Impact of health professionals utilization induced by musculoskeletal disorders among active subjects

in Osteoporosis International (2005, March), 16(Suppl.3), 110

Vitamin D inadequacy: global prevalence and skeletal implications

in Osteoporosis International (2005, March), 16(Suppl.3), 64

Vitamin D inadequacy : global prevalence and skeletal implications

in BONE (2005), 36(S2), 462

Time dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: a consensus statement using a meta-analytic approach

in Annals of the Rheumatic Diseases (2004), 63(7), 759-766

OBJECTIVES: To provide an updated document assessing the global, NSAID-specific, and time dependent risk of gastrointestinal (GI) complications through meta-analyses of high quality studies. METHODS: An ... [more ▼]

OBJECTIVES: To provide an updated document assessing the global, NSAID-specific, and time dependent risk of gastrointestinal (GI) complications through meta-analyses of high quality studies. METHODS: An exhaustive systematic search was performed. Inclusion criteria were: RCT or controlled study, duration of 5 days at least, inactive control, assessment of minor or major NSAID adverse effects, publication range January 1985 to January 2003. The publications retrieved were assessed during a specifically dedicated WHO meeting including leading experts in all related fields. Statistics were performed conservatively. Meta-regression was performed by regressing NSAID adjusted estimates against study duration categories. RESULTS: Among RCT data, indolic derivates provided a significantly higher risk of GI complications related to NSAID use than for non-users: RR = 2.25 (1.00; 5.08) than did other compounds: naproxen: RR = 1.83 (1.25; 2.68); diclofenac: RR = 1.73 (1.21; 2.46); piroxicam: RR = 1.66 (1.14; 2.44); tenoxicam: RR = 1.43 (0.40; 5.14); meloxicam: RR = 1.24 (0.98; 1.56), and ibuprofen: RR = 1.19 (0.93; 1.54). Indometacin users had a maximum relative risk for complication at 14 days. The other compounds presented a better profile, with a maximum risk at 50 days. Significant additional risk factors included age, dose, and underlying disease. The controlled cohort studies provided higher estimates: RR = 2.22 (1.7; 2.9). Publication bias testing was significant, towards a selective publication of deleterious effects of NSAIDs from small sized studies. CONCLUSION: This meta-analysis characterised the "compound" and "time" aspects of the GI toxicity of non-selective NSAIDs. The risk/benefit ratio of such compounds should thus be carefully and individually evaluated at the start of long term treatment. [less ▲]

Incidence of gastrointestinal symptoms among patients taking conventional non-steroidal anti-inflammatory drugs: a pragmatic study in 1946 Belgian outpatients

in Osteoporosis International (2003, November), 14(Suppl. 7), 90

Projecting the prevalence of osteoarthritis and osteoporosis over the five forthcoming decades: their increasing impact on public health

in Osteoporosis International (2003, November), 14(Suppl. 7), 65-66

Use of healthcare resources related to gastrointestinal toxicity of NSAIDS

in Osteoporosis International (2003, November), 14(Suppl. 7), 14

Numerus clausus en fin de troisieme candidature en medecine: mort annoncee d'une heresie?

in Revue Médicale de Liège (2003), 58(7-8, Jul-Aug), 508-14

Owing to the establishment of a procedure aiming at a reduction of the medical supply (numerus clausus), the French Community of Belgium had decided to introduce, at the end of the third year of medical ... [more ▼]

Owing to the establishment of a procedure aiming at a reduction of the medical supply (numerus clausus), the French Community of Belgium had decided to introduce, at the end of the third year of medical studies (third candidature), a procedure of selective attribution of the certificate allowing for a unlimited medical practice. We assessed the predictive value of the results obtained during and at the end of the first candidature (first year of medicine) for the attribution of this certificate. We studied the results of the 225 students enrolled in the first candidature in medicine at the University of Liege during the academic year 1997-1998, and we correlated them to the subsequent attribution (1999-2000- and 2000-2001) of the certificate. The success of the first candidature in the first or second session is an important predicting factor towards the reception of the certificate. A non-authorization to continue the studies in medicine in case of failure in the first session or a non-authorization to repeat the first candidature in case of failure in the second session would have, respectively, a negative predictive value (NPV) of 91.9% and 97.4% and would allow to restream 111 students at the end of the first session or 39 students at the end of the first candidature. The results of the preliminary assessments mode during the month of January are also highly predictive of the chances to get the certificate. Among the 160 students who have not successfully passed a minimum of 3 exams, only 14 students obtained the certificate. The restreaming of those students would correspond to a NPV of 91.2%. Students who were not successful in a minimum of 2 exams would have less than 5% chance to obtain the certificate. In this case, 109 students would be restreamed (NPV = 95.4%). In conclusion, the selection of the students who will obtain, at the end of the third year of medicine, the certificate allowing them for an unlimited medical practice is obtained, in a large proportion, during the first candidature and especially after the session of January. In view of those results and considering the decree abolishing the selection at the end of the third year of medical studies, one could argue about the appropriateness of the current procedure, chosen by the French Community of Belgium, compared to other solutions prioritising an earlier selection of the future doctors. [less ▲]