[The oral anticoagulants’ burden].

Background: Oral anticoagulants generate a burden of care that can affect the patient’s quality of life. The concept of treatment’s burden measures the impact of medical care for the patient’s quality of life. Various factors can exacerbate the burden.

[Discontinuation of artificial hydration in patients at the end of life: A systematic review of the literature].

Background: Since the revision of the french law in 2016, artificial hydration is considered as a treatment and its withdrawal is part of the fight against extraordinary treatment at the end of life. Given its symbolism, the decision of withdrawal can be difficult for the patient, his or her entourage, and caregivers. The objective of this study was to assess the benefits and risks associated with artificial hydration (AH) at the end of life and the existing means of communication around this decision.

Nurses' Influenza Vaccination and Hesitancy: A Systematic Review of Qualitative Literature.

Vaccine hesitancy (VH) is defined as "". This hesitancy affects caregivers and more specifically nurses. The purpose of this study is to assess determinants of influenza VH in the nurse's community.

[Not Available].

Context: In France, breast cancer has been the most commonly diagnosed and the most lethal cancer in women. The risk-benefit ratio of organized breast cancer screening has been the focus of much scientific controversy, especially about overdiagnosis. A citizen conference and some scientific organizations have asked for a better education for women.

[Information around organized breast cancer screening. Do INCa and Cancer Rose meet criteria for decision aids?].

Background: Controversies around organized breast cancer screening emphasize the need for information for women. In France, the institute of cancer (INCa) is in charge of conveying this information. Cancer Rose's website (CR) provides complementary information considering INCa's incomplete.

Citizen consultation and organized breast cancer screening.

Scientific controversies on breast cancer screening have induced the French authorities to launch online citizen consultation. The objective of this netnography was to identify the knowledge and values underlying contributors' choices. The choice of supporters was often based on emotions: impression of disease severity and efficacy of screening, fearfulness stemming from personal experience and testimony from relatives.

[Information media and decision support tools for cancer screening.].

Context: In France, breast cancer has been the most commonly diagnosed and the most lethal cancer in women. The risk-benefit ratio of organized breast cancer screening has been the focus of much scientific controversy, especially about overdiagnosis. A citizen conference and some scientific organizations have asked for a better education for women.

[Discrepancies and overdiagnosis in breast cancer organized screening. A "methodology" systematic review].

Background: The risk-benefit ratio of breast cancer organized screening is the focus of much scientific controversy, especially about overdiagnosis. The aim of this study was to relate methodological discrepancies to variations in rates of overdiagnosis to help build future decision aids and to better communicate with patients.

Methods: A systematic review of methodology was conducted by two investigators who searched Medline and Cochrane databases from 01/01/2004 to 12/31/2016.

Frequency, types, and potential clinical significance of medication-dispensing errors.

Introduction And Objectives: Many dispensing errors occur in the hospital, and these can endanger patients. The purpose of this study was to assess the rate of dispensing errors by a unit dose drug dispensing system, to categorize the most frequent types of errors, and to evaluate their potential clinical significance.

Methods: A prospective study using a direct observation method to detect medication-dispensing errors was used.

Cardiac troponin I release after hip surgery correlates with poor long-term cardiac outcome.

Background And Objective: The aim of this study was to assess the incidence of perioperative myocardial damage detected by serial measurements of troponin I after hip surgery and its association with late cardiovascular outcome.

Methods: Troponin I was measured during the first three postoperative days in 88 consecutive patients undergoing hip surgery. Values above the 99th percentile (0.

LBBB in aircrew with low cardiac risk: diagnostic application of multislice CT.

Introduction: Because of its excellent negative predictive value for diagnosing coronary stenoses, multislice computed tomography (MSCT) may be a way to assess the absence of significant coronary stenosis. We discussed its place in aeromedical decision-making for aircrew members with a low level of cardiovascular risk factors and acquired left bundle branch block (LBBB).

Methods And Results: During the period 2002-2004, 12 male aircrew members (mean age: 42.

[Multislice computed tomography to detect coronary stenosis among asymptomatic patients with cardiovascular risk factors and equivocal prior stress test: preliminary study].

Unlabelled: Multislice computed tomography (MSCT) is a non-invasive and validated technique to detect coronary stenoses. Some questions remain about its accuracy to detect coronary stenoses (CS), especially for asymptomatic patients (P) when a prior stress test isn't conclusive.

Methods: MSCT was performed among 45 asymptomatic men (mean age: 58,3 +/- 16), with a high ten year risk of fatal cardiovascular disease (SCORE 2003 data for low-risk regions of Europe), without any previous coronary history and with previous non conclusive exercise testing.

[Alcohol and rhythm disorders].

