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Touzet S, Buchet-Poyau K, Denis A, Occelli P, Jacquin L, Potinet V, Sigal A, Delaroche-Gaudin M, Fayard-Gonon F, Tazarourte K, Douplat M. Impact of the presence of a mediator on patient violent or uncivil behaviours in emergency departments: a cluster randomised crossover trial. Eur J Emerg Med 2024; 31:201-207. [PMID: 38329117 DOI: 10.1097/mej.0000000000001121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND IMPORTANCE Several studies reported that violent behaviours were committed by patients against healthcare professionals in emergency departments (EDs). The presence of mediators could prevent or resolve situations of tension. OBJECTIVE To evaluate whether the presence of mediators in EDs would have an impact on violent behaviours committed by patients or their relatives against healthcare professionals. Design, settings and participants A 6-period cluster randomised crossover trial was performed in 4 EDs during 12 months. Patients aged ≥18 and their relatives were included. INTERVENTION In order to prevent or resolve situations of tension and conflict, four mediators were recruited.Outcome measure and analysis Using a logistic regression mixed model, the rate of ED visits in which at least one act of violence was committed by a patient or their relatives, reported by healthcare professionals, was compared between the intervention group and the control group. RESULTS A total of 50 429 ED visits were performed in the mediator intervention group and 50 851 in the control group. The mediators reported 1365 interventions; >50% of the interventions were to answer questions about clinical management or waiting time. In the intervention group, 173 acts of violence were committed during 129 ED visits, and there were 145 acts of violence committed during 106 ED visits in the control group. The rate of ED visits in which at least one act of violence was committed, was 0.26% in the intervention group and 0.21% in the control group (OR = 1.23; 95% CI [0.73-2.09]); on a 4-level seriousness scale, 41.6% of the acts of violence were rated level-1 (acts of incivility or rudeness) in the intervention group and 40.0% in the control group. CONCLUSION The presence of mediators in the ED was not associated with a reduction in violent or uncivil behaviours committed by patients or their relatives. However, the study highlighted that patients had a major need for information regarding their care; improving communication between patients and healthcare professionals might reduce the violence in EDs. TRIAL REGISTRATION Clinicaltrials.gov (NCT03139110).
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Affiliation(s)
- Sandrine Touzet
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | | | | | - Pauline Occelli
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | - Laurent Jacquin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Véronique Potinet
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
| | - Alain Sigal
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | | | - Florence Fayard-Gonon
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | - Karim Tazarourte
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Marion Douplat
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
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Beissel A, Denis A, Laborie S, Pillet F, Gauthier-Moulinier H, Hommey S, Tume LN, Butin M, Touzet S. Impact of a nurse education programme on oral feeding in a neonatal unit. Nurs Crit Care 2024; 29:287-295. [PMID: 36054567 DOI: 10.1111/nicc.12840] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Premature neonates often experience feeding difficulties during their hospital stay, and evidence-based interventions have been shown to improve feeding outcomes. AIM This study investigated whether an infant-cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding in neonates in a neonatal intensive care unit. STUDY DESIGN A quality improvement study with a pre, during and post intervention test design. All premature neonates admitted to the unit were eligible. The feeding programme included a four-month nurse training module and nurse coaching. RESULTS A hundred and twenty-five nurses or nurse assistants attended the programme and 706 neonates were included. The median time to independent oral feeding (IOF) was 40, 36 and 37 days, respectively, for pre, during and post intervention. The reduction in time to IOF observed during the post-intervention period compared with the baseline period was significant (HR = 1.32, CI 95%: 1.01-1.74). No difference was noted in the length of hospital stay between the three study periods. CONCLUSIONS An infant-cue based nurse educational feeding bundle can promote earlier achievement of IOF in preterm neonates. RELEVANCE TO CLINICAL PRACTICE This quality improvement study demonstrates the impact that a nurse-driven intervention in neonatal care can have on improving practice. Feeding interventions involve the early introduction of oral feeding, non-nutritive sucking (NNS), and oral motor stimulation, and should be individualized for each neonate. These individualized feeding interventions applied by all nurses and assistant nurses, can facilitate the achievement of earlier independent oral feeding in preterm infants and should be included in neonatal critical care nurse education programs.
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Affiliation(s)
- Anne Beissel
- Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Angélique Denis
- Université Lyon I, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Sophie Laborie
- Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Fabienne Pillet
- Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | | | - Sophie Hommey
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Recherche Clinique et Épidémiologique, Lyon, France
| | - Lyvonne N Tume
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
- Paediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK
| | - Marine Butin
- Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- International center for research in infectiology, INSERM U1111, CNRS UMR5308, University of Lyon 1, Lyon, France
| | - Sandrine Touzet
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Recherche Clinique et Épidémiologique, Lyon, France
- Université Lyon 1, Research on Healthcare Performance Lab, Lyon, France
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Bendszus M, Fiehler J, Subtil F, Bonekamp S, Aamodt AH, Fuentes B, Gizewski ER, Hill MD, Krajina A, Pierot L, Simonsen CZ, Zeleňák K, Blauenfeldt RA, Cheng B, Denis A, Deutschmann H, Dorn F, Flottmann F, Gellißen S, Gerber JC, Goyal M, Haring J, Herweh C, Hopf-Jensen S, Hua VT, Jensen M, Kastrup A, Keil CF, Klepanec A, Kurča E, Mikkelsen R, Möhlenbruch M, Müller-Hülsbeck S, Münnich N, Pagano P, Papanagiotou P, Petzold GC, Pham M, Puetz V, Raupach J, Reimann G, Ringleb PA, Schell M, Schlemm E, Schönenberger S, Tennøe B, Ulfert C, Vališ K, Vítková E, Vollherbst DF, Wick W, Thomalla G. Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial. Lancet 2023; 402:1753-1763. [PMID: 37837989 DOI: 10.1016/s0140-6736(23)02032-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [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] [Received: 09/04/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Recent evidence suggests a beneficial effect of endovascular thrombectomy in acute ischaemic stroke with large infarct; however, previous trials have relied on multimodal brain imaging, whereas non-contrast CT is mostly used in clinical practice. METHODS In a prospective multicentre, open-label, randomised trial, patients with acute ischaemic stroke due to large vessel occlusion in the anterior circulation and a large established infarct indicated by an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) of 3-5 were randomly assigned using a central, web-based system (using a 1:1 ratio) to receive either endovascular thrombectomy with medical treatment or medical treatment (ie, standard of care) alone up to 12 h from stroke onset. The study was conducted in 40 hospitals in Europe and one site in Canada. The primary outcome was functional outcome across the entire range of the modified Rankin Scale at 90 days, assessed by investigators masked to treatment assignment. The primary analysis was done in the intention-to-treat population. Safety endpoints included mortality and rates of symptomatic intracranial haemorrhage and were analysed in the safety population, which included all patients based on the treatment they received. This trial is registered with ClinicalTrials.gov, NCT03094715. FINDINGS From July 17, 2018, to Feb 21, 2023, 253 patients were randomly assigned, with 125 patients assigned to endovascular thrombectomy and 128 to medical treatment alone. The trial was stopped early for efficacy after the first pre-planned interim analysis. At 90 days, endovascular thrombectomy was associated with a shift in the distribution of scores on the modified Rankin Scale towards better outcome (adjusted common OR 2·58 [95% CI 1·60-4·15]; p=0·0001) and with lower mortality (hazard ratio 0·67 [95% CI 0·46-0·98]; p=0·038). Symptomatic intracranial haemorrhage occurred in seven (6%) patients with thrombectomy and in six (5%) with medical treatment alone. INTERPRETATION Endovascular thrombectomy was associated with improved functional outcome and lower mortality in patients with acute ischaemic stroke from large vessel occlusion with established large infarct in a setting using non-contrast CT as the predominant imaging modality for patient selection. FUNDING EU Horizon 2020.
