Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines.

BACKGROUND: The allergic rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic rhinitis, but a quantitative analysis for severity assessment is lacking. OBJECTIVE: To study whether a visual analog scale (VAS) for global rhinitis symptoms could be used to assess the disease severity according to ARIA. METHODS: Three thousand fifty-two allergic rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). RESULTS: Severity had more impact on VAS levels than duration: mild intermittent rhinitis (3.5, 2.4-5.0 cm), mild persistent rhinitis (4.5, 3.2-5.6 cm), moderate/severe intermittent rhinitis (6.7, 5.3-7.7 cm) and moderate/severe persistent rhinitis (7.2, 6.1-8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as 'mild' rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as 'moderate/severe' rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (rho = 0.46; P < 0.0001). CONCLUSION: A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic rhinitis.

[Newly treated epilepsy: a French observational study]. / Observatoire national des premières instaurations d'un traitement anti-épileptique (OPIA).

AIMS: To assess the characteristic features of epileptic patients treated for the first time with oral anti-epileptic treatments. Patients and methods. All outpatients (adults and children), who consulted for epileptic attacks and for whom an oral anti-epileptic treatment was necessary, as a first time prescription, were enrolled consecutively in this study from April 2001 up to January 2003. Data were available from a structured questionnaire delivered to all participating neurologists. RESULTS: Two hundred sixty neurologists included 2220 patients (1162 males, 1057 females with a mean age of 41 years (from 1 month to 96 years). Forty-one percent of these patients were referred by a general practitioner and 22 percent by emergency departments. Four hundred and thirty-seven patients (19.7 percent) had only experienced a single seizure at treatment initiation. Patients were classified according to focal epilepsy (43.9 percent of patients), generalized epilepsy (46.4 percent of patients), or non-classified epilepsy (9.7 percent of patients). Sixty-six percent of patients had a biological check-up. Ninety-three percent of patients underwent an EEG and 80.7 per cent a CT scan or brain MRI. The high risk of recurrence was the main reason given by neurologists for instituting anti-epileptic treatment. The reason for initiating treatment was syndromic diagnosis in 23.7 percent of patients with multiple seizures. The most frequently prescribed drug was valproic acid (58.2 percent of patients) chosen because of its practical use and broad anti-epileptic spectrum. CONCLUSION: This study provides a considerable amount of epidemiological and clinical information with a special emphasis on epilepsy syndromes, diagnostic assessment and factors that influence the initiation of treatment or not.

[Evaluation of an educational program on asthma for pharmacists]. / Evaluation d'une action de formation de pharmaciens officinaux sur l'asthme.

OBJECTIVES: The purpose of this work was to assess the impact of an educational program on asthma for dispensing pharmacists and their teams aimed at improving patient awareness and self-care (use of consultations, drug use, inhalation techniques). METHODS: This retrospective study used a before-after design (T0/T1 year). The patients were recruited by their primary care physician in the vicinity of dispensing pharmacies that had participated in the educational program. Data were collected with a self-administered questionnaire. The study population was divided into two groups, patients who were clients at a pharmacy that had participated in the program ("educated patients") or not ("non-educated patients"). RESULTS: After 1 year, there were fewer emergency consultations, more frequent follow-up visits, greater use of chronic inhalation therapy, better control of drug use techniques, and better knowledge of the asthmatic disease in "educated" patients. DISCUSSION: This study demonstrates the importance of educational programs for dispensary teams: better response to the demands of patients and physicians, better management of the disease and its treatment, better observance and consequently better control of asthma.

The Dwyer procedure in the treatment of idiopathic scoliosis. A 10-year follow-up review of 21 patients.

Despite the well-known Dwyer procedure, developed in 1969, comprehensive reports on its use, with long-term follow-up, are relatively scarce. The purposes of this study were to detect eventual late complications and to compare late results with postoperative angular curve correction. This article reports on 21 children operated on between October 1972 and October 1975 and reviewed with a minimum follow-up of 10 years (10 other patients were lost to follow-up after 5 years). Patients had idiopathic lumbar or thoracolumbar curves (average curve, 56 degrees). Results are discussed with a special reference to longitudinal observation. There is a great correction of the instrumented curve (postoperative, 5 degrees), but a loss of correction of 10 degrees is generally observed, prevented by a complete immediate correction or even hypercorrection. The upper curve, noninstrumented, also shows improvement (mean preoperative, 38 degrees; postoperative, 22 degrees; 10 years, 22 degrees) but re-equilibration cannot be predicted. Pseudarthrosis of one intervertebral space occurs frequently, and may cause failure of the cable with a loss of correction of 10-20 degrees. Kyphosis (or simple loss of lumbar lordosis) is commonly observed but should be balanced with correction of rotation. The following conclusions were made: morbidity is not severe, despite the advanced surgical technique. The technique is difficult and has a direct consequence on the quality of results; pseudarthrosis is a frequent complication, followed by important loss of correction; indications should be discussed carefully in idiopathic lumbar and thoracolumbar curves. It is still too early to advocate either anterior instrumentation of Zielke (VDS) or segmental posterior instrumentation (C. D. Luque) because of short-term follow-up.