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Abbas M, Patrizia C, Fabienne M, Marc B, Lucia P, Fabrice C, Martin D, Camelia P. Minimal clinically important differences in health-related quality of life after treatment with direct-acting antivirals for chronic hepatitis C: ANRS CO22 HEPATHER cohort (PROQOL-HCV). Qual Life Res 2024:10.1007/s11136-024-03622-2. [PMID: 38580786 DOI: 10.1007/s11136-024-03622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE Patient Reported Outcomes Quality of Life survey for HCV (PROQOL-HCV) is a specific tool developed to assess health-related quality of life (HRQoL) in patients with chronic hepatitis C receiving direct-acting antivirals (DAA). Thresholds for clinically meaningful changes in PROQOL-HCV scores should be documented to improve the tool's use in clinical practice. This study aimed to estimate the minimal clinically important differences (MCIDs) in PROQOL-HCV scores before and after HCV cure by DAA among participants in the prospective cohort ANRS-CO22 HEPATHER. METHODS Data from 460 chronic HCV patients were collected at DAA initiation (baseline) and 24 weeks after treatment end. MCIDs were estimated for the six HRQoL dimensions (Physical Health (PH), Emotional Health (EH), Future Uncertainty (FU), Intimate Relationships (IR), Social Health (SH), and Cognitive Functioning (CF)) using two approaches: anchor-based and score distribution-based. Each MCID was estimated for improvement/deterioration both globally and separately for patients with a baseline PRQoL-HCV score ≤ 50 (group1) and patients with a baseline PRQoL-HCV score > 50 (group2). RESULTS The pooled MCIDs for improvement/deterioration globally, in group1, and in group2, respectively, were as follows: 8.8/- 7.6, 9.7/- 9.5, and 6.0/- 6.9 for PH; 7.1/- 4.6, 7.7/- 9.6, and 6.6/- 6.7 for EH; 6.7/- 6.7, 8.2/- 8.2, and 6.0/- 6.0 for FU; 7.0/- 7.0, 5.4/- 5.4, and 6.2/- 6.2 for IR; 7.7/- 7.7, 8.6/- 8.6, and 6.5/- 6.5 for SH; 7.3/- 5.6, 9.1/- 8.0, and 6.5/- 6.3 for CF. CONCLUSIONS The overall MCID for the PROQOL-HCV scores ranged from 6.7 to 8.8 for improvement and from - 7.7 to - 4.6 for deterioration. The effect of DAA on PROQOL-HCV scores seemed particularly beneficial for patients with lower baseline scores. This subgroup could be motivated to take DAA if they are informed of the benefits for their HRQoL.
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Affiliation(s)
- Mourad Abbas
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Carrieri Patrizia
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
- Faculté de Médecine, Inserm UMR 1252 SESSTIM, Aix-Marseille Univ, 27 Bd Jean Moulin, 13385, Marseille, France.