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Affiliation(s)
- Martin Bendszus
- Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jens Fiehler
- Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; eppdata GmbH, Hamburg, Germany
| | - Fabien Subtil
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biométrie et Biologie Évolutive, Université de Lyon, Villeurbanne, France
| | - Susanne Bonekamp
- Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Blanca Fuentes
- Department of Neurology and Stroke Center, Hospital La Paz Institute for Health Research-La Paz University Hospital-Universidad Autonoma de Madrid, Madrid, Spain
| | - Elke R Gizewski
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Michael D Hill
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, Health Science Centre, University of Calgary & Foothills Medical Centre, Calgary, AB, Canada
| | - Antonin Krajina
- Department of Radiology, Faculty of Medicine in Hradec Kralove, Charles University, Czech Republic
| | - Laurent Pierot
- Department of Neuroradiology, Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France
| | - Claus Z Simonsen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Kamil Zeleňák
- Clinic of Radiology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | | | - Bastian Cheng
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Angélique Denis
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biométrie et Biologie Évolutive, Université de Lyon, Villeurbanne, France
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University Graz, Graz, Austria
| | - Franziska Dorn
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Bonn, Bonn, Germany
| | - Fabian Flottmann
- Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Gellißen
- Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes C Gerber
- Institute of Neuroradiology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Dresden Neurovascular Center, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Mayank Goyal
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, Health Science Centre, University of Calgary & Foothills Medical Centre, Calgary, AB, Canada
| | - Jozef Haring
- Department of Neurology, Faculty Hospital Trnava, Trnava, Slovakia
| | - Christian Herweh
- Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Silke Hopf-Jensen
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, DIAKO Krankenhaus gGmbH, Flensburg, Germany
| | - Vi Tuan Hua
- Department of Neurology, Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France
| | - Märit Jensen
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Kastrup
- Klinik für Neurologie, Klinikum Bremen Mitte, Bremen, Germany
| | - Christiane Fee Keil
- Institut für Neuroradiologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - Andrej Klepanec
- Department of Radiology, Faculty Hospital Trnava, Trnava, Slovakia
| | - Egon Kurča
- Clinic of Neurology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Ronni Mikkelsen
- Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Stefan Müller-Hülsbeck
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, DIAKO Krankenhaus gGmbH, Flensburg, Germany
| | - Nico Münnich
- Klinikum Dortmund gGmbH, Klinikum der Universität Witten/Herdecke, Dortmund, Germany
| | - Paolo Pagano
- Department of Neuroradiology, Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France
| | - Panagiotis Papanagiotou
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Klinikum Bremen Mitte, Bremen, Germany; Department of Radiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gabor C Petzold
- Vascular Neurology Research Group, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Mirko Pham
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Volker Puetz
- Department of Neurology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Dresden Neurovascular Center, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Jan Raupach
- Department of Radiology, Faculty of Medicine in Hradec Kralove, Charles University, Czech Republic
| | - Gernot Reimann
- Klinikum Dortmund gGmbH, Klinikum der Universität Witten/Herdecke, Dortmund, Germany
| | | | - Maximilian Schell
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Eckhard Schlemm
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | - Bjørn Tennøe
- Department of Neuroradiology, Oslo University Hospital, Oslo, Norway
| | - Christian Ulfert
- Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Kateřina Vališ
- St Anne's University Hospital Brno, Brno, Czech Republic
| | - Eva Vítková
- Department of Neurology, Faculty of Medicine in Hradec Kralove, Charles University, Czech Republic
| | | | - Wolfgang Wick
- Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Götz Thomalla
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
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Rousset-Jablonski C, Mekki Y, Denis A, Reynaud Q, Nove-Josserand R, Durupt S, Touzet S, Perceval M, Ray-Coquard I, Golfier F, Durieu I. Human papillomavirus prevalence, persistence and cervical dysplasia in females with cystic fibrosis. J Cyst Fibros 2022:S1569-1993(22)01415-1. [DOI: 10.1016/j.jcf.2022.11.005] [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] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 12/15/2022]
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Termoz A, Delvallée M, Damiolini E, Marchal M, Preau M, Huchon L, Mazza S, Habchi O, Bravant E, Derex L, Nighoghossian N, Cakmak S, Rabilloud M, Denis A, Schott AM, Haesebaert J. Co-design and evaluation of a patient-centred transition programme for stroke patients, combining case management and access to an internet information platform: study protocol for a randomized controlled trial - NAVISTROKE. BMC Health Serv Res 2022; 22:537. [PMID: 35459183 PMCID: PMC9027042 DOI: 10.1186/s12913-022-07907-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background Stroke affects many aspects of life in stroke survivors and their family, and returning home after hospital discharge is a key step for the patient and his or her relatives. Patients and caregivers report a significant need for advice and information during this transition period. Our hypothesis is that, through a comprehensive, individualised and flexible support for patients and their caregivers, a patient-centred post-stroke hospital/home transition programme, combining an Internet information platform and telephone follow-up by a case manager, could improve patients’ level of participation and quality of life. Methods An open parallel-group randomized trial will be conducted in two centres in France. We will recruit 170 adult patients who have had a first confirmed stroke, and were directly discharged home from the stroke unit with a modified Rankin score ≤3. Intervention content will be defined using a user-centred approach involving patients, caregivers, health-care professionals and social workers. Patients randomized to the intervention group will receive telephonic support by a trained case manager and access to an interactive Internet information platform during the 12 months following their return home. Patients randomized to the control group will receive usual care. The primary outcome is patient participation, measured by the “participation” dimension score of the Stroke Impact Scale 6 months after discharge. Secondary outcomes will include, for patients, quality of life, activation, care consumption, as well as physical, mental and social outcomes; and for caregivers, quality of life and burden. Patients will be contacted within one week after discharge, at 6 and 12 months for the outcomes collection. A process evaluation alongside the study is planned. Discussion Our patient-centred programme will empower patients and their carers, through individualised and progressive follow-up, to find their way around the range of available healthcare and social services, to better understand them and to use them more effectively. The action of a centralised case manager by telephone and the online platform will make it possible to disseminate this intervention to a large number of patients, over a wide area and even in cases of geographical isolation. Trial registration: ClinicalTrials NCT03956160, Posted: May-2019 and Update: September-2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07907-5.
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Affiliation(s)
- Anne Termoz
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France. .,Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France.
| | - Marion Delvallée
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
| | - Eléonore Damiolini
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Mathilde Marchal
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Marie Preau
- Groupe de Recherche en Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
| | - Laure Huchon
- Médecine Physique et Réadaptation, Hospices Civils de Lyon, Hôpital Henry Gabrielle, Lyon, France
| | - Stéphanie Mazza
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
| | - Ouazna Habchi
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Estelle Bravant
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France.,Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Laurent Derex
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France.,Service Neuro-vasculaire, Hospices Civils de Lyon, Hôpital Pierre Wertheimer, Lyon, France
| | - Norbert Nighoghossian
- Service Neuro-vasculaire, Hospices Civils de Lyon, Hôpital Pierre Wertheimer, Lyon, France
| | - Serkan Cakmak
- Service Neuro-vasculaire, Hôpital Nord Ouest, Villefranche-sur-Saône, France
| | - Muriel Rabilloud
- Service de Biostatistique et Bioinformatique Hospices Civils de Lyon Pôle Santé Publique, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Université Claude Bernard Lyon 1, CNRS, UMR 5558, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Angélique Denis
- Service de Biostatistique et Bioinformatique Hospices Civils de Lyon Pôle Santé Publique, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Université Claude Bernard Lyon 1, CNRS, UMR 5558, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Anne-Marie Schott
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France.,Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France.,Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
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Laborie S, Abadie G, Denis A, Touzet S, Fischer Fumeaux CJ. A Positive Impact of an Observational Study on Breastfeeding Rates in Two Neonatal Intensive Care Units. Nutrients 2022; 14:nu14061145. [PMID: 35334802 PMCID: PMC8951536 DOI: 10.3390/nu14061145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023] Open
Abstract
We aimed to investigate whether the participation in an observational study on breastfeeding (Doal) modified breastfeeding outcomes in enrolling neonatal intensive care units (NICUs). This bi-centric before-and-after study included neonates who were admitted during a 4-month period before and a 4-month period after the implementation of Doal. Breastfeeding intention and breastfeeding rates at discharge were compared between the two periods. The association between inclusion in Doal and breastfeeding at discharge was assessed among the infants fulfilling the inclusion criteria of Doal. The present study included 655 neonates. After adjustments, both breastfeeding (aOR 1.21, 95%CI [1.1; 1.4], p = 0.001) and exclusive breastfeeding (aOR 1.8, 95%CI [1.4; 2.3], p < 0.001) at discharge increased in the period after. Breastfeeding intention was higher in one center in the period after (79%) compared to before (59%, p = 0.019). Compared to the period before, neonates who were not included in Doal in the period after had a lower chance to be breastfed at discharge, whereas those included were more frequently exclusively breastfed. The participation in an observational study on breastfeeding was associated with an increase in breastfeeding outcomes in enrolling neonatal intensive care units (NICUs). Patients who are not included deserve attention as they are at risk to be disadvantaged regarding breastfeeding success.
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Affiliation(s)
- Sophie Laborie
- Service de Réanimation Néonatale et Néonatologie, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69677 Bron, France
- Correspondence: ; Tel.: +33-427855284
| | - Géraldine Abadie
- Réanimation Pédiatrique et Médecine Néonatale, CHU Félix Guyon, 97405 Saint Denis de la Réunion, France;
| | - Angélique Denis
- Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, CNRS, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France;
- Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, 69003 Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, UMR 5558, CNRS, 69100 Villeurbanne, France
| | - Sandrine Touzet
- Service de Recherche Clinique et Épidémiologique, Pôle Santé Publique, Hospices Civils de Lyon, 69003 Lyon, France;
- Research on Healthcare Performance Lab, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Céline J. Fischer Fumeaux
- Department Mother-Woman-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
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Laborie S, Denis A, Raverot V, Claris O, Bacchetta J, Butin M. A third of premature neonates displayed inadequate 25-hydroxyvitamin D levels before being discharged from a French neonatal intensive care unit. Acta Paediatr 2022; 111:104-106. [PMID: 34587322 DOI: 10.1111/apa.16126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/10/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Sophie Laborie
- Hospices Civils de LyonDepartement of Neonatal Intensive Care Hôpital Femme Mère Enfant Bron France
| | - Angélique Denis
- Université de Lyon Lyon France
- Université Claude Bernard Lyon 1 Villeurbanne France
- Service de Biostatistique et Bioinformatique Hospices Civils de LyonPôle Santé Publique Lyon France
- CNRSUMR 5558Laboratoire de Biométrie et Biologie ÉvolutiveÉquipe Biostatistique‐Santé Villeurbanne France
| | - Véronique Raverot
- LBMMS, Biochemistry unit, Hormonology laboratory Groupement hospitalier Est Hospices Civils de Lyon Bron France
| | - Olivier Claris
- Hospices Civils de LyonDepartement of Neonatal Intensive Care Hôpital Femme Mère Enfant Bron France
- Université Claude Bernard Lyon 1 Lyon France
| | - Justine Bacchetta
- Faculté de Médecine Lyon Est Université Claude Bernard Lyon 1 Lyon France
- Rhumatologie et Dermatologie Pédiatriques Centre de Référence des Maladies Rares du Calcium et du Phosphore Service de Néphrologie Hospices Civils de LyonHôpital Femme Mère Enfant Bron France
- INSERM 1033, Prévention des Maladies Osseuses Lyon France
| | - Marine Butin
- Hospices Civils de LyonDepartement of Neonatal Intensive Care Hôpital Femme Mère Enfant Bron France
- Centre International de Recherche en Infectiologie INSERM U1111CNRS UMR5308Ecole Normale Supérieure de LyonUniversité Claude Bernard Lyon 1 Lyon France
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Gruner M, Denis A, Masliah C, Amil M, Metivier-Cesbron E, Luet D, Kaasis M, Coron E, Le Rhun M, Lecleire S, Antonietti M, Legoux JL, Lefrou L, Renkes P, Tarreirias AL, Balian P, Rey P, Prost B, Cellier C, Rahmi G, Samaha E, Fratte S, Guerrier B, Landel V, Touzet S, Ponchon T, Pioche M. Narrow-band imaging versus Lugol chromoendoscopy for esophageal squamous cell cancer screening in normal endoscopic practice: randomized controlled trial. Endoscopy 2021; 53:674-682. [PMID: 32698233 DOI: 10.1055/a-1224-6822] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Narrow-band imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect esophageal squamous cell carcinoma (SCC) but its specificity, which appears higher than that of Lugol chromoendoscopy in expert centers, remains to be established in general practice. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy in the detection of esophageal SCC and high grade dysplasia (HGD) in current general practice (including tertiary care centers, local hospitals, and private clinics). METHODS This prospective randomized multicenter trial included consecutive patients with previous or current SCC of the upper aerodigestive tract who were scheduled for gastroscopy. Patients were randomly allocated to either the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, NBI examination was performed after white-light endoscopy. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis. RESULTS 334 patients with history of SCC were included and analyzed (intention-to-treat) from 15 French institutions between March 2011 and December 2015. In per-patient analysis, sensitivity, specificity, positive and negative likelihood values were 100 %, 66.0 %, 21.2 %, and 100 %, respectively, for Lugol chromoendoscopy vs. 100 %, 79.9 %, 37.5 %, and 100 %, respectively, for NBI. Specificity was greater with NBI than with Lugol (P = 0.002). CONCLUSIONS As previously demonstrated in expert centers, NBI was more specific than Lugol in current gastroenterology practice for the detection of early SCC, but combined approaches with both NBI and Lugol could improve the detection of squamous neoplasia.
