BackgroundCramps are involuntary painful muscle contractions that mainly affect older people. Cramps may cause severe pain and sleep disturbance. Little information exists on the prevalence and the main features of cramps in primary care settings. The objective of this study was to estimate the prevalence and the main features of cramps among primary care patients aged 60 years and older.MethodsWe prospectively enrolled 516 patients aged 60 years and older in a cross-sectional study at 25 general practices in Alsace – France between October 2011 and March 2012. Questionnaires were used to obtain information about demographics, cramp presence and main features, medical history, and treatment.ResultsThe adjusted prevalence was 46 % (95 % CI: 38–53 %). Thirty-one per cent of the study sample reported being woken up by cramps, 15 % had cramps more than 3 times a month. Logistic regression revealed a slightly higher prevalence in the age group 65–69 years compared to 60–64 years. No significant association was observed between other age groups and prevalence, or between gender and prevalence. The main localization of cramps was in the calves (80 %). The duration since onset was 5 years or more for 58 %.ConclusionsCramps are common in primary care, and although only a minority of patients report suffering from cramps more than once a week, many patients report cramp-related sleep disturbance. Further studies are needed to assess risk factors and therapeutic options for patients suffering from cramps in primary care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0509-9) contains supplementary material, which is available to authorized users.

SUMMARYVacuum-assisted closure involving the implantation of polyvinyl alcohol foam is a technique recently developed for the treatment of patients suffering from either wound infection or chronic wounds. This method has been shown to improve and accelerate wound healing. However, little is known about the cell populations that infiltrate the foam, and their potential role in resolving the infection and promoting granulation tissue formation. Our study demonstrates that wound-implanted foams are mainly infiltrated with granulocytes, but that mononuclear cells, including macrophages and minor populations of T, B and natural killer lymphocytes, are also present. We show that foam-infiltrating T cells, especially CD41 T cells, constitute a phenotypically and functionally heterogeneous population influenced by woundinfecting bacteria. Thus, T lymphocytes could play a role in wound cleansing. In addition, our data indicate that implanted polyvinyl alcohol foams might be suitable microenvironments for manipulating T cell-mediated immune responses in patients.

Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety.Objective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases.Material and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement.Results: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data.Discussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool’s usability must be evaluated and improved in further research.

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