, most (83.7%) hospitalised children had no reported comorbidity.
Catégories: Actus Santé

Modelling the effect of the interaction between vaccination and non-pharmaceutical measures on COVID-19 incidence

Since December 2019, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly from Wuhan (China) across the globe, affecting more than 200 countries by mid-2021, with over 190 M reported cases and around 4 M fatalities. During the first year of the pandemic, affected countries implemented a variety of non-pharmaceutical interventions to control virus transmission. In December 2020, countries started administering several authorised vaccines under a limited supply scenario. In this context, a SEIR-type continuous-time deterministic disease model was developed to explore the effect of vaccination in terms of vaccination rate and efficacy, together with varying non-pharmaceutical protection measures, on disease incidence in the initial phase of vaccination. For this, the model incorporates (i) a protection measure including low (self-protection), medium (mobility limitation), high (closure of indoor facilities) and very high (lockdown) protection levels, (ii) quarantine for confirmed cases, and (iii) vaccination rate and efficacy of four type of vaccines (Pfizer, Moderna, Astra Zeneca or Janssen). The model was veri[fi]ed and evaluated using the response timeline and vaccination strategies and rates in the Basque Country (N. Spain). Once the model performance was validated, different initial phase (when 30% of the population is vaccinated) vaccination scenarios were simulated, including (i) a realistic vaccine limited supply scenario, and (ii) four potential full vaccine supply scenarios where a unique vaccine type is administered. The Pfizer scenario resulted in the lowest prevalence of infection and cumulative mortality, particularly for low- and medium-level protection rates. However, regardless of the administered vaccine, a high-level protection scenario is the most effective to control the virus transmission and disease mortality in the studied initial phase of vaccination. The model here, which is based on this example, could be easily applied to other regions or countries, modifying the strategies implemented and initial conditions.
Catégories: Actus Santé

Respiratory symptoms of Swiss people with Primary Ciliary Dyskinesia

Background: Mostly derived from chart reviews, where symptoms are recorded in a nonstandardised manner, clinical data about primary ciliary dyskinesia (PCD) are inconsistent, which leads to missing and unreliable information. We assessed the prevalence and frequency of respiratory symptoms and studied differences by age and sex among an unselected population of Swiss people with PCD. Methods: We sent a questionnaire that included items from the FOLLOW-PCD standardised questionnaire to all Swiss PCD registry participants. Results: We received questionnaires from 74 out of 86 (86%) invited persons or their caregivers (age range: 3-73 years; median age: 23), including 68% adults ([≥]18 years) and 51% females. Among participants, 70 (94%) reported chronic nasal symptoms, most frequently runny nose (65%), blocked nose (55%), or anosmia (38%). Ear pain and hearing problems were reported by 58% of the participants. Almost all (99%) reported cough and sputum production. The most common chronic cough complications were gastroesophageal reflux (n=11; 15%), vomiting (n=8; 11%), and urinary incontinence (n=6; 8%). Only 9 participants (12%) reported frequent wheeze, which occurred mainly during infection or exercise, while 49 persons (66%) reported shortness of breath; 9% even at rest or during daily activities. Older patients reported more frequent nasal symptoms and shortness of breath. We found no difference by sex or ultrastructural ciliary defect. Conclusion: This is the first study that describes patient-reported PCD symptoms. The consistent collection of standardised clinical data will allow us to better characterise the phenotypic variability of the disease and study disease course and prognosis.
Catégories: Actus Santé

Incretin hypersecretion in gestational diabetes mellitus

Background Incretins are crucial stimulators of insulin secretion after food intake. We investigated the incretin response during an oral glucose tolerance test in pregnant women with and without gestational diabetes. Methods Subjects underwent a 5-point OGTT with 75 g glucose. We assessed insulin secretion and levels of total GLP-1, GIP, glicentin and glucagon during the OGTT. Findings We examined 167 women (33 with GDM) during gestational week 26.95 (2.15 SD). Insulin secretion was significantly lower in women with GDM (p<0.001). Postprandial GLP-1 and GIP were ~20% higher in women with GDM (all p<0.05) independent from age, BMI and gestational age. GLP-1 increase associated with insulin secretion only in GDM, but not in NGT. Postprandial GLP-1 levels associated negatively with birth weight. Interpretation The more pronounced GLP-1 increase in women with GDM could be part of a compensatory mechanism counteracting GLP-1 resistance. Higher GLP-1 levels might be protective against fetal overgrowth.
Catégories: Actus Santé

Estimating the transmissibility of SARS-CoV-2 during periods of high, low and zero case incidence

Against a backdrop of widespread global transmission, a number of countries have successfully brought large outbreaks of COVID-19 under control and maintained near-elimination status. A key element of epidemic response is the tracking of disease transmissibility in near real-time. During major outbreaks, the reproduction rate can be estimated from a time-series of case, hospitalisation or death counts. In low or zero incidence settings, knowing the potential for the virus to spread is a response priority. Absence of case data means that this potential cannot be estimated directly. We present a semi-mechanistic modelling framework that draws on time-series of both behavioural data and case data (when disease activity is present) to estimate the transmissibility of SARS-CoV-2 from periods of high to low -- or zero -- case incidence, with a coherent transition in interpretation across the changing epidemiological situations. Of note, during periods of epidemic activity, our analysis recovers the effective reproduction number, while during periods of low -- or zero -- case incidence, it provides an estimate of transmission risk. This enables tracking and planning of progress towards the control of large outbreaks, maintenance of virus suppression, and monitoring the risk posed by re-introduction of the virus. We demonstrate the value of our methods by reporting on their use throughout 2020 in Australia, where they have become a central component of the national COVID-19 response.
Catégories: Actus Santé

Premorbid frailty predicts short and long term outcomes of reperfusion treatment in acute stroke

Background: Frailty is the most important short and long term predictor of disability in the elderly and thus might influence the clinical outcome of acute treatment of stroke. Objective: to evaluate whether frailty predicts short- and long term all-cause mortality and neurological recovery in elderly patients who underwent reperfusion acute treatment of stroke. Methods: the study included consecutive patients older than 65 years who underwent reperfusion treatment in a single stroke Unit from 2015 to 2016. Predictors of stroke outcomes were assessed including demographics, baseline NIHSS, time to needle, treatment and medical complications. Premorbid Frailty was assessed with a comprehensive geriatric assessment (CGA) including functional, nutritional, cognitive, social and comorbidities status. At three and twelve months, all-cause death and clinical recovery (using modified Ranking scale, mRS) were evaluated. Results: One-hundred and two patients who underwent acute reperfusion treatment for stroke entered the study (mean age 77.5, 65- 94 years). Frailty was diagnosed in 32 out of 70 patients and associated with older age (p=0.001) but no differences in baseline NIHSS score, vascular risk profile or treatment management strategy. Frailty status was associated with worse improvement at 24 hours and higher in-hospital mortality. At follow-up, frail patients showed poorer survival at 3 (25% vs 3%, p=0.008) and 12 (38% vs 7%, p=0.001) months. Frailty was the best predictor of neurological recovery at one year follow-up (mRS 3.2 + 1.9 vs 1.9 + 1.9). Discussion: frailty is an important predictor of efficacy of acute treatment of stroke beyond classical predictors of stroke outcomes. Larger longitudinal studies are thus warranted in order to evaluate the risk-benefit of reperfusion treatment in the growing elderly frail population.
Catégories: Actus Santé

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