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Affiliation(s)
- Mélissa Gruner
- Gastroenterology Division, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Angélique Denis
- Pole de Santé Publique, Statistics and Medical Research Department, Hospices Civils de Lyon, Lyon, France
| | - Claude Masliah
- Gastroenterology Division, Clinique Mutualiste de l'Estuaire, Saint Nazaire, France
| | - Morgane Amil
- Gastroenterology Division, Centre Hospitalier Départemental Les Oudairies, La Roche sur Yon, France
| | | | - Dominique Luet
- Gastroenterology Division, Centre Hospitalo-Universitaire Larrey, Angers, France
| | - Medhi Kaasis
- Gastroenterology Division, Centre Hospitalier de Cholet, Cholet, France
| | - Emmanuel Coron
- Hepatogastroenterology Department, Hotel Dieu, Nantes, France
| | - Marc Le Rhun
- Hepatogastroenterology Department, Hotel Dieu, Nantes, France
| | - Stéphane Lecleire
- Gastroenterology Division, Hôpital Charles Nicolle, Centre Hospitalo-Universitaire, Rouen, France
| | - Michel Antonietti
- Gastroenterology Division, Hôpital Charles Nicolle, Centre Hospitalo-Universitaire, Rouen, France
| | - Jean-Louis Legoux
- Gastroenterology Division, Hôpital La Source, Centre Hospitalier Régional, Orléans, France
| | - Laurent Lefrou
- Gastroenterology Division, Hôpital La Source, Centre Hospitalier Régional, Orléans, France
| | - Pascal Renkes
- Gastroenterology Division, Hôpital Clinique Claude Bernard, Metz, France
| | | | | | - Philippe Rey
- Gastroenterology Division, Hôpital d'Instruction des Armées, Legouest, Metz, France
| | - Bénédicte Prost
- Gastroenterology Division, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | - Christophe Cellier
- Gastroenterology Division, Hôpital Européen Georges Pompidou, Paris, France
| | - Gabriel Rahmi
- Gastroenterology Division, Hôpital Européen Georges Pompidou, Paris, France
| | - Elia Samaha
- Gastroenterology Division, Hôpital Européen Georges Pompidou, Paris, France
| | - Serge Fratte
- Gastroenterology Division, Centre Hospitalier Régional, Belfort, France
| | - Béatrice Guerrier
- Gastroenterology Division, Centre Hospitalier Bourg en Bresse, Bourg en Bresse, France
| | - Verena Landel
- Direction Recherche Clinique et Innovations, Hospices Civils de Lyon, Lyon, France
| | - Sandrine Touzet
- Pole de Santé Publique, Statistics and Medical Research Department, Hospices Civils de Lyon, Lyon, France
| | - Thierry Ponchon
- Gastroenterology Division, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Lyon 1 University Claude Bernard, Lyon, France.,INSERM U1032, LabTAU, Lyon, France
| | - Mathieu Pioche
- Gastroenterology Division, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Lyon 1 University Claude Bernard, Lyon, France.,INSERM U1032, LabTAU, Lyon, France
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Rousset-Jablonski C, Haesebaert J, Denis A, Reix P, Llerena C, Perceval M, Touzet S, Durieu I. Human Papilloma Virus Vaccination Among Female Patients Attending French Pediatric Cystic Fibrosis Centers. J Pediatr Adolesc Gynecol 2021; 34:317-323. [PMID: 33338628 DOI: 10.1016/j.jpag.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/22/2020] [Revised: 11/06/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To describe human papilloma virus (HPV) vaccination practice among adolescent girls with cystic fibrosis (CF) and to identify reasons for non-vaccination. DESIGN Cross-sectional multicentric study. SETTING AND PARTICIPANTS Girls aged 9-17 years, attending 7 French pediatric CF centers, and their accompanying adult. INTERVENTIONS Administration of a self-report questionnaire. MAIN OUTCOME MEASURES The proportion of girls having received or receiving HPV vaccination, compliance with the vaccination schedule, factors associated with vaccination, and reasons for vaccination and for non-vaccination. RESULTS A total of 113 girls and 104 accompanying adults participated. The mean age was 13.6 years (standard deviation 2.5; range 9-17). A total of 34 (30.9%) patients reported having received HPV vaccination. Among the 34 girls aged 15 years or older, 15 (44.1%) were vaccinated. Most patients (58.8%) started vaccination between 11 and 14 years of age (mean age 13.9). Most vaccine prescriptions (67.6%) were made by a CF center health care provider. Factors associated with vaccination were older age (odds ratio [OR] = 1.27, 95% confidence interval [CI] = 1.01-1.6, P = .037 for each year older), previous vaccination by the accompanying parent of one of their children for hepatitis B (OR = 8.01, 95% CI = 0.96-67.02), P = .055), and parental influence on decision-making (OR = 2.77, 95% CI = 0.97-7.95, P = .058). Health care providers' positive advice and fear of HPV-related disease were the main reasons given to justify vaccination decisions. Insufficient knowledge and concerns about potential side effects were the main barriers. CONCLUSION HPV vaccination remains insufficient among girls with CF. CF health care providers may play a crucial role in HPV vaccination acceptance, and their sensitization to cervical cancer prevention is mandatory.
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Affiliation(s)
- Christine Rousset-Jablonski
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; Department of Obstetrics and Gynecology, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; Department of Surgical Oncology, Leon Berard Cancer Center, Centre Léon Bérard, Lyon, France; EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France.
| | - Julie Haesebaert
- EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France; Pôle de Santé Publique-Service de Recherche et d'Epidémiologie Cliniques, Hospices civils de Lyon, Groupement hospitalier Est, Bron, France
| | - Angélique Denis
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - Philippe Reix
- Service de Pneumologie Pédiatrique et CRCM enfant, Hospices civils de Lyon, Hôpital Femme Mère Enfant, Bron, France; UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France
| | - Cathy Llerena
- Pneumologie Pédiatrique, Antenne Pédiatrique du CIC, Center Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - Marie Perceval
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France
| | - Sandrine Touzet
- EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France; Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - Isabelle Durieu
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France
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10
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Vlachos K, Denis A, Kitamura T, Takigawa M, Frontera A, Martin R, Bourier F, Martin CA, Cheniti G, Pambrun T, Sacher F, Hocini M, Haissaguerre M, Jais P, Derval N. The role of marshall bundle epicardial connections in atrial tachycardias after atrial fibrillation ablation. Europace 2021. [DOI: 10.1093/europace/euab116.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial tachycardias (ATs) are often seen in the context of AF ablation.
Objectives
We evaluated the role of the Marshall bundle (MB) network in left atrial (LA) ATs using high-density high-spatial resolution 3D mapping.
Methods
199 post-AF ablation LA tachycardias were mapped in 140 consecutive patients (112 (80%) males, mean age: 61.8 years); 133 (66.8%) were macro-reentrant and 66 (33.2%) were scar-related re-entry. MB-dependent perimitral AT (PMAT) was diagnosed where the difference between the post pacing interval and the tachycardia cycle length (PPI-TCL) was <20ms in parts of the expected MB-dependent perimitral circuit (within the VOM, the ridge between the left pulmonary veins and LA appendage (LAA), the anterior LA and between 6- and 11-o’clock of the mitral annulus) and the PPI-TCL was >20ms in areas bypassed by the VOM (the distal coronary sinus (CS), the posterior LA and the mitral isthmus). MB-related re-entry was diagnosed by PPI-TCL <20ms at the left lateral ridge, posterior base of LAA, inferolateral LA or VOM ostium; and PPI-TCL >20ms in the septal annulus. Typically, in MB-dependent localized re-entry, the earliest activation was found along the MB-LA endocardial connection or MB-CS epicardial connection.
Results
The MB network was found to participate in 60 (30.2%) re-entrant ATs, 31 PMATs and 29 localized re-entries. High-frequency multiphasic fragmented electrograms with long duration were often recorded endocardially or epicardially at the MB-LA or MB-CS connections. The amplitude and duration of these signals were 0.5 ± 0.79 mV and 65 ± 40 ms for MB-PMATs and 0.26 ± 0.28mV and 122 ± 67 ms for MB-localized re-entries. Unipolar EGMs at the site of endocardial-epicardial breakthrough had a rS pattern in all MB-related ATs. Of 60 MB-related ATs, 49 (81.6%) terminated with RF ablation, 44 (73.3%) at the MB-LA junction and 5 (8.3%) at the MB-CS junction, while 9 (15%) terminated after 2.5-5 cc of alcohol infusion inside the vein of Marshall (VOM). Of the 31 MB-related macroreentrant ATs, 17 (54.8%) terminated at the MB-LA junction, 5 (16.1%) at the MB-CS junction and 7 (22.6%) with alcohol infusion inside the VOM. Two macroreentries (6.5%) using the MB did not terminate with RF energy either endocardially at the MB-LA junction or epicardially at the MB-CS junction, and we were unable to identify or cannulate the VOM for ethanol infusion. Of the 29 localized re-entrant ATs using the MB, 27 (93.1%) terminated at the MB-LA junction, none terminated at the MB-CS junction and 2 (6.9%) terminated after alcohol infusion. After a mean follow up of 12 months, only 4 patients (6.7%) had AT recurrence.
