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Dymore-Brown LA, Ahluwalia A, Dangoisse C, Zaman F, Sereeyotin J, Mehta S, Metaxa V. An Update on Gender Disparity in Critical Care Conferences. Crit Care Explor 2024; 6:e1075. [PMID: 38577272 PMCID: PMC10994516 DOI: 10.1097/cce.0000000000001075] [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] [Indexed: 04/06/2024] Open
Abstract
This commentary's objective was to identify whether female representation at critical care conferences has improved since our previous publication in 2018. We audited the scientific programs from three international (International Symposium on Intensive Care and Emergency Medicine [ISICEM], European Society of Intensive Care Medicine [ESICM], and Society of Critical Care Medicine [SCCM]) and two national (State of the Art [SOA] and Critical Care Canada Forum) critical care conferences from the years 2017 to 2022. We collected data on the number of female faculty members and categorized them into physicians, nurses, allied health professions (AHPs), and other. Across all conferences, there was an increased representation of females as speakers and moderators over the 6 years. However, at each conference, male speakers outnumbered female speakers. Only two conferences achieved gender parity in speakers, SCCM in 2021 (48% female) and 2022 and SOA in 2022 (48% female). These conferences also had the highest representation of female nursing and AHP speakers (25% in SCCM, 2021; 19% in SOA, 2022). While there was a statistically significant increase in female speakers (p < 0.01) in 2022 compared with 2016, there was a persistent gender gap in the representation of men and female physicians. While the proportion of female moderators increased in each conference every year, the increase was statistically only significant for ISICEM, ESICM, and SCCM (p < 0.05). The proportion of female nurses and AHP speakers increased in 2022 compared with 2016 (p < 0.0001) but their overall representation was low with the highest proportion (25%) in the 2022 SCCM conference and the lowest (0.5%) in the 2017 ISICEM conference. This follow-up study demonstrates a narrowing but persisting gender gap in the studied critical care conferences. Thus, a commitment toward minimizing gender inequalities is warranted.
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Affiliation(s)
- Laura-Anne Dymore-Brown
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Amrit Ahluwalia
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Carole Dangoisse
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Faryal Zaman
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jariya Sereeyotin
- Department of Anaesthesiology, Division of Critical Care Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sangeeta Mehta
- Department of Medicine, Sinai Health, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom
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Buchheim JI, Billaud JN, Feuerecker M, Strewe C, Dangoisse C, Osterman A, Mehta S, Crucian B, Schelling G, Choukér A. Exploratory RNA-seq analysis in healthy subjects reveals vulnerability to viral infections during a 12- month period of isolation and confinement. Brain Behav Immun Health 2021; 9:100145. [PMID: 34589891 PMCID: PMC8474453 DOI: 10.1016/j.bbih.2020.100145] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/07/2020] [Accepted: 09/16/2020] [Indexed: 11/28/2022] Open
Abstract
Exposure to stressful environments weakens immunity evidenced by a detectable reactivation of dormant viruses. The mechanism behind this observation remains unclear. We performed next generation sequencing from RNA extracted from blood samples of 8 male subjects collected before, during and after a 12-month stay at the Antarctic station Concordia. RNA-seq data analysis was done using QIAGEN Ingenuity Pathway Analysis (IPA) software. Data revealed the inactivation of key immune functions such as chemotaxis and leukocyte recruitment which persisted after return. Next to the activation of the stress response eIF2 pathway, interferon signaling was predicted inactivated due to a downregulation of 14 downstream genes involved in antiviral immunity. Among them, the interferon stimulated genes (ISGs) IFITM2 and 3 as well as IFIT3 exhibited the strongest fold changes and IFIT3 remained downregulated even after return. Impairment of antiviral immunity in winter-over crew can be explained by the downregulation of a battery of ISGs. Whole blood transcriptome analysis during 12-months of isolation in the Antarctic. Data show an inactivation of key immune functions and pathways without recovery. The IFN pathway is most affected showing a downregulation of 14 downstream genes. The results suggest impairment of antiviral immunity and vulnerability to infection.
