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Barbarot S, Aubert H, Stalder JF, Roye S, Delarue A. The Patient-Oriented Scoring of Atopic Dermatitis and SCORAD in young children: New data on interpretability and clinical usefulness. J Eur Acad Dermatol Venereol 2024; 38:175-181. [PMID: 37669855 DOI: 10.1111/jdv.19494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/27/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND There is limited data about the clinical meaningfulness of the Scoring of Atopic Dermatitis (SCORAD) and Patient-Oriented SCORAD (PO-SCORAD), particularly in children with mild-to-moderate AD. Regular use of patient-reported outcomes, may deliver more accurate information about the overall health status of AD patients than routine but sparse physician assessments. OBJECTIVE To confirm the correlation between SCORAD, PO-SCORAD, Patient-Oriented Eczema Measure (POEM) and Investigator's Global Assessment (IGA). To evaluate the interpretability and clinical usefulness of the SCORAD and PO-SCORAD scores in children. METHODS Data were drawn from a 12-week randomized controlled trial in 335 children, aged 2-6 years, with mainly mild-to-moderate AD. Investigators captured SCORAD and IGA at each study visit. Parents used PO-SCORAD twice-weekly, and POEM once-weekly. RESULTS There were strong correlations between PO-SCORAD and SCORAD (r = 0.874), PO-SCORAD and POEM (0.734) and PO-SCORAD and IGA (0.613). The best fit ('k' statistic: 0.68) between SCORAD and IGA classes was noted for the following SCORAD categories: <12 (clear/almost clear); 12-25 (mild); and ≥25 (moderate/severe). PO-SCORAD area under the curve over 8 weeks was significantly greater than that of SCORAD (p = 0.0002), giving a better estimate of disease severity between visits. Patients with a flare within the next 7 days had significantly higher PO-SCORAD scores 7 days before the flare (p < 0.0001). Moderate erythema was the most significant flare predictor (p < 0.0001). CONCLUSION PO-SCORAD is robust and reliable and appears to warrant far greater utility in routine clinical practice than other scores. PO-SCORAD, used twice-weekly, may improve the management of patients with AD.
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Affiliation(s)
- S Barbarot
- Department of Dermatology, CHU Nantes, INRAE, UMR 1280, PhAN, Nantes Université, Nantes, France
| | - H Aubert
- Department of Dermatology, CHU, Nantes Université, Nantes, France
| | - J-F Stalder
- Department of Dermatology, CHU, Nantes Université, Nantes, France
| | - S Roye
- Institut de Recherche Pierre Fabre, Toulouse, France
| | - A Delarue
- Pierre Fabre Dermatologie, Lavaur, France
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Delarue A, Godart F, Baudelet J, Domanski O, Houeijeh A. The effects of pulmonary branches stenting on the pulmonary arteries hemodynamic and growth kinetic. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Fontanges PA, De Jonkheere J, Baudelet J, Godart F, Domanski O, Delarue A, Houeijeh A. Clinical hypnosis associated with local anesthesia for cardiac catheterization in pediatric population. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Delarue A, Godart F, Domanski O, Baudelet J, Rakza T, Houeijeh A. The effects of pulmonary branches stenting on the pulmonary arteries hemodynamic and growth kinetic. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kettroussi M, Mur S, Bonnevalle M, Godart F, Sfeir R, Le Duc K, Domanski O, Baudelet J, Rakza T, Delarue A, Fayoux P, Storme L, Houeijeh A. Immediate and midterm adverse events after the surgical closure of the patent ductus arteriosus in preterm newborns. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Delarue A, Dragon-Durey MA, Darnige L. [Contribution of antiphosphatidylserine/prothrombin (anti-PS/PT) antibody detection in the diagnosis and management of antiphospholipid syndrome (APS)]. Rev Med Interne 2022; 43:545-551. [PMID: 35752484 DOI: 10.1016/j.revmed.2022.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 10/17/2022]
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disease and one of the most common causes of acquired thrombophilia. It is characterised by the occurrence of thrombotic or obstetric events associated with the presence of persistent antiphospholipid antibodies. The diagnosis can be challenging, particularly because some biological tests can be disturbed by anticoagulant treatment or inflammation. In the recent years, new antiphospholipid antibodies, including anti-phosphatidylserine/prothrombin antibodies (anti-PS/PT), have emerged but their clinical significance and causality remain uncertain. Biologically, several studies have found a strong correlation between the presence of lupus anticoagulant (LA) and anti-PS/PT antibodies. Clinically, the presence of anti-PS/PT antibodies is associated with an increased risk of thrombosis and obstetric complications. There is also an association with thrombocytopenia, suggesting that the presence of anti-PS/PT antibodies may be associated with more severe clinical APS. Among seronegative APS patients, 6-17% of patients are positive for anti-PS/PT antibodies. This might influence the therapeutic management of patients. This article aims to provide an update on contribution of anti-PS/PT antibodies detection for the diagnosis and management of APS.
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Affiliation(s)
- A Delarue
- Service de médecine vasculaire, Assistance Publique-hôpitaux de Paris-Centre (AP-HP.CUP), 75015 Paris, France
| | - M-A Dragon-Durey
- Service d'immunologie biologique, Assistance Publique-hôpitaux de Paris-Centre (AP-HP.CUP), 75015 Paris, France
| | - L Darnige
- Service d'hématologie biologique, Assistance Publique-hôpitaux de Paris-Centre (AP-HP.CUP), 75015 Paris, France; Université de Paris, Inserm, Innovative Therapies in Haemostasis, 75006 Paris, France.
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Guédon A, Delarue A, Mohamedi N, Roffé A, Khider L, Gendron N, Goudot G, Détriché G, Chocron R, Oudard S, Smadja D, Mirault T, Messas E. Relationship between kalemia and intensive care unit admission or death in hospitalized COVID-19 patients: A cohort study. JMV-Journal de Médecine Vasculaire 2022; 47:3-10. [PMID: 35393089 PMCID: PMC8557982 DOI: 10.1016/j.jdmv.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023]
Abstract
Background Methods Results Conclusion
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Izaaryene J, Tradi F, Vidal V, Bartoli JM, Delarue A, Petit P. Transjugular intrahepatic portosystemic shunt placement in an infant weighing less than 22 pounds. Diagn Interv Imaging 2020; 101:685-687. [PMID: 32307283 DOI: 10.1016/j.diii.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/13/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- J Izaaryene
- Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France.