Conclusions
MB re-entrant ATs accounted for up to 29% of the left ATs after AF ablation. Ablation of the MB-LA or CS-MB connections or alcohol infusion inside the VOM is required to treat these arrhythmias. Abstract Figure.
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Affiliation(s)
- K Vlachos
- University of Bordeaux, Bordeaux, France
| | - A Denis
- University of Bordeaux, Bordeaux, France
| | - T Kitamura
- University of Bordeaux, Bordeaux, France
| | - M Takigawa
- University of Bordeaux, Bordeaux, France
| | - A Frontera
- University of Bordeaux, Bordeaux, France
| | - R Martin
- University of Bordeaux, Bordeaux, France
| | - F Bourier
- University of Bordeaux, Bordeaux, France
| | - CA Martin
- University of Bordeaux, Bordeaux, France
| | - G Cheniti
- University of Bordeaux, Bordeaux, France
| | - T Pambrun
- University of Bordeaux, Bordeaux, France
| | - F Sacher
- University of Bordeaux, Bordeaux, France
| | - M Hocini
- University of Bordeaux, Bordeaux, France
| | | | - P Jais
- University of Bordeaux, Bordeaux, France
| | - N Derval
- University of Bordeaux, Bordeaux, France
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Boudreau V, Reynaud Q, Denis A, Colomba J, Touzet S, Desjardins K, Bourdy SP, Durieu I, Rabasa-Lhoret R. Impact of 1h oral glucose tolerance test on the clinical status of adult cystic fibrosis patients over a 4-year period. PLoS One 2021; 16:e0246897. [PMID: 33735186 PMCID: PMC7971459 DOI: 10.1371/journal.pone.0246897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/27/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report the clinical profile associated with G60 and I60 over a 4-year prospective observational period in 2 large cohorts of adult patients with CF. METHODS 319 patients were included (210 Canadian and 119 French) and classified according to their inclusion G60 (≥ or < 11.1 mmol/L) and the median inclusion I60 (≥ or < 24 mU/I). Forced expiratory volume in 1 second (FEV1), body mass index (BMI) were collected on OGTT days. Linear mixed regression models were used to assess the effect of G60 and I60. RESULTS High G60 was not associated to a lower FEV1 at inclusion and the follow-up decline was not higher in the high G60 group (Coefficient [95% CI]: -3.4 [-7.4;0.6], p = 0.0995.). There was no significant association between BMI and G60. Patients with high I60 tended to have a higher mean BMI (+0.5 kg/m2 [0.0 to 1.1], p = 0.05) but no interaction over time was observed. CONCLUSIONS High G60 is not associated with a lower lung function at inclusion nor its decline over a 4-year follow-up. High I60 is slightly associated to a higher weight at inclusion, but not with BMI evolution over time in adult patients.
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Affiliation(s)
- Valérie Boudreau
- Montreal Clinical Research Institute, Québec, Canada
- Département de nutrition et de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Quitterie Reynaud
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices civils de Lyon, F-69495 Pierre Bénite, France
- Université de Lyon, Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Angélique Denis
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Université de Lyon, Lyon, France
| | - Johann Colomba
- Montreal Clinical Research Institute, Québec, Canada
- Département de nutrition et de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Sandrine Touzet
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Université de Lyon, Lyon, France
| | | | - Stéphanie Poupon Bourdy
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Université de Lyon, Lyon, France
| | - Isabelle Durieu
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices civils de Lyon, F-69495 Pierre Bénite, France
- Université de Lyon, Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Rémi Rabasa-Lhoret
- Montreal Clinical Research Institute, Québec, Canada
- Département de nutrition et de Médecine, Université de Montréal, Montréal, Québec, Canada
- Cystic fibrosis clinic, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
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Chaléat-Valayer E, Denis A, Zelmar A, Pujol A, Bernadou A, Bard-Pondarré R, Touzet S. VETCOSED study: efficacy of compressive garments for patients with hypermobile Ehlers–Danlos syndrome on shoulder stability and muscles strength. Disabil Rehabil 2020; 44:3165-3172. [DOI: 10.1080/09638288.2020.1860142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Angélique Denis
- Pôle de Santé Publique, Hospices Civils de Lyon, LYON, France
| | - Amélie Zelmar
- Pôle de Santé Publique, Hospices Civils de Lyon, LYON, France
| | - Anne Pujol
- Centre Médico-Chirurgical de réadaptation des Massues, Croix-Rouge française, Lyon, France
| | - Amandine Bernadou
- Centre Médico-Chirurgical de réadaptation des Massues, Croix-Rouge française, Lyon, France
| | - Rachel Bard-Pondarré
- Centre Médico-Chirurgical de réadaptation des Massues, Croix-Rouge française, Lyon, France
| | - Sandrine Touzet
- Pôle de Santé Publique, Hospices Civils de Lyon, LYON, France
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Denis A, Touzet S, Poupon-Bourdy S, Llerena C. P040 Clinical effects of the transition from paediatric to adult care for patients with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30376-3] [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: 11/28/2022]
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14
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Toin T, Reynaud Q, Denis A, Durieu I, Mainguy C, Touzet S, Reix P. WS15.3 HOMA indexes diagnosis performance for Cystic Fibrosis-Related Diabetes. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30246-0] [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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Hoegy D, Bleyzac N, Gauthier-Vasserot A, Cannas G, Denis A, Hot A, Bertrand Y, Occelli P, Touzet S, Dussart C, Janoly-Dumenil A. Impact of a paediatric-adult care transition programme on the health status of patients with sickle cell disease: study protocol for a randomised controlled trial (the DREPADO trial). Trials 2020; 21:152. [PMID: 32039737 PMCID: PMC7008523 DOI: 10.1186/s13063-019-4009-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/18/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Thanks to advancements in medical care, a majority of patients with sickle cell disease (SCD) worldwide live beyond 18 years of age, and therefore, patients initially followed in paediatric departments are then transferred to adult departments. This paediatric-adult care transition is a period with an increased risk of discontinuity of care and subsequent morbidity and mortality. During this period, the patient will have to manage new interlocutors and places of care, and personal issues related to the period of adolescence. To take into consideration all these aspects, an interesting approach is to use the whole system approach to the patient, as presented in the biopsychosocial approach. The aim of this trial is to evaluate the impact of the proposed biopsychosocial paediatric-adult transition programme. METHODS The DREPADO study is a multicentre randomised control trial comparing a control group (Arm A) to an interventional group with a paediatric-adult transition programme based on a biopsychosocial approach (Arm B). To be included, patients should have the SS, SC, or Sβ form of sickle cell disease and be aged between 16 and 17 years. The randomisation in a 1:1 ratio assigns to Arm A or B. The primary outcome is the number of hospital admissions and emergencies for complications in the index hospital, in the 2 years after the first consultation in the adult department of care. Secondary outcomes consider the quality of life, but also include coping skills such as sense of self-efficacy and disease knowledge. To provide patient and parent knowledge and coping skills, the transition programme is composed of three axes: educational, psychological, and social, conducted individually and in groups. DISCUSSION By providing self-care knowledge and coping skills related to SCD and therapeutics, helping empower patientsin relation to pain management and emotions, and facilitating the relationship to oneself, others, and care in Arm B of the DREPADO study, we believe that the morbidity and mortality of patients with SCD may be reduced after the proposed paediatric-adult transition programme. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03786549; registered on 17 December 2018; https://clinicaltrials.gov/.
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Affiliation(s)
- Delphine Hoegy
- EA 4129 P2S Parcours Santé Systémique-Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France.
- Pharmacie Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 place d'Arsonval, 69003, Lyon, France.
- Institut des Sciences Pharmaceutiques et Biologiques, Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France.
- INSERM U1111-CNRS UMR 5308 ENS Lyon, Université Lyon 1, Lyon, France.
| | - Nathalie Bleyzac
- EMR 3738, PK/PD modeling in oncology, Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
- Centre Antipoison, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier-Vasserot
- INSERM U1111-CNRS UMR 5308 ENS Lyon, Université Lyon 1, Lyon, France
- Institut d'Hématologie et d'Oncologie Pédiatrique de Lyon, Hospices Civils de Lyon, Lyon, France
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Giovanna Cannas
- INSERM U1111-CNRS UMR 5308 ENS Lyon, Université Lyon 1, Lyon, France
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
- Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Arnaud Hot
- Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- INSERM U1111-CNRS UMR 5308 ENS Lyon, Université Lyon 1, Lyon, France
- Institut d'Hématologie et d'Oncologie Pédiatrique de Lyon, Hospices Civils de Lyon, Lyon, France
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France
| | - Pauline Occelli
- Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- EA 7425 HESPER Health Services and Performance Research, Université Lyon 1, Lyon, France
| | - Sandrine Touzet
- Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- EA 7425 HESPER Health Services and Performance Research, Université Lyon 1, Lyon, France
| | - Claude Dussart
- EA 4129 P2S Parcours Santé Systémique-Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
- Pharmacie Centrale, Hospices Civils de Lyon, Lyon, France
| | - Audrey Janoly-Dumenil
- EA 4129 P2S Parcours Santé Systémique-Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
- Pharmacie Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 place d'Arsonval, 69003, Lyon, France
- Institut des Sciences Pharmaceutiques et Biologiques, Université Claude Bernard Lyon 1, Université Lyon 1, Lyon, France
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Geoffray MM, Denis A, Mengarelli F, Peter C, Gallifet N, Beaujeard V, Grosmaitre CJ, Malo V, Grisi S, Georgieff N, Magnificat S, Touzet S. Using ESDM 12 hours per week in children with autism spectrum disorder: feasibility and results of an observational study. Psychiatr Danub 2019; 31:333-339. [PMID: 31596826 DOI: 10.24869/psyd.2019.333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Early intervention for Autism Spectrum Disorder (ASD) in France is heterogeneous and poorly evaluated to date. Early Start Denver Model (ESDM) is a developmental and behavioral model of intervention for toddlers with ASD which has already shown very interesting outcomes on the development of children with ASD in various studies with different settings. However, it is not possible with the current research to agree on the best setting. Thus, we implemented an ESDM program according to our context where children are often pre-schooling early from 30 months old. This therapy was applied by a multidisciplinary team working in close collaboration with parents and other partners. SUBJECTS AND METHODS A prospective observational study including 19 toddlers with ASD was conducted. We evaluated improvement on the cognitive level of toddlers with ASD receiving therapist-delivered ESDM intervention for 12 hours per week. RESULTS Significant improvements in verbal and nonverbal cognitive skills at the Mullen Scale of Early Learning were obtained after 10 months of intervention in our sample. The largest improvement was in receptive language development quotient with a mean improvement of 19.6 points. We also observed promising outcomes in daily adaptive behavior, with a slight improvement in communication at the Vineland Adaptive Behavioral Scale. These outcomes, when compared to the conclusions of previous studies, are leading us to the need for a therapy duration beyond 10 months. CONCLUSIONS Our outcomes were very encouraging even with low cognitive and nonverbal children. These outcomes may be confirmed in a multicenter randomized controlled trial that is ongoing.
