Liste des publications scientifiques du CHU de Clermont-Ferrand

Cette liste prend en compte l'ensemble des publications scientifiques du CHU référencées sur PubMed de 1973 au 31.12.2020

Auteurs : Fayet, F; Fan, A; Rodere, M; Pereira, B; Soubrier, M ; et al.

Revue : Patient preference and adherence - ISSN : 1177-889X - NLMID : 101475748
Date de Publication : Février 2020
Vol. : 14 Pages : 363-369

Résumé : Poor patient adherence to anti-TNF treatment has proven to be a major roadblock to effective management. Therapeutic patient education (TPE) is now recognized as a crucial tool in managing conditions like chronic inflammatory rheumatism and in improving treatment adherence. This study aimed to assess whether different TPE programs might improve adherence to subcutaneous anti-tumor necrosis factor (anti-TNF) treatment in patients with rheumatoid arthritis (RA), ankylosing spondyloarthritis (AS), and psoriatic arthritis (PsA).This was a retrospective, observational, monocentric study of current care practices. We included 193 patients (124 women; mean age 53.3 ± 14.8 years). All patients received subcutaneous anti-TNF treatment and one of three TPE models, delivered by a nurse, from 2009 to 2013. The cohort was grouped according to different educational models: M1: information (N=92); M2: individual TPE (N=80); and M3: individual and group TPE sessions (N=21). Adherence was assessed with the Morisky Medication Adherence Scale (MMAS-4™). Scores were rated as follows: good adherence (MMAS-4 = 4), moderate adherence (MMAS-4 = 2-3), and poor adherence (MMAS-4 = 0-1).The mean disease duration was 10 years [95% CI: 5 to 18]. The cohort comprised 113 patients with RA, 73 with AS, and seven with PsA. Overall, 146 (75.7%) patients displayed good adherence, 34 (17.6%) displayed moderate adherence, and 13 (6.7%) displayed poor adherence. The M3 group displayed less adherence than the M1 and M2 groups. Old age was the only factor correlated with good adherence (p=0.005). The level of knowledge had no significant impact on adherence.This study demonstrated good adherence to anti-TNF treatment in patients that received TPE, particularly when it was delivered in individual sessions.

Mots clés auteurs : /chronic inflammatory rheumatism/subcutaneous anti-TNF/therapeutic education/treatment adherence

Auteurs : Samalin, L; Yrondi, A; Charpeaud, T; Courtet, P; Llorca, PM ; et al.

Revue : Journal of affective disorders - ISSN : 1573-2517 - NLMID : 7906073
Date de Publication : Mars 2020
Vol. : 264 Pages : 318-323

Résumé : ECT is the most effective treatment of major depressive episode (MDE) but remains a neglected treatment. The French Society for Biological Psychiatry and Neuropsychopharmacology aimed to determine whether prescribing practice of ECT followed guidelines recommendations.This multicenter, retrospective study included adult patients with major depressive disorder (MDD) or bipolar disorder (BD), who have been treated with ECT for MDE. Duration of MDE and number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests.Seven hundred and forty-five individuals were included. The mean duration of MDE before ECT was 10.1 months and the mean number of lines of treatment before ECT was 3.4. It was significantly longer for MDD single episode than recurrent MDD and BD. The presence of first-line indications for using ECT was significantly associated to shorter duration of MDE (9.1 vs 13.1 months, p<0.001) and lower number of lines of treatment before ECT (3.3 vs 4.1, p<0.001).This is a retrospective study and not all facilities practicing ECT participated that could limit the extrapolation of the results.Compared to guidelines, ECT was not used as first-line strategy in clinical practice. The presence of first-line indications seemed to reduce the delay before ECT initiation. The improvements of knowledge and access of ECT are needed to decrease the gap between guidelines and clinical practice.

Mesh : Adult|Bipolar Disorder/therapy|Depressive Disorder, Major/therapy|Electroconvulsive Therapy|Humans|Retrospective Studies|Treatment Outcome

Mots clés auteurs : /Bipolar disorder/Clinical guidelines/Electroconvulsive therapy/Major depressive disorder/Major depressive episode

Auteurs : Guessoum, SB; Lachal, J; Radjack, R; Benoit, L; Moro, MR ; et al.

Revue : Psychiatry research - ISSN : 1872-7123 - NLMID : 7911385
Date de Publication : Septembre 2020
Vol. : 291 Pages : 113264

Résumé : The aim of this paper was to review the literature on adolescent psychiatric disorders related to the COVID-19 pandemic and lockdown. Stressful life events, extended home confinement, brutal grief, intrafamilial violence, overuse of the Internet and social media are factors that could influence the mental health of adolescents during this period. The COVID-19 pandemic could result in increased psychiatric disorders such as Post-Traumatic Stress, Depressive, and Anxiety Disorders, as well as grief-related symptoms. Adolescents with psychiatric disorders are at risk of a break or change in their care and management; they Mai experience increased symptoms. The COVID-19 pandemic and lockdown Mai have a negative impact on the mental health of adolescents, although there is still no data on the long term impact of this crisis. Adolescents' individual, familial, and social vulnerability, as well as individual and familial coping abilities, are factors related to adolescent mental health in times of crisis. Adolescents are often vulnerable and require careful consideration by caregivers and healthcare system adaptations to allow for mental health support despite the lockdown. Research on adolescent psychiatric disorders in times of pandemics is necessary, as such a global situation could be prolonged or repeated.