| | - F Tradi
- Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France
| | - V Vidal
- Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France
| | - J-M Bartoli
- Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France
| | - A Delarue
- University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France; Department of Pediatric Surgery, Hopital de la Timone, 13005 Marseille, France
| | - P Petit
- Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France
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Faye O, Meledie N'Djong AP, Diadie S, Coniquet S, Niamba PA, Atadokpede F, Yao Yoboue P, Thierno Dieng M, Zkik A, Castagne C, Zumaglini F, Delarue A. Validation of the Patient-Oriented SCORing for Atopic Dermatitis tool for black skin. J Eur Acad Dermatol Venereol 2019; 34:795-799. [PMID: 31587383 PMCID: PMC7154547 DOI: 10.1111/jdv.15999] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/05/2019] [Indexed: 01/14/2023]
Abstract
Background SCORing for Atopic Dermatitis (SCORAD) is a tool developed by the European Task Force on Atopic Dermatitis (AD) which is used by physicians to assess AD severity during consultations with their patients. Patient‐Oriented SCORAD (PO‐SCORAD) is a self‐assessment tool for use by patients which has been validated in a study performed in European countries. However, there is currently no adapted tool for evaluating AD severity in black skin. Objective To evaluate the performance of the version of the PO‐SCORAD specifically adapted for black skin patients (children and adults) with AD. Methods In this multicenter, cross‐sectional and non‐interventional study, children and adults with AD were recruited during regular consultations. This international study was performed in seven sub‐Saharan countries (Benin, Burkina Faso, Cameroon, Ivory Coast, Gabon, Mali and Senegal). During the consultation, AD severity was assessed by the physician using SCORAD score and by the patients or parents using PO‐SCORAD. Results One hundred and thirteen patients were included, 72 children and 41 adults, mainly females (61.6%). SCORAD assessed by physicians and PO‐SCORAD assessed by patients/parents were well correlated (r = 0.66, P < 0.0001). Correlation coefficients for SCORAD and PO‐SCORAD subscale scores were also good, except for symptom intensity criteria. Conclusion Altogether, these data indicate that PO‐SCORAD for black skin correlates well with SCORAD and is therefore a valuable tool, which requires no specific level of education, for use by black skin patients with AD.
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Affiliation(s)
- O Faye
- Dermatology Unit, Marchoux Institute, Bamako, Mali
| | | | - S Diadie
- Le Dantec University Hospital, Dakar, Senegal
| | - S Coniquet
- Libreville University Hospital, Libreville, Gabon
| | - P A Niamba
- Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso
| | - F Atadokpede
- Hubert Koutoukou Maga National University Hospital, Cotonou, Benin
| | - P Yao Yoboue
- Treichville University Hospital, Abidjan, Ivory Coast
| | | | - A Zkik
- Pierre Fabre, Boulogne Billancourt, France
| | - C Castagne
- Pierre Fabre, Boulogne Billancourt, France
| | | | - A Delarue
- Pierre Fabre Dermatologie, Lavaur, France
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Tiplica G, Boralevi F, Konno P, Malinauskiene L, Kaszuba A, Laurens C, Saint-Aroman M, Delarue A. The regular use of an emollient improves symptoms of atopic dermatitis in children: a randomized controlled study. J Eur Acad Dermatol Venereol 2018; 32:1180-1187. [DOI: 10.1111/jdv.14849] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/18/2018] [Indexed: 01/09/2023]
Affiliation(s)
- G.S. Tiplica
- 2nd Dermatology Clinic; Colentina Clinical Hospital; “Carol Davila” University of Medicine; Bucharest Romania
| | - F. Boralevi
- Pediatric Dermatology unit; Hôpital Pellegrin-Enfants; CHU Bordeaux; University Hospital of Bordeaux; Bordeaux France
| | - P. Konno
- East-Tallinn Central Hospital; Tallinn Estonia
| | - L. Malinauskiene
- Center of Allergy; Vilnius City Clinical Hospital Antakalnis affiliation; Vilnius Lithuania
| | - A. Kaszuba
- Specjalistyczne Gabinety Lekarskie; “DERMED”; Lodz Poland
| | - C. Laurens
- Pierre Fabre Dermatologie; Lavaur France
| | | | - A. Delarue
- Pierre Fabre Dermatologie; Lavaur France
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Chong JH, Prey S, Mya HT, Delarue A, Labreze C. Can the extent of heart rate reduction predict the clinical response of infantile haemangiomas to propranolol? Br J Dermatol 2018; 178:e196-e197. [PMID: 28886210 DOI: 10.1111/bjd.15966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J H Chong
- Department of Pediatric Medicine, Dermatology Service, KK Women's & Children's Hospital, 100 Bukit Timah Road, Singapore, 229899.,Department of Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - S Prey
- Department of Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - H T Mya
- Department of Hematology, Singapore General Hospital, Singapore
| | - A Delarue
- Pierre Fabre Dermatologie, Lavaur, France
| | - C Labreze
- Department of Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
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Szepietowski J, Wolkenstein P, Veraldi S, Tennstedt D, Machovcová A, Delarue A. Acne across Europe: an online survey on perceptions and management of acne. J Eur Acad Dermatol Venereol 2017; 32:463-466. [DOI: 10.1111/jdv.14719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology; Medical University; Wroclaw Poland
| | - P. Wolkenstein
- Department of Dermatology; Hôpital Henri Mondor; APHP, UPEC; Créteil France
| | - S. Veraldi
- Department of Pathophysiology and Transplantation; University of Milan; Milan Italy
| | - D. Tennstedt
- Department of Dermatology; UCL, Cliniques Universitaires St-Luc; Brussels Belgium
| | - A. Machovcová
- Department of Dermatology and Venereology; Motol Hospital; Prague Czech Republic
| | - A. Delarue
- Pierre Fabre Dermatologie; Les Cauquillous; Lavaur France
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Wolkenstein P, Machovcová A, Szepietowski J, Tennstedt D, Veraldi S, Delarue A. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol 2017; 32:298-306. [DOI: 10.1111/jdv.14475] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/28/2017] [Indexed: 11/26/2022]
Affiliation(s)
- P. Wolkenstein
- Department of Dermatology; Hôpital Henri Mondor; APHP; UPEC; Créteil France
| | - A. Machovcová
- Department of Dermatology and Venerology; Motol Hospital; Prague Czech Republic
| | - J.C. Szepietowski
- Department of Dermatology, Venerology and Allergology; Medical University; Wroclaw Poland
| | - D. Tennstedt
- Department of Dermatology; UCL; Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - S. Veraldi
- Department of Pathophysiology and Transplantation; University of Milan; Milan Italy
| | - A. Delarue
- Pierre Fabre Dermatologie; Les Cauquillous; Lavaur France
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Martini J, Huertas C, Turlier V, Saint-Martory C, Delarue A. Efficacy of an emollient cream in the treatment of xerosis in diabetic foot: a double-blind, randomized, vehicle-controlled clinical trial. J Eur Acad Dermatol Venereol 2017; 31:743-747. [DOI: 10.1111/jdv.14095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 11/09/2016] [Indexed: 11/26/2022]
Affiliation(s)
- J. Martini
- Endocrinology Department; Rangueil University Hospital; Toulouse France
| | - C. Huertas
- Podology Unit; Purpan University Hospital; Toulouse France
| | - V. Turlier
- Pierre Fabre Dermo-Cosmétique; Centre de Recherche sur la Peau; Hôtel-Dieu; Toulouse France
| | - C. Saint-Martory
- Pierre Fabre Dermo-Cosmétique; Centre de Recherche sur la Peau; Hôtel-Dieu; Toulouse France
| | - A. Delarue
- Pierre Fabre Dermatologie; Lavaur France