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Affiliation(s)
- Marie-Maude Geoffray
- Department of Child and Adolescent Psychiatry, CH le Vinatier, 95 Boulevard Pinel, 69 Bron, France,
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Sacher F, Roumegou P, Duchateau J, Derval N, Denis A, Pambrun T, Escande W, Takigawa M, Lam A, Andre C, Chauvel R, Hocini M, Haissaguerre M, Jais P, Cochet H. 5201Intra-cardiac thrombus in patients undergoing ventricular tachycardia ablation. a computed tomographic scan study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Embolic event is one of the complications of VT ablation. This may be due to the presence of intra-cardiac thrombus before ablation. However, there is no clear consensus on how to rule out thrombus before the procedure.
Objective
We sought to examine the prevalence and risk factors of intra-cardiac thrombus with cardiac computed tomographic (CT) scan in patients undergoing scar-related VT ablation.
Methods
In absence of contra-indication, all patients undergoing scar-related VT ablation at our institution underwent contrast-enhanced cardiac CT within one week before ablation. 324 consecutive patients (292 male, 59±16 yo) have been included in this study. The etiology was ischemic cardiomyopathy (CMP) (n=191), arrhythmogenic right ventricular CMP (ARVC) (n=37), congenital CMP (n=11) or other CMP (n=85). LVEF was <40% in 154 patients (48%).
Results
Intra-cardiac thrombus was diagnosed in 29 (9%) patients: in the left atrium (n=8), in the right atrium (n=1), in the left ventricle (n=15), in the right ventricle (n=3), in right and left atrium (n=1), and in left atrium and right ventricle (n=1). Moreover in 2, a bilateral pulmonary embolism was identified. The population with thrombus was older (65±12 vs 58±16 years, p=0,005), with more permanent atrial fibrillation (AF) (28% vs 8%; p=0.005). Patients with left ventricular (LV) aneurysm were at higher risk of thrombus 50% vs 3% (p<0.001). The average CHADSVASC score was similar for both groups (2,5 vs 2,1; p=0.179). After matching for age and sex, only ischemic CMP and LV aneurysm were risk factors for thrombus. Because of arrhythmic storm, ablation was performed by epicardial approach only, in 5 patients with intra-ventricular thrombus and by retroaortic approach only, in 2 patients with LAA thrombus. No embolic event occurred during these procedures.
Conclusion
CT scans help eliminating intra-cardiac thrombus before VT ablation procedure. A high proportion of thrombus (9%) was identified. Whereas LV thrombus should systematically be ruled out before scar related VT ablation, in patients with AF, a LAA thrombus should also be eliminated as well as RV thrombus in patients with ARVC.
Acknowledgement/Funding
ANR-10-IAHU-04
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Affiliation(s)
- F Sacher
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - P Roumegou
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - J Duchateau
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - N Derval
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - A Denis
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - T Pambrun
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - W Escande
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - M Takigawa
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - A Lam
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - C Andre
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - R Chauvel
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - M Hocini
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - M Haissaguerre
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - P Jais
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
| | - H Cochet
- Bordeaux University Hospital and IHU LIRYC, Bordeaux-Pessac, France
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Reynaud Q, Rousset Jablonski C, Poupon-Bourdy S, Denis A, Rabilloud M, Lemonnier L, Nove-Josserand R, Durupt S, Touzet S, Durieu I. Pregnancy outcome in women with cystic fibrosis and poor pulmonary function. J Cyst Fibros 2019; 19:80-83. [PMID: 31272894 DOI: 10.1016/j.jcf.2019.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 12/13/2018] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND To investigate how poor pre-gestational pulmonary function influenced pregnancy outcome and clinical status evolution in women with cystic fibrosis. METHODS Pregnancies in women without lung transplantation with a first delivery reported to the French cystic fibrosis registry between 2000 and 2012 were identified. Pregnancy outcomes and clinical trends (body mass index - BMI, and pulmonary function) over a 4-year follow-up in women with poor pre-gestational pulmonary function, defined as forced expiratory volume (FEV1) ≤ 50%, were compared to those in women with FEV1 ˃ 50%. RESULTS A total of 149 women had a first delivery and 36 (24.2%) of these had pre-gestational FEV1 ≤ 50%. There was no significant difference in age or frequency of assisted conception between the 2 groups. The rate of cesarean section was significantly higher in women with FEV1 ≤ 50% (43.7% vs. 21.1%, p = .01). The frequency of preterm birth did not differ significantly between the two groups, but median infant birthweight was significantly lower in women with FEV1 ≤ 50% (2705 g; range: 650-3700 vs. 3044 g; range: 1590-3860, p = .003). Despite significantly lower FEV1 and BMI the year before pregnancy for women with poor pulmonary function, the decline in these parameters during the study period did not differ significantly between the two groups. CONCLUSION Poor pre-gestational pulmonary function in women with cystic fibrosis was associated with a higher rate of cesarean section and a clinically significant impact on fetal growth, but was not associated with more important pulmonary and nutritional decline over the study period.
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Affiliation(s)
- Quitterie Reynaud
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices Civils de Lyon, F-69495 Pierre Bénite, France; Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, F-69003 Lyon, France.
| | - Christine Rousset Jablonski
- Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, F-69003 Lyon, France; Service d'obstétrique et gynécologie, Hospices Civils de Lyon, F-69495 Pierre Bénite, France
| | | | - Angélique Denis
- Pôle de santé publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Muriel Rabilloud
- Pôle de santé publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | | | - Raphaële Nove-Josserand
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices Civils de Lyon, F-69495 Pierre Bénite, France
| | - Stéphane Durupt
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices Civils de Lyon, F-69495 Pierre Bénite, France
| | - Sandrine Touzet
- Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, F-69003 Lyon, France; Service d'obstétrique et gynécologie, Hospices Civils de Lyon, F-69495 Pierre Bénite, France
| | - Isabelle Durieu
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices Civils de Lyon, F-69495 Pierre Bénite, France; Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, F-69003 Lyon, France
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Rouzé H, Viprey M, Allemann S, Dima A, Denis A, Poupon-Bourdy S, Reix P, Camara B, Pin I, Durieu I, Reynaud Q, Touzet S. P069 Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing and hospitalisation data. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30363-7] [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: 11/27/2022]
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20
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Occelli P, Quenon JL, Kret M, Domecq S, Denis A, Delaperche F, Claverie O, Castets-Fontaine B, Amalberti R, Auroy Y, Parneix P, Michel P. Improving the safety climate in hospitals by a vignette-based analysis of adverse events: a cluster randomised study. Int J Qual Health Care 2019; 31:212-218. [PMID: 29917154 DOI: 10.1093/intqhc/mzy126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/09/2017] [Revised: 03/20/2018] [Accepted: 05/26/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To assess the impact of a vignette-based analysis of adverse events (AEs) on the safety climate (SC) of care units. DESIGN Prospective, open, cluster (a unit) randomised controlled trial. SETTING Eighteen acute care units of seven hospitals in France. PARTICIPANTS Healthcare providers who worked in the units. INTERVENTION Vignette-based analyses of AEs were conducted with unit's providers once per month for six consecutive months. The AEs were real cases that occurred in other hospitals. The hospital risk manager conducted each analysis as follows: analysis of the immediate and root causes of the AE; assessment of the care unit's vulnerabilities and existing barriers in the occurrence of an identical AE and search for solutions. MAIN OUTCOME MEASURE SC was measured using the French version of the Hospital Survey on Patient Safety Culture questionnaire. The primary outcome was the difference in the 'Organisational learning and continuous improvement' dimension score, from before to after the analyses. RESULTS Median participation rate in the analyses was 20% (range: 7-45%). Before intervention, the response rate to the SC survey was 80% (n = 210) in the intervention group and 73% (n = 191) in the control group. After intervention, it was 59% (n = 141) and 63% (n = 148), respectively. The dimension score evolved differently for the groups from before to after intervention (intervention: +10.2 points ±8.8; control: -3.0 points ±8.5, P = 0.04). Side effects were not measured. CONCLUSIONS Vignette-based analysis was associated with the improvement of the perception of participants regarding their institution's capacity for organisational learning and continuous improvement.
