Patients treated with vitamin K oral anticoagulants in family practice: a new approach to bleeding risk assessment. An ancillary study by the CACAO prospective general practice cohort.

Background: The ability of bleeding risk scores to predict major bleeding (MB) or clinically relevant nonmajor bleeding (CRNMB) remains a topic of contention, particularly in nonselected patients in family practice. In addition, the capacity to predict bleeding risk using simple variables has yet to be established.

Objectives: The main objective was to confirm that severe anemia was the most predictive factor for the estimation of bleeding risk in patients treated with vitamin K antagonists (VKAs).

Unresolved questions on venous thromboembolic disease. Therapeutic management of superficial vein thrombosis (SVT). Consensus statement of the French Society for Vascular Medicine (SFMV).

Superficial vein thrombosis (SVT), a manifestation of venous thromboembolism (VTE), is a common condition, yet of all the types of VTE, it has been the least well studied. Recent studies have challenged the conception that SVT is a benign disease, showing that its risk factors overlap with those of deep-vein thrombosis (DVT) and that it is frequently associated with DVT or pulmonary embolism (PE). In 2010, the CALISTO trial demonstrated the benefit of treatment with fondaparinux at the dose of 2.

[Influence of water immersion on the use of epidural anesthesia during labor].

Objective: Immersion in water during labor could reduce pain and use of epidural anesthesia during childbirth. The main objective of this study was to evaluate the influence of immersion in water during labor on the use of epidural anesthesia in a midwife care setting.

Methods: We conducted a single-center retrospective study of all women who gave birth in the physiological ward of Saint-Étienne University Hospital between October 2020 and December 2022.

Reorganisation of GP surgeries during the COVID-19 outbreak: analysis of guidelines from 15 countries.

Background: General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries.

Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care.

Background: Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results have been reported about the factors independently associated with inappropriate dosing.

Management of superficial venous thrombosis in unevaluated situations: Cancer, severe renal impairment, pregnancy and post-partum.

Background: Information is lacking as to the management of patients with superficial venous thrombosis (SVT) whose profile has been excluded from trials, such as patients with active cancer, severe renal impairment, or pregnancy.

Objectives: To describe the frequency and management of SVT occurring in these situations.

Methods: We retrospectively analyzed the frequency, management and evolution of all patients with isolated SVT associated with either active cancer, severe renal impairment, or pregnant or postpartum women, diagnosed in 2 university hospital between January 1st, 2015 and December 31st, 2016.

How GPs adapted their practices and organisations at the beginning of COVID-19 outbreak: a French national observational survey.

Objectives: To describe how general practitioners (GPs) adapted their practices to secure and maintain access to care in the epidemic phase. A secondary objective was to explore if GPs' individual characteristics and type of practice determined their adaptation.

Design: Observational study using an online questionnaire.

Intention to get vaccinations against COVID-19 in French healthcare workers during the first pandemic wave: a cross-sectional survey.

Background: Healthcare workers (HCWs) are at the frontline of the COVID-19 pandemic and identified as a priority target group for COVID-19 vaccines. We aimed to determine COVID-19 vaccine acceptance rate in HCWs in France.

Methods: We conducted an anonymous survey from 26 March to 2 July 2020.

Intention to participate in a COVID-19 vaccine clinical trial and to get vaccinated against COVID-19 in France during the pandemic.

Introduction: The world is facing the COVID-19 pandemic. The development of a vaccine is challenging. We aimed to determine the proportion of people who intend to get vaccinated against COVID-19 in France or to participate in a vaccine clinical trial.

Vaccination for Human Papillomavirus: an historic and bibliometric study.

A systematic literature review was conducted to describe in a historical perspective the evolution of studies concerning HPV vaccination. The search identified 794 articles of which 568 were included. The first article was published in 2001, and the maximum annual number of publications was reached in 2014.

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Introduction: Human papillomavirus infection is the most common sexually transmitted infection and is associated with cervical cancer and several other cancers. Although the human papillomavirus vaccine is highly effective and has an excellent safety record, vaccination coverage rates vary around the world and are very low in France.Purpose of research: A literature review on the last five years in the MEDLINE and Public Health Databases was conducted in November 2017.

Patient decision aid in vaccination: a systematic review of the literature.

Introduction: Decision-making for patients and their families in the field of vaccination is difficult, involving many multidimensional factors. The complexity of this process is directly responsible for the phenomenon of vaccine hesitancy. Decision aids are instruments that provide information on a specific subject, explaining the advantages and disadvantages of a decision in a personalized way, thus clarifying the patient's values.

Anticoagulants' Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study.

Purpose: Most real-world studies on anticoagulants have been based on health insurance databases or performed in secondary care. The aim of this study was to compare safety and effectiveness between patients treated with vitamin K antagonists (VKAs) and patients treated with direct oral anticoagulants (DOACs) in a general practice setting.

Methods: The CACAO study (Comparison of Accidents and their Circumstances with Oral Anticoagulants) is a multicenter prospective cohort study conducted among ambulatory patients taking an oral anticoagulant.

Human papillomavirus (HPV) vaccination: What can be found on the Web? Qualitative analysis of the Doctissimo.fr forum data.

Background: Vaccine hesitancy is a major issue in general practice. Regarding human papillomavirus, less than 20% of young French girls are vaccinated. With widespread availability of health information, the Internet seems to be a place of choice to discuss this reluctance.

Impact of a Prescription Support Tool to Improve Adherence to the Guidelines for the Prescription of Oral Antithrombotics: The Combi-AT Randomized Controlled Trial Using Clinical Vignettes.

Ensuring the appropriateness of prescriptions of oral antithrombotics (ATs, including antiplatelet and anticoagulant agents) is a crucial safety issue, particularly for patients with multiple chronic conditions. Our main objective was to assess the impact of a prescription support tool, synthesized from international guidelines on oral ATs in adult outpatients, on improving physician adherence to the guidelines for prescription of oral ATs. A web-based, open randomized controlled trial using clinical vignettes was conducted in France from November 2018 to February 2019.

Avoiding disease mongering: A checklist for vascular physicians and researchers.

Disease mongering is an expression created in 1992 by a medical journalist, Lynn Payer, to qualify the "selling of sickness that widens the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments". This interesting concept led us to question whether, as researchers with publication and career interests in superficial vein thrombosis, we were not shaping a benign condition into a disease. Since the publication of the CALISTO trial in 2010, anticoagulant management of superficial vein thrombosis remains debated.

Evaluation of a prescription support-tool for chronic management of oral antithrombotic combinations in adults using clinical vignettes: protocol of a randomised controlled trial.

Introduction: Improving the appropriateness of prescriptions of oral antithrombotic (AT) drugs, especially AT combinations, is crucial because these drugs are implicated in bleeding events. We developed a prescription support-tool synthesising guidelines on chronic management of oral AT combinations. Our main objective is to assess the impact of this tool on improving the prescription of oral ATs to comply with guidelines.