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Scholtissen S, Guillemin F, Bruyère O, Collette J, Dousset B, Kemmer C, Culot S, Crémer D, Dejardin H, Hubermont G, Lefebvre D, Pascal-Vigneron V, Weryha G, Reginster JY. Assessment of determinants for osteoporosis in elderly men. Osteoporos Int 2009; 20:1157-66. [PMID: 19011728 DOI: 10.1007/s00198-008-0789-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/08/2008] [Indexed: 10/21/2022]
Abstract
SUMMARY The aim of this cross-sectional study was to determine and quantify some determinants associated to low bone mineral density (BMD) in elderly men. This study showed that ageing, a lower body mass index (BMI), a higher blood level of C-terminal cross-linking telopeptides of type I collagen (CTX-1), family history of osteoporosis, and/or fracture and prior fracture were associated with bone mineral density. INTRODUCTION Our aims were to identify some determinants associated to low bone mineral density in men and to develop a simple algorithm to predict osteoporosis. METHODS A sample of 1,004 men aged 60 years and older was recruited. Biometrical, serological, clinical, and lifestyle determinants were collected. Univariate, multivariate, and logistic regression analyses were performed. Receiver operating characteristic analysis was used to assess the discriminant performance of the algorithm. RESULTS In the multiple regression analysis, only age, BMI, CTX-1, and family history of osteoporosis and/or fracture were able to predict the femoral neck T-score. When running the procedure with the total hip T-score, prior fracture also appeared to be significant. With the lumbar spine T-score, only age, BMI, and CTX-1 were retained. The best algorithm was based on age, BMI, family history, and CTX-1. A cut-off point of 0.25 yielded a sensibility of 78%, a specificity of 59% with an area under the curve of 0.73 in the development and validation cohorts. CONCLUSION Ageing, a lower BMI, higher CTX-1, family history, and prior fracture were associated with T-score. Our algorithm is a simple approach to identify men at risk for osteoporosis.
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Leblanc E, Narducci F, Lefebvre D, Villers A. [How I do... to define circumstances of an immediate conversion into a laparotomy, during a laparoscopic or a robotically-assisted laparoscopic surgery]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2009; 37:275-276. [PMID: 19272825 DOI: 10.1016/j.gyobfe.2009.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Indexed: 05/27/2023]
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Bégin C, Lefebvre D. La psychothérapie dialectique comportementale des personnalités limites. SANTE MENTALE AU QUEBEC 2008. [DOI: 10.7202/502094ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Tout clinicien qui travaille un tant soit peu auprès des personnalités limites pourra évoquer une série d'épisodes relationnels intenses qui taxent autant le professionnel que l'individu qui pose ces gestes. Dans ce contexte, le silence des praticiens d'allégeance comportementale en a étonné plus d'un. Ce n'est en effet que depuis le début des années 90 que les préceptes cognitifs-béhavioraux et la technologie afférente sont appliqués au traitement du trouble de la personnalité limite. Les travaux de Linehan se distinguent par les efforts consentis pour démontrer l'efficacité de l'approche dialectique comportementale. Cet article présente l'historique et la philosophie de l'approche de Linehan, les critères diagnostiques, les principaux outils cliniques, l'exploration des dilemmes dialectiques et des modes de traitement ainsi que les stratégies thérapeutiques de base utilisées dans cette approche.
