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Master Thesis

Étude descriptive des populations martiniquaises et niçoises atteintes de sclérose en plaque EDSS ≤ à six sur des critères physiques, psychologiques et sociaux avec évaluation de leur prise en charge médicale et paramédicale sur une année

Abstract : Introduction: Martinique is a French territory considered medically understaffed compared to Nice, which offers a satisfying range of treatment. Multiple sclerosis (MS) shows an increase of its prevalence rate on these two French territories. This work aims to compare the patients suffering from multiple sclerosis in Martinique and Nice on a functional, social, psychological, medical and paramedical level, and also based on their standard of living.
Material and method: this study was conducted at the general hospitals of Nice and Martinique from November 2019 to January 2021. It involves 81 patients in Nice and 82 patients in Martinique. The data were collected from a survey filled by the patients and followed by a clinical examination. The main assessment criterion is based on the comparison of the average multiple sclerosis severity score (MSSS) of MS patients between Nice and Martinique, with secondary assessment criteria based on the assessment of motor, sensory, cerebellar, visual, cognitive (using the CSCT), thymic and genito-urinary functions, as well as the record of their symptomatic treatment and background therapy and the assessment of their quality of life.
Results: there is no significant difference between the average MSSS scores between Nice (3,22 ± 2,77) and Martinique (3,56 ± 2,63) (p = 0,2896). On a motor level, there are no statistically significant differences on the various assessments. On a sensory level, the patients from Nice show an alteration of the tactile sense that is more frequent than for the patients from Martinique. On a visual level, a more significant number of nystagmus can be found in the patients from Martinique (24) compared to those from Nice (9) (p=0,0058). As for the cognitive and genito-urinary assessments, there are no statistically significant differences between Nice and Martinique. On a thymic level, the patients in Nice present a higher Beck depression inventory (BDI) score (19,23 ± 13,69) than those in Martinique (9,51 ± 8,79) (p < 0,0001). The therapeutic assessment shows that FAMPRIDINE is prescribed more frequently in Nice, as well as BIOTINE. GILENYA and AUBAGIO are more often prescribed in Martinique compared to Nice. As for their treatment, the patients in Martinique consult more often their neurologist (4,86 ± 4,71 per year) compared to those in Nice (2,69 ± 3,49) (p = 0,003). The vitamin D levels, below 30 ng/ml on both territories, are non-comparative. All the Medical outcome study short form-36 (MOS SF 36) scores are statistically lower than the general population (9,91 ± 9,08) (p < 0,0001) except for the mental health perception in Nice which is higher. However, only the perceptions of physical limitations are higher in Martinique (50 ± 45,77) compared to Nice, and the perception of psychological limitations is higher in Nice (69,21 ± 8,21) compared to Martinique (62,5 ± 18,49) (p = 0,04).
Conclusion: there is no significant difference between Nice and Martinique about the severity of patients suffering from MS. The differences have to do with some criteria including tactile sensitivities, higher depression criteria in Nice and nystagmus levels that are more frequent in Martinique. The patients in Martinique consult more often their neurologist and on both territories a low rate of multidisciplinary care can be found.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03206280
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Friday, April 23, 2021 - 10:32:04 AM
Last modification on : Friday, November 12, 2021 - 6:38:25 PM

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  • HAL Id : dumas-03206280, version 1

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Cédric Thibault. Étude descriptive des populations martiniquaises et niçoises atteintes de sclérose en plaque EDSS ≤ à six sur des critères physiques, psychologiques et sociaux avec évaluation de leur prise en charge médicale et paramédicale sur une année. Médecine humaine et pathologie. 2021. ⟨dumas-03206280⟩

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