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van der Sluiszen NNJJM, Vermeeren A, Jongen S, Theunissen EL, van Oers ACM, Van Leeuwen CJ, Maret A, Desforges C, Delarue A, Ramaekers JG. On-the-road driving performance after use of the antihistamines mequitazine and l-mequitazine, alone and with alcohol. Psychopharmacology (Berl) 2016; 233:3461-9. [PMID: 27488192 PMCID: PMC4989021 DOI: 10.1007/s00213-016-4386-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/18/2016] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Previous studies demonstrated that mequitazine produces mild sedation after single doses. Its enantiomer, l-mequitazine, has a stronger potency for the H1 receptor. The aim of the current study was to assess the effects of l-mequitazine and mequitazine, alone and with alcohol, on driving. METHODS Twenty-five healthy volunteers were treated with l-mequitazine 2.5, 5.0 and 10 mg, mequitazine 10 mg and placebo, alone and in combination with alcohol in a double-blind crossover design. Driving performance was assessed using the standardized highway driving test in normal traffic. Its primary measure is the Standard Deviation of the Lateral Position (SDLP). Secondary measures consisted of an auditory word learning test during driving, and subjective measures of driving performance. RESULTS L-mequitazine 2.5 and 5.0 mg showed no effect on SDLP in the highway driving test, while SDLP significantly increased after l-mequitazine 10 mg (alone +1.59 cm; with alcohol +1.41 cm) and mequitazine 10 mg (with alcohol +1.17 cm). Alcohol significantly impaired all performance measures (SDLP +2.63 cm) but did not interact with the effects of treatment. Subjective measures indicated that participants were aware of the impairing effects of alcohol, but not of l-mequitazine and mequitazine. CONCLUSION L-mequitazine can be considered safe to drive in dosages of 2.5 and 5.0 mg. L-mequitazine 10 mg led to mild driving impairment. Alcohol impaired all performance measures and added to the effects of l-mequitazine and mequitazine.
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Affiliation(s)
- N N J J M van der Sluiszen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
| | - A Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - S Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - E L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - A C M van Oers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - C J Van Leeuwen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - A Maret
- Institut de Recherche Pierre Fabre, Ramonville, France
| | - C Desforges
- Institut de Recherche Pierre Fabre, Ramonville, France
| | - A Delarue
- Institut de Recherche Pierre Fabre, Ramonville, France
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
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Affiliation(s)
- C Labrèze
- Pediatric Dermatology Unit, Pellegrin Children's Hospital, Place Amélie Raba-Leon, Bordeaux, 33076, France.
| | | | - A Delarue
- Pierre Fabre Dermatologie, Lavaur, France
| | - N Moore
- Departement de Pharmacologie, Université de Bordeaux, Bordeaux, France
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Collin P, Yoshida M, Delarue A, Lucas C, Jossaume T, Lädermann A. Evaluating postoperative rotator cuff healing: Prospective comparison of MRI and ultrasound. Orthop Traumatol Surg Res 2015; 101:S265-8. [PMID: 26283053 DOI: 10.1016/j.otsr.2015.06.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/16/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this prospective comparative single centre study was to compare postoperative rotator cuff healing rates as assessed by magnetic resonance imaging (MRI) versus ultrasonography (US). MATERIAL AND METHODS Between October 2012 and February 2013, 61 patients underwent arthroscopic repair of postero-superior rotator cuff tears. Each patient underwent MRI and US 6 months later. The findings were assessed independently by two observers. We compared intra-observer and inter-observer levels of agreement regarding healing rates assessed by MRI and US. RESULTS Intra-observer agreement regarding the MRI interpretation was 95% (κ coefficient, 0.83) for one observer and 98% (κ coefficient, 0.94) for the other. Values of κ for inter-observer agreement ranged across readings from 0.76 to 0.90. When MRI was taken as the reference, US had 80% sensitivity and 98% specificity. DISCUSSION MRI and US provide similar assessments of postoperative rotator cuff healing, although US is less sensitive. Intra-observer and inter-observer agreements are very good.
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Affiliation(s)
- P Collin
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France.
| | - M Yoshida
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France; Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - A Delarue
- Service de kinésithérapie, Unité de Réadaptation Fonctionnelle en Milieu Professionnel Le Patis Fraux, 35770 Vern-sur-Seiche, France
| | - C Lucas
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France
| | - T Jossaume
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France
| | - A Lädermann
- Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpitaux Universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland; Faculté de médecine, Université de Genève, rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital de La Tour, rue J.-D.-Maillard 3, 1217 Meyrin, Switzerland
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Saudez, Tiplica G, Delarue A. P-361 – Les émollients: traitement en prévention des poussées de DA. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Prey S, Voisard JJ, Ortis V, Delarue A, Lebbé G, Taïeb A, Ezzedine K, Leaute-Labreze C. Trois ans de données de tolérance du propranolol dans le traitement de l’hémangiome infantile en France grâce à l’analyse de la base de données de vigilance de l’ATU. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Boralevi F, Saint Aroman M, Delarue A, Raudsepp H, Kaszuba A, Bylaite M, Tiplica GS. Long-term emollient therapy improves xerosis in children with atopic dermatitis. J Eur Acad Dermatol Venereol 2013; 28:1456-62. [PMID: 24267728 DOI: 10.1111/jdv.12314] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 10/11/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hydration with topical emollients forms the backbone of treatment for mild atopic dermatitis (AD), but few randomized controlled trials have assessed their efficacy in young children. OBJECTIVES Assess the efficacy and tolerability of long-term emollient therapy in the treatment of moderate to severe xerosis in young children with AD. METHODS This was a phase III, multicentre, double-blind, randomized, vehicle-controlled trial. Children (n = 251) aged 2-6 years with AD-associated xerosis were randomized 1 : 1 to a 28-day treatment with an emollient combining glycerol and paraffin or its vehicle. Non-responders at the end of the double-blind period were treated open label with emollient until day 84. Responders stopped treatment until reassessment on day 56. Those who relapsed after stopping treatment were treated open label with emollient until day 84. RESULTS During the double-blind period, xerosis score (XS) of the scoring atopic dermatitis (SCORAD) index, objective SCORAD and visual analogue score decreased and skin hydration increased more in the emollient group than in the vehicle group (P < 0.001 for all measures). More patients were responders with emollient than with vehicle (66.1% vs. 45.6%, P < 0.001). During the open-label period, stopping emollient treatment led to relapse but improvement returned if treatment was restarted with emollient. Regular use of the emollient also yielded improvement in children who did not initially respond. Adverse events were similar in the two groups, and no treatment-related severe adverse events were reported. CONCLUSIONS Long-term therapy with emollient is effective and well tolerated for the treatment of xerosis in children with atopic dermatitis.