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Ras M, Girbal-Neuhauser E, Paul E, Spérandio M, Lefebvre D. Protein extraction from activated sludge: an analytical approach. WATER RESEARCH 2008; 42:1867-1878. [PMID: 18067947 DOI: 10.1016/j.watres.2007.11.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 11/12/2007] [Accepted: 11/13/2007] [Indexed: 05/25/2023]
Abstract
To investigate the efficiency of different methods on exopolymeric substance (EPS) extraction, mechanical and chemical treatments were applied on two activated sludges, regarding the yield of protein extraction as well as their compatibility with usual quantification methods. Mechanical disruption methods do not drastically affect protein measurements by both bicinchoninic acid (BCA) and modified Lowry methods. Chemical compounds such as cationic exchange resin and triton show high interference with modified Lowry method while the protein quantification by BCA method is not affected. In addition, inner sludge compounds were shown to interfere with both methods: BCA and modified Lowry measurement respectively overestimate and underestimate protein content. According to these data, BCA method was chosen in this study as the most appropriate protein quantification method in sludge extracts. Comparison of various extraction protocols, combining mechanical and/or chemical treatments, shows that efficiency can be increased by repeating the same method or by applying a prior mechanical treatment. Proteins are preferably extracted by triton treatments, indicating the importance of hydrophobic interactions linking proteins to the EPS matrix. The amount of extracted proteins reaches 182 and 148 mg eq.BSA g(-1)VSS using triton/triton and ultraturax/triton extractions, respectively. Protease activity/extracted protein ratios vary widely depending on extraction protocols. Protease seemed to be preferably extracted by ultrasound and triton treatments (150-220 U mg(-1)protein). This study underlines that the choice of a relevant coupled quantification/extraction method is of great importance for efficient EPS determination.
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Hennequin S, Lefebvre D, El Moudni A. Fuzzy multimodel of timed Petri nets. IEEE TRANSACTIONS ON SYSTEMS, MAN, AND CYBERNETICS. PART B, CYBERNETICS : A PUBLICATION OF THE IEEE SYSTEMS, MAN, AND CYBERNETICS SOCIETY 2008; 31:245-51. [PMID: 18244786 DOI: 10.1109/3477.915347] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This paper deals with discrete event systems (DES) modeled either by discrete timed Petri nets without conflict or by continuous Petri nets. A fuzzy rule-based multimodel is developed for this kind of system. The behavior of each Petri net transition is described by the combination of two linear local fuzzy models. Using the Takagi-Sugemo model in a systematic way, we define the exact modeling for both classes of timed Petri nets. As a result, we notice that classical sets result in the exact description of discrete timed Petri nets. On the contrary, only fuzzy sets are suitable to describe continuous Petri nets exactly. The proposed fuzzy multimodels are very interesting from a control point of view. In that sense, general results such as convergence for timed Petri nets are given.
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Lefebvre D, Lips D, Giffroy JM. The European Convention for the Protection of Pet Animals and tail docking in dogs. REV SCI TECH OIE 2007; 26:619-628. [PMID: 18293610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The European Convention for the Protection of Pet Animals was opened for signature in Strasbourg on 13 November 1987 and entered into force on 1 May 1992. This Convention states that: 'Surgical operations for the purpose of modifying the appearance of a pet animal or for other non-curative purposes shall be prohibited and, in particular: the docking of tails'. At present, 15 of the 27 States in the European Union have ratified this Convention (with or without reserving their position on tail docking) and have prohibited cosmetic surgical operations. In addition, four European States have prohibited these operations, even though they did not ratify the Convention. These policy positions agree with both the current knowledge on tail amputations in dogs and the opinions of official veterinary associations in Europe and North America.
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Mateusen B, Maes DGD, Van Soom A, Lefebvre D, Nauwynck HJ. Effect of a porcine circovirus type 2 infection on embryos during early pregnancy. Theriogenology 2007; 68:896-901. [PMID: 17719623 DOI: 10.1016/j.theriogenology.2007.07.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 06/19/2007] [Accepted: 07/14/2007] [Indexed: 11/20/2022]
Abstract
The aim of the present study was to assess the effects of porcine circovirus type 2 (PCV2) on porcine embryos and their receptor sows during the first 21 days of pregnancy. Hatched blastocysts exposed to 10(5.0) TCID50 PCV2 per ml (strain 1121, fifth passage PK15) and negative control embryos were transferred to PCV2-immune receptor sows at the 7th day of the cycle. Two weeks after transfer (D21), the receptor sows were euthanized and embryos were recovered. They were assessed macroscopically for viability and examined for viral antigen-positive cells by immunoperoxidase staining. The embryonic survival rate of the PCV2-exposed embryos (6.4%, 7 viable embryos out of 110 transferred) was significantly lower than the survival rate of the negative control embryos (65.4%, 34 viable embryos out of 52 transferred). All of the non-viable PCV2-exposed embryos (n=9) displayed immunohistochemical positive signals for PCV2-antigen in degenerated tissues. In the PCV2-exposed embryos that were categorized as viable at D21, small clusters (n=4) or no PCV2-positive cells (n=3) were detected. The pregnancy results of the receptor sows that received PCV2-exposed embryos (1/5) were considerably different from the negative control receptors (2/2), with 3 out of 5 sows displaying a regular return to oestrus. In conclusion, it can be stated that PCV2 can replicate in embryos and might lead to embryonic death. In a small proportion of embryos, PCV2 exposure does not have a detrimental effect on embryo development before D21.
