[Metabolic testing rates after initiation of antipsychotic treatment in persons initially treated by conventional mood-stabilizers].

Objectives: To assess the rate of metabolic testing after initiation of second-generation antipsychotics (SGA) prescription in persons initially treated by conventional mood-stabilizers (lithium or anticonvulsants, as a proxy of bipolar disorder diagnosis) and to compare the rates of metabolic testing in these persons with those in persons with initiation of first-generation antipsychotics (FGA) prescription or with no antipsychotic prescription.

Method: Data were anonymously extracted from the 2004 to 2006 French national health database of the Régime Social des Travailleurs Indépendants (RSI). Patients aged 18 years and over were included in the cohort if they fulfilled the following criteria over a three-month inclusion period: refunding of lithium or anticonvulsant over the 3 months without discontinuation (as a proxy of bipolar disorder diagnosis), no concomitant refunding over the 3months of antipsychotic, and no concomitant refunding over the 3 months of an anti-diabetic drug (as a marker of diabetes) or a lipid-lowering drug (as a marker of hyperlipidemia).

Underrepresentation of elderly people in randomised controlled trials. The example of trials of 4 widely prescribed drugs.

Background: We aimed to determine the representation of elderly people in published reports of randomized controlled trials (RCTs). We focused on trials of 4 medications--pioglitazone, rosuvastatin, risedronate, and valsartan-frequently used by elderly patients with chronic medical conditions.

Methods And Findings: We selected all reports of RCTs indexed in PubMed from 1966 to April 2008 evaluating one of the 4 medications of interest.

Influence of the drug exposure definition on the assessment of the antipsychotic metabolic impact in patients initially treated with mood-stabilizers.

What Is Already Known About This Subject: • Metabolic disturbances represent a well-known side effect of second generation antipsychotics. However, studies comparing second generation antipsychotic drugs (SGAPs) and first generation antipsychotic drugs (FGAPs) through administrative databases have shown contrasting findings, which may be attributable to methodological differences.

What This Paper Adds: • The definition of antipsychotic exposure impacts on the association between antipsychotics and metabolic risk in studies carried out through administrative databases.

Low exposure to sunlight is a risk factor for Crohn's disease.

Background: Low sunshine exposure might contribute to the pathogenesis of inflammatory bowel disease (IBD).

Aim: To assess the geographic distribution of IBD incidence in relation to sunshine exposure in France to test the hypothesis that higher sun exposure is associated with lower IBD risk.

Methods: Using the national health insurance database, incidence rates of Crohn's disease (CD) and ulcerative colitis (UC) were estimated for each of the 94 French administrative areas ('départements'), between 2000 and 2002.

Antipsychotic use patterns in persons initially treated with mood stabilizers: a naturalistic study.

Introduction: Little information is available on the pattern of use of antipsychotics in naturalistic conditions in persons initially treated with "conventional" mood stabilizers (lithium and anticonvulsants).

Methods: Data on community prescriptions were extracted from the 2004-2006 claims database of a French health care insurance fund for self-employed workers. Patients included were those continuously exposed to mood stabilizers without concomitant dispensing of antipsychotics over at least a 3-month period.

Psychotropic medication in the French child and adolescent population: prevalence estimation from health insurance data and national self-report survey data.

Background: The aim of this work is to estimate the French frequencies of dispensed psychotropic prescriptions in children and adolescents. Prevalence estimations of dispensed prescriptions are compared to the frequencies of use of psychotropic reported by 17 year-old adolescents.

Methods: Prescription data is derived from national health insurance databases.

Fine-scale geographic variations of inflammatory bowel disease in France: correlation with socioeconomic and house equipment variables.

Background: In a previous study we found a north-south gradient for Crohn's disease (CD) incidence in France. The aim of the present study was to determine if socioeconomic factors may influence the geographic distribution of CD and ulcerative colitis (UC) in France.