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Affiliation(s)
- Pauline Occelli
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France.,Health Services and Performance Research (EA 7425 HESPER), Université de Lyon 1, Lyon, France
| | - Jean-Luc Quenon
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine, Pessac, France
| | - Marion Kret
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine, Pessac, France
| | - Sandrine Domecq
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine, Pessac, France
| | - Angélique Denis
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France.,Health Services and Performance Research (EA 7425 HESPER), Université de Lyon 1, Lyon, France
| | - Florence Delaperche
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine, Pessac, France
| | - Olivier Claverie
- Laboratoire des problèmes sociaux et de l'action collective département de sociologie, Université Victor Segalen, Bordeaux, France
| | - Benjamin Castets-Fontaine
- Laboratoire des problèmes sociaux et de l'action collective département de sociologie, Université Victor Segalen, Bordeaux, France
| | - René Amalberti
- Institut de médecine aérospatiale du service de santé des armées, Brétigny sur Orge, France.,Haute autorité de santé, Saint-Denis, France
| | - Yves Auroy
- Institut de médecine aérospatiale du service de santé des armées, Brétigny sur Orge, France.,Hôpital d'instruction des armées du Val de Grace, Paris, France
| | - Pierre Parneix
- Centre de coordination de la lutte contre les infections nosocomiales Sud-Ouest, Bordeaux, France
| | - Philippe Michel
- Health Services and Performance Research (EA 7425 HESPER), Université de Lyon 1, Lyon, France.,Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine, Pessac, France.,Hospices Civils de Lyon, Lyon France
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21
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Rouzé H, Viprey M, Allemann S, Dima AL, Caillet P, Denis A, Poupon-Bourdy S, Camara B, Llerena C, Reix P, Durieu I, Reynaud Q, Touzet S. Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing, and hospitalization data. Patient Prefer Adherence 2019; 13:1497-1510. [PMID: 31564837 PMCID: PMC6732572 DOI: 10.2147/ppa.s211769] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is a life-shortening genetic condition that usually affects several organs and involves significant treatment burden. Adherence to medication is important for successful CF management. OBJECTIVE To describe medication adherence according to age, therapeutic class, and pharmaceutical form in adults and children followed in four regional CF centers in France. METHODS We conducted a cross-sectional study with non-transplanted patients followed in two adult and two pediatric centers during 2015 who were covered by the French National Health Insurance (NHI). Sociodemographic, clinical, hospitalization, and prescription data were collected from patient medical records. Medication dispensations were extracted from the regional French NHI database. Adherence was calculated over 12 months using continuous medication availability (CMA) accounting for dose adjustments and hospitalizations. Drug-specific CMA was computed in R with the AdhereR package for each medication prescribed more than 3 months, which was averaged to obtain a composite CMA score (cCMA) for all treatments and per therapeutic class as well as pharmaceutical form for each patient. RESULTS A total of 228 patients were included. The number of chronic medications increased with age (r=0.50, p<0.001): a median of 7 medications per patient were prescribed. The mean±SD cCMA was significantly different between age groups (p=0.0098): it was 0.71±0.20 for the 0-5 years age group, 0.73±0.16 for 6-11 years, 0.64±0.17 for 12-17 years, 0.57±0.23 for 18-25 years, and 0.65±0.20 for the over 25 years age group. cCMA varied significantly according to pharmaceutical forms: the mean±SD cCMA was 0.70±0.21 for oral medications and 0.54±0.28 for inhaled medications (p<0.001). CONCLUSION This study suggests that adherence to medication regimens in CF patients remains suboptimal and varies substantially between age groups and pharmaceutical forms. These variations in adherence should be considered when developing effective strategies to improve adherence.
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Affiliation(s)
- Héloïse Rouzé
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Correspondence: Héloïse RouzéHospices Civils de Lyon, Pôle de Santé Publique, Bâtiment A, 6ème étage, 162 Avenue Lacassagne69003Lyon, FranceTel +33 47 211 5132Email
| | - Marie Viprey
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Samuel Allemann
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Alexandra L Dima
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Pascal Caillet
- Department of Clinical Pharmacology, CHU de Nantes, Nantes, France
| | - Angélique Denis
- Public Health Department, Hospices Civils de Lyon, Lyon, France
| | | | - Boubou Camara
- Pulmonary Department, Adult CF Center, CHU de Grenoble, Grenoble, France
| | - Catherine Llerena
- Pediatric Pulmonology Department, Pediatric CF Center, CHU de Grenoble, Grenoble, France
| | - Philippe Reix
- Pediatric Pulmonology Department, Pediatric CF Center, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
| | - Isabelle Durieu
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Quitterie Reynaud
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Sandrine Touzet
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
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Rousseau C, Le Thiec M, Ferrer L, Rusu D, Rauscher A, Maucherat B, Frindel M, Baumgartner P, Fleury V, Denis A, Debeaupuis E, Campion L, Kraeber-Bodéré F. Résultats préliminaires d’une étude prospective tep/tdm 68ga-psma chez des patients atteints de récidive occulte d’un cancer de la prostate : performances diagnostiques et impact sur la prise en charge thérapeutique. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.010] [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: 11/29/2022]
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Denis A, Reynaud Q, Boudreau V, Poupon-Bourdy S, Rabasa-Lhoret R, Durieu I, Touzet S. Association between the 1-hour plasma glucose during oral glucose tolerance testing and clinical evolution in Canadian and French cystic fibrosis adult patients: A GLYC-ONE database longitudinal study. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.189] [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: 10/28/2022] Open
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Pioche M, Denis A, Allescher HD, Andrisani G, Costamagna G, Dekker E, Fockens P, Gerges C, Groth S, Kandler J, Lienhart I, Neuhaus H, Petruzziello L, Schachschal G, Tytgat K, Wallner J, Weingart V, Touzet S, Ponchon T, Rösch T. Impact of 2 generational improvements in colonoscopes on adenoma miss rates: results of a prospective randomized multicenter tandem study. Gastrointest Endosc 2018; 88:107-116. [PMID: 29410020 DOI: 10.1016/j.gie.2018.01.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/18/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Numerous randomized studies have shown that changing certain features of colonoscopes, usually incorporated when switching from one endoscope generation to the next, mostly do not increase adenoma yield. There is, however, indirect evidence that it may be necessary to skip one instrument generation (ie, changing from one generation to the next but one) to achieve this effect. METHODS We compared the latest-generation colonoscopes from one company (Olympus Exera III, 190-C) with the next to last one (Olympus 160/5-C) in a prospective multicenter study randomized for the order of colonoscopes in a tandem fashion, involving 2 different examiners. Patients with increased risk for colorectal neoplasia undergoing colonoscopy (positive fecal occult blood test, personal/familial history of colorectal cancer/adenoma, rectal bleeding, recent change in bowel movements) were included. The primary outcome was the adenoma miss rate with the 190 (190-C) colonoscope in comparison with the 160/5 colonoscope (160/5-C). RESULTS A total of 856 patients (48.8% male; mean age, 58.3 years) with a personal (41%) or family (38%) history of colorectal neoplasia, rectal bleeding (19%), and other indications were included. Of the 429 patients in the 190-C first group, 16.6% (95% confidence interval [CI], 13.0%-20.1%) had at least one adenoma missed during the first procedure, compared with 30.2% (95% CI, 25.9%-34.6%) in the group with 160/5-C first (P < .001). Similarly, the adenoma detection rate during the first colonoscopy was 43.8% versus 36.5% (P = .030) for 190-C versus 160/5-C, respectively. CONCLUSIONS This randomized tandem trial showed lower adenoma miss rates and higher adenoma detection rates for the newer 190 colonoscopes compared with the 160/5 series. These results suggest that it takes multiple improvements, such as those implemented over 2 instrument generations, before an effect on adenoma (miss) rate can be observed. (Study registration number: ISRCTN 2010-A01256-33.).
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Affiliation(s)
- Mathieu Pioche
- Gastroenterology and Endoscopy Division, Hôpital Edouard Herriot, Lyon, France
| | - Angélique Denis
- Hospices Civils de Lyon, Pôle Information médicale Evaluation Recherche, Lyon, France; Université de Lyon, Laboratoire Health Services and Performance Research (HESPER) Lyon, France
| | - Hans-Dieter Allescher
- Department of Medicine, Klinikum Garmisch-Partenkirchen, Academic Teaching Hospital of the LMU Munich, Garmisch-Partenkirchen, Germany
| | | | | | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - Paul Fockens
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - Christian Gerges
- Department of Gastroenterology, Evangelisches Krankenhaus, Dusseldorf, Germany
| | - Stefan Groth
- Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Jennis Kandler
- Department of Gastroenterology, Evangelisches Krankenhaus, Dusseldorf, Germany
| | - Isabelle Lienhart
- Gastroenterology and Endoscopy Division, Hôpital Edouard Herriot, Lyon, France
| | - Horst Neuhaus
- Department of Gastroenterology, Evangelisches Krankenhaus, Dusseldorf, Germany
| | | | - Guido Schachschal
- Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Kristien Tytgat
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - Jürgen Wallner
- Department of Medicine, Klinikum Garmisch-Partenkirchen, Academic Teaching Hospital of the LMU Munich, Garmisch-Partenkirchen, Germany
| | - Vincens Weingart
- Department of Medicine, Klinikum Garmisch-Partenkirchen, Academic Teaching Hospital of the LMU Munich, Garmisch-Partenkirchen, Germany
| | - Sandrine Touzet
- Hospices Civils de Lyon, Pôle Information médicale Evaluation Recherche, Lyon, France; Université de Lyon, Laboratoire Health Services and Performance Research (HESPER) Lyon, France
| | - Thierry Ponchon
- Gastroenterology and Endoscopy Division, Hôpital Edouard Herriot, Lyon, France
| | - Thomas Rösch
- Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Denis A, Pambrun T, Martin R, Derval N, Sacher F. Isoproterenol testing in arrhythmogenic right ventricular cardiomyopathy: another brick in the wall?—Authors’ reply. Europace 2018; 20:f138-f139. [DOI: 10.1093/europace/euy101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Denis
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L’institut de rythmologie et modélisation cardiaque, Université de Bordeaux, Avenue Magellan, 33604 Bordeaux-Pessac, France
| | - T Pambrun
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L’institut de rythmologie et modélisation cardiaque, Université de Bordeaux, Avenue Magellan, 33604 Bordeaux-Pessac, France
| | - R Martin
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L’institut de rythmologie et modélisation cardiaque, Université de Bordeaux, Avenue Magellan, 33604 Bordeaux-Pessac, France
| | - N Derval
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L’institut de rythmologie et modélisation cardiaque, Université de Bordeaux, Avenue Magellan, 33604 Bordeaux-Pessac, France
| | - F Sacher
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L’institut de rythmologie et modélisation cardiaque, Université de Bordeaux, Avenue Magellan, 33604 Bordeaux-Pessac, France
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Wolf M, Vlachos K, Kitamura T, Denis A, Jais P, Derval N. 260Vein-of-Marshall mediated complex atrial tachycardia. Europace 2018. [DOI: 10.1093/europace/euy015.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Wolf
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - K Vlachos
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - T Kitamura
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - A Denis
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - P Jais
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - N Derval
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
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Lam A, Wolf M, Kitamura T, Takigawa M, Martin C, Bourier F, Frontera A, Sacher F, Derval N, Denis A, Pambrun T, Duchateau J, Hochini M, Haissaguerre M, Jais P. 519Are recurrences of post MI VT due to substrate progression of insufficient index ablation? A 4 years FU study. Europace 2018. [DOI: 10.1093/europace/euy015.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Lam
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Wolf
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - T Kitamura
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Takigawa