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Pietersma D, Lacroix R, Lefebvre D, Cue R, Wade KM. Trends in growth and age at first calving for Holstein and Ayrshire heifers in Quebec. CANADIAN JOURNAL OF ANIMAL SCIENCE 2006. [DOI: 10.4141/a05-080] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective was to provide an overview of heifer growth in Quebec and analyze its relationship with age at first calving. Heifer body weights, wither heights, body condition scores, and breeding events collected from 1993 to 2003 were obtained and combined with first lactation data, mature body weights, type classification final score and frame/capacity, and estimated breeding values for milk, conformation, frame/capacity, and Lifetime Profit Index. Analyses were restricted to 39 animal-level variables. The resulting data set consisted of 44 989 Holsteins and 2294 Ayrshires with data available for at least one variable. The average age at first calving was 26.5 and 27.1 mo for Holsteins and Ayrshires, respectively. For Holsteins, average daily gains in body weights were 0.79, 0.89, 0.87, and 0.70 kg d-1 for 0 to 4 mo (birth to weaning), 4 to 10 mo (to target onset of puberty), 10 to 14 mo (to first breeding), and 14 mo to pre-calving periods of growth, respectively. Body weights at 14 mo, conception, and post calving were 398, 464, and 601 kg, respectively, and relative to mature body weight were 59, 68 and 89%, respectively. Correlations with age at first calving, corrected for herd and year of birth effects, were positive for body weight at conception (0.69), body weight at first calving (0.31), and number of breedings (0.37), and negative for the average daily gain from conception to post calving (-0.38) and body weight at 14 mo relative to mature body weight (-0.20). For Ayrshires, body weights and average daily gains were lower than for Holsteins, but body weights relative to mature body weight and correlations were generally similar. Holsteins and Ayrshires calved substantially earlier and at a heavier body weight compared with Quebec data from the 1980s. The results of this study suggest that heifer growth may not be a limiting factor in reducing the average age at first calving in Québec. Key words: Dairy cattle, field-recorded data, heifer, growth
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Penel N, Yazdanpanah Y, Chauvet M, Clisant S, Giard S, Neu J, Lefebvre D, Foumier C, Bonneterre J. Prevention of wound infection in breast cancer surgery with a strategy based on administration of antibiotic prophylaxis in patients at high risk of wound infection occurrence. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80364-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Paul E, Camacho P, Lefebvre D, Ginestet P. Organic matter release in low temperature thermal treatment of biological sludge for reduction of excess sludge production. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2006; 54:59-68. [PMID: 17087370 DOI: 10.2166/wst.2006.547] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Thermal treatment applied in association with a biological system allows for a significant reduction in excess sludge production (approximately 50%). In general, heat treatment is described as a sludge disintegration technique. This paper offers a thorough study on the impact of heat treatment, at temperatures below 100 degrees C, on the solubilisation of the sludge COD and its biodegradability. Discontinuous heating experiments were performed on activated and digested sludge. At all temperatures tested the released COD for digested sludge was systematically higher than that for activated sludge (15 and 40%, respectively, at 95 degrees C for 40 min of contact time). For the first 30 min, a 1st order kinetic, with respect to the residual COD, was systematically found. In the range of 40-95 degrees C, digested sludge had a lower activation energy than activated sludge (26 kcal/mol compared to 70-160 kcal/mol). COD solubilisation is thus more positively influenced by temperature in the case of activated sludge. This may be due to the significant difference in the ratio of protein/carbohydrate in digested and activated sludge (1-5 and 0.2-0.7, respectively). The increase in the COD/TKN ratio in the solubilised fraction after thermal treatment of activated sludge suggests a preferential solubilisation of proteins over carbohydrates. Respirometric tests performed on the solubilised COD showed that whatever the sludge origin, only 40-50% of released COD is biodegradable at a conventional hydraulic retention time (i.e., 24 h). Hence, heat treatment would act more through organic matter solubilisation rather than by a biodegradability increase.
