[Difficulties encountered by the general practitioner in the management of the elderly people in complex medical and psycho-social condition: role of mobile teams].

Objective: Assessed the difficulties encountered by general practitioners in the care of the elderly with complex medical and psycho-social conditions, their knowledge of the geriatric network, the interest engendered by setting-up mobile community based geriatric units.

Methods: The survey was both qualitative and quantitative and took the form of a telephone interview and a multimodal questionnaire (telephone interview, postal or email questionnaire) of general practitioners in the areas of Annecy, Grenoble and Roanne (France).

Results: Sixty five per cent of the 129 GPs contacted by telephone said the survey interested them.

[Evaluation of adherence to recommendations within 3 months after comprehensive geriatric assessment by an inpatient geriatric consultation team].

Background: Frail elderly patients during their hospitalization can benefit of a comprehensive geriatric assessment (CGA) by an inpatient geriatric consultation team (IGCT). This assessment yields recommendations aiming to improve medical and social management during the patient's hospital stay and after discharge.

Objectives: This study examines the socio-demographic profile of patients assessed by the IGCT and describes the type of recommendations, their adherence rate at 3 months and their impact in terms of mortality, rehospitalization, and institutionalization.

Revisiting long-term adherence to highly active antiretroviral therapy in Senegal using latent class analysis.

Background: Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy.

Methods: Between August 1998 and April 2002, 404 adult patients were enrolled.

[Frailty: learnings from the SAFEs cohort study and future perspectives for the research].

Even though the efforts in research have detailed further the physiopathology and the dynamics of the frailty process an operational definition of frailty is still far from being unequivocal. Studies carried out from the SAFEs cohort study allowed a pragmatic approach in the identification of the at-risk groups for the lost of independency during the hospital stay and factors influencing their future at short-, mid- and long-term. Based upon these results, we propose to discuss the relevance of the current operational indicators of frailty in order to show that clinical markers or indicators are insufficient to differentiate the frailty process from normal ageing.

Nursing home admission in elderly subjects with dementia: predictive factors and future challenges.

Objectives: The aim of this study was to identify factors predictive of nursing home admission (NHA) over a period of 1 year among elderly subjects with dementia.

Methods: The study population was drawn from the SAFES cohort that was formed within a national research program into the recruitment of emergency departments in 9 teaching hospitals. Subjects were to have been hospitalized in a medical ward in the same hospital as the emergency department to which they were initially admitted.

[Predictors of functional decline of older persons after an hospitalisation in an acute care for elder unit: importance of recent functional evolution].

Objectives: To identify the predictors of functional decline of older persons after hospitalization in an Acute Care for Elder unit (ACE).

Methods: Retrospective observational study based on a population hospitalised in ACE unit in Grenoble University Hospital. Dead patients within hospitalisation and patient fully disable or already hospitalized 15 days before hospitalisation were excluded.

[Factors predictive of long-term mortality in patients aged 75 years or older hospitalized from the emergency department: the SAFES cohort].

Objectives: To identify the factors predictive of long-term mortality among a cohort of subjects aged 75 years or older hospitalized from the emergency department.

Methods: Variables from the standardized geriatric assessment of members of the multicenter SAFES cohort were applied to a Cox model to predict mortality over a 3-year follow-up.

Results: This cohort comprised 1306 patients with a mean age of 85+/-6 years.

Potentially inappropriate use of psychotropic medications in hospitalized elderly patients in France: cross-sectional analysis of the prospective, multicentre SAFEs cohort.

Background: In France, there is evidence to suggest that 50% of elderly individuals are prescribed psychotropic medications. However, it is known that use of these agents increases the risk of falls, fractures and delirium in older people.

Objective: To study the consumption of 'potentially inappropriate medication' (PIM) among patients aged>or=75 years, paying particular attention to psychotropic drugs and the factors influencing the use of 'potentially inappropriate psychotropics' (PIPs).

Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units.

Background: among elderly patients, readmission in the month following hospital discharge is a frequent occurrence which involves a risk of functional decline, particularly among frail subjects. While previous studies have identified risk factors of early readmission, geriatric syndromes, as markers of frailty have not been assessed as potential predictors.

Objective: to evaluate the risk of early unplanned readmission, and to identify predictors in inpatients aged 75 and over, admitted to medical wards through emergency departments.

A 84-month follow up of adherence to HAART in a cohort of adult Senegalese patients.