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Affiliation(s)
- F Boralevi
- Pediatric Dermatology Unit, CHU Bordeaux, University Hospital of Bordeaux, Hôpital Pellegrin-Enfants, Bordeaux, France; CIC 0005, Centre d'investigation clinique, Bordeaux, France
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Blanchet-Bardon C, Tadini G, Machado Matos M, Delarue A. Association of glycerol and paraffin in the treatment of ichthyosis in children: an international, multicentric, randomized, controlled, double-blind study. J Eur Acad Dermatol Venereol 2011; 26:1014-9. [PMID: 22118417 DOI: 10.1111/j.1468-3083.2011.04304.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Efficacy and tolerance should be considered in topical treatments of chronicle affections with impaired skin barrier function such as ichthyosis. OBJECTIVES To demonstrate the efficacy of Dexeryl in reducing severity of ichthyosis. METHODS A prospective, multicentre, randomized, placebo controlled study was performed with patients under 18 years suffering from a non-bullous form of ichthyosis. A double-blind period using Dexeryl (an emollient cream containing glycerol 15% and paraffin 10%) or placebo (its vehicle) during 4 weeks followed by an open label period with all patients treated by Dexeryl for 8 weeks. Improvement of ichthyosis was assessed by cutaneous xerosis evolution (SRRC score): the percentage of patients with 50% reduction of the SRRC score at D28 was the primary criterion. The assessment of pruritus [visual analogue scale (VAS)], global evaluation and safety were secondary. RESULTS The percentage of patients with at least 50% reduction of SRRC score at D28 was significantly higher in Dexeryl group (60.3%) vs. vehicle group (43.5%; P = 0.008). Reduction of pruritus on VAS was significantly higher at D28 with Dexeryl (-2.16) compared to that in placebo (-1.49), P < 0.05. The improvement continues through the open label period: at D84 we observed -2.5 of SRRC score in the Dexeryl group vs.-1.8 for the group previously treated by vehicle. Investigators found Dexeryl efficacy as satisfying for about 80% of treated patients vs. 50% with vehicle. Concerning safety, most of the adverse events were not related to treatment. CONCLUSIONS Dexeryl showed a significant improvement of xerosis and related symptoms in children with ichthyosis and was well tolerated.
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Campanile M, Nicolas A, LeBel S, Delarue A, Guys JM, de Lagausie P. Frantz's tumor: is mutilating surgery always justified in young patients? Surg Oncol 2010; 20:121-5. [PMID: 20106656 DOI: 10.1016/j.suronc.2009.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 12/16/2009] [Accepted: 12/16/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND Solid pseudopapillary tumor (Frantz's tumor) of the pancreas is a rare lesion. It is of low-grade malignancy but can cause extensive local invasion. The aim of this study was to assess the outcome of Frantz's tumors after incomplete resection. METHODS We contacted all authors who published case reports describing incomplete resection of Frantz's tumor between 1985 and 2008 to request follow-up information. RESULTS Follow-up information was obtained for 11 out 18 patients who underwent incomplete resection. Estimated median survival rate was 5.7 years (69.5 months). CONCLUSION Since Frantz's tumor typically develops mainly in children and young women, a 5.7 year survival rate is unacceptable. Thus complete resection of locally invasive solid-pseudopapillary tumor of the pancreas is always justified, even at the price of difficult, mutilating surgery.
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Affiliation(s)
- M Campanile
- Department of Pediatric Surgery, Hôpital Timone Enfants, Marseille, France.
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Delarue A, Bergeron C, Mechinaud-Lacroix F, Coze C, Raphael M, Patte C, Patte C. Lymphome non-Hodgkinien de l’enfant : Prise en charge chirurgicale lors d’un tableau abdominal révélateur. ACTA ACUST UNITED AC 2008; 145:454-8. [DOI: 10.1016/s0021-7697(08)74655-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Delarue A, Bergeron C, Mechinaud-Lacroix F, Coze C, Raphael M, Patte C. [Pediatric non-Hodgkin's lymphoma: primary surgical management of patients presenting with abdominal symptoms. Recommendations of the Lymphoma Committee of the French Society to Combat Pediatric Cancers (SFCE)]. J Chir (Paris) 2008; 145:454-458. [PMID: 19106866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Over the past two decades, dramatic improvements in the treatment of children with Non-Hodgkin's Lymphoma have led to cure rates close to 90%, even in advanced-stage disease. The most frequent localization is abdominal, where Burkitt or Burkitt-like subtypes are predominant. Initial management often occurs in the setting of a urgent surgical intervention where multiple complications may gravely threaten prognosis within days or even hours. The SFCE Lymphoma Committee's guidelines for optimal management include: 1) The diagnosis of lymphoma should be systematically evoked whenever the clinical context is not consistent with idiopathic intussusception, particularly in children over the age of 3 or when clinical and/or ultrasound findings are not typical; 2) Limited bowel resection should be performed only if it allows complete tumor removal and is technically simple without extensive dissection or risk of major complications; 3) If surgical resection is likely to be difficult, risky, or incomplete, surgery should be limited to sampling of peritoneal fluid and tumor; 4) In all cases, adequate tissue should be obtained and sent to the pathology department in appropriate media Analysis of tumor material may require, in addition to histology and cytology, immunophenotyping, cytogenetics, and molecular biology studies in order to arrive at an accurate diagnosis and prognosis and to guide treatment choices.
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Affiliation(s)
- A Delarue
- Service de chirurgie pédiatrique, hôpital d'enfants de la Timone - Marseille.
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Affiliation(s)
- S Zeidan
- Department of Pediatric Surgery, Timone-Enfants Hospital, Marseille, France.
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de Lagausie P, Bonnard A, Berrebi D, Lepretre O, Statopoulos L, Delarue A, Guys JM. Abdominal lymphangiomas in children: interest of the laparoscopic approach. Surg Endosc 2006; 21:1153-7. [PMID: 17177082 DOI: 10.1007/s00464-006-9091-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Revised: 07/11/2006] [Accepted: 08/02/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Lymphangiomas are rare benign lesions of the lymphatic system. The most common symptoms are abdominal tumor or "acute abdomen" in children. The treatment of choice is complete surgical resection, but the recurrence rate with incomplete resection is high, and laparotomy exposes the patient to adhesions. The authors report their experience with the lymphangioma laparoscopic approach. METHODS This retrospective study examined 15 consecutive operations for lymphangiomas in children, ages 5 months to 14 years, treated during the 5-year period from 1999 to 2004. RESULTS Six patients were treated using the primary laparotomy approach, and nine patients underwent the laparoscopic procedure, six successfully. Three conversions were necessary (1 case requiring partial colectomy, 1 retroperitoneal case with adherence on the aorta and vena cava, 1 case with partial volvulus). Morbidity included two cases of acute occlusion caused by adhesions after laparotomy. There was no recurrence of lymphangioma during a mean follow-up period of 35 months. CONCLUSION The laparoscopy procedure could be used successfully for abdominal lymphangioma, even in an emergency. When the laparoscopic resection is impossible, laparotomy or sclerotherapy can be discussed.