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Affiliation(s)
- Judith-Irina Buchheim
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | | | - Matthias Feuerecker
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | - Claudia Strewe
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | - Carole Dangoisse
- Department of Anesthesia and Critical Care, Ysbyty Gwynedd Hospital, Bangor, Wales, UK
| | - Andreas Osterman
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, Germany
| | | | | | - Gustav Schelling
- Department of Anesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Choukér
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany
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Salik D, Dupire G, Sass U, Dangoisse C, Franck D, Labadens A, Marangoni M, Vilain C, Smits G. Variable expressivity in Buschke-Ollendorff syndrome. Ann Dermatol Venereol 2021; 149:128-131. [PMID: 34511237 DOI: 10.1016/j.annder.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/10/2021] [Accepted: 07/30/2021] [Indexed: 11/24/2022]
Affiliation(s)
- D Salik
- Department of Dermatology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1020 Brussels, Belgium.
| | - G Dupire
- Department of Dermatology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1020 Brussels, Belgium
| | - U Sass
- Inter-Hospital Department of Dermatology, CHU Saint-Pierre, CHU Brugmann, HUDERF, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - C Dangoisse
- Department of Dermatology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1020 Brussels, Belgium
| | - D Franck
- Department of Plastic Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1020 Brussels, Belgium
| | - A Labadens
- Department of Plastic Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1020 Brussels, Belgium
| | - M Marangoni
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - C Vilain
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB, Center of Human Genetics, Université Libre de Bruxelles, 1020 Brussels, Belgium; Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Campus de La Plaine, Boulevard du Triomphe, Building C, CP 263, 1050 Brussels, Belgium
| | - G Smits
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB, Center of Human Genetics, Université Libre de Bruxelles, 1020 Brussels, Belgium; Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Campus de La Plaine, Boulevard du Triomphe, Building C, CP 263, 1050 Brussels, Belgium
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André MS, Salik D, Richert B, Dangoisse C. Cyanose et érosion post-bulleuse de l’avant-bras chez un nouveau-né. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.263] [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: 10/22/2022]
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Gerbaux M, Diallo S, Dedeken L, Dangoisse C, Bott A, Heritier S, Salik D, Ferster A. Effective rescue treatment with vemurafenib of an infant with high-risk Langerhans cell histiocytosis. Ann Dermatol Venereol 2020; 147:782-785. [PMID: 32653217 DOI: 10.1016/j.annder.2020.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/19/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The recently identified role of a BRAF somatic mutation in the pathophysiology of Langerhans cell histiocytosis (LCH) offers new therapeutic options. Herein we describe the case of a 10-month-old infant with refractory high-risk LCH successfully treated with vemurafenib. OBSERVATION The patient first presented with cutaneous LCH at the age of 2 months. The disease remained undiagnosed until she was 6 months old, when it rapidly evolved to a multisystemic high-risk and life-threatening disease, refractory to 2 lines of chemotherapy. BRAFV600E mutation was found at skin biopsy, and targeted therapy with vemurafenib was started when she was 10 months old. The treatment induced a fast and sustained response, but rapid relapse occurred after treatment discontinuation, leading to resumption of treatment, once more resulting in a sustained response. CONCLUSION Our case highlights the first-line role of dermatologists in establishing the diagnosis of LCH, especially in children, in whom the eruption may be difficult to identify, leading to delayed diagnosis. Targeted therapy with vemurafenib has recently been described in children in this indication and our results support its efficacy, highlighting the need for prolonged treatment and raising the question of maintenance therapy, as well as the necessity for large-scale and long-term studies.
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Affiliation(s)
- M Gerbaux
- Department of hematology and oncology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, 266, avenue Brugmann, 1180 Uccle, Brussels, Belgium.