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Gognalons-Nicolet M, Lefebvre D. [From blind knowledge to experiential knowledge]. REVUE MEDICALE SUISSE 2005; 1:371-4. [PMID: 15776801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A postgraduate course in psychosomatic and psychosocial medicine for general practitioners started in 1999 from Marc Archinard advice. It consists of about half the hours required for the "Attestation de formation complémentaire" granted by the Swiss Academy of psychosomatic and psychosocial medicine (AMPP). This article describes the elaboration of a questionnaire assessing the professional competences acquired by the practitioners after the course. As practitioners they valorise knowledge coming from their experiences on patient relationships and group exchanges, own maturational process, delegation process as well as expansion of therapeutic choices.
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Elias A, Cadène A, Elias M, Puget J, Tricoire JL, Colin C, Lefebvre D, Rousseau H, Joffre F. Extended Lower Limb Venous Ultrasound for the Diagnosis of Proximal and Distal Vein Thrombosis in Asymptomatic Patients after Total Hip Replacement. Eur J Vasc Endovasc Surg 2004; 27:438-44. [PMID: 15015197 DOI: 10.1016/j.ejvs.2003.12.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess the performance of extended lower limb venous ultrasound (US) for the diagnosis of asymptomatic deep vein thrombosis (DVT) and to estimate a 3-month DVT incidence on repeated US after total hip replacement. DESIGN Diagnostic performance study and prospective cohort study. MATERIALS AND METHODS US was compared to phlebography in 70 consecutive patients and interobserver agreement was assessed in the last 48 patients at day 8. US was repeated in these 48 patients at day 13 and day 90. RESULTS Phlebography demonstrated a DVT in 18/70 (26%) patients, with five proximal and 13 distal and US in 23/70 (33%) patients, with eight proximal and 15 distal. Sensitivity and specificity of US with 95% CI were 94% (73-100) and 89% (76-96), respectively. Sensitivity in isolated distal vein thrombosis was 92% (67-99). The Kappa coefficient for agreement between observers was 0.84 (0.66-1.00). Follow-up showed a DVT in 15/48 (31%) patients on day 8, in 20/48 patients (42%) on day 13. DVT recurred in two patients during follow-up. CONCLUSIONS The incidence of asymptomatic DVT is still significant despite prophylaxis but most DVTs remain distal and occur in the first 2 weeks. Extended US could replace phlebography for systematic screening in clinical trials using surrogate endpoints in view of its high accuracy and reliability.