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Affiliation(s)
- P de Lagausie
- Service de Chirurgie Pédiatrique, Hôpital d'Enfant la Timone, 264 rue Saint Pierre, 13005, Marseille, France.
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Demazières A, Luthringer R, Coppel E, Gilles C, Fleury C, Roegel JC, Delarue A, Laur C, Lagrue G. Ability of a new oral nicotine substitute to reduce smoking urge in moderate smokers. Addict Behav 2006; 31:537-43. [PMID: 15964703 DOI: 10.1016/j.addbeh.2005.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Revised: 05/09/2005] [Accepted: 05/13/2005] [Indexed: 11/30/2022]
Abstract
The aim of this study was to assess the effectiveness of a new nicotine lozenge ( Nicopass 1.5 mg) in reducing smoking urge after an overnight abstinence. Twenty-four moderate smokers participated in a randomized, double-blind, placebo-controlled, 2-period crossover trial. The results showed that 1.5 mg-nicotine lozenge is superior to placebo in reducing smoking urge (p = 0.0001). In addition, nicotine lozenge, but not placebo, significantly improved vigilance and psychomotor performances (p < 0.05) and displayed a cardiac chronotropic effect. Thus, the 1.5-mg nicotine lozenge appears as an effective aid to alleviate acute tobacco withdrawal symptoms in moderate smokers.
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Affiliation(s)
- A Demazières
- FORENAP Research Institute for Neuroscience, Pharmacology and Psychiatry, 27 rue du 4eme RSM, 68250 Rouffach, France.
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Castagnetti M, Delarue A, Gentet JC. Optimizing the surgical management of lung nodules in children with osteosarcoma: thoracoscopy for biopsies, thoracotomy for resections. Surg Endosc 2004; 18:1668-71. [PMID: 15931485 DOI: 10.1007/s00464-003-9315-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 05/26/2004] [Indexed: 11/26/2022]
Abstract
BACKGROUND The goal of this study was to assess the role of thoracoscopy (TS) and thoracotomy (TT) in the management of lung nodules in children with osteosarcoma. METHODS Charts of 16 osteosarcoma patients undergoing surgery for lung nodules were retrospectively analyzed for a correlation between nodule localization at CT scan, findings at surgery, and pathology. RESULTS Fourteen TSs were performed in 10 children, eight of which were converted: two for technical problems, and six for inconsistency between CT scan and intraoperative findings. In three converted cases, TT allowed detection of more nodules than CT scan and/or TS. Eight TTs were performed as primary intention in seven children, in one as secondary surgery after a previous TS. In three cases, TT detected more nodules than CT scan. Overall, TT detected more nodules than CT scan in seven of 16 cases (sensitivity, 56.2%), six of whom had a predicted bilateral involvement. Neoplastic tissue was present in lung samples of all but three patients (86.4%). CONCLUSIONS Lung nodules in osteosarcoma patients are usually metastases. CT scan is unreliable in detecting all the nodules, especially in the case of predicted bilateral involvement. If excision of all metastases is considered the goal of surgery, a TT approach should be chosen in patients with more than one thoracic nodule.
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Affiliation(s)
- M Castagnetti
- Department of Paediatric Surgery, Hopital d'Enfant de la Timone, Rue Saint-Pierre 264, 13385 Cedex 5, Marseille, France.
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Delarue A, Gerhardt MF, Merrot T, Roquelaure B, Guys JM, Trivin F. The cholecystocolic bypass with jejunal interposition graft for bile acid depletion in bile and portal blood in guinea pigs. Pediatr Surg Int 2003; 19:371-5. [PMID: 12845456 DOI: 10.1007/s00383-003-1013-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2002] [Indexed: 11/29/2022]
Abstract
Ileal bypass and cholecystostomy are used in children with selected cholestatic diseases to lower the bile acid (BA) levels in bile and blood and improve outcome. The efficacy of a cholecystocolic bypass in achieving the same goals was investigated in guinea pigs. In the study group (n=7), a cholecystocolic bypass was performed using a jejunal graft interposed between the gallbladder and the cecum. In the control group (n=5), a cholecystojejunal bypass was performed with a similar graft implanted in the proximal jejunum. Total BA concentration was measured in bile and portal blood at surgery (D0) and 30 days later (D30) by pooling the concentrations of 7 individual BA. D30/D0 BA ratios were compared. All animals developed normally without clinical symptoms. A 76% reduction in the bile T-BA levels was observed in both groups (p<0.05). A 80% decrease of T-BA levels was observed in portal vein in study group (p<0.05), suggesting that ileal bile flow and BA ileal reabsorption were highly impaired. No change in portal vein BA levels was observed in control group. Cholecystocolic bypass led to a significant loss of bile acids in guinea pigs and might be considered for bile diversion in pediatric patients with selected cholestatic diseases.
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Affiliation(s)
- A Delarue
- Department of Pediatric Surgery, Hôpital d'Enfants de la Timone, 13385 Marseille Cedex 5, France.
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Abstract
More than 85% of prenatal ovarian cysts have a follicular or luteal origin. Their natural history is a spontaneous involution. However, adnexal torsion resulting in the loss of the ovary can occur at any time of the evolution. Pre and postnatal changes in the sonographic aspects allow to choose the appropriate therapeutical indications: conservative approach, laparoscopic surgery, or percutaneous aspiration. Prenatal aspiration must be avoided. The last prenatal sonographic examination should be performed as close as possible from the end of the gestation, and the first postnatal echography within the first 24 hours of life. Surgery of prenatal complicated cysts has to be planned a few days after birth. Uncomplicated prenatal cysts will be treated depending on size and echographic patterns at birth.
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Affiliation(s)
- C Louis-Borrione
- Service de chirurgie pédiatrique, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
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Affiliation(s)
- J M Guys
- Department of Paediatric Surgery, La Timone's Hospital, Marseille, France.
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Delarue A, Paut O, Simeoni J, Lepra SB, Nicollas R. Costal cartilage grafting for repair of a recurrent tracheoesophageal fistula in a 1.6-kg baby with esophageal atresia. Pediatr Surg Int 2002; 18:162-4. [PMID: 11956786 DOI: 10.1007/s003830100700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A large intraoperative tracheal tear occurred during correction of a type III esophageal atresia in a 1,630-g premature baby. It was repaired by primary suture. Recurrence of the tracheoesophageal fistula (TEF) was treated operatively with esophageal exclusion and costal cartilage grafting (CCG) onto the tracheal defect. At 3 months of age, successful esophageal reconstruction was performed using a posterior mediastinal colonic interposition. On 27-month follow-up, the child was symptom-free and thriving. Surgical options for TEF recurrence and intraoperative management of the tracheal air leak are discussed. CCG is advocated as an attractive material for tracheal repair even in low-weight prematures.
