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Biomedical subjects

N Nicoloyannis

Publications and source records attributed to N Nicoloyannis.

5 recordsLinked to original sources

Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children.

OBJECTIVES: A pharmacoeconomic study to compare, in terms of: medical effectiveness, quality of life and costs two treatment strategies ('homeopathic strategy' vs 'antibiotic strategy') used in routine medical practice by allopathic and homeopathic GPs in the treatment of recurrent acute rhinopharyngitis in 18-month to 4-year-old children. METHODS: Statistical analysis of data obtained from a population of 499 patients included in a previous 6-month prospective, pragmatic study. The patients were regrouped according to type of drug prescribed. Medical effectiveness was assessed in terms of (i) episodes of acute rhinopharyngitis, (ii) complications, (iii) adverse effects. Quality of life was assessed using the Par-Ent-Qol scale. Direct medical costs (medical consultations, drug prescriptions, prescriptions for further tests) and indirect medical costs (sick-leave) were evaluated from three viewpoints (society, patient, Social Security) using public prices and French Social Security tariffs. RESULTS: The 'homeopathic strategy' yielded significantly better results than the 'antibiotic strategy' in terms of medical effectiveness (number of episodes of rhinopharyngitis: 2.71 vs 3.97, P<0.001; number of complications: 1.25 vs 1.95, P<0.001), and quality of life (global score: 21.38 vs 30.43, P<0.001), with lower direct medical costs covered by Social Security (88 Euros vs 99 Euros, P<0.05) and significantly less sick-leave (9.5% of parents vs 31.6% of parents, P<0.001). CONCLUSIONS: Homeopathy may be a cost-effective alternative to antibiotics in the treatment of recurrent infantile rhinopharyngitis.

Acute Disease↗

Costs of asthma are correlated with severity: a 1-yr prospective study.

Asthma prevalence is increasing and asthma-related costs are likely to increase, but few studies have analysed the relationship of asthma costs and severity. The impact of severity on costs was quantified in a cohort of 318 asthmatic patients followed up prospectively for 1 yr. Patients presenting with a broad range of severity of the disease (intermittent, mild persistent, moderate persistent, severe persistent) were recruited by chest physicians throughout France and treated for 1 yr according to customary clinical practice and following international guidelines. Severity, direct and indirect costs, and quality of life (QoL) were assessed. A multivariate analysis was conducted to relate factors contributing to the costs measured. Mean direct costs for goods and services excluding hospitalization, numbers of consultations, supplementary examinations, and the use and cost of bronchodilators and corticosteroids, indirect costs of days lost from work, and adverse QoL parameters all increased significantly with increasing severity. This also applied to mean age, body weight, asthma duration, depression of forced expiratory volume in one second, and inhaled corticosteroid posology in the 234 patients completing the study. There was a significant relationship (r=0.614, p<0.001) between direct costs (hospitalization and cures were excluded) and three domains of the QoL questionnaire (mobility, pain and energy). Overall costs of asthma (including individual direct costs, indirect costs, and intangible quality of life costs) are clearly related to severity. This is the first study in asthma to combine rigorous independent classification of grades of severity in statistically valid numbers of patients of grades receiving "real-world" treatment and followed-up prospectively for 1 yr. It allowed severity to be accurately related to direct, indirect and intangible costs of asthma. Quality of life explained a significant part of these costs.

Adolescent↗

Is short-term odour recognition predictable from odour profile?

Smelling an odour induces a pattern of sensations, images and memories which participate in identification. It was proposed that perceptual memory performances for odours could be inferred from the description of these olfactory representations. The subject was asked to elaborate an odour descriptor profile, and a short-term odour recognition memory task was chosen to test the individual perceptual memory performance. Two pattern-recognition methods based on artificial neural networks and discriminant analysis were carried out and allowed odour profile and perceptual memory performance to be related. Insofar as the subjects gave dichotomic responses in the recognition memory task, each response could be evaluated in terms of correct or incorrect responses. Simulations indicated that the olfactory recognition memory performance can be predicted in man from odour-elicited semantic profiles by using artificial neural networks. It was also shown that all semantic descriptors do not participate in olfactory recognition to the same degree. Low-level information, such as intensity, familiarity and hedonic judgements, did not allow the artificial neural network to predict the olfactory performance. By contrast, high-level information, such as gustatory, olfactory and visual evocations, allowed artificial networks to make such predictions.

Adult↗

Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works.

A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment.

Adolescent↗