| | - Marcellin Fabienne
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Bourliere Marc
- Department of Hepatology and Gastroenterology, Hôpital Saint Joseph, Marseille, France
| | - Parlati Lucia
- Institut Cochin, CNRS, INSERM, Université de Paris, 75014, Paris, France
- Hôpital Cochin, 24, Rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Carrat Fabrice
- Unité de Santé Publique, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Institut National de La Santé Et de La Recherche Médicale, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, Sorbonne Université, 75012, Paris, France
| | - Duracinsky Martin
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), Hôpital Hôtel-Dieu, APHP, UMR1123, Université de Paris, Inserm, Paris, France
| | - Protopopescu Camelia
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Tomaszewski M, Marc B, Kherad O, Restellini-Kherad S, Barkun AN, Margaret W, Bessissow T. A209 ENDOSCOPY BLEEDING RISK IN PATIENTS WITH INHERITED COAGULATION DISORDERS, A RETROSPECTIVE STUDY. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Tomaszewski
- Internal Medicine, McGill University, Montreal, QC, Canada
| | - B Marc
- Internal Medicine, McGill University, Montreal, QC, Canada
| | - O Kherad
- Internal Medicine, Hôpital de la Tour and University of Geneva, Meyrin, Switzerland
| | | | - A N Barkun
- Gastroenterology, McGill University Health Center, Montreal, QC, Canada
| | - W Margaret
- Hematology, McGill University Health Centre, Montreal, QC, Canada
| | - T Bessissow
- Gastroenterology, McGill University Health Center, Montreal, QC, Canada
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Le portz B, Bron J, Devoldere G, Haillot O, Janin P, Lefort J, Leo J, Marc B, Montaigne O, Mouton A, Rodde P, Brouziyne M, Saussine C. La prothèse de soutien uretrobulbaire transobturatrice et prépubienne Surgimesh M-SLING* pour l’incontinence après prostatectomie : résultats cliniques d’une évaluation prospective de 86 cas à 1 an. Prog Urol 2014; 24:888-9. [DOI: 10.1016/j.purol.2014.08.229] [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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Faudeux C, Giovannini-Chami L, Gatin A, Montaudie I, Haas H, Berard E, Breaud J, Fournier J, Marc B, Schweitzer C, Tran A, Dupont A. SFP CO-57 - Formation aux gestes d’urgence par simulation: validation de grilles d’évaluation. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71968-2] [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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Braconnier F, Marc B. Chantier de restauration du beffroi de la cathédrale d’Orléans : les mains des salariés, principal vecteur de contamination au plomb. ARCH MAL PROF ENVIRO 2013. [DOI: 10.1016/j.admp.2013.07.009] [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: 10/26/2022]
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Charles A, Marc B, Sabine V. 247 Improving comprehensive care of patients with cardiovascular risk factors. BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041624.66] [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: 11/03/2022]
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Marc B. [Ambroise Pare and the recognition of nurse midwives]. Soins 2001:19-21. [PMID: 12012990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- B Marc
- Hôpital Jean Verdier, Bondy (93), DEA d'histoire des sciences et des idées (Paris XII), doctorant en histoire contemporaine (Paris IV-Sorbonne)
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Marc B. [Nurses during the First World War. A modern vision of nursing care and the recognition of sacrifices]. Soins 2001:18-20. [PMID: 12008596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- B Marc
- Hôpital Jean Verdier, Bondy
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Marc B, Bouchez-Buvry A, Wepierre JL, Boniol L, Vaquero P, Garnier M. Carbon-monoxide poisoning in young drug addicts due to indoor use of a gasoline-powered generator. ACTA ACUST UNITED AC 2001; 8:54-6. [PMID: 16083675 DOI: 10.1054/jcfm.2001.0474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report six fatal cases of unintentional carbon-monoxide poisoning which occurred in a house occupied by young people. The source of carbon monoxide was a gasoline-powered generator. For all victims, an external body examination was carried out and blood and urine samples collected. Blood carboxyhaemoglobin (COHb) was performed using an automated visible spectrophotometric analysis. Blood-alcohol level quantification was performed using gas chromatography and drug screening in urine was performed by a one-step manual qualitative immunochromatography (Syva Rapid test, Behring Diagnostics Inc.) for benzoylecgonine (the main metabolite of cocaine in urine), morphine, 11-nor-Delta(9)-THC-9-COOH (cannabinoids) and d-methamphetamine. In all victims the COHb value was as high or higher than 65%. No alcohol was found in blood samples, but urine samples were positive for methamphetamine, cocaine and cannabis in five cases and for opiates in one case. In four victims, the urine sample was positive for at least three drugs. The availability and accuracy of rapid toxicological screening is an important tool for the medical examiner at the immediate scene of a clinical forensic examination.
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Affiliation(s)
- B Marc
- Emergency Forensic Unit (Urgences médico-judiciaires), University Hospital Jean Verdier (AP-HP), Bondy, France.