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Affiliation(s)
- A Delarue
- Department of Pediatric Surgery, Hôpital d'Enfants de la Timone, 13385 Marseille Cedex 5, France
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Merrot T, Delarue A, Chaumoitre K, Panuel M, Sigaudy S, Chazalette JP, Alessandrini P. [Bilateral vas deferens agenesis and inguinal hernia in a child. A rare, early presentation of cystic fibrosis]. Arch Pediatr 2001; 8:728-30. [PMID: 11484456 DOI: 10.1016/s0929-693x(00)90306-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Epididymal and ductal anomalies can be discovered incidentally during inguinal herniorraphy in children. The congenital bilateral absence of vas deferens is frequently associated with cystic fibrosis. CASE REPORT This agenesia of vas deferens was detected in a 5-month-old boy who underwent an inguinal herniorraphy. Although the child did not present any symptoms, he actually presented cystic fibrosis: the sudoral test showed high levels of chloride (95 mmol/L) and an isolated homozygous delta F 508 deletion on the gene CFTR was evidenced on genetic investigations. CONCLUSION The congenital bilateral absence of vas deferens is the most frequent anomaly of the male genital tract discovered in adults investigated for azoospermia. Relations with cystic fibrosis are well established but congenital bilateral absence of vas deferens discovered during infancy is an exceptional situation that requires genetic investigations to show evidence of a likely underlying cystic fibrosis.
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Affiliation(s)
- T Merrot
- Unité de chirurgie viscérale, CHU Nord, chemin des Bourrelys, 13015 Marseille, France.
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Abstract
BACKGROUND/PURPOSE The appendix graft (AG) is used widely for urinary tract replacement in children. Biliary tract replacement is less common. The purpose of this retrospective multicentric study was to evaluate the safety of appendix grafting for biliary reconstruction. METHODS The files of 33 patients treated at 7 European pediatric centers were reviewed. Indications included choledochal cyst (CC) in 5 cases, biliary trauma (BT) in 1, and biliary atresia (BA) in 27. In CC and BT patients, the graft was inserted isoperistaltically between the proximal biliary duct and second duodenum. In all but one of the BA patients, the graft was placed antiperistaltically by patching its cecal end onto the porta hepatis. RESULTS Postoperatively, all CC and BT patients initially became asymptomatic but developed laboratory evidence of anicteric cholestasis within 1 year. The most common manifestation was increased gamma-glutamyl-transpeptidase level (GGT), whereas histologic findings showed liver damage (mainly fibrosis). Reoperation has been carried out in 4 CC and 1 BT patients within a mean period of 19 months after appendix grafting. The graft procedure was converted to hepaticojejunostomy (HJ) in 4 and to choledocoduodenostomy in 1. Surgical exploration showed kinking in 1 patient and stenosis in 1. In the remaining 3 cases, there was no discernible cause of cholestasis, and appendix histology findings were normal. In all 5 reoperated patients, liver function findings returned to normal within 1 month. Reoperation is scheduled for the remaining CC patient who currently requires ursodesoxycholic medication to maintain normal liver function and presents histologic evidence of "de novo" sclerosing cholangitis. Results of appendix grafting also were poor in the 27 BA patients. Procedure-related perioperative complications occurred in 4 (15%) including 1 early death from graft necrosis. Another early death resulted from intestinal hemorrhage. Jaundice cleared in only 8 (28%). CONCLUSIONS The findings of this study suggest that the AG is unsuitable for routine biliary repair in children. It should be used only as a salvage technique when conventional HJ repair is contraindicated. Because of the high risk of graft dysfunction, we recommend screening tests to detect biochemical or histologic cholestasis in any patient previously treated with appendix grafting.
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Affiliation(s)
- A Delarue
- Service de Chirurgie Pédiatrique, Hôpital d'Enfants de la Timone, Marseille, France
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Guys JM, Simeoni-Alias J, Fakhro A, Delarue A. RE: USE OF POLYDIMETHYLSILOXANE FOR ENDOSCOPIC TREATMENT OF NEUROGENIC URINARY INCONTINENCE IN CHILDREN. J Urol 2000. [DOI: 10.1097/00005392-200006000-00076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Delarue A, Camboulives J, Bollini G, Bardot J, Guys JM. Delayed cure of an omphalocele requiring abdominosternoplasty, right hepatectomy and partial splenectomy. Eur J Pediatr Surg 2000; 10:58-61. [PMID: 10770250 DOI: 10.1055/s-2008-1072325] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A large ventral hernia resulting from the primary treatment of an omphalocele according to the Gross technique was repaired at age 16. The girl presented with extra-abdominal development of the liver and the spleen along with hypotrophy of the abdominal and thoracic cavities. The operation included enlargement sternoplasty, liver and spleen-size reduction and prosthetic abdominal closure. The cosmetic and functional results are good and stable on 7-year follow-up. Surgical issues and blood transfusion policy are discussed. A multi-disciplinary pediatric surgical approach is advocated.
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Affiliation(s)
- A Delarue
- Department of Pediatric Surgery, Hôpital d'Enfants de la Timone, Marseille, France
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Delarue A, Paut O, Guys JM, Montfort MF, Lethel V, Roquelaure B, Pellissier JF, Sarles J, Camboulives J. Inappropriate liver transplantation in a child with Alpers-Huttenlocher syndrome misdiagnosed as valproate-induced acute liver failure. Pediatr Transplant 2000; 4:67-71. [PMID: 10731063 DOI: 10.1034/j.1399-3046.2000.00090.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 3-yr-old boy received valproic acid (VPA) for recurrent seizures. He developed coma and acute liver failure that were attributed to VPA toxicity, and underwent emergency orthotopic liver transplantation (OLTx). Despite good graft function, his neurological state worsened and led to death a few months later. The diagnosis of Alpers-Huttenlocher Syndrome (AHS) was suspected, subsequently to liver Tx, in view of ongoing neurologic deterioration and magnetic resonance imaging (MRI) findings. The syndrome, recessively inherited, associates brain degeneration with liver failure, and is now considered a mitochondrial disease. Enzyme activity deficiencies of the respiratory chain were identified in muscle mitochondria, as well as morphologic abnormalities of mitochondria in the explanted liver. Guidelines for diagnosis are presented, in order to differentiate the liver failure in AHS from that induced by genuine VPA toxicity. It is recommended to avoid liver Tx in patients with AHS given the fatal neurological course of the disease.