| | - S Diallo
- Department of hematology and oncology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, 266, avenue Brugmann, 1180 Uccle, Brussels, Belgium
| | - L Dedeken
- Department of hematology and oncology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, 266, avenue Brugmann, 1180 Uccle, Brussels, Belgium
| | - C Dangoisse
- Department of dermatology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, Brussels, Belgium
| | - A Bott
- Department of dermatology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, Brussels, Belgium
| | - S Heritier
- JF. Emile, laboratory EA4340, GHU Paris-Saclay, Versailles university, Ambroise-Paré hospital, Paris, France
| | - D Salik
- Department of dermatology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, Brussels, Belgium
| | - A Ferster
- Department of hematology and oncology, université libre de Bruxelles, hôpital universitaire des enfants reine Fabiola, 266, avenue Brugmann, 1180 Uccle, Brussels, Belgium
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Strewe C, Thieme D, Dangoisse C, Fiedel B, van den Berg F, Bauer H, Salam AP, Gössmann-Lang P, Campolongo P, Moser D, Quintens R, Moreels M, Baatout S, Kohlberg E, Schelling G, Choukèr A, Feuerecker M. Modulations of Neuroendocrine Stress Responses During Confinement in Antarctica and the Role of Hypobaric Hypoxia. Front Physiol 2018; 9:1647. [PMID: 30534078 PMCID: PMC6276713 DOI: 10.3389/fphys.2018.01647] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 08/12/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
The Antarctic continent is an environment of extreme conditions. Only few research stations exist that are occupied throughout the year. The German station Neumayer III and the French-Italian Concordia station are such research platforms and human outposts. The seasonal shifts of complete daylight (summer) to complete darkness (winter) as well as massive changes in outside temperatures (down to -80°C at Concordia) during winter result in complete confinement of the crews from the outside world. In addition, the crew at Concordia is subjected to hypobaric hypoxia of ∼650 hPa as the station is situated at high altitude (3,233 m). We studied three expedition crews at Neumayer III (sea level) (n = 16) and two at Concordia (high altitude) (n = 15) to determine the effects of hypobaric hypoxia on hormonal/metabolic stress parameters [endocannabinoids (ECs), catecholamines, and glucocorticoids] and evaluated the psychological stress over a period of 11 months including winter confinement. In the Neumayer III (sea level) crew, EC and n-acylethanolamide (NAE) concentrations increased significantly already at the beginning of the deployment (p < 0.001) whereas catecholamines and cortisol remained unaffected. Over the year, ECs and NAEs stayed elevated and fluctuated before slowly decreasing till the end of the deployment. The classical stress hormones showed small increases in the last third of deployment. By contrast, at Concordia (high altitude), norepinephrine concentrations increased significantly at the beginning (p < 0.001) which was paralleled by low EC levels. Prior to the second half of deployment, norepinephrine declined constantly to end on a low plateau level, whereas then the EC concentrations increased significantly in this second period during the overwintering (p < 0.001). Psychometric data showed no significant changes in the crews at either station. These findings demonstrate that exposition of healthy humans to the physically challenging extreme environment of Antarctica (i) has a distinct modulating effect on stress responses. Additionally, (ii) acute high altitude/hypobaric hypoxia at the beginning seem to trigger catecholamine release that downregulates the EC response. These results (iii) are not associated with psychological stress.
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Affiliation(s)
- Claudia Strewe
- Laboratory of Translational Research "Stress and Immunity", Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Detlef Thieme
- Institute of Doping Analysis and Sports Biochemistry, Dresden, Germany
| | | | - Barbara Fiedel
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung, Bremerhaven, Germany
| | | | - Holger Bauer
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung, Bremerhaven, Germany
| | - Alex P Salam
- IPEV/PNRA-ESA Antarctic Program, Brest, Antarctica
| | - Petra Gössmann-Lang
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung, Bremerhaven, Germany
| | - Patrizia Campolongo
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Dominique Moser
- Laboratory of Translational Research "Stress and Immunity", Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Roel Quintens
- Radiobiology Unit, Belgian Nuclear Research Centre (SCKCEN), Mol, Belgium
| | - Marjan Moreels
- Radiobiology Unit, Belgian Nuclear Research Centre (SCKCEN), Mol, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Belgian Nuclear Research Centre (SCKCEN), Mol, Belgium.,Department of Molecular Biotechnology, Ghent University, Ghent, Belgium
| | - Eberhard Kohlberg