Methods: Using the national health insurance databases, incidence rates of CD and UC were estimated for each of 341 metropolitan "job areas" in 2000-2002.

Prevalence and patterns of methylphenidate use in French children and adolescents.

Objective: The aim of the study was to describe the prevalence and utilization patterns of methylphenidate (MPH) in children and adolescents in France.

Methods: This was a population-based retrospective study in which the cohort consisted of patients for whom data were extracted from the dispensation drug claims database of the national health insurance (NHI) fund for self-employed workers. Annual prevalence of MPH use was evaluated on patients aged 6-18 years who were reimbursed for at least one MPH prescription a year.

Geographical variations of inflammatory bowel disease in France: a study based on national health insurance data.

Background And Aim: A north-south gradient in inflammatory bowel disease (IBD) incidence has been found in Europe and the United States. Its existence is inferred from comparisons of registries that cover only small portions of territories. Several studies suggest that IBD incidence in the north has reached a plateau, whereas in the south it has risen sharply.

[Selective cyclooxygenase-2 inhibitors. A population-based analysis of use in France over a three-year period and comparison with randomised clinical trials].

Objectives: The use of selective cyclooxygenase-2 (COX-2) inhibitors is highly controversial today, mainly because of doubts about cardiovascular tolerance. Few studies have assessed the use of these drugs in daily clinical practice. This study aims to assess the changes in their use in daily practice in France and to compare it with their use in randomized clinical trials.

The methods for handling missing data in clinical trials influence sample size requirements.

Objective: Results of studies estimating osteoarthritis progression may be affected by missing values. In clinical trials assessing disease-modifying osteoarthritis drugs, sample sizes should be calculated using close estimates of outcome variables.

Study Design And Setting: Supposing a two-parallel group design in hip osteoarthritis clinical trials, we estimated sample sizes using the joint space width (JSW), number of patients with JSW progression >0.

Influence of medial meniscectomy on tibiofemoral joint space width.

Objective: The aim of this study was to evaluate the influence of partial medial meniscectomy on tibiofemoral joint space width (JSW).

Design: Thirty-seven patients (mean age: 51 years), suffering from medial meniscal lesions, (post-traumatic (n=22) or degenerative (n=15)), and requiring arthroscopic partial meniscectomy, were enrolled in a prospective, controlled study. Bilateral weight-bearing radiographs in extended and flexed position were performed in the same Radiology Unit just before and 2 days after meniscectomy.

Evaluation of the smallest detectable difference in outcome or process variables in ankylosing spondylitis.

Objective: To evaluate the smallest detectable difference (SDD) of symptomatic outcome or process variables in ankylosing spondylitis (AS) patients from various countries.

Methods: Thirty consecutive AS patients with axial involvement were recruited from 1 center in each of 4 countries (Spain, Morocco, France, The Netherlands), for a total of 120 patients. Fourteen variables were studied in 6 domains: pain (3 variables), stiffness (1 variable), function (2 variables), spinal mobility (3 variables), patient global assessment (4 variables), and the domain of enthesiopathy (1 variable).

Type 2 diabetes mellitus among beneficiaries of the french national health insurance for self-employed workers (AMPI): comparison of the management of craftsmen or tradesmen with professionals patients.

Background: Although the management of diabetes mellitus varies according to non medical factors, the influence of socioprofessional category has been not fully studied. This study compared the management of type 2 diabetes mellitus in craftsmen or tradesmen with professionals categories.

Methods: All claims to the French National Sickness Insurance Fund for self-employed workers (AMPI) from its mainland France beneficiaries in 1998 were retrospectively analysed.

Measurement of joint space width in hip osteoarthritis: influence of joint positioning and radiographic procedure.

Objectives: We assessed the influence of patient positioning and radiographic procedure, and defined a smallest detectable difference (SDD) in hip osteoarthritis (OA).