Objectives: To assess long-term adherence of the first HIV-1 patients receiving highly active antiretroviral therapy (HAART) in Senegal, and to identify the main determinants of adherence.

Methods: The first 180 patients enrolled in the Senegalese HAART initiative between August 1998 and April 2001 followed up for at least 30 days were eligible. Adherence was assessed monthly at each drug dispensation between November 1999 and November 2006 by a pharmacist using a pill count completed by a questionnaire.

Loss of independence in Katz's ADL ability in connection with an acute hospitalization: early clinical markers in French older people.

Background: The preservation of autonomy and the ability of elderly to carry out the basic activities of daily living, beyond the therapeutic care of any pathologies, appears as one of the main objectives of care during hospitalization.

Objectives: To identify early clinical markers associated with the loss of independence in elderly people in short stay hospitals.

Methods: Among the 1,306 subjects making up the prospective and multicenter SAFEs cohort study (Sujet Agé Fragile: Evolution et suivi-Frail elderly subjects, evaluation and follow-up), 619 medical inpatients, not disabled at baseline and hospitalized through an emergency department were considered.

[Early indicators of prolonged hospitalization of the elderly: pilot study at Strasbourg University Hospital].

Objectives: The aim of this study was to identify early indicators of prolonged hospital stays by elderly patients.

Methods: This prospective pilot study, conducted at Strasbourg University Hospital, included patients aged 75 years or older who were hospitalized via the emergency department (SAFES cohort: Sujet Agé Fragile: Evaluation et suivi, that is, Frail Elderly Subjects: Evaluation and Follow-up). A gerontologic evaluation of these patients during the first week of their hospitalization furnished the data for an exact logistic regression.

Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study.

Objectives: To evaluate survival and investigate causes of death among HIV-1 infected adults receiving HAART in Senegal.

Design: An observational prospective cohort.

Methods: Mortality was assessed in the first patients enrolled between August 1998 and April 2002 in the Senegalese antiretroviral drug access initiative.

Long-term benefits of highly active antiretroviral therapy in Senegalese HIV-1-infected adults.

Objectives: To assess the long-term survival, as well as the immunologic and virologic effectiveness, adherence, and drug resistance, in HIV-infected patients receiving highly active antiretroviral therapy (HAART) in one of the oldest and best-documented African cohorts.

Methods: A prospective observational cohort study included the first 176 HIV-1-infected adults followed in the Senegalese government-sponsored antiretroviral therapy initiative launched in August 1998. Patients were followed for a median of 30 months (interquartile range, 21-36 months).

Adherence to HAART and its principal determinants in a cohort of Senegalese adults.

Background: Access to programmes providing highly active antiretroviral therapy (HAART) is recent in Africa. In Senegal, a national initiative was launched in 1998. The capacity of African patients to adhere to complex antiretroviral treatments (ARV) is largely unknown.

Access to antiretroviral drugs and AIDS management in Senegal.

Objectives: Description and analysis of the Senegalese Antiretroviral Drug Access Initiative (ISAARV), the first governmental highly active antiretroviral therapy (HAART) treatment programme in Africa, launched in 1998.

Methods And Results: ISAARV was initially an experimental project designed to evaluate the feasibility, efficacy and acceptability of HAART in an African context. It was based on four principles: collective definition of the strategy, with involvement of the health professionals who would be called on to execute the programme; matching the objectives to available means (gradual enrollment according to drug availability); monitoring by several research programmes; and ongoing adaptation of treatment and follow-up according to the latest international recommendations.

Low rate of genotypic HIV-1 drug-resistant strains in the Senegalese government initiative of access to antiretroviral therapy.

Objective: To monitor the prevalence of antiretroviral (ARV)-resistant HIV-1 viruses, and the genotypic mutations in patients enrolled in the Senegalese initiative for access to antiretroviral treatment (ART).

Methods: A total of 80 patients with a virological follow-up of at least 6 months were selected, 68 were ART-naive and 12 ART-experienced. Genotypic resistance to ARV was studied at baseline for a random subset of patients and at each rebound in plasma viral load during ART, by sequencing the protease and reverse transcriptase genes.

The Senegalese government's highly active antiretroviral therapy initiative: an 18-month follow-up study.

Objective: To study the feasibility, effectiveness, adherence, toxicity and viral resistance in an African government HAART initiative.

Methods: A prospective observational cohort study started in Dakar in August 1998. Initial treatment consisted of two nucleoside reverse transcriptase inhibitors and one protease inhibitor.