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung, Bremerhaven, Germany
| | - Gustav Schelling
- Laboratory of Translational Research "Stress and Immunity", Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Alexander Choukèr
- Laboratory of Translational Research "Stress and Immunity", Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Matthias Feuerecker
- Laboratory of Translational Research "Stress and Immunity", Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
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Dangoisse C. Éditorial. Ann Dermatol Venereol 2018; 145:A3-A4. [DOI: 10.1016/j.annder.2018.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fisher R, Dangoisse C, Crichton S, Whiteley C, Camporota L, Beale R, Ostermann M. Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis. BMJ Open 2016; 6:e011363. [PMID: 27797987 PMCID: PMC5073479 DOI: 10.1136/bmjopen-2016-011363] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Patients with cancer frequently require unplanned admission to the intensive care unit (ICU). Our objectives were to assess hospital and 180-day mortality in patients with a non-haematological malignancy and unplanned ICU admission and to identify which factors present on admission were the best predictors of mortality. DESIGN Retrospective review of all patients with a diagnosis of solid tumours following unplanned admission to the ICU between 1 August 2008 and 31 July 2012. SETTING Single centre tertiary care hospital in London (UK). PARTICIPANTS 300 adult patients with non-haematological solid tumours requiring unplanned admission to the ICU. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOMES Hospital and 180-day survival. RESULTS 300 patients were admitted to the ICU (median age 66.5 years; 61.7% men). Survival to hospital discharge and 180 days were 69% and 47.8%, respectively. Greater number of failed organ systems on admission was associated with significantly worse hospital survival (p<0.001) but not with 180-day survival (p=0.24). In multivariate analysis, predictors of hospital mortality were the presence of metastases (OR 1.97, 95% CI 1.08 to 3.59), Acute Physiology and Chronic Health Evaluation II (APACHE II) Score (OR 1.07, 95% CI 1.01 to 1.13) and a Glasgow Coma Scale Score <7 on admission to ICU (OR 5.21, 95% CI 1.65 to 16.43). Predictors of worse 180-day survival were the presence of metastases (OR 2.82, 95% CI 1.57 to 5.06), APACHE II Score (OR 1.07, 95% CI 1.01 to 1.13) and sepsis (OR 1.92, 95% CI 1.09 to 3.38). CONCLUSIONS Short-term and medium-term survival in patients with solid tumours admitted to ICU is better than previously reported, suggesting that the presence of cancer alone should not be a barrier to ICU admission.
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Affiliation(s)
- Richard Fisher
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
- Department of Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Carole Dangoisse
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Siobhan Crichton
- Division of Health and Social Care Research, King's College London, London, UK
| | - Craig Whiteley
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
| | - Luigi Camporota
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
| | - Richard Beale
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Guy's & St Thomas’ Hospital NHS Foundation Trust, London, UK
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Affiliation(s)
- Carole Dangoisse
- Department of Critical Care Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
| | - Pierre-François Laterre
- Department of Critical Care Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
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Dangoisse C, Dickie H, Tovey L, Ostermann M. Correction of hyper- and hyponatraemia during continuous renal replacement therapy. Nephron Clin Pract 2015; 128:394-8. [PMID: 25592652 DOI: 10.1159/000369347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/27/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Severe hyper- and hyponatraemia is associated with significant risks, yet its correction can also have serious consequences when implemented too fast or inadequately. The safe correction of serum sodium levels is particularly challenging when renal replacement therapy (RRT) is required. METHODS Using 2 case scenarios, we aim to illustrate a simple method of correcting hyper- and hyponatraemia safely by step-wise manipulation of the dialysate/replacement fluid. RESULTS During continuous RRT, hypernatraemia can be corrected effectively and safely by adding small pre-calculated amounts of 30% NaCl to the dialysate/replacement fluid bags aiming for a [Na(+)] in the fluid that allows safe equilibration and correction of the serum [Na(+)]. To correct hyponatraemia safely, pre-calculated amounts of sterile water can be added in a step-wise manner to achieve a fluid [Na(+)] that equals the desired target serum [Na(+)]. CONCLUSION During continuous RRT, the step-wise adjustment of [Na(+)] of dialysate/replacement fluids offers a safe and reliable method to correct sodium disorders.