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Marc B. [Nurses during the first World War. The necessary passage from volunteerism to professionalism]. Soins 2001:22-4. [PMID: 12008491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- B Marc
- Hôpital Jean Verdier, Bondy
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Marc B. [Patients in the first world war. The saving reinforcement of the benevolent hospital attendant]. Soins 2001:22-3. [PMID: 12008441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- B Marc
- Hôpital Jean-Verdier, Bondy
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Marc B. [Psychology. The nurse and the violence of intimacy]. Soins 2001:49-50. [PMID: 12008452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Marc B. [Nurses during the First World War; health disasters during the initial phases of conflict]. Soins 2000:24-6. [PMID: 11324247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- B Marc
- Service des urgences médico-judiciaires, hôpital Jean-Verdier, Bondy
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Marc B. Basic knowledge of Internet in forensic medicine: logging on, fetching files and information. Med Sci Law 2000; 40:293-300. [PMID: 11281350 DOI: 10.1177/002580240004000403] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The Internet stands at the forefront of telecommunications in medicine, including forensic medicine, since information technology (IT) has been able to revolutionize medical and scientific practices. Today, forensic physicians and professionals need to be familiar with the use of computers and the key applications of information technology: multimedia and the Internet. From the office, the forensic physician can communicate with other physicians by means of e-mail, take part in discussion groups, obtain information on meetings and get information from public libraries and various databases by means of file transfer protocol. The search among the huge amount of information is facilitated by the 'click and play' use of the Internet, by its increased ease and availability of access and by faster communications to an increasing number of accessible technical, scientific and biomedical resources. Therefore, it is useful to introduce some of the most frequent concepts encountered when exploring the Internet, to give simple references for any forensic physician exploring the Internet and to present typical Internet aspects by illustrations saved from worldwide websites and linked to the accompanying text. Some of the main forensic websites and basic Internet procedures are described, explaining how to search and exchange information in the domain of forensic medicine and sciences. Search engines and search procedures on the worldwide web are briefly explained. The aim of this paper is to give forensic physicians, scientists and law professionals some basic tools and references to access the vast possibilities of the Internet.
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Affiliation(s)
- B Marc
- Emergency Forensic Unit, University Hospital Jean Verdier, Bondy, France
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Abstract
A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed.
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Affiliation(s)
- B Marc
- Emergency Forensic Unit, University Teaching Hospital Jean Verdier (AP-HP), Bondy, France
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Marc B, Bontemps V, Baudry F, Richard B, Ghaith A, Garnier M. Drugs of abuse in urine of young adult drivers involved in road accidents in a Paris suburb (1996). ACTA ACUST UNITED AC 2000; 7:77-81. [PMID: 16083655 DOI: 10.1054/jcfm.2000.0366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- B Marc
- Emergency Forensic Unit (Urgences médico-judiciaires), University Hospital Jean Verdier (AP-HP), 93143 Bondy cedex, France.
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Abstract
Sexual assaults under benzodiazepine submission have been described, since use of benzodiazepine enables non consensual sexual activity but rarely fully reported. An accurate evaluation of the phenomenon has seemed interesting. Files of 23 adult males and females examined at the Emergency Forensic Unit of an University Teaching Hospital near Paris were reviewed. All the victims had complained from sexual assault under drug submission, in the years 1996 and 1997. A complete examination for sexual assault was realised linked to clinical examination of drug intoxication. Every victim of rape under drug submission was sampled for urine screening (mean delay of 17.5 h after sexual assault) and blood alcohol level quantification. Urine was screened for benzodiazepines, cocaine, opiates and cannabinoids with qualitative immunochromatographic test. Traumatic lesions of sexual penetration were retrieved in 10 victims and sperm in 5. Clinical signs of benzodiazepine intoxication were retrieved in 12 out of 23 victims. Urine benzodiazepine screening was positive, over the cut-off values (300 ng/mL)when sampled less than 20 h after the facts. In 6 out of 23 victims, drugs of abuse and alcohol were associated to benzodiazepines. A reinforced attention can be brought to the rape under drug submission including the need of a proper examination and samplings shortly after the alleged facts to ascertain the diagnosis and to help the victim facing the Justice inquiry.