Mesh : Adaptation, Psychological|Adolescent|Betacoronavirus|COVID-19|Coronavirus Infections/psychology|Delivery of Health Care|Humans|Mental Disorders/psychology|Mental Health|Pandemics|Pneumonia, Viral/psychology|Quarantine/psychology|SARS-CoV-2

Mots clés auteurs : /Adolescent/Covid-19/Depression/Mental disorder/Pandemic/Post-traumatic stress disorder

Auteurs : Jacomet, C; Ologeanu-Taddei, R; Prouteau, J; Bastiani, P; Dellamonica, P ; et al.

Revue : JMIR mHealth and uHealth - ISSN : 2291-5222 - NLMID : 101624439
Date de Publication : Avril 2020
Vol. : 8 Numéro 4 Pages : e16140

Résumé : The development of electronic health (eHealth) has offered the opportunity for remote care provision. eHealth addresses issues for patients and professionals favoring autonomy and compliance, respectively, while fostering closer links both between patients and health care professionals and among health care professionals themselves.The aim of this study was to analyze the patterns of use, benefits, and perceived obstacles in eHealth among people living with HIV (PLHIV) and their caring physicians at hospitals.An online multicenter observational survey was conducted October 15-19, 2018 in 51 medical units across France by means of self-administered questionnaires to collect sociodemographic and medical data, and perceptions of eHealth. Multiple correspondence analysis followed by mixed unsupervised classification were performed to analyze data of the respondents.A total of 279 PLHIV and 219 physicians responded to all parts of the questionnaire. Three groups of PLHIV were identified based on multivariate analysis. Group 1 comprised "eHealth believers" (121/279, 43.4%), who were more frequently above 60 years old and more likely to be receiving treatments other than antiretrovirals. Group 2, the "technology skeptics" (86/279, 30.8%), comprised more women with at least one child. Group 3, the "internet adopters" (72/279, 25.8%), were more frequently under 49 years of age, men who have sex with men, and more likely to use mobile apps for obtaining wellness/health information and related subjects. Three groups of physicians also emerged. Group 1 comprised those "strongly confident in eHealth" (95/219, 43.4%), who more frequently used mobile apps for wellness/health information and were more likely to accept prescription assistance software. Group 2 comprised physicians "strongly opposed to eHealth" (80/219, 36.5%), frequently asserting that eHealth challenges confidentiality. Group 3 were "open to eHealth" (44/219, 20.1%), comprising a higher proportion of infectious disease specialists, and were more likely to believe that medical apps are useful for patient education and information. No link was found between the groups of PLHIV and physicians.The literature on eHealth mainly classifies people as enthusiasts and skeptics; however, we identified a third profile among both PLHIV and physicians, albeit without a direct link between them. For PLHIV, this third group is attentive to eHealth for improving their health condition, and for physicians, this group considers eHealth to offer benefits to patients and their own practice.

Mots clés auteurs : /HIV/collection of digitized personal information/connected objects/eHealth/health applications/internet for information retrieval/survey/telemedicine

Auteurs : Vuillermet, C; Meillat, H; Manceau, G; Lefevre, JH; , ; et al.

Revue : Surgery - ISSN : 1532-7361 - NLMID : 417347
Date de Publication : Novembre 2020
Vol. : 168 Numéro 5 Pages : 786-792

Résumé : Bladder invasion by colon cancer is rare; however, its management is still controversial. Our objective was to report outcomes and identify risk factors for local recurrence in colon cancer with clinically suspected bladder invasion.We conducted a retrospective study in 23 centers in France. All patients who underwent colon surgery with bladder resection (2010-2017) were included. Metastatic and recurrent colon cancers were excluded.One hundred and seventeen patients (men = 73) were included. Partial cystectomy occurred in 108 patients (92.3%), with a total cystectomy occurring in 9 patients (7.7%). Neoadjuvant treatment was given to 31 patients (26.5%). Major morbidity was 20.5%. R0 resection rates were 87.2%. Histologically confirmed bladder invasion was present in 47%. Thirty-four patients were pN+, while 60 patients (51.3%) received adjuvant chemotherapy. Mean follow-up was 33.8 months. Three-year overall survival and disease-free survival were 82.9% and 59.5%. Rates of local recurrence and distant recurrence were 14.5% and 18.8%, respectively; the local recurrences (11/17; 65%) were in the bladder, while 4 of these patients had a bladder recurrence despite not having histologically confirmed bladder invasion at the index surgery. The rate of bladder recurrence after histologic bladder invasion was 13% (7/55), while the rate of bladder recurrence without primary bladder invasion was 7% (4/62) (P = .343). Neoadjuvant therapy, type of cystectomy, and adjuvant therapy did not influence local recurrence (P > .445 each). R1 bladder resections, when compared with a R0 bladder resections, were associated with an increased rate of local recurrence (63% vs 10%; P < .0001).Clinically suspected bladder invasion increases local recurrence even in the absence of histologically confirmed bladder invasion. Only complete resections with R0 margins decrease local recurrence. Careful, detailed postoperative surveillance is required, even without pathologic bladder invasion.

Mesh : Aged|Aged, 80 and over|Colonic Neoplasms/mortality/pathology/surgery|Cystectomy|Female|Humans|Male|Middle Aged|Neoplasm Invasiveness|Neoplasm Recurrence, Local|Prognosis|Retrospective Studies|Urinary Bladder/pathology|Urinary Bladder Neoplasms/mortality/surgery