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Affiliation(s)
- Carole Dangoisse
- Department of Critical Care, Guy's & St. Thomas' NHS Foundation Hospital Trust, London, UK
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Fisher R, Dangoisse C, Crichton S, Slanova S, Starsmore L, Manickavasagar T, Whiteley C, Ostermann M. Factors associated with short-term and long-term mortality in solid cancer patients admitted to the ICU. Crit Care 2015. [PMCID: PMC4470625 DOI: 10.1186/cc14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yilmaz L, Dangoisse C, Semaille P. [Infantile hemangioma: a new indication for propranolol? Retrospective study: a case-series of 25 infants]. Rev Med Brux 2015; 36:3-9. [PMID: 25856965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In 2008, the New England Journal of Medicine reported a new indication for propranolol: treatment of complicated infantile hemangioma (IH). The objective of this study is to identify any adverse events and to measure the efficacy of propranolol in children with complicated IH, through a retrospective, observational, case-series study of 25 patients treated with propranolol at the Hôpital Universitaire des Enfants Reine Fabiola in Belgium. OBSERVATIONS 25 patients were submitted to this therapy. The treatment was stopped prematurely for two of them, by parental fear of side effects and 48 % presented one or more adverse events; all of which were transient and rapidly controlled by adjusting the doses administered. Mean age at the start of treatment was 4,8 months. A clearly favorable response was observed in 100 % of patients at their first visit after treatment initiation ; a total response was seen in 9 patients, with subtotal and partial responses observed in 9 and 3 patients, respectively, by the end of treatment. CONCLUSION The real efficacy of propranolol for complicated IH was confirmed by the clearly evident improvement observed in all patients and the absence of non-responders. As global tolerance was also good, propranolol can therefore be considered to be an appropriate first- line treatment for complicated IH.
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Vujovic A, André J, Salmon D, Harag S, Dangoisse C, Kolivras A. Épidémiologie et prise en charge des teignes du cuir chevelu. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Background Foreign body ingestion complicated by perforation of the digestive tract is a well-known occurrence. Contrary to this, perforation by fishbones has most often been described in South East Asian populations, and has the unusual characteristic of often being paucisymptomatic until secondary complications occur. Case presentation We report the case of a 56 year-old man of asian origin who presented with a liver abscess of unknown origin, complicated by septic shock with multiorgan failure. He was later found to have a fishbone impacted in the left lobe of the liver, which had perforated the stomach and gone by unnoticed until presentation. The fishbone was extracted through laparotomy and the abscess was drained. Conclusion This report highlights a cause of liver abscesses which is likely underreported in Northern European populations and which, although rare in occurrence, should be part of our diagnostic algorithm of “cryptogenic abscesses” since surgical removal of the foreign object as drainage warrant definitive treatment.
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Affiliation(s)
| | - Pierre-François Laterre
- Department of Critical Care Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200 Brussels, Belgium.
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Yilmaz L, Dangoisse C, Semaille P. [Infantile hemangioma and propranolol: a therapeutic "revolution". Literature review]. Rev Med Brux 2013; 34:479-484. [PMID: 24505868] [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: 06/03/2023]
Abstract
Infantile hemangioma (IH) is the most common benign vascular tumour affecting children. Most infantile hemangiomas are self-limiting, but some require specific treatment. Propranolol has been proposed for the treatment of infantile hemangiomas. The aim of this study is to explore the mechanism of action of propranolol for the treatment of infantile hemangiomas and to demonstrate its safety and efficacy through a review of the literature. The non cardioselective bêta-blocker propranolol has been used in a pediatric setting for 40 years and, since 2008, has a new indication. A clearly significant improvement has been observed in the condition of children with complicated IH (10%) treated with propranolol. This new indication has been widely described in the international literature. Various explanations have been put forward for the mechanism of action including a vasoconstrictor, antiangiogenic and apoptotic effect of propranolol on the different cells making up an IH. Overall tolerance is good and the efficacy markedly superior to that of any other treatments used for this purpose. In conclusion, with its good tolerance profile and superior efficacy versus all the other available therapies, propranolol can be considered to be a first-line treatment for complicated IH.