Cardiovascular disease is the main cause of mortality in chronic alcoholics. There is a clear association between excessive alcohol consumption and the risk of sudden cardiac death. The pro-arrhythmogenic effect of ethanol could be responsible for some of these cases of arrhythmia and sudden death in subjects with an alcoholic cardiomyopathy and also in those with an apparently normal heart.

[False aneurysm of the left ventricle. A sometimes late finding].

Left ventricular pseudo-aneurysm is a rare complication of myocardial infarction, usually of the inferior wall. It is generally a sudden event due to rupture of the heart which is contained by the pericardium. The outcome is usually rapidly fatal by secondary rupture or adiastole.

[Deterged large abscess of the aortic valve ring disclosed after infective endocarditis].

The authors report the case of a very large deterged aortic valve ring abscess detected at long-term after infective endocarditis during investigation of symptomatic consequent aortic regurgitation. The different imaging methods of diagnostic import are reviewed with special emphasis on the role of transoesophageal echocardiography during infective endocarditis.

[Contribution of transesophageal echocardiography in the investigation of the atrium in systemic embolism].

Transesophageal echocardiography (TEE) is a semi-invasive examination that provides better images of the atrium than classical transthoracic echocardiography (TTE) due to the anatomical positioning of the captor and the high frequency Doppler apparatus used. We used TEE and TTE to evaluate the incidence of the cardiac origin of emboli in 46 patients with unexplained stroke or transient ischemic attack (TIA): 23 had documented heart disease (mean age 60 years) and 23 had no cardiac disease (mean age 43 years). Among those with existing heart disease, 4% of the anomalies certainly or probably responsible for the emboli in addition to the underlying cardiopathy were detected by TTE versus 37% by TEE (as compared to values reported in the literature: 25% by TTE and 51% by TEE).

Streptococcal bacteremia in neutropenic adult patients.

In order to define the circumstances of occurrence, clinical presentation and prognostic factors of streptococcal bacteremia in neutropenic patients, we retrospectively reviewed 60 cases of streptococcal bacteremia following intensive chemotherapy for acute myeloblastic leukemia (AML), acute lymphoblastic leukemia (ALL) or allogeneic bone marrow transplantation. Causative streptococcal species included streptococcus viridans (42 cases), streptococcus faecalis (12), streptococcus pneumoniae (4) and other streptococci (2). All patients were febrile and 32% presented diffuse pneumopathy with frequent isolation of streptococci from bronchoalveolar washing fluids.

[Mid-term results of heart valve replacement with 2 types of pericardial heterograft. Apropos of 208 cases].

Medium-term results of valve replacement with a pericardial bioprosthesis were analysed in 141 patients receiving an Ionescu-Shiley aortic prosthesis and in 67 patients receiving a Mitroflow aortic (42), mitral (21) or double mitro-aortic (4) bioprostheses. There were 8 deaths in the operative (5.7%) and medium term (56 months) follow-up periods in the Ionescu group and a cumulative survival of 625 patient-years.

[Normal aging, hypertension and left ventricular filling].

Because of discrepancy in interpretation of early diastolic filling indices in normal subjects and hypertensive, we studied the correlations between age and radionuclide angiographic peak filling rate (PFR), doppler echocardiographic early E and late A waves, left ventricular mass (LVM), blood pressure (BP) and ejection fraction (EF) in cautiously screened 30 untreated hypertensive and 30 age paired normal subjects (mean of age 52 +/- 17 ranging from 34 to 78 years). No patient had gross obesity nor coronary artery disease. Univariate analysis revealed strong correlations between LV filling and age in normal (r = -0.

[Factors influencing survival after surgery of pure non-ischemic mitral insufficiency].

Uni and multifactorial (Cox) statistical analysis of the results of surgery in a series of 247 patients operated between 1969 and 1988 for pure, non-ischaemic mitral regurgitation was undertaken to determine the factors influencing operative and late mortality. All but 3 cases were adults, average age 51 years, and very symptomatic (75 per cent Class III et IV of NYHA Classification). Dystrophic or degenerative lesions were responsible for 53 per cent of cases of regurgitation whilst rheumatic valvular disease was only observed in 30 per cent of cases.

Evaluation of a Candida antigen detection test (Cand-Tec) in the diagnosis of deep candidiasis in neutropenic patients.

The diagnostic efficiency of a serum Candida antigen detection test Cand-Tec test) was prospectively investigated in 104 leukemic patients treated by intensive chemotherapy or allogeneic bone marrow transplantation. Candida antigen titers were determined on admission and then weekly as long as patients remained neutropenic. Nine patients had a proven disseminated yeast infection (diagnosed only at autopsy in five cases).