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Lefebvre D, Ménard N, Pierre JS. Modelling the influence of demographic parameters on group structure in social species with dispersal asymmetry and group fission. Behav Ecol Sociobiol 2003. [DOI: 10.1007/s00265-002-0578-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Laroche M, Moulinier L, Leger P, Lefebvre D, Mazières B, Boccalon H. Bone mineral decrease in the leg with unilateral chronic occlusive arterial disease. Clin Exp Rheumatol 2003; 21:103-6. [PMID: 12673899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The links between osteoporosis and arteriosclerosis have been established by numerous epidemiological studies. Could arteriosclerosis induce bone mineral loss via ischemia or other pathological process? We carried out a comparative study of bone mineral density in both legs of patients with unilateral arterial disease of the lower limbs. METHODS We studied 25 patients, 22 men and 3 women, whose mean age was 62.3 years (range 35-88 years). These patients had unilateral lower limb arterial disease of at least 3 months duration with a systolic index at least 50% lower on the affected than on the healthy side. Bone mineral content (BMC) and bone mineral densities (BMD) of the femoral neck, femur, tibia, foot and ankle of the affected and the unaffected legs were measured by dual x-ray absorptiometry (Lunar DPXL) and the results compared. RESULTS Bone mineral density was significantly lower in the femur (-3.7%, p = 0.04), the foot and the ankle (-3%, p = 0.05) of the affected leg. There was a non-significant decrease in BMD of the whole femoral neck (-1.2%) and the trochanter (-4.4%, p = 0.08) on the affected side. Tibial bone mineral density was identical in both legs. Bone mineral content was lower on the affected side (-5.3%, p = 0.05) whereas fat mass and muscle mass were the same in both legs. CONCLUSION The ischemia resulting from arterial disease of the lower limbs appears to have a direct deleterious effect on bone mineralization.
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Gaudin V, Libault M, Pouteau S, Juul T, Zhao G, Lefebvre D, Grandjean O. Mutations in LIKE HETEROCHROMATIN PROTEIN 1 affect flowering time and plant architecture in Arabidopsis. Development 2001; 128:4847-58. [PMID: 11731464 DOI: 10.1242/dev.128.23.4847] [Citation(s) in RCA: 180] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In plants, recent studies have demonstrated links between the regulation of developmental processes and chromatin dynamics and organisation. Analysis of new mutations affecting overall plant architecture, leaf development and flowering time in Arabidopsis has allowed us to clone and characterise LHP1, the Drosophila heterochromatin protein 1 (HP1) homologue. LHP1 has the chromo and chromo shadow domains central to the function of animal proteins. Yeast two hybrid studies and in planta deletion experiments suggest similar modes of action in plants and animals via homodimer formation. In vivo localisation experiments revealed a specific subnuclear protein distribution in foci throughout the nucleus. Our data suggest that LHP1 may act as a main regulator of gene expression in plants, through formation of heterochromatin-like repressive complexes, to control developmental pathways involved in organ and cell size, and the vegetative to reproductive phase transition.
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MESH Headings
- Amino Acid Sequence
- Animals
- Arabidopsis/genetics
- Arabidopsis/growth & development
- Arabidopsis Proteins/chemistry
- Arabidopsis Proteins/genetics
- Base Sequence
- Cell Nucleus/genetics
- Chromobox Protein Homolog 5
- Chromosomal Proteins, Non-Histone/chemistry
- Chromosomal Proteins, Non-Histone/genetics
- Cloning, Molecular
- Conserved Sequence
- DNA, Complementary/genetics
- DNA, Plant/genetics
- Dimerization
- Gene Expression Regulation, Developmental
- Gene Expression Regulation, Plant
- Genes, Plant
- Molecular Sequence Data
- Mutation
- Plant Leaves/growth & development
- Protein Structure, Tertiary
- Sequence Homology, Amino Acid
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Penel N, Fournier C, Kara A, Sarini J, Lefebvre D. [Anticancer chemotherapy, risk factor for infection at the operated site in cervicofacial surgery]. Presse Med 2001; 30:892-5. [PMID: 11413843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND In order to evaluate occurrence and risk factors for wound infection (WI) in head and neck uncontaminated surgery, we carried out a prospective study. METHODS From january 1997 through january 1999, we prospectively evaluated 212 wounds of all patients having uncontaminated head and neck surgery at the Oscar Lambret Cancer Center (neck dissections, parotidectomies, thyroidectomies, explorative cervicotomies, cutaneous resections). No antibiotic prophylaxis was given. WI was defined as a wound with pus. Statistical evaluation was performed using the chi 2 test. In univariate analysis, differences were considered significant p < 0.05. RESULTS The overall WI rate was 6.6% (14/212). In univariate analysis, previous chemotherapy is the only risk factor for WI were: (p < 0.00001). Multivariate analysis was not performed. CONCLUSION Like other cancer locations, chemotherapy was a major risk factor for WI. In these cases, a phase ill trial could confirm efficacy of standard antibiotic.