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Affiliation(s)
- L Yilmaz
- Clinique de Dermatologie, H.U.D.E.R.F., Bruxelles.
| | - C Dangoisse
- Clinique de Dermatologie, H.U.D.E.R.F., Bruxelles
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16
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Heuschling A, Dangoisse C, Harag S, André J. [Hereditary epidermolysis bullosa: clinical and ultrastructural analysis of 21 cases]. Rev Med Brux 2012; 33:4-11. [PMID: 22512144] [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: 05/31/2023]
Abstract
Hereditary epidermolysis bullosa (HEB) constitute a genodermatosis group with variable clinical severity. The aim of the study was to confront the diagnosis established by electron microscopy (EM), with the clinical presentation and evolution, genetic analysis and immunofluorescence, and to observe if there was concordance. Biopsies diagnosed as HEB in the last 15 years, were retrieved from the database of the C.H.U. Saint-Pierre EM lab. Each corresponding medical file was reviewed and the following data were recorded: date of birth, sex, age, age at biopsy, ultrastructural characteristics, degree of certainty regarding the EM diagnosis, family history, clinical lesions and their evolution as well as other diagnostic tests performed. 21 patients, aged 1 day to 26 year old were included. A HEB simplex was diagnosed in 10 cases, a junctional EBH in 5 cases and a dystrophic HEB in 6 cases. Immunofluorescence was requested in 4 cases. 7 patients benefited from a genetic analysis. Physical examination revealed hyperpigmented spots in 1 case. A patient with dystrophic HEB had a family history of symptoms restricted to the nails. 4 patients died. In conclusion, the accurate clinical diagnosis of the HEB sub-type is difficult because of the symptomatology heterogeneity. EM remains the gold standard for diagnosis even if immunofluorescence and genetic analysis should be more systematically considered.
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Affiliation(s)
- A Heuschling
- Département interhospitalier de Dermatologie des C.H.U. Brugmann, C.H.U. Saint-Pierre et H.U.D.E.R.F, Bruxelles
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17
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Dangoisse C. [Atopic dermatitis]. Rev Med Brux 2011; 32:230-234. [PMID: 22034750] [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: 05/31/2023]
Abstract
Atopic dermatitis is a common chronic inflammatory skin disease. It is a disease mostly of childhood, but also of adult life. The classical course of childhood eczema shows improvement in 80% of the cases. The pathogenesis of the disease is now better understood but the world wide prevalence of atopic dermatitis has increased two to threefold over the past 30 years. Atopic dermatitis affects considerably quality of life as well in children as in adults. Important clues in the understanding of the pathogenesis of the disease are genetic factors, skin barrier dysfunction and immune dysregulation. Triggers of atopic dermatitis are well identified: food and airborne allergens, contact allergens, skin microorganisms, irritants and psychological stress. Concerning therapy, the different topical and systemic options are described, as well as the importance of therapeutic education.
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Affiliation(s)
- C Dangoisse
- Departament Interhospitalier de Dermatologie, C.H.U. Brugmann, C.H.U. Saint-Pierre et. H.U.D.E.R.F., Bruxelles.
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18
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Provost P, Dangoisse C. [Pruritus: diagnostic strategy and therapeutic approach]. Rev Med Brux 2008; 29:540-545. [PMID: 19202709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Pruritus, defined as an abnormal cutaneous sensation that will provoke the desire to scratch, is the leading symptom of cutaneous disorders. However, some pruritus will be the only sign of several internal pathologies. More than hundreds etiologies are possibles. That is why a diagnostic algorithm is necessary for an optimal care and to define which investigations to make. This algorithm will distinguish localized pruritus and diffuse pruritus. The presence of specifics cutaneous lesions will be constitute a great help for making diagnosis.
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Affiliation(s)
- P Provost
- Département Inter-Hospitalier Universitaire de Dermatologie des C.H.U. Brugmann, H.U.D.E.R.F. et Saint-Pierre, Bruxelles.
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19
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Delplace D, da Costa LM, Goffin L, Wechsler ME, Sass U, André J, Dangoisse C, Song M. Oral ulceration: an unusual manifestation of Churg-Strauss syndrome. J Eur Acad Dermatol Venereol 2007; 21:969-72. [PMID: 17659008 DOI: 10.1111/j.1468-3083.2006.02086.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Churg-Strauss Syndrome (CSS) is a relatively rare entity characterized by asthma, transient pulmonary infiltrates, eosinophilia and systemic vasculitis. Oral ulceration is a possible clinical manifestation of some systemic vasculitides, such as Wegener's granulomatosis (WG) or giant cell arteritis, but has never been reported with Churg-Strauss syndrome. We report the first observation of a palatine ulceration in a 15-year-old girl with Churg-Strauss syndrome.