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - C Martin
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - F Bourier
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - A Frontera
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - F Sacher
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - N Derval
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - A Denis
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - T Pambrun
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - J Duchateau
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Hochini
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | | | - P Jais
- Hospital Haut Leveque, Bordeaux-Pessac, France
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Denis A, Mirallie E, Dru D, Autain Renaudin K, Kraeber-Bodéré F, Ansquer C. Apport de la TEP/TDM au 18 FDG dans le bilan préopératoire des phéochromocytomes. Étude rétrospective comparative par rapport à la scintigraphie à la MIBG. Médecine Nucléaire 2018. [DOI: 10.1016/j.mednuc.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Denis A, Sacher F, Derval N, Martin R, Lim HS, Pambrun T, Massoullie G, Duchateau J, Cochet H, Pillois X, Cheniti G, Frontera A, Takigawa M, Vlachos K, Martin C, Kitamura T, Hocini M, Douard H, Jaïs P, Haïssaguerre M. Arrhythmogenic response to isoproterenol testing vs. exercise testing in arrhythmogenic right ventricular cardiomyopathy patients. Europace 2018; 20:f30-f36. [DOI: 10.1093/europace/euy007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/16/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Denis
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - F Sacher
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - N Derval
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - R Martin
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H S Lim
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - T Pambrun
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - G Massoullie
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - J Duchateau
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H Cochet
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - X Pillois
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - G Cheniti
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - A Frontera
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Takigawa
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - K Vlachos
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - C Martin
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - T Kitamura
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Hocini
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H Douard
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - P Jaïs
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Haïssaguerre
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
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Fischer Fumeaux CJ, Denis A, Prudon MB, Plaisant F, Essomo Megnier-Mbo CM, Fernandes L, Touzet S, Claris O, Laborie S. Early Use of Mother's Own Raw Milk, Maternal Satisfaction, and Breastfeeding Continuation in Hospitalised Neonates: A Prospective Cohort Study. Neonatology 2018; 113:131-139. [PMID: 29186707 DOI: 10.1159/000480535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/17/2016] [Accepted: 08/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Despite the critical importance of breast milk for preterm and sick neonates, there is no consensus regarding the use of raw mother's own milk (MOM) in neonatal units. OBJECTIVES This study aimed to describe the use of raw MOM in hospitalised neonates before day 7 (early use), and to investigate: (i) related factors, (ii) maternal satisfaction, and (iii) the association with breastfeeding continuation. METHODS This prospective cohort included 516 neonates intended to be breastfed in 2 French neonatal units. Neonates receiving raw MOM before day 7 were compared to those who did not. The association between early use of MOM and breastfeeding continuation at hospital discharge, and up to 6 months later, was measured by logistic regression. RESULTS More than one-third (36.2%) of breastfed neonates did not receive any MOM during their first week, mainly due to organisational constraints and staff reluctance. Maternal satisfaction related to early raw MOM use was high (96%), and was coupled with a more frequent maternal feeling of being supported in breastfeeding (p = 0.003). There was a significant association between early use of MOM and breastfeeding continuation at discharge (OR 2.92, 95% CI 1.94-4.40, p < 0.0001), which persisted 6 months later (OR 2.70, 95% CI 1.21-6.03, p = 0.023). This association appeared independent in multivariable analyses (at discharge: aOR 2.03, 95% CI 1.27-3.25, p = 0.003; 6 months later: aOR 2.46, 95% CI 1.02-5.92, p = 0.045). CONCLUSION While the early use of raw MOM in hospitalised neonates can be limited by multiple factors, it appears supportive for mothers, and might represent a simple opportunity to improve breastfeeding in neonatal units.
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Affiliation(s)
- Céline J Fischer Fumeaux
- Department of Woman Mother Child, Clinic of Neonatology, University Hospital of Lausanne, Lausanne, Switzerland
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Martin CA, Martin R, Wong T, Maury P, Dallet C, Takigawa M, Frontera A, Cheniti G, Thompson N, Massouillie G, Kitamura T, Wolf M, Duchateau J, Vlachos K, Pambrun T, Denis A, Derval N, Hocini M, Haissaguerre M, Jais P, Sacher F. 37Effect of activation wavefront on electrogram characteristics during ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/europace/eux283.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Frontera A, Martin R, Takigawa M, Cheniti G, Dallet C, Kitamura T, Thompson N, Wolf M, Massoullie G, Vlachos K, Denis A, Hocini M, Cochet H, Sacher F, Jaïs P, Derval N, Haïssaguerre M. 073_16987-H2 EGM Fractionation in Apparently Healthy Tissue: Time to Redefine the Voltage Threshold for Diseased Atrium? JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.034] [Citation(s) in RCA: 1] [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: 11/26/2022]
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Martin CA, Sawhney V, Martin R, Takigawa M, Frontera A, Cheniti G, Thompson N, Massouillie G, Kitamura T, Wolf M, Duchateau J, Vlachos K, Denis A, Pambrun T, Sacher F, Hocini M, Jais P, Haissaguerre M, Ezzat V, Lowe MD, Derval N. 77USe of ultra-high density activation mapping to aid isthmus identification in atrial macro-reentrant tachycardias in complex congenital heart disease. Europace 2017. [DOI: 10.1093/europace/eux283.072] [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: 11/13/2022] Open
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34
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Frontera A, Takigawa M, Martin R, Thompson N, Cheniti G, Massouille G, Duchateau J, Kitamura T, Wolf M, Al-Jefairi N, Vlachos K, Yamashita S, Denis A, Hocini M, Cochet H, Sacher F, Jaïs P, Derval N, Haïssaguerre M. 073_16988-H2 Electrogram Signature of Specific Activation Patterns: Analysis of Atrial Arrhythmias at High-Density Endocardial Mapping. JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.033] [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: 11/24/2022]
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Chaleat-Valayer E, Bard-Pondarre R, Bernard JC, Roumenoff F, Lucet A, Denis A, Occelli P, Touzet S. Upper limb and hand patterns in cerebral palsy: Reliability of two new classifications. Eur J Paediatr Neurol 2017; 21:754-762. [PMID: 28532985 DOI: 10.1016/j.ejpn.2017.04.1332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/14/2016] [Revised: 02/28/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the inter- and intra-rater reliability of two previously developed classifications of upper limb and hand patterns. METHOD Two hundred and twelve films of patients with CP (118 of UL postures and 94 of hand tasks; median age 14, 3-46 years) were viewed by 18 examiners from 2 different rehabilitation centers, and one expert who had participated in the design of the classifications. They classed upper limb (3 patterns with sub-types) and hand patterns (2 patterns with subtypes) twice, at 2 months' interval. Inter- and intra-rater reliability were analysed. RESULTS Intra-rater and inter-rater reliability were very high for upper limb and hand patterns (0.87 < k < 0.92), and high for the subtypes (0.58 < k < 0.68). Examiners stated that both classifications were useful and feasible in clinical practice. INTERPRETATION Despite the single, short training session on use of the classifications, agreement between the examiners and the expert examiner was good to high, confirming that these classifications are easy to use and reliable. The classifications proposed here provide homogenous terminology for use in both clinical practice and research, to describe, evaluate and follow-up changes in upper limb and hand patterns in patients with cerebral palsy, particularly those with dyskinesia.
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Affiliation(s)
- E Chaleat-Valayer
- Médecin de Médecine Physique et de Réadaptation, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France
| | - R Bard-Pondarre
- Ergothérapeute, Service enfants - adolescents, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France.
| | - J C Bernard
- Médecin de Médecine Physique et de Réadaptation, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France
| | - F Roumenoff
- Médecin de Médecine Physique et de Réadaptation, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France
| | - A Lucet
- Médecin de Médecine Physique et de Réadaptation, Croix-Rouge française CMPRE de Bois Larris, Avenue Jacqueline-Mallet, 60260 Lamorlaye, France
| | - A Denis
- Biostatisticien, Unité de recherche en Qualité et Sécurité des soins, Pôle Information Médicale, Evaluation, Recherche, Hospices Civils de Lyon, 162 avenue Lacassagne, 69424 Lyon Cedex 03, France
| | - P Occelli
- Médecin de santé publique, Unité de recherche en Qualité et Sécurité des soins, Pôle Information Médicale, Evaluation, Recherche, Hospices Civils de Lyon, 162 avenue Lacassagne, 69424 Lyon Cedex 03, France; EA 7425 HESPER - Laboratoire Health Services and Performance Research, Université de Lyon, 69003 Lyon, France
| | - S Touzet
- Médecin de santé publique, Unité de recherche en Qualité et Sécurité des soins, Pôle Information Médicale, Evaluation, Recherche, Hospices Civils de Lyon, 162 avenue Lacassagne, 69424 Lyon Cedex 03, France; EA 7425 HESPER - Laboratoire Health Services and Performance Research, Université de Lyon, 69003 Lyon, France
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Gendreau H, Molinier O, Foulet-Rogé A, Denis A, Besançon A, Goupil F. MALT pulmonaire et lupus, un continuum ? Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2017.07.010] [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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Lesne A, Rouquette O, Touzet S, Petit-Laurent F, Tourlonias G, Pasquion A, Rivory J, Aguero Garcete G, Scanzi J, Chalumeau S, Chambon-Augoyard C, Moussata D, Leger-Nguyen F, Degeorges S, Chauvenet M, Fontanges T, Baubet S, Brulet P, Billioud C, Thimonier E, Stroeymeyt-Martin K, Hamel B, Graillot E, Cruiziat C, Scalone O, O'Brien M, Péré-Vergé D, Souquet JC, Phelip JM, Poincloux L, Poupon-Bourdy S, Denis A, Magaud L, Ponchon T, Pioche M. Adenoma detection with blue-water infusion colonoscopy: a randomized trial. Endoscopy 2017; 49:765-775. [PMID: 28399611 DOI: 10.1055/s-0043-105073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
UNLABELLED Background and aims Colonoscopy is currently the reference method to detect colorectal neoplasia, yet some adenomas remain undetected. The water infusion technique and dying with indigo carmine has shown interesting results for reducing this miss rate. The aim of this study was to compare the adenoma detection rate (adenoma and adenocarcinoma; ADR) and the mean number of adenomas per patient (MAP) for blue-water infusion colonoscopy (BWIC) versus standard colonoscopy. Methods We performed a multicenter, randomized controlled trial in eight units, including patients with a validated indication for colonoscopy (symptoms, familial or personal history, fecal occult blood test positive). Consenting patients were randomized 1:1 to BWIC or standard colonoscopy. All colonoscopies were performed by experienced colonoscopists. All colonoscopy quality indicators were prospectively recorded. Results Among the 1065 patients included, colonoscopies were performed completely for 983 patients (514 men; mean age 59.1). The ADR was not significantly different between the groups; 40.4 % in the BWIC group versus 37.5 % in the standard colonoscopy group (odds ratio [OR] 1.13; 95 % confidence interval [CI] 0.87 - 1.48; P = 0.35). MAP was significantly greater in the BWIC group (0.79) than in the standard colonoscopy group (0.64; P = 0.005). For advanced adenomas, the results were 50 (10.2 %) and 36 (7.3 %), respectively (P = 0.10). The cecal intubation rate was not different but the time to cecal intubation was significantly longer in BWIC group (9.9 versus 6.2 minutes; P < 0.001). Conclusion Despite the higher MAP with BWIC, the routine use of BWIC does not translate to a higher ADR. Whether increased detection ultimately results in a lower rate of interval carcinoma is not yet known. CLINICAL TRIALS REGISTRATION EudraCT 2012-A00548 - 35; NCT01937429.