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Affiliation(s)
- A Delarue
- Department of Pediatric Surgery, Hôpital Timone-Enfants, Marseille, France
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Abstract
PURPOSE We report on the injection of polydimethylsiloxane for endoscopic treatment of urinary incontinence in children with neurogenic bladder and determine the optimal criteria for patient selection. MATERIALS AND METHODS We have treated 17 boys and 16 girls since 1995. The etiology of incontinence was spina bifida in 24 cases. Previous surgery was performed in 18 patients, including bladder neck reconstruction in 15 and bladder augmentation in 9. Mean patient age at injection was 13 years (range 7 to 17). We administered 1, 2 and 3 injections in 21, 11 and 1 patients, respectively. Mean volume at each injection was 3.2 cc. Mean interval between injections was 6 months (range 3 to 15). In all cases injection was done transurethrally. RESULTS Followup ranged from 6 to 41 months (median 16). A total of 11 patients (33.3%) are dry (continence for greater than 4 hours and no urinary pad use during the day) and 8 (24.2%) are improved (continence for 2 to 3 hours and minimal pad use). Results are poor in 14 cases. Overall previous bladder neck surgery or preoperative detrusor hyperactivity did not influence results. Good results were mainly associated with female gender (47.4% of girls versus 10.5% of boys achieved cure). CONCLUSIONS Injection of polydimethylsiloxane at the bladder neck resulted in continence in 33% of neurogenic bladder cases. Better results occurred in girls and injection did not compromise other surgical procedures. Polydimethylsiloxane seems more suitable than bovine collagen due to potential problems with biological product use.
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Affiliation(s)
- J M Guys
- Fédération de Chirurgie Pédiatrique, Hôpital d'enfants de la Timone, Marseille, France
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Levadoux M, Picon G, Gadea J, Delarue A, Jouve JL, Bollini G. [Iterative fractures in type I primary hyperoxaluria. Report of 2 cases]. Rev Chir Orthop Reparatrice Appar Mot 1999; 85:75-80. [PMID: 10327470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
PURPOSE OF THE STUDY Type I primary hyperoxaluria is a rare autosomal recessive disease linked to a deficit in an hepatic enzyme. The purpose of this study was to analyze orthopedics problems caused by type I primary hyperoxaluria before and after liver and kidney transplantation. MATERIAL AND METHODS Two cases of children carrying this type I primary hyperoxaluria followed up after liver kidney transplantation are presented and compared to last publications. RESULTS Combined transplantation progressively corrected osseous lesions and aspect of the stroma. However it did not provide protection against fractures particularly for femoral neck fractures. DISCUSSION In type I hyperoxaluria overproduction of calcium oxalate causes its accumulation in the whole organism and particularly in bone. Osseous fragility favors pathological fractures. Only combined liverkidney transplantation can save and cure these children. Frequency of this fracture after transplantation indicates preventive plating at first pain, possibly at the same time as transplantation. Kidney transplant failure puts the patient in a "congealed" clinical state where the bone is very rich in oxalate and where the hemodialysis does not eliminate oxalate salts. CONCLUSION Type I primary hyperoxaluria is a very rare disease. Fractures are very common even after liver and kidney transplantation and especialy femoral neck fractures. We think that preventive plating must be done at first pain. We do not have any explanation for bony weakness after liver-kidney transplantation.
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Affiliation(s)
- M Levadoux
- Service de Chirurgie Orthopédique et Traumatologie H.I.A. Ste Anne Bd Ste Anne, Toulon
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40
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Abstract
BACKGROUND Indication for surgical exploration of the contralateral groin during unilateral herniorraphy in children is the subject of a worldwide debate. Routine exploration based on the likelihood of a patent processus vaginalis (PV) according to age, gender or side to some extent leads to unnecessary procedures, while routine abstention may leave a peritoneal sac, likely to later induce a symptomatic hernia in about 10% of cases. METHODS AND PATIENTS One hundred and twenty-five children aged from 1 month to 15 years underwent transinguinal laparoscopic assessment of the contralateral groin, using a 3 mm trocar and a 70 degrees telescope gently introduced through the exposed PV. Surgical exploration was performed only in those patients who exhibited a patent PV, and in patients where the groin was poorly visualized due to technical problems. RESULTS Regardless of age, contralateral surgery was not considered in 88 (70%) of the 125 children. Among the 37 patients that were operated upon, eight had a negative exploration due to an erroneous endoscopic evaluation. Surgery was avoided in 35 (56%) of the 62 infants aged less than 2 years, including nine of the 13 prematures who were previously routinely operated upon. Conversely, in the 63 older patients who were readily spared from surgical exploration, the videoscopic evaluation allowed appropriate selection for contralateral surgery in six. CONCLUSION A routine policy, either of surgery or observation, is no longer indicated as a quick, safe and cost-effective method is available to detect a patent PV. The transinguinal laparoscopy is safe and could be easily performed by surgeons already skilled in pediatric herniorraphy. Therefore, the videoscopic transinguinal contralateral evaluation is worth being promoted to ensure an appropriate surgery tailored to the anatomical features.
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Affiliation(s)
- A Delarue
- Département de chirurgie pédiatrique, hôpital d'enfants de la Timone, Marseille, France
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41
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Delarue A, Garcia-Meric P, Martin C, Piguet C, André N, Galli G, Guys JM. Antenatal rupture of a diverticular rectal duplication with neonatal perineal fistulization. Pediatr Surg Int 1998; 13:288-9. [PMID: 9553192 DOI: 10.1007/s003830050319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A cystic pelvic malformation was found in a fetus on antenatal sonography (US) at 26 weeks of gestational age that was no longer present 3 weeks later on control US. The male child presented at birth with a right-sided perineal mass that fistulized with meconial drainage. A radiopaque enema showed a low posterior rectal fistula filling a poorly delineated pouch. Surgery performed through a posterior sagittal approach allowed identification and closure of the fistula and pouch drainage. The diagnosis of a diverticular rectal duplication was considered, although no intestinal lining was observed macroscopically or histologically. The child's anorectal function was normal after a 20-month follow-up. Labeling of the malformation and embryological hypotheses are discussed since the case does not fulfill all the criteria of an intestinal duplication. Surgical techniques are discussed, with an emphasis on the sagittal posterior approach.
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Affiliation(s)
- A Delarue
- Fédération de Chirurgie Pédiatrique, Hôpital Timone-Enfants, Marseille, France
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42
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Laneury JP, Duchene P, Hirt P, Delarue A, Gleizes S, Houin G, Molinier P. Comparative bioavailability study of codeine and ibuprofen after administration of the two products alone or in association to 24 healthy volunteers. Eur J Drug Metab Pharmacokinet 1998; 23:185-9. [PMID: 9725479 DOI: 10.1007/bf03189337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The study objective was to compare the bioavailability of codeine and ibuprofen after oral administration of the two drugs alone or in association. The study was performed in three different periods, each separated by a wash-out of 6 days. Plasma concentrations were measured in 24 healthy volunteers after administration of a single oral dose of codeine phosphate (25 mg) and/or ibuprofen (200 mg). Codeine and ibuprofen assays were performed using two different HPLC methods. The relative bioavailabilities of codeine and ibuprofen (alone or in association) were 106 +/- 24% (mean +/- sd) and 101 +/- 19%, respectively. The results obtained demonstrated that bioavailabilities of codeine and ibuprofen were not modified when the two drugs were administrated alone or in association.