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Affiliation(s)
- D Delplace
- Department of Dermatology, University Hospital Saint-Pierre, Brugmann and HUDERF, Free University of Brussels, Belgium.
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20
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Dastani Z, Dangoisse C, Boucher B, Desbiens K, Krimbou L, Dufour R, Hegele RA, Pajukanta P, Engert JC, Genest J, Marcil M. A novel nonsense apolipoprotein A-I mutation (apoA-IE136X) causes low HDL cholesterol in French Canadians. Atherosclerosis 2006; 185:127-36. [PMID: 16023124 DOI: 10.1016/j.atherosclerosis.2005.05.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [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: 02/04/2005] [Revised: 05/09/2005] [Accepted: 05/31/2005] [Indexed: 10/25/2022]
Abstract
The molecular causes of severe high-density lipoprotein cholesterol (HDL-C) deficiency was examined in a group of 54 unrelated French Canadian subjects. The lecithin:cholesterol acyl transferase (LCAT) and apolipoprotein (apo) A-I gene were analyzed in all probands by direct DNA sequencing. While no LCAT mutation was detected, a novel nonsense apoA-I mutation (E136X) was found in 3/54 probands. Genetic analysis of two kindreds showed a strong co-segregation of the apoA-I locus with the low HDL-C trait. The E136X mutation was detected in families by MaeI restriction digestion. E136X carriers (n=17) had marked HDL-C deficiency; among the nine carriers > or = 35 years old, five men had developed premature coronary artery disease (CAD). A peptide of apparent molecular weight of 14 kDa was identified in fresh plasma, the HDL fractions and lipoprotein deficient plasma from the three probands but not in normal controls (n=3), suggesting that the mutant apoA-I peptide is secreted and binds lipids. The mutation was not observed in an additional 210 chromosomes from unrelated subjects of French Canadian descent, < 60 years of age, with CAD and low HDL-C levels. We conclude that apoA-I (E136X) is a cause of HDL-C deficiency in the French Canadian population and is associated with premature CAD.
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Affiliation(s)
- Zari Dastani
- Division of Cardiology, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montréal, Qué., Canada H3A 1A1
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21
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Hortala M, Dangoisse C, Bruderer P, Sznajer Y, Sass U, Song M. P196 - Alopécie diffuse et hyper IgM syndrome lié à l’X. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79925-7] [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: 11/26/2022]
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22
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Darsow U, Laifaoui J, Kerschenlohr K, Wollenberg A, Przybilla B, Wüthrich B, Borelli S, Giusti F, Seidenari S, Drzimalla K, Simon D, Disch R, Borelli S, Devillers ACA, Oranje AP, De Raeve L, Hachem JP, Dangoisse C, Blondeel A, Song M, Breuer K, Wulf A, Werfel T, Roul S, Taieb A, Bolhaar S, Bruijnzeel-Koomen C, Brönnimann M, Braathen LR, Didierlaurent A, André C, Ring J. The prevalence of positive reactions in the atopy patch test with aeroallergens and food allergens in subjects with atopic eczema: a European multicenter study. Allergy 2004; 59:1318-25. [PMID: 15507101 DOI: 10.1111/j.1398-9995.2004.00556.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The atopy patch test (APT) was proposed to evaluate IgE-mediated sensitizations in patients with atopic eczema (AE). OBJECTIVE The prevalence and agreement with clinical history and specific IgE (sIgE) of positive APT reactions was investigated in six European countries using a standardized method. METHODS A total of 314 patients with AE in remission were tested in 12 study centers on clinically uninvolved, non-abraded back skin with 200 index of reactivity (IR)/g of house dust mite Dermatophagoides pteronyssinus, cat dander, grass, and birch pollen allergen extracts with defined major allergen contents in petrolatum. Extracts of egg white, celery and wheat flour with defined protein content were also patch tested. APT values were evaluated at 24, 48, and 72 h according to the European Task Force on Atopic Dermatitis (ETFAD) guidelines. In addition, skin-prick test (SPT) and sIgE and a detailed history on allergen-induced eczema flares were obtained. RESULTS Previous eczema flares, after contact with specific allergens, were reported in 1% (celery) to 34% (D. pteronyssinus) of patients. The frequency of clear-cut positive APT reactions ranged from 39% with D. pteronyssinus to 9% with celery. All ETFAD intensities occured after 48 and 72 h. Positive SPT (16-57%) and elevated sIgE (19-59%) results were more frequent. Clear-cut positive APT with all SPT and sIgE testing negative was seen in 7% of the patients, whereas a positive APT without SPT or sIgE for the respective allergen was seen in 17% of the patients. APT, SPT and sIgE results showed significant agreement with history for grass pollen and egg white (two-sided Pr > /Z/ < or = 0.01). In addition, SPT and sIgE showed significant agreement with history for the other aeroallergens. With regard to clinical history, the APT had a higher specificity (64-91% depending on the allergen) than SPT (50-85%) or sIgE (52-85%). Positive APT were associated with longer duration of eczema flares and showed regional differences. In 10 non-atopic controls, no positive APT reaction was seen. CONCLUSION Aeroallergens and food allergens are able to elicit eczematous skin reactions after epicutaneous application. As no gold standard for aeroallergen provocation in AE exists, the relevance of aeroallergens for AE flares may be evaluated by APT in addition to SPT and sIgE. The data may contribute to the international standardization of the APT.