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Affiliation(s)
- B Marc
- Emergency Forensic Unit (Urgences Médico-Judiciaires), University Hospital Jean Verdier (AP-HP), Bondy, France.
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Marc B, Baudry F, Douceron H, Ghaith A, Wepierre JL, Garnier M. Suicide by electrocution with low-voltage current. J Forensic Sci 2000; 45:216-22. [PMID: 10641944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Three cases of suicide by electrocution with low-voltage current were observed in five years (1994-1998) by medical clinical forensic examiners of an Emergency Forensic Unit of the Paris suburb among 2,000 external death examinations. The cases involved one woman, aged 72 and two men, aged 38 and 41. In the last two cases, electric burns were retrieved under bared electric wires, placed on the arms or fingers in order to realize a hand-to-hand electric circuit involving the heart muscle. In the other case, the electric circuit between mouth and foot also involved the heart muscle. Household low-voltage current delivered (220 V in France) had a sufficient strength to induce local muscular paralysis and heart fibrillation. In the three cases, blood samples taken have retrieved very high levels of muscular enzymes (CPK, LDH) correlated to the mechanism of electric death. The rareness of suicide by electrocution and its forensic characteristics are detailed in order to help the clinical forensic examiners, prosecutors, and police officers concerned by such death examinations.
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Affiliation(s)
- B Marc
- Emergency Forensic Unit (Urgences médico-judiciaires), University Teaching Hospital Jean Verdier, Bondy, France.
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Adle-Biassette H, Marc B, Benhaiem-Sigaux N, Durigon M, Gray F. [Cerebral infarctions in a drug addict inhaling heroin]. Arch Anat Cytol Pathol 1996; 44:12-17. [PMID: 8762883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Cerebral infarcts complicating heroin abuse have been seldom reported and only clinically and radiologically documented. We report a pathological case of cerebral infarct in a heroin sniffer. A 31 year old, male, heroin sniffing addict for several years, with no known past neurological history, was found dead one morning. The evening before, he had presented the usual signs of recent heroin intake. Opiates were found in large amounts in blood and urine. Post mortem HIV serology was negative. Post mortem examination revealed the usual signs of heroin addiction, but no cutaneous signs of IV drug use. Myocardial ischemic lesions of various ages involved the anterolateral part of the left ventricle; coronary arteries were normal. Neuropathological study revealed, partly cystic infarcts involving both cerebral hemispheres. They were mostly cortical with an intralaminar pattern and a watershed distribution at the boundaries between the territories of the anterior and middle cerebral arteries and the middle posterior cerebral arteries. Intracerebral vessels, large intracranial and cervical arteries were normal.
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Hassine D, Gray F, Chekroun R, Chrétien F, Marc B, Durigon M, Schouman-Claeys E. [Early cerebral lesions in HIV infection. Postmortem radio-pathologic correlations in non-AIDS asymptomatic seropositive patients]. J Neuroradiol 1995; 22:148-60. [PMID: 7472529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In order to evaluate the diagnostic and prognostic value of MRI in the very early stages of HIV infection, we have compared the results of postmortem brain MRI and neuropathological studies in 7 asymptomatic HIV seropositive individuals, 8 seronegative controls with similar cause of death and 6 patients who died of AIDS in the absence of focal cerebral changes (opportunistic infection or tumour). Cerebral atrophy was consistently evaluated by both techniques. Seropositive asymptomatic cases were significantly more atrophic than the seronegative controls and significantly less atrophic than AIDS patients. Small high signal intensity areas in the white matter and basal ganglia were not significantly more frequent in seropositives than in seronegatives. No corresponding lesion was found at neuropathological examination. Diffuse myelin pallor of the cerebral white matter on myelin preparation was somewhat more severe in seropositive asymptomatic cases than in seronegative controls and less than in AIDS cases. However, these differences were not statistically significant. No significant correlation could be found between neuropathological myelin pallor and diffuse signal abnormalities of the white matter on MRI. We conclude that brain abnormalities are present at the early asymptomatic stage of HIV infection. These include vasculitis with opening of the blood brain barrier and consequent myelin pallor and gliosis of the white matter, and moderate brain atrophy. However MRI correlates are discrete or non specific on post mortem examination, and some probably correspond to scars of transient vascular inflammation. It is very unlikely that MRI examination has any diagnostic or prognostic value at the early stages of the disease.