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Pietersma D, Lacroix R, Lefebvre D, Block TE, Wade KM. A case-acquisition and decision-support system for the analysis of group-average lactation curves. J Dairy Sci 2001; 84:730-9. [PMID: 11286426 DOI: 10.3168/jds.s0022-0302(01)74527-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case-acquisition and decision-support system was developed to support the analysis of group-average lactation curves and to acquire example cases from domain specialists. This software was developed through several iterations of a three-step approach involving 1) problem analysis and formulation in consultation with two dairy nutrition specialists; 2) development of a case-acquisition and decision-support prototype by the system developer; and 3) use of the prototype by the domain specialists to analyze and classify milk-recording data from example herds. The overall problem was decomposed into three subproblems: removal of outlier tests and lactation curves of individual cows; interpretation of group-average lactation curves; and diagnosis of detected abnormalities at the herd level through the identification of potential management deficiencies. For each subproblem, a software module was developed allowing the user to analyze both graphical and numerical performance representations and classify these representations using predefined linguistic descriptors. The example-based method for the development of the program proved to be very useful, facilitating the communication between system developer and domain specialists, and allowing the specialists to explore the appropriateness of the various prototypes developed. The resulting software represents a formalization of the approach to group-average lactation curve analysis, elicited from the two domain specialists. In future research, the case-acquisition and decision-support system will be complemented with knowledge to automate identified classification tasks, which will be captured through the application of machine-learning techniques to example cases, acquired from domain specialists using the software.
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Penel N, Lefebvre D, Fournier C, Sarini J, Kara A, Lefebvre JL. Risk factors for wound infection in head and neck cancer surgery: A prospective study. Head Neck 2001; 23:447-55. [PMID: 11360305 DOI: 10.1002/hed.1058] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The goal of this prospective study is to determine risk factors for wound infections (WI) for patients with head and neck cancer who underwent surgical procedure with opening of upper aerodigestive tract mucosa. METHODS One hundred sixty-five consecutive surgical procedures were studied at Oscar Lambret Cancer Center within a 24-month interval. Twenty-five variables were recorded for each patient. Statistical evaluation used Chi2 test analysis (categorical data) and Mann-Whitney test (continuous variables). RESULTS The overall rate of WI was 41.8%. Univariate analysis indicated that five variables were significantly related to the likelihood of WI: tumor stage (p =.044), previous chemotherapy (p =.008), duration of preoperative hospital stay (p = 022), permanent tracheostomy (p =.00008), and hypopharyngeal and laryngeal cancers (p =.008). CONCLUSIONS Despite antibiotic prophylaxis, WI occurrence is high. These data inform the head and neck surgeon, when a patient is at risk for WI and may help to design future prospective studies.
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Lefebvre D, Penel N, Deberles MF, Fournier C. [Incidence and surgical wound infection risk factors in breast cancer surgery]. Presse Med 2000; 29:1927-32. [PMID: 11244620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND In order to evaluate occurrence and risk factors for wound infection (WI) in breast cancer surgery, we carried out a prospective study. METHODS From September 1996 through April 1997, an infection control physician prospectively evaluated 542 wounds of all patients having breast cancer surgery at the Oscar Lambret Cancer Center. WI was defined as a wound with pus. Antibiotic prophylaxis was given in case of immediate breast reconstruction. Statistical evaluation was performed using the c < or = test for categorial data and non-parametric Mann-Whitney test for continuous data. In univariate analysis, differences were considered significant at p < 0.01. RESULTS The overall WI rate was 3.51% (19/352). In univariate analysis, risk factors for WI were: total preoperative hospital stay (p = 0.01), previous chemotherapy (p = 0.01), previous oncologic surgery (p = 0.03) and immediate breast reconstruction (p = 0.002). In mutivariate analysis, we observed two independent predictive factors for WI: previous chemotherapy (p = 0.05) and immediate breast reconstruction (p = 0.02). CONCLUSIONS Previous anticancer chemotherapy was a major risk factor. In these cases, a phase III trial could confirm efficacy of standard antibiotic prophylaxis. Breast reconstruction was the second major risk factor. Standard antibiotic prophylaxis (used in our study) was insufficient.
