Publications by authors named "Cohen-Bittan J"

Background: Hip fracture is common and associated with high morbidity and mortality rates. Selective serotonin reuptake inhibitors (SSRIs) influence platelet hemostasis and might result in abnormal bleeding. This study aims to determine whether the use of SSRIs in older patients undergoing hip fracture surgery is associated with the risk of perioperative red blood cell (RBC) transfusion.

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  • The study evaluated a new prehabilitation program for older adults scheduled for hip or knee replacement due to arthritis, focusing on its feasibility and participant satisfaction.
  • Participants were adults aged 75 and older, receiving both hospital and home support that included nutritional, psychological, and physical health components.
  • Results showed high participant engagement (89% completed the program), significant satisfaction ratings (60% rated it as "excellent" before surgery, increasing to 100% after), and a willingness to recommend it to others.
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  • Lewy body dementia (LBD) is the second most common neurodegenerative disorder after Alzheimer's disease (AD) and this study focuses on comparing decline in functionality between LBD and AD patients over 18 months.
  • The research involved 37 AD and 36 LBD patients aged over 70, all with a minimum MMSE score of 20, and found that LBD patients experienced a significant decline in Activities of Daily Living (ADL) compared to AD patients.
  • Specifically, LBD patients showed a more rapid decrease in autonomy regarding personal care tasks such as bathing and dressing, highlighting a faster decline in their functional ability than that seen in AD patients.
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Patients and surgeons may be reluctant on spinal surgery over 80 years old, fearing medical complications despite the possible improvement on quality of life. However, fewer reservations for lower limb prosthetic surgery (LLPS) seem to be arisen in this population. Is spinal surgery after 80 years-old responsible of more complications than lower limb surgery? The consecutive files of 164 patients over 80 years that had spinal surgery or LLPS were analyzed.

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  • - The study aims to identify modifiable factors linked to post-operative atrial fibrillation (POAF) in older patients (70+ years) undergoing hip fracture surgery, as limited data exists on this topic outside of cardiothoracic surgery.
  • - Conducted as a nested case-control study in Paris, it involved 757 patients, with a matched analysis revealing an 8.5% incidence of POAF, predominantly affecting older, mostly female patients with significant comorbidities.
  • - Key modifiable factors contributing to POAF included delays in surgery beyond 48 hours and the need for more than 2 units of packed red blood cells, emphasizing the importance of timely and effective perioperative care.
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Objectives: Myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML) are associated with systemic inflammatory and autoimmune diseases (SIADs) in 10-30% of cases. The aims of this study were (i) to evaluate the prevalence of venous thromboembolism VTE in patients presenting with both MDS/CMML and SIADs, (ii) to describe risk factors associated with thrombosis, and (iii) to analyse the impact of VTE on overall survival and transformation to acute myeloid leukaemia in comparison to patients with MDS/CMML-associated SIADs without VTE.

Methods: This retrospective multicentre case-control study was conducted among patients with MDS/CMML and dysimmune disorders and featured in the French retrospective database of the French Network of Dysimmune Disorders Associated with Hemopathies (MINHEMON), diagnosed with MDS/CMML and dysimmune disorders.

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Objectives: Vitamin D deficiency is common in patients undergoing hip fracture surgery (HFS) and has been found to be associated with poor post-operative outcome in other settings. This study aimed to analyze the association between vitamin D status and prognosis after HFS.

Design: Observational, prospective, single-center study.

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  • The study investigates the relationship between medication administered during the perioperative care of older patients (70+) who underwent hip fracture surgery and the incidence of postoperative delirium.
  • Conducted in a Paris academic hospital, it included 490 patients, with a notable 44% experiencing delirium post-surgery.
  • Key findings revealed that factors like advanced age, dementia, depression, and preoperative beta-blocker use were more strongly linked to delirium than the medications used during care.
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  • There is a strong connection between emergency departments and drug-related harm, highlighting the need for careful medication management.
  • Healthcare providers should systematically assess the risk of iatrogenic accidents (medical mistakes) and evaluate new prescriptions to prevent such incidents during emergency visits.
  • Precautionary measures are essential when a nurse is managing an emergency room, especially during the hospitalization of elderly patients.
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Background: Postoperative urinary retention (POUR) is a common hip fracture (HF) complication. Although fecal impaction (FI) is one of the oft-cited causes of POUR in clinical practice, evidence regarding this association is scarce.

Objective: The aim of this study was to determine whether FI was associated with POUR after HF surgery in older patients.

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Hip fracture (HF) is common in the geriatric population and is associated with a poor vital and functional prognosis which could be impacted by immunological changes. The objective here is to decipher immune changes occurring in the 1st days following HF and determine how phenotype, function, and regulation of innate and adaptive compartments adapt during acute stress event. We included HF patients, aged over 75 years.

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Background: Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points can be established to identify non-adherent patients.

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Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-month mortality after HF.

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Background: Biomarkers prove valuable for diagnosing postoperative bacterial infection, but data in elderly patients are scarce. Here we analyze how procalcitonin and C-reactive protein (CRP) perform for bacterial infection diagnosis after traumatic orthopedic surgery in elderly patients.

Methods: We included all patients admitted to our perioperative geriatrics unit after traumatic orthopedic surgery.

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Introduction: Proximal femoral fracture is associated with severe morbidity and mortality and high socioeconomic costs. The main mechanical complication of internal fixation in trochanteric fracture is lag-screw cut-out through the femoral head. Several factors are involved, but remain controversial.

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Objectives: To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings.

Design: Retrospective study.

Setting: Perioperative geriatric care unit.

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Our society faces a major challenge concerning management of the health and socio-economic burden caused by acute physical stress in the older population (+75years). In particular, hip-fracture surgery (HFS) represents a major health care preoccupation, affecting 1.6 million patients worldwide, resulting in a significant drop in life quality and autonomy.

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Unlabelled: Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.

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Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups.

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Background: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated.

Objective: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months.

Methods: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND).

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Objective: Relapsing polychondritis (RP) is a rare condition characterized by recurrent inflammation of cartilaginous tissue and systemic manifestations. Data on this disease remain scarce. This study was undertaken to describe patient characteristics and disease evolution, identify prognostic factors, and define different clinical phenotypes of RP.

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Background: Orthopedic surgery is more and more frequent in the older patients and is associated with a high mortality rate. Although serum procalcitonin levels are associated with prognosis in young adults, data are still lacking in the elderly population, and especially after surgery. The main objective of this study was to determine the prognostic value of procalcitonin levels in a large geriatric orthopedic population, and we compared it with clinical variables and biomarkers.

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