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Affiliation(s)
- D Hassine
- Service de Radiologie, Hôpital Raymond Poincaré, Faculté de Médecine, Paris-Ouest, Garches
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Garnier M, Zkhiri F, Marc B, Paries P, Attali J, Valensi P. Red blood cell sodium content in NID diabetic patients with hemorheological abnormalities. Clin Hemorheol Microcirc 1995. [DOI: 10.3233/ch-1995-15305] [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: 11/15/2022]
Affiliation(s)
- M. Garnier
- Laboratoire de Biochimie, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - F. Zkhiri
- Laboratoire de Biochimie, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - B. Marc
- Laboratoire de Biochimie, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - P. Paries
- Service d'endocrinologie et nutrition, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - J.R. Attali
- Service d'endocrinologie et nutrition, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - P. Valensi
- Service d'endocrinologie et nutrition, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
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Mejean A, Marc B, Rigot JM, Mazeman E. Re: Use of methylene blue and selective embolization of the pudendal artery for high flow priapism refractory to medical and surgical treatments. J Urol 1993; 149:1149. [PMID: 8483239 DOI: 10.1016/s0022-5347(17)36332-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
We have designed a venous compression device implantable at the base of the penis outside the tunica albuginea. Because it does not require exposure of individual veins for ligation, the risk to the cavernous nerve is practically nil. It occludes the venous return only temporarily, and thus collaterals are less likely to occur. In this preliminary acute study in dogs (N = 13), the penile venous compression device was shown to be effective and safe in controlling penile venous drainage and maintaining rigid erection.
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Affiliation(s)
- J S Paick
- Department of Urology, University of California School of Medicine, San Francisco 94143
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Abstract
A retrospective analysis of 156 rigid ureteroscopic stone procedures in 145 patients revealed successful manipulation in 90%. The stone-free rate after adjunctive procedures was 95%. Access was achieved without balloon dilation in all but 18 patients. There were 24 perforations, occurring in 31% of proximal, 8% of mid ureteral and 8% of distal stone manipulations. Of the evaluable patients 63% underwent radiographic assessment for stricture disease, 75% at 6 months or more after the procedure. The stricture rate was 3.5% in all patients and 5.9% in patients with perforations. Of 37 patients evaluated for vesicoureteral reflux only 1 had reflux. Questionnaire followup was obtained for 74% of the patients (mean followup 2.6 years) and 32% felt normal within 3 days. Postoperative symptoms included flank pain (13%), renal colic (12%), pelvic discomfort (30%) and Double-J stent related complaints (49%). Of the patients 15% have reported recurrent stones. Ureteroscopy is effective and well tolerated, and it has minimal long-term complications.