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Arsenault HH, Lefebvre D. Homomorphic cameo filter for pattern recognition that is invariant with changes in illumination. OPTICS LETTERS 2000; 25:1567-1569. [PMID: 18066278 DOI: 10.1364/ol.25.001567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We introduce a new matched filter method that yields correlation peaks that are invariant with changes in the illumination of any targets. A scene containing objects at unknown locations is first subjected to a logarithmic transformation that changes the multiplicative constant to an additive background, which is then discriminated against by means of a composite filter containing a cameo of the true target and a term with which to discriminate against other false targets. Experimental results are shown.
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Penel N, Lefebvre D, Lefebvre JL. [Wound infection in head and neck cancer surgery]. Bull Cancer 1999; 86:985-95. [PMID: 10660693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Wound infections (WIs) are the main cause of post-surgical morbidity in head and neck surgery. They arise with an especially immunocompromised predisposition and mainly involve oropharyngeal flora bacteria. However, the assessment of the incidence of these infections differs in the literature (0 to 87%). This in part accounts for the lack of a real consensus as to the definition (do all mucocutaneous fistulae attest to WIs?). For this reason, the analysis of their risk factors and the means of the prevention is difficult. In class 1 surgery, the incidence of WIs ranges 0 to 6%. In this case, antiobioprophylaxis does not seem to be justified. In surgery opening the mucosa, it is difficult to classify the surgical procedures in Altemeier's classes 2 and 3. There are many arguments, in particular physiopathological arguments, to consider that the contamination of surgical bed of surgery does continue after the operation. The incidence of WIs varies widely from one study to the next. Without antibiotic prophylaxis, from 40 to 87% WIs are observed. With preventive antibiotherapy, the incidence ranges between 3.4 to 47%. Various risk factors have been described, in particular: tumour size and node extension, tracheotomy prior to surgery. Four multi-factor studies have shown, in multivariate analysis, totally different risk factors. The prevention of these WIs is currently based on hospital hygiene rules and antibiotic prophylaxis. The optimum conditions have still not been determined. Reliable data to define, the incidence and risk factors of these WIs are missing. New prospective studies are definitely required.
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Moscovici J, Galinier P, Hammoudi S, Lefebvre D, Juricic M, Vaysse P. Contribution to the study of the venous vasculature of the penis. Surg Radiol Anat 1999; 21:193-9. [PMID: 10431333 DOI: 10.1007/bf01630901] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The penile veins are thought to be responsible for some erectile disorders. The aim of this study was to describe the anatomy and function of these veins. The venous systems of 25 cadaveric penises were studied by various anatomic and histologic techniques. The superficial veins arising from the tegumentary layers drain into the superficial dorsal vein which in three-quarters of cases empties into the left great saphenous vein. The veins of the deep internal system, running below the deep fascia of the penis, emerge from the erectile bodies and can be divided into two systems, one anterosuperior and the other posteroinferior. The anterosuperior system comprises the veins of the glans which will form the deep dorsal vein; the latter receives blood from the medial portion of the corpus spongiosum and from the free portion of the corpora cavernosum mainly via the circumflex veins. It ends in the pre-prostatic plexus. The posteroinferior system, issuing from the posterior portion of the erectile bodies, is composed of the bulbar, cavernous and crural veins which drain towards the pre-prostatic plexus and the internal pudendal veins. Anastomoses link the two networks, superficial and deep. Study of the structure of the veins of the deep system reveals the presence of muscular cushions, which we have shown to have adrenergic innervation. These findings are compared with those of the literature, which show variations which are mainly of number. The place of veins in the mechanism of erection is discussed.
