Publications by authors named "Etienne Ojardias"

5 Publications

  • Page 1 of 1

Recurrence or Relapse of COVID-19 in Older Patients: A Description of Three Cases.

J Am Geriatr Soc 2020 10 13;68(10):2179-2183. Epub 2020 Aug 13.

Groupe Immunité des Muqueuses et Agents Pathogènes-EA3064, University Hospital of Saint-Etienne, Saint-Etienne, France.

Background: COVID-19 has infected millions of people worldwide, particularly in older adults. The first cases of possible reinfection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported in April 2020 among older adults.

Design/setting: In this brief report, we present three geriatric cases with two episodes of SARS-CoV-2 infection separated by a symptom-free interval.

Participants: The participants of this brief report are three cases of hospitalized geriatric women.

Measurements/results: We note clinical and biological worsening during the second episode of COVID-19 for all three patients. Also, there is a radiological aggravation. The second episode of COVID-19 was fatal in all three cases.

Conclusion: This series of three geriatric cases with COVID-19 diagnosed two times apart for several weeks questions the possibility of reinfection with SARS-CoV-2. It raises questions in clinical practice about the value of testing for SARS-CoV-2 infection again in the event of symptomatic reoccurrence. J Am Geriatr Soc 68:2179-2183, 2020.
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http://dx.doi.org/10.1111/jgs.16728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361461PMC
October 2020

[Therapeutic education in elderly over 75 years old living at home A pilot study of 48 patients].

Geriatr Psychol Neuropsychiatr Vieil 2020 03;18(1):43-52

Département de gérontologie clinique, CHU de Saint-Étienne, France.

Therapeutic patient education (TPE) allows elderly as well as young adults to evaluate patient's self-care and adaptation skills to their own clinical condition. Falling is a symptom present in various chronic diseases, which leads to loss of autonomy, fear of recidivism and frequent admissions into institutions. Study objective was to evaluate at 3 and 6 months the impact of TPE on fall recurrence, perceived quality of life and fear of falling, in elderly over 75 living at home.

Methods: We performed a prospective study comparing two groups: a group participating in day hospital (group "TPE") and a control group (group "Hospitalized") of elderly patient not receiving TPE recruited in short geriatric stays following a fall at home.

Results: 28 patients in the "TPE" group and 20 patients in the "Hospitalized" group were included. The "TPE" group reported significantly better perceived quality of life at 3 months and 6 months. At 6 months, fear of falling was twice as high in the "Hospitalized" group than in the "TPE" group.

Conclusions: The group of subjects who was able to benefit from therapeutic education at home had an improved quality of life at 3 and 6 months and a decrease in the fear of falling at 6 months.
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http://dx.doi.org/10.1684/pnv.2019.0841DOI Listing
March 2020

Impact of Geriatric Hotlines on Health Care Pathways and Health Status in Patients Aged 75 Years and Older: Protocol for a French Multicenter Observational Study.

JMIR Res Protoc 2020 Feb 13;9(2):e15423. Epub 2020 Feb 13.

Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint Etienne, France.

Background: In France, emergency departments (EDs) are the fastest and most common means for general practitioners (GPs) to cope with the complex issues presented by elderly patients with multiple conditions. EDs are overburdened, and studies show that being treated in EDs can have a damaging effect on the health of elderly patients. Outpatient care or planned hospitalizations are possible solutions if appropriate geriatric medical advice is provided. In 2013, France's regional health authorities proposed creating direct telephone helplines, "geriatric hotlines," staffed by geriatric specialists to encourage interactions between GP clinics and hospitals. These hotlines are designed to improve health care pathways and the health status of the elderly.

Objective: This study aims to describe the health care pathways and health status of patients aged 75 years and older hospitalized in short-stay geriatric wards following referral from a geriatric hotline.