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Affiliation(s)
- M L Stoller
- Department of Urology, University of California School of Medicine, San Francisco
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Marc B, Baud FJ. Discussion of "Pitfalls in the diagnosis of drug smuggler's abdomen". J Forensic Sci 1992; 37:681-2. [PMID: 1463502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Gray F, Lescs MC, Keohane C, Paraire F, Marc B, Durigon M, Gherardi R. Early brain changes in HIV infection: neuropathological study of 11 HIV seropositive, non-AIDS cases. J Neuropathol Exp Neurol 1992; 51:177-85. [PMID: 1538241 DOI: 10.1097/00005072-199203000-00007] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.7] [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: 12/27/2022] Open
Abstract
We examined 11 brains of human immunodeficiency virus (HIV) seropositive cases who died from unnatural causes (10 intravenous drug abusers who died from heroin overdose and 1 homosexual dead from a gunshot injury); 10 brains of HIV seronegative heroin addicts who died from overdose and 1 seronegative drug abuser who died from gunshot injury served as controls. Complete postmortem examination did not show evidence of acquired immune deficiency syndrome (AIDS) or AIDS related complex. Terminal changes including nerve cell ischemia, edema and diffuse vascular congestion were observed in all cases. Perivascular pigment deposition with macrophages was a constant finding in drug addicts and was probably related to chronic intravenous injection. In contrast, cerebral vasculitis was significantly more frequent and marked in HIV seropositive cases and was often associated with lymphocytic meningitis. Granular ependymitis, myelin pallor with reactive astrocytosis and microglial proliferation were also more frequent and more severe in HIV seropositive cases. Immunocytochemistry was negative for HIV antigens. Our study further supports the view that early central nervous system changes occur in HIV infection.
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Affiliation(s)
- F Gray
- Département de Pathologie Cellulaire et Tissulaire, Faculté de Médecine de Créteil, Université Paris XII, France
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Marc B, Baud FJ, Maison-Blanche P, Leporc P, Garnier M, Gherardi R. Cardiac monitoring during medical management of cocaine body packers. J Toxicol Clin Toxicol 1992; 30:387-97. [PMID: 1512812 DOI: 10.3109/15563659209021554] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The cardiac risk of cocaine body packing was studied by means of continuous ECG monitoring in 13 cocaine body-packers during spontaneous elimination. The packages were all well manufactured bundles (McCarron type 2) not susceptible to spontaneous breakage. At the beginning of the Holter study, packages were still present in the bowel of twelve patients (range: 2 to 196). The mean time of Holter recording was 46 h (range 16 h to 75 h). Ten patients eliminated all their packages during the time of Holter recording. No ECG modifications were recorded for all of the patients in regard to usually admitted standard requirements of the American Heart Association. While initial cardiac frequencies were within the normal range, a significant decrease of pulse rates was associated with the elimination of bundles. We conclude that the McCarron type 2 cocaine body-packers are not in impending danger of cardiac acute events allowing a non-surgical management of these individuals.
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Affiliation(s)
- B Marc
- Hôpital Fernand Widal, Paris, France
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Abstract
A new method was tested for estimating time after death in the middle range of postmortem interval (weeks). Creatinine muscular concentration in human cadaver is positively correlated to postmortem estimation. Temperature should be mainly related to the creatinine transformation rate. A stronger correlation was found at 11 degrees C up to 30 days and at 20 degrees Celsius up to 15 days.
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Affiliation(s)
- F Brion
- Service d'Anatomie Pathologique Médecine Légale, Hôpital Raymond Poincaré, Garches, France
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Abstract
Air embolism has been described in pregnant women and is a classic cause of death during attempted abortion by syringing. Death was caused by the introduction of an amount of air sufficient to cause a substantial air lock in the heart, pulmonary trunk or arteries. If the surface of the placenta has been stripped by the syringe, venous spaces are opened and air can pass into the circulation. Orogenital sex with vaginal insufflation can also cause air embolism during pregnancy. We report a case of air embolism in a 40-year-old non-pregnant woman subsequent to vaginal insertion of a foreign body (carrot) for an autoerotic purpose. The mechanism is roughly similar to syringing, the foreign body acting like a piston to displace a sufficient amount of air. In the present case, the endometrium stripping was probably due to the presence of an intrauterine device. As such risks may often be encountered and as, to our knowledge, no similar case has previously been reported, we may speculate if such air embolisms are underdiagnosed or dissimulated by the partners when questioned by the medical rescue teams.