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Adam F, Libier M, Oszustowicz T, Lefebvre D, Beal J, Meynadier J. Preoperative small-dose ketamine has no preemptive analgesic effect in patients undergoing total mastectomy. Anesth Analg 1999; 89:444-7. [PMID: 10439763 DOI: 10.1097/00000539-199908000-00036] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We evaluated the preemptive analgesic effect of a small dose of ketamine given before or immediately after surgery in a randomized, double-blinded study performed in 128 women undergoing total mastectomy. Group 1 patients received ketamine 0.15 mg/kg as a 5-mL i.v. injection 5 min before surgery and isotonic saline 5 mL i.v. at the time of skin closure. Group 2 received 5 mL i.v. of isotonic saline, then 0.15 mg/kg i.v. ketamine. A standard general anesthesia procedure including sufentanil was used. In the recovery room, patient-controlled analgesia i.v. morphine was used for postoperative analgesia. Postoperative pain was assessed by measuring morphine consumption and visual analog scale pain scores. No significant intergroup differences were seen in the pain scores. Patient-controlled analgesia morphine consumption was lower during the first 2 h after surgery in patients given ketamine at the time of skin closure. No patient complained of hallucinations or nightmares. The incidence of adverse effects was not different between the two groups. In conclusion, administering ketamine at the end of surgery is more effective in reducing morphine consumption than it is when given before surgery. IMPLICATIONS We administered the same small dose of ketamine before or after surgery. The preoperative administration of 0.15 mg/kg ketamine in patients undergoing total mastectomy did not elicit a preemptive analgesic effect. Ketamine given at closure reduced the patient-controlled analgesia morphine requirement in the first 2 h after surgery.
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Allouche-Cometto L, Leger P, Rousseau H, Lefebvre D, Bendayan P, Elefterion P, Boccalon H. Comparative of blood flow to the ankle-brachial index after iliac angioplasty. INT ANGIOL 1999; 18:154-7. [PMID: 10424373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Interest of blood flow and ankle brachial pressure index (ABPI) to evaluate result of iliac angioplasty. METHODS ABPI and blood flow rates were measured before and after angioplasty in 22 lower extremities of 16 patients with iliac stenosis. Blood flow rates were determined by means of a nuclear magnetic resonance (NMR) flow meter. RESULTS The day after angioplasty, flow and pressure were increasing significantly, whereas a month later, only blood flow was increasing significantly. In a group of patients with near-normal ABPI before angioplasty (ABPI > or = 0.8), there was, on the day following the angioplasty, a significant increase in ABPI and pulsatile blood flow rates; flow rates increased considerably a month after the operation whereas ABPI stay stable. In a group of patients with clearly abnormal ABPI before angioplasty (ABPI <0.80), there was a significant increase in ABPI and blood flow rates the day after angioplasty and again a month later. CONCLUSIONS Flow therefore seems to vary independently of pressure. The possible use of flow measurement to detect restenoses is yet to be studied.
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Lefebvre D, Boney CM, Ketelslegers JM, Thissen JP. Inhibition of insulin-like growth factor-I mitogenic action by zinc chelation is associated with a decreased mitogen-activated protein kinase activation in RAT-1 fibroblasts. FEBS Lett 1999; 449:284-8. [PMID: 10338149 DOI: 10.1016/s0014-5793(99)00419-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The mechanisms responsible for the resistance to the anabolic actions of IGF-I induced by zinc deficiency are not understood. We showed that zinc chelation by DTPA (diethylenetriaminepenta-acetic acid) inhibits [3H]thymidine incorporation stimulated by IGF-I in Rat-1 fibroblasts. This inhibition was specific of zinc chelation since it was prevented by the addition of zinc to DTPA. The stimulation of MAPK, which is crucial for the [3H]thymidine incorporation induced by IGF-I in Rat-1 cells, was partially blunted by DTPA. Therefore, the inhibition of the mitogenic action of IGF-I in Rat-1 fibroblasts by DTPA is potentially caused by decreased MAPK activation by IGF-I.
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