Summary Based on the Genomic Data Sharing Policy issued in August 2007, the National Institutes of Health (NIH) has supported several repositories such as the database of Genotypes and Phenotypes (dbGaP). dbGaP is an online repository that provides access to large-scale genetic and phenotypic datasets with more than 1000 studies. However, navigating the website and understanding the relationship between the studies are not easy tasks. Moreover, the decryption of the files is a complex procedure. In this study we propose the dbgap2x R package that covers a broad range of functions for searching dbGaP studies, exploring the characteristics of a study and easily decrypting the files from dbGaP. Availability and implementation dbgap2x is an R package with the code available at https://github.com/gversmee/dbgap2x. A containerized version including the package, a Jupyter server and with a Notebook example is available at https://hub.docker.com/r/gversmee/dbgap2x. Supplementary information Supplementary data are available at Bioinformatics online.

SummaryGuidelines advise performing a computed tomography head scan for all anticoagulated head injured patients, but the risk of intracranial haemorrhage (ICH) after a minor head injury is unclear. We conducted a systematic review and meta‐analysis to determine the incidence of ICH in anticoagulated patients presenting with a minor head injury and a Glasgow Coma Score (GCS) of 15. We followed Meta‐Analyses and Systematic Reviews of Observational Studies guidelines. We included all prospective studies recruiting consecutive anticoagulated emergency patients presenting with a head injury. Anticoagulation included vitamin‐K antagonists (warfarin, fluindione), direct oral anticoagulants (apixaban, rivaroxaban, dabigatran and edoxaban) and low molecular weight heparin. A total of five studies (including 4080 anticoagulated patients with a GCS of 15) were included in the analysis. The majority of patients took vitamin K antagonists (98·3%). There was significant heterogeneity between studies with regards to mechanism of injury and methods. The random effects pooled incidence of ICH was 8·9% (95% confidence interval 5·0–13·8%). In conclusion, around 9% of patients on vitamin K antagonists with a minor head injury develop ICH. There is little data on the risk of traumatic intracranial bleeding in patients who have a GSC 15 post‐head injury and are prescribed a direct oral anticoagulant.

Mesurer l’incidence des hémorragies intracrâniennes retardées chez les patients traités par anticoagulants et victimes d’un traumatisme crânien.

To measure the impact of delayed intracranial hemorrhage in patients treated by anticoagulants who are victims of a head injury. We conducted a prospective study within two university hospitals. Every patient treated by anticoagulants and victim of a head injury was included. Upon their arrival in the emergency department, they had a physical examination with determination of the Glasgow Coma Scale (GCS), and a blood test to measure the international normalized ratio (INR). A brain computed tomography (CT scan) was then carried up in the next hour. In case of intracranial hemorrhage, an antagonization of the anticoagulant activity was immediately performed. Otherwise, patients were monitored in the emergency department, and a second brain CT scan was realized 24 hours after the fall. The primary endpoint was the occurrence of an intracranial hemorrhage at the second CT scan. Between July 2013 and December 2014, 419 patients were included. The average of age was at 81 ± 12 years old and the sex ratio 0.79. 334 patients (79.8%) were treated with anti-vitamin K, 73 (17.4%) with new anticoagulants, and 12 patients by a low-molecular-weight heparin (2.9%). 407 patients (97.1%) had a GCS on arrival at 13 or 14, and 12 patients (2.9%) had a GCS at less than 13. 35 patients (10.4%) had an INR lower than 1.5, 201 patients (48.0%) had an INR between 1.5 and 3, 98 patients (23.3%) had an INR higher than 3. 43 patients (10.3%) had an intracranial hemorrhage at the initial CT scan [95% CI 7.4-13.2]. For 7 patients (1,7%), the second CT scan showed a delayed intracranial hemorrhage, despite a normal initial CT 1.7%, [95% CI 0.4-2.9]. Six patients with an intracranial hemorrhage were treated by anti-vitamin K, and one patient by dabigatran. The INR of these patients was between 1.4 and 3. They all received a treatment for antagonize the anticoagulant activity. No patient had required a neurosurgical procedure. Our study confirms the possibility of delayed intracranial hemorrhage in patients with anticoagulation who are victims of a head injury. The systematic implementation of a control CT scan 24 hours after the fall allows the detection of these lesions, and the therapeutic management.

Évaluer et améliorer le délai de réalisation de la TDM cérébrale initiale des patients traités par anticoagulants et victimes d’un traumatisme crânien.

L’InVS a mis en place un signalement des intoxications au monoxyde de carbone avec la circulaire DGS/7 C/2004/540 du 15 novembre 2004. Ce dispositif a pour but de prévenir le risque de récidive, d’évaluer l’incidence de ces intoxications et d’en décrire les circonstances et facteurs de risque afin de concevoir des politiques de prévention adaptées. En régions Aquitaine et Poitou-Charentes, en accord avec la cellule InVS de la région, les déclarations se font en temps réel au centre anti-poison. Nous avons étudié de manière rétrospective et observationnelle les dossiers d’intoxications au monoxyde carbone déclarés au centre anti-poison et de toxicovigilance de Bordeaux sur l’année 2012. L’objectif était de faire un état des lieux de la tenue des dossiers, à savoir l’implémentation des éléments utiles pour effectuer la déclaration obligatoire à l’Agence régionale de santé. Au total 252 patients ont été impliqués dont 95 hommes, 94 femmes et 45 enfants de moins de 16 ans. Le lieu de survenue de l’intoxication était précisé dans 99 % des cas et la durée d’exposition au gaz dans 24,6 % des cas. La recherche d’un tabagisme actif chez les patients vivants de plus de 15 ans a été notée dans 16,2 %. La recherche d’une grossesse chez les femmes en âge de procréer a été effectuée dans 12,5 % des cas. Le résultat du dosage du CO expiré a été noté dans 64 cas et celui de la carboxyhémoglobinémie dans 176 cas ; 42 patients ont eu les deux prélèvements. Ainsi 76 patients ont été signalés comme intoxiqués au CO sans avoir eu de prélèvement de celui-ci. L’implémentation des dossiers de patients intoxiqués au CO est insuffisante pour effectuer un signalement complet auprès de notre autorité de tutelle. Le développement d’un questionnaire associé au dossier informatique médical du patient, permettrait un meilleur recueil des données indispensables au signalement des cas d’intoxication au monoxyde de carbone.

Décrire l’évolution de la douleur dans les sept jours qui suivent un traumatisme bénin du rachis cervical.