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Affiliation(s)
- B Marc
- Service d'Anatomie et Cytologie Pathologiques/Médecine légale, Hĵpital Raymond Poincaré, Garches, France
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Gherardi R, Marc B, Alberti X, Baud F, Diamant-Berger O. A cocaine body packer with normal abdominal plain radiograms. Value of drug detection in urine and contrast study of the bowel. Am J Forensic Med Pathol 1990; 11:154-7. [PMID: 2343843 DOI: 10.1097/00000433-199006000-00010] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Drug packets are usually detected by ordinary abdominal radiographs, which is of major importance in the apprehension and prosecution of drug body packers, but false negatives may occur. We report the case of a cocaine body packer who had used the prograde route and in whom the initial abdominal plain films were normal. The diagnosis of cocaine body packing was assessed by seldom-described complementary methods of detection, including drug detection in the urine and contrast study of the bowel.
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Affiliation(s)
- R Gherardi
- Emergency Forensic Medicine Unit, Paris, France
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Marc B, Baud FJ, Aelion MJ, Gherardi R, Diamant-Berger O, Blery M, Bismuth C. The cocaine body-packer syndrome: evaluation of a method of contrast study of the bowel. J Forensic Sci 1990; 35:345-55. [PMID: 2329330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The questionable reliability of the conventional procedures for detection of ingested drug packages triggered us to evaluate the accuracy of a method of contrast study of the bowel in 23 nonsurgically managed cocaine body-packers. A single dose (60 mL) of a water-soluble contrast compound (amidotrizoate + meglumine) was given orally after initial clinical examination and drug detection in urine. Thereafter, roentgenograms were performed daily after spontaneous passage until obtaining two packet-free stools and negative views. Roentgenograms showed packages when performed at least 3 h after the ingestion of the contrast compound. Sensitivity and specificity of the method with respect to the detection of residual packets in the body, assessed by subsequent examination of stools, was good and did not diminish as the number of packages decreased during the time spent in ward. No side-effects were observed. We conclude that oral administration of a water-soluble contrast compound is an easily performed, efficient, and safe method for the nonsurgical management of cocaine body-packers.
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Affiliation(s)
- B Marc
- Urgences Médico-Judiciaires, Hôtel-Dieu, Paris, France
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Resmond-Richard F, Marc B, Toubon P, Chaperon J, Delattre JP. [Airocontamination in dental practice: specific risks and means of prevention]. Actual Odontostomatol (Paris) 1989:727-40. [PMID: 2638801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Fatal nitrous oxide poisoning usually occurs accidentally during the administration of general anesthesia. It seldom occurs during autoerotic behavior or in acute drug abuse. We report an unusual case of a health professional who committed suicide by inhaling nitrous oxide.
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Affiliation(s)
- A Chadly
- Department of Anatomy and Pathologic Cytology, Legal Medicine, Raymond Poincaré Hospital, Garches, France
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Affiliation(s)
- B Marc
- Forensic Emergencies Department, Hôtel-Dieu de Paris, France
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Abstract
The presence of opiates and benzoylecgonine, the major metabolite of cocaine, in the urine was detected by means of enzyme immunoassay in a series of 120 smugglers who had either ingested or inserted into their rectum cocaine or heroin packaged for transportation. There was a striking relation between the presence of drugs in the urine and swallowing of drug-filled bundles (cocaine 49 of 50 cases, heroin 9 of 10). The proportion of positive results was also high in cases of rectal insertion (cocaine 2 of 2, heroin 35 of 58). In 30 cases of cocaine-packet ingestion, serial measurements showed that the accuracy of the test progressively decreased with respect to the detection of residual packets in the body. Drug detection in the urine of suspected body-packers seems to be a useful test, positive results justifying subsequent radiological investigations.
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Affiliation(s)
- R K Gherardi
- Emergency Forensic Service and Biochemistry-Toxicology Laboratory, Hôtel Dieu, Paris, France
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Marc B. Bemerkung zu der Arbeit: „Über die Kristallisation aus wässerigen Lösungen.". Z PHYS CHEM 1909. [DOI: 10.1515/zpch-1909-6733] [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: 11/15/2022]
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