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Affiliation(s)
- Adriane Lesne
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.,Lyon 1 University Claude Bernard, Lyon, France
| | - Olivier Rouquette
- Hepatogastroenterology Department, University Hospital d'Estaing, Clermont-Ferrand, France
| | - Sandrine Touzet
- Hospices Civils de Lyon, pôle Information médicale Evaluation Recherche, and Université de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon, France
| | - Fabien Petit-Laurent
- Hepatogastroenterology Department, Nord Ouest Hospital, Villefranche-sur-Saône, France
| | - Gwenaelle Tourlonias
- Hepatogastroenterology Department, University Hospital Croix Rousse, Lyon, France
| | - Audrey Pasquion
- Hepatogastroenterology Department, University Hospital Saint-Etienne, Saint-Priest en Jarez, France.,Hepatogastroenterology Department, St Joseph St Luc Hospital, Lyon, France
| | - Jérôme Rivory
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.,Hepatogastroenterology Department, University Hospital Croix Rousse, Lyon, France
| | | | - Julien Scanzi
- Hepatogastroenterology Department, University Hospital d'Estaing, Clermont-Ferrand, France
| | - Sylvaine Chalumeau
- Hepatogastroenterology Department, Nord Ouest Hospital, Villefranche-sur-Saône, France
| | | | - Driffa Moussata
- Hepatogastroenterology Department, University Hospital Lyon Sud, Pierre-Bénite, France
| | - Florence Leger-Nguyen
- Hepatogastroenterology Department, Nord Ouest Hospital, Villefranche-sur-Saône, France
| | - Stéphane Degeorges
- Hepatogastroenterology Department, Public Hospital Bourgoin-Jallieu, France
| | - Marion Chauvenet
- Hepatogastroenterology Department, University Hospital Lyon Sud, Pierre-Bénite, France
| | - Thierry Fontanges
- Hepatogastroenterology Department, Public Hospital Bourgoin-Jallieu, France
| | - Sandrine Baubet
- Hepatogastroenterology Department, University Hospital Croix Rousse, Lyon, France
| | - Philippe Brulet
- Hepatogastroenterology Department, Public Hospital Bourgoin-Jallieu, France
| | - Claire Billioud
- Hepatogastroenterology Department, University Hospital Croix Rousse, Lyon, France
| | - Elsa Thimonier
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | | | - Benjamin Hamel
- Hepatogastroenterology Department, Nord Ouest Hospital, Villefranche-sur-Saône, France
| | - Emmanuelle Graillot
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | - Claire Cruiziat
- Hepatogastroenterology Department, Public Hospital Bourgoin-Jallieu, France
| | - Olivia Scalone
- Hepatogastroenterology Department, Nord Ouest Hospital, Villefranche-sur-Saône, France
| | - Marc O'Brien
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | - Denis Péré-Vergé
- Hepatogastroenterology Department, St Joseph St Luc Hospital, Lyon, France
| | | | - Jean-Marc Phelip
- Hepatogastroenterology Department, University Hospital Saint-Etienne, Saint-Priest en Jarez, France
| | - Laurent Poincloux
- Hepatogastroenterology Department, University Hospital d'Estaing, Clermont-Ferrand, France
| | - Stéphanie Poupon-Bourdy
- Hospices Civils de Lyon, pôle Information médicale Evaluation Recherche, and Université de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon, France
| | - Angélique Denis
- Hospices Civils de Lyon, pôle Information médicale Evaluation Recherche, and Université de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon, France
| | - Laurent Magaud
- Hospices Civils de Lyon, pôle Information médicale Evaluation Recherche, and Université de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon, France
| | - Thierry Ponchon
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.,Lyon 1 University Claude Bernard, Lyon, France.,INSERM U1032, LabTau, Lyon, France
| | - Mathieu Pioche
- Hepatogastroenterology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.,Lyon 1 University Claude Bernard, Lyon, France.,INSERM U1032, LabTau, Lyon, France
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Wolf M, Sacher F, Cochet H, Kitamura T, Takigawa M, Frontera A, Cheniti G, Vlachos K, Martin R, Denis A, Pambrun T, Derval N, Hocini M, Haissaguerre M, Jais P. P1112Long-term outcome of LAVA elimination in ablation of post-myocardial infarction ventricular tachycardia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1112] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wolf M, Takigawa M, Derval N, Vlachos K, Kitamura T, Frontera A, Cheniti G, Martin R, Thompson N, Denis A, Pambrun T, Sacher F, Haissaguerre M, Jais P, Hocini M. P1393Pattern and timing of coronary sinus activation in complex atrial tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux158.021] [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: 11/12/2022] Open
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Frontera A, Takigawa M, Martin R, Thompson N, Cheniti G, Kitamura T, Wolf M, Vlachos K, Massouille G, Denis A, Hocini M, Sacher F, Jais P, Haissaguerre M, Derval N. P253Can EGM fractionation occur in healthy tissue? Electrophysiological mechanism and significance during atrial tachycardia rhythm. Europace 2017. [DOI: 10.1093/ehjci/eux171.009] [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: 11/14/2022] Open
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Chaumeil A, Sacher F, Casset C, Qu F, Mcspadden L, Derval N, Denis A, Hocini M, Jais P, Haissaguerre M. P481Can an ICD determine the origin of focal VT? Europace 2017. [DOI: 10.1093/ehjci/eux141.204] [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: 11/14/2022] Open
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Wolf M, Kitamura T, Sacher F, Cochet H, Vlachos K, Cheniti G, Frontera A, Takigawa M, Martin R, Thompson N, Derval N, Denis A, Hocini M, Haissaguerre M, Jais P. 1219Comparison of procedural endpoints for ablation of post-myocardial infarction ventricular tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux154.003] [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: 11/14/2022] Open
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Frontera A, Takigawa M, Thompson N, Martin R, Cheniti G, Kitamura T, Wolf M, Massouille G, Vlachos K, Hocini M, Denis A, Sacher F, Jais P, Haissaguerre M, Derval N. P385Relationship of voltage and EGM duration at sites of fractionation during atrial tachycardias and paced rhythms. Europace 2017. [DOI: 10.1093/ehjci/eux141.110] [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: 11/12/2022] Open
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Wolf M, Kitamura T, Sacher F, Cochet H, Vlachos K, Cheniti G, Frontera A, Takigawa M, Martin R, Thompson N, Derval N, Denis A, Hocini M, Haissaguerre M, Jais P. 752Long-term outcome of LAVA elimination in ablation of post-myocardial infarction ventricular tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux147.001] [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: 11/14/2022] Open
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Frontera A, Takigawa M, Kitamura T, Martin R, Vlachos K, Cheniti G, Thompson N, Massouille G, Wolf M, Hocini M, Denis A, Sacher F, Jais P, Haissaguerre M, Derval N. P386Relationship between scar and atrial tachycardia mechanisms: insight from registered magnetic resonance and ultra-high density activation mapping using the Rhythmia system. Europace 2017. [DOI: 10.1093/ehjci/eux141.111] [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: 11/14/2022] Open
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47
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Frontera A, Takigawa M, Martin R, Dallet C, Kitamura T, Thompson N, Cheniti G, Vlachos K, Massouille G, Denis A, Sacher F, Hocini M, Jais P, Haissaguerre M, Derval N. P383Characterization of reentrant atrial tachycardia circuits with a high density mapping system. Europace 2017. [DOI: 10.1093/ehjci/eux141.108] [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: 11/12/2022] Open
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Chaumeil A, Sacher F, Casset C, Qu F, Mcspadden L, Derval N, Denis A, Hocini M, Haissaguerre M, Jais P. P480The value of ICD electrograms for localization of foci originating from different locations within the left ventricle. Europace 2017. [DOI: 10.1093/ehjci/eux141.203] [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: 11/12/2022] Open
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Frontera A, Martin R, Thompson N, Takigawa M, Kitamura T, Cheniti G, Massouille G, Vlachos K, Wolf M, Denis A, Hocini M, Sacher F, Jais P, Haissaguerre M, Derval N. P384Characterization of slow conductions areas in scar-related atrial tachycardia. Insights from high density mapping system. Europace 2017. [DOI: 10.1093/ehjci/eux141.109] [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: 11/13/2022] Open
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Gourraud J, Morio F, Amara N, Sacher F, Mabo P, Babuty D, Mansourati J, Pasquié J, Denis A, Maury P, Jesel L, Gilles L, Solnon A, Guyomarch B, Kyndt F, Barc J, Thollet A, Probst V. Risk stratification of arrhythmia and death in ARVC. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30499-8] [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: 11/24/2022]
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