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Affiliation(s)
- J P Laneury
- Adme Bioanalyses, Parc Haute Technologie, Mougins, France
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43
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Tsimaratos M, Bérard E, Sigaudy S, Almahana T, Delarue A, Roquelaure B, Costet C, Antignac C, Gubler MC, Picon G, Philip N, Sarles J. Chronic renal failure and cranioectodermal dysplasia: a further step. Pediatr Nephrol 1997; 11:785-6. [PMID: 9438667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Fallouh K, Delarue A, Petit P, Chrestian MA, Portas M, Horschowski N, Bernard JL. [Atypical mesoblastic nephroma with metastases right away?]. Bull Cancer 1997; 84:807-12. [PMID: 9339186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The diagnosis of a metastatic kidney tumor arising in a 2-month infant is discussed between atypical mesoblastic nephroma and clear cell sarcoma. The precocity of distant metastases, their location in bone marrow, liver and thoracic soft tissues, and their association with myelofibrosis set up an original clinical presentation which seems to have never been described elsewhere. Treatment strategy with surgery of the primary followed by a polychemotherapy combining vincristin-etoposide-ifosfamide and the short term follow-up are reported.
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Affiliation(s)
- K Fallouh
- Fédération d'oncologie pédiatrique du CHRU de Marseille, hôpital de la Timone, France
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45
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Goupille P, Diot P, Valat JP, Lemarie E, Valat C, Asquier E, Delarue A, Le Pape A. Imaging of pulmonary disease in rheumatoid arthritis using J001X scintigraphy: preliminary results. Eur J Nucl Med 1995; 22:1411-5. [PMID: 8586087 DOI: 10.1007/bf01791150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of this study was to determine the ability of technetium-99m J001X scintigraphy to image active pulmonary involvement in patients suffering from rheumatoid arthritis (RA). J001X is a fully characterized acylated poly(1,3)galactoside, isolated from Klebsiella membranes, which is able to bind recruited macrophages after aerosol administration. J001X scintigraphy was compared with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs) and bronchoalveolar lavage (BAL) in 15 patients suffering from RA. Patients were considered to have pulmonary involvement when they had an interstitial syndrome on HRCT and a decrease of 20% in TCO/VE (transfer coefficient) on PFTs and/or an abnormal BAL (lymphocytosis higher than 20% and/or percentage of neutrophils higher than 10%). Pulmonary involvement was present in eight patients, and absent in seven. Of the eight patients with pulmonary involvement, all had abnormal BAL, two had an interstitial syndrome on HRCT, two had decreased TCO/VE and three had positive J001X scintigraphy. Of the seven patients without pulmonary involvement, six had normal BAL (not available in one), two had an interstitial syndrome on HRCT, one had decreased TCO/VE and two had positive J001X scintigraphy. According to our gold standard of pulmonary involvement, the sensitivity of J001X scintigraphy for the detection of pulmonary involvement in RA was 37.5%, the specificity was 71.4% and the positive predictive value was 60%. The ability of J001X scintigraphy to detect active pulmonary involvement during RA appears unclear in this study but it may detect processes unnoticed by the other modalities. These patients will be followed 12 and 24 months later and the changes in J001X scintigraphy, HRCT and PFTs will be compared to demonstrate whether J001X scintigraphy is able to assess an active process in the pulmonary involvement during RA and to specify its predictive value.
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Affiliation(s)
- P Goupille
- Service de Rhumatologie, Hôpital Trousseau, Tours, France
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46
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Devred P, Panuel M, Faure F, Petit P, Ballini P, Bourlière B, Gentet JC, Delarue A. [Diagnostic case: rhabdomyosarcoma of the biliary tracts]. J Radiol 1995; 76:1129-30. [PMID: 8676308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- P Devred
- Radiologie Pédiatrique, Hôpital d'Enfants de la Timone, Marseille
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47
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Abstract
A two-year-old boy was admitted for melena. Ultrasonography depicted an abnormal intestinal structure in the right iliac fossa and the diagnosis of Meckel's diverticulum was suggested. Laparoscopic approach confirmed the diagnosis and allowed resection.
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Affiliation(s)
- M Panuel
- Department of Pediatric Radiology, Hôpital d'Enfants Centre Hospitalo-Universitaire Timone, Marseille, France
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48
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Abstract
82 endoscopic surgical procedures (abdominal: 77; thoracic: 5) were performed by the same surgeon on 75 children aged from 1 month to 17 years (median 8.1 years) during the two-year period from January 1991 to December 1992. Due to the multispecialization of the Children's Hospital, a variety of pathologies were explored or treated with appendectomy accounting for 33% (27/82). There were no perioperative deaths. Three major complications occurred (1 post-appendectomy peritonitis, 1 hemorrhage during splenectomy and 1 post-operative occlusion). 14 patients required conversion to open surgery. Indications for endoscopic exploration of advanced lesions, prospective indications, and policy when confronted with a healthy appendix are discussed.
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Affiliation(s)
- A Delarue
- Department of Pediatric Surgery, Hôpital d'Enfants de la Timone, Marseilles, France
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49
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Diot P, Diot E, Lemarie E, Guilmot JL, Baulieu JL, Asquier E, Valat C, Delarue A, Le Pape A. Imaging of pulmonary disease in scleroderma with J001X scintigraphy. Thorax 1994; 49:504-8. [PMID: 8016775 PMCID: PMC474875 DOI: 10.1136/thx.49.5.504] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND J001X is an acylated poly-galactoside isolated from the membrane of Klebsiella and able to interact with macrophages, mainly in their activated state. The aim of the present study was to determine the ability of 99m-labelled technetium (99mTc)-J001X scintigraphy to image pulmonary disease, defined by high resolution computed tomographic scanning and pulmonary function tests, in patients suffering from scleroderma. METHODS Patients were considered to have pulmonary disease when they had at least two positive signs on high resolution computed tomography, or a decrease in lung volume and single breath carbon monoxide transfer, or both, with no disease process other than scleroderma in their medical history. Positive J001X scintigraphic imaging was defined by symmetrical bilateral pulmonary fixation three and five hours after inhalation of 99mTc-J001X. J001X scintigraphic results were compared with disease activity as indicated by bronchoalveolar lavage (BAL) fluid lymphocytosis. RESULTS Seventeen patients were studied, in 12 of whom J001X scintigraphy was positive. There was no correlation between BAL lymphocytosis and J001X scintigraphic findings, nor between BAL and pulmonary scleroderma. This was not surprising because of the high specificity of macrophage targeting by J001X. CONCLUSIONS Follow up of a larger population over a longer period is needed to establish whether there is a prognostic value for positive J001X scintigraphic findings in scleroderma.
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Affiliation(s)
- P Diot
- Département des Maladies Respiratories, CHU Bretonneau, Tours, France
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50
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Panuel M, Bourliere-Najean B, Gentet JC, Scheiner C, Delarue A, Faure F, Devred P. Aggressive neuroblastoma with initial pulmonary metastases and kidney involvement simulating Wilms' tumor. Eur J Radiol 1992; 14:201-3. [PMID: 1314181 DOI: 10.1016/0720-048x(92)90087-p] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M Panuel
- Department of Pediatric Radiology, CHU Timone, Marseille, France
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