Methods: OA hip patients each had a standardized pelvic radiograph and, 5 min later, a modified pelvic radiograph with the feet internally rotated 5 degrees (part 1 of the study), the X-ray beam centred on the umbilicus (part 2), or another standardized pelvic radiograph (part 3).

Results: Corresponding mean differences in joint space width (JSW) measurements (limits of agreement) between views were +0.

Effect of multifaceted intervention promoting early switch from intravenous to oral acetaminophen for postoperative pain: controlled, prospective, before and after study.

Problem: Need to improve the efficiency of postoperative pain management by early switching from intravenous to oral acetaminophen.

Design: Implementation of local guidelines aimed at improving nurses' and doctors' behaviour. A controlled, prospective, before and after study evaluated its impact on appropriateness and costs.

Radiographic assessment of hip osteoarthritis progression: impact of reading procedures for longitudinal studies.

Objective: To compare radiographic reading procedures and evaluate their impact on sample size in hip osteoarthritis (OA) longitudinal studies.

Methods: Pelvic radiographs performed twice, three years apart, in 104 patients with hip OA were read by a single reader using the Kellgren and Lawrence system, joint space narrowing scale, and joint space width (JSW). Reading procedures were (a) films read as single radiographs, (b) films grouped by patient but read in random order, (c) films grouped by patient and chronologically ordered, all with landmarks for JSW measurements, (d) films read as single radiographs, without landmarks for JSW measurements.

Assessing smallest detectable change over time in continuous structural outcome measures: application to radiological change in knee osteoarthritis.

Interpreting changes in continuous structural outcome measures is a common problem in clinical research and in daily practice. We propose a method for estimating whether difference observed between two successive measures in an individual constitutes a statistically relevant change or a change induced by variability. This statistically relevant change is based on an analysis of reproducibility.

Variability in knee radiographing: implication for definition of radiological progression in medial knee osteoarthritis.

Objectives: (1) To assess reproducibility of medial knee joint space width (JSW) measurement in healthy subjects and osteoarthritic (OA) patients. (2) To define minimal relevant radiological change in knee JSW based on the reproducibility of its measurement.

Patients And Methods: (1) Healthy volunteers: in the first part of the study, 20 knees of healthy adult volunteers were radiographed in the weightbearing, anteroposterior extended view, twice, two weeks apart, using three different radiographic procedures: (a) without guidelines, (b) with guidelines and without fluoroscopy, (c) with guidelines and fluoroscopy.

Piroxicam therapy: a double blind, randomized, multicenter study comparing 2 versus 4 week treatment in patients with painful knee osteoarthritis with effusion.

Objective: To compare the efficacy and safety of piroxicam 20 mg once a day for 14 or 28 days in patients with knee osteoarthritis (OA) and synovial effusion.

Methods: We conducted a multicenter, randomized, double blind study in 1905 outpatients. Efficacy was assessed by changes in synovial effusion, pain on a 100 mm visual analog scale (VAS), and impairment using Lequesne's functional index.

Osteoarthritis of the hip: agreement between joint space width measurements on standing and supine conventional radiographs.

Objective: To assess the effect of standing position on joint space width (JSW) measurements of the hips with and without osteoarthritis (OA) on pelvic radiographs.

Methods: Adult patients aged 18 or more had pelvic anteroposterior conventional radiographs standing and supine performed by a single radiologist in the same radiology unit according to standardised guidelines. JSW measurements in mm were made by a single reader blind to patients' identity and type of view, using a 0.

Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints.

Study Design: Prospective randomized study to compare the efficacy of facet joint injection with lidocaine and facet joint injection with saline in two groups of patients with low back pain, with and without clinical criteria that were determined in a previous study to implicate the facet joint as the primary source of the pain.

Objectives: To assess the efficacy of single facet joint anesthesia versus placebo (saline injections) and to determine clinical criteria that are predictive of significant relief of LBP after injection.

Summary Of Background Data: There is no syndrome that discriminates between lower back pain caused by facet joint and that caused by other structures.