Methods: The study will be conducted over 24 months in seven French university hospital centers. It will include all patients aged 75 and older, living in their own homes or nursing homes, who are admitted to short-stay geriatric wards following hotline consultation. Two questionnaires will be filled out by medical staff at specific time points: (1) after conducting the telephone consultation and (2) on admitting the patient to a short-stay geriatric medical care. The primary endpoint will be mean hospitalization duration. The secondary endpoints will be intrahospital mortality rate, the characteristics of patients admitted via the hotline, and the types of questions asked and responses given via the hotline.

Results: The study was funded by the National School for Social Security Loire department (École Nationale Supérieure de Sécurité Sociale) and the Conference for funders of prevention of autonomy loss for the elderly of the Loire department in November 2017. Institutional review board approval was obtained in April 2018. Data collection started in May 2018; the planned end date for data collection is May 2020. Data analysis will take place in the summer of 2020, and the first results are expected to be published in late 2020.

Conclusions: The results will reveal whether geriatric hotlines provide the most effective management of elderly patients, as indicated by shorter mean hospitalization durations. Shorter hospital durations could lead to a reduced risk of complications-geriatric syndromes-and the domino chain of geriatric conditions that follow. We will also describe different geriatric hotlines from different cities and compare how they function to improve the health care of the elderly and pave the way toward new advances, especially in the organization of the care path.

Trial Registration: ClinicalTrials.gov NCT03959475; https://clinicaltrials.gov/ct2/show/NCT03959475.

International Registered Report Identifier (irrid): DERR1-10.2196/15423.
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http://dx.doi.org/10.2196/15423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055780PMC
February 2020

The Effects of Anodal Transcranial Direct Current Stimulation on the Walking Performance of Chronic Hemiplegic Patients.

Neuromodulation 2020 Apr 23;23(3):373-379. Epub 2019 May 23.

Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA, 7424, 42023, Saint-Etienne, France.

Objective: To evaluate the effect of a single session of tDCS over the primary motor cortex of the lower limb (M1-LL) vs. placebo on the walking performance in chronic hemiplegic patients.

Patients And Methods: Randomized, cross-over, double-blinded study. Eighteen patients with initially complete hemiplegia and poststroke delay >6 months were included. Each patient received a single session of anodal stimulation (2 mA, 20 min) over M1-LL (a-tDCS condition) and a pseudostimulation session (SHAM condition). The order of the two sessions was randomly assigned, with an 11-day interval between the two sessions. The anodal electrode was centered on the hotspot identified with Transcranial magnetic stimulation. The cathode was placed above the contralesional orbitofrontal cortex. Walking performance was evaluated with the Wade test and the 6-minute walk test (6MWT), gait parameters with GAITRite, and balance with posturography. These tests were performed during and 1 hour after the stimulation. Baseline assessments were performed the day before and 10 days after each session.

Results: The comparison between the 6MWT under a-tDCS vs. SHAM conditions demonstrated a nonsignificant positive effect of the stimulation by 15% during stimulation (p = 0.360) and a significant positive effect of 25% 1 hour after stimulation (p = 0.038). No significant differences were observed for the other evaluations.

Discussion: These results showed a significant positive effect of a single session of anodal tDCS of the M1-LL in chronic hemiplegic patients. This proof-of-concept study supports the conduct of clinical studies evaluating the effectiveness of a walking training program associated with iterative tDCS stimulation.

Conflict Of Interest: The authors reported no conflict of interest.
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http://dx.doi.org/10.1111/ner.12962DOI Listing
April 2020

Cutaneous Mycobacterium chelonae infection in a patient with rheumatoid arthritis treated with glucocorticoids.

Joint Bone Spine 2019 01 30;86(1):105. Epub 2018 Jun 30.

Department of rheumatology, North hospital, university hospital of Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France; SAINBIOSE, Inserm U1059, university of Lyon, 42023 Saint-Étienne, France; CIC Inserm U1408, university of Lyon, 42023 Saint-Étienne, France. Electronic address:

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http://dx.doi.org/10.1016/j.jbspin.2018.06.004DOI Listing
January 2019