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Affiliation(s)
- U Darsow
- Department of Dermatology and Allergy Biederstein, Technical University Munich and Division of Environmental Dermatology and Allergy GSF/TUM, Munich, Germany
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23
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Dangoisse C. [Dermo-cosmetics and prevention of skin aging]. Rev Med Brux 2004; 25:A365-70. [PMID: 15516073] [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: 05/01/2023]
Abstract
Skin aging is the result of the addition of intrinsic aging (chronological aging) and extrinsic aging induced by environmental factors among whose ultraviolet radiation plays a predominant role (actinic aging). The physiopathological mechanisms of skin aging are well better known. UV radiations act either directly on DNA either through the formation of free radicals. The skin aging is characterized by the decline of numerous skin functions. Its clinical presentation is accentuated in UV exposed-skin. To struggle against skin aging is first of all to prevent it by means of an efficient photoprotection, an adequate general life style and preventive treatments as alpha-hydroxyacids, retinoids and antioxidants.
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Affiliation(s)
- C Dangoisse
- Service de Dermatologie, Hôpital Universitaire des Enfants Reine Fabiola, ULB, Bruxelles
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24
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Dangoisse C, Mendes da Costa L. [Antihistamines]. Rev Med Brux 2000; 21:A394-8. [PMID: 11068500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The H1-receptor antagonists (H1-antihistamines) are among the most widely used medications in the world. We review the molecular basis of action, pharmacology, efficacy in allergic disorders (rhinoconjunctivitis, asthma, urticaria, atopic dermatitis) and adverse effects. Special advices are given for the young children, the elderly, in case of liver or renal insufficiency and during pregnancy and breast-feeding.
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Affiliation(s)
- C Dangoisse
- Service de Dermatologie, C.H.U. Saint-Pierre, U.L.B
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26
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Dangoisse C. [Acariasis and domestic animals]. Rev Med Brux 2000; 21:A243-5. [PMID: 11068473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Various parasitic dermatoses in man can find their origin in domestic animals. Acariasis are skin zoonoses which are not well known by the dermatologists and general practitioners. Due to different ectoparasite mites, the acariasis always cause prurigo in man but different areas of the body are involved. The treatment of the domestic animals usually allows the cure of the owner's skin disease.
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Affiliation(s)
- C Dangoisse
- Service de Dermatologie, C.H.U. Saint-Pierre, U.L.B
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27
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Dangoisse C, Song M. [Particular aspects of ulcers in children]. Rev Med Brux 1997; 18:241-4. [PMID: 9411652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Leg ulcers of juvenile onset are uncommon. The infectious origin is fairly frequent but the presence of leg ulcers in children should prompt an investigation into possible underlying causes especially hemangioma, vasculitis, inborn errors of metabolism (i.e. prolidase deficiency), hemoglobinopathies, occult spinal dysraphism and immunodeficiencies. Bacteriological investigations are essential and a skin biopsy specimen may be able to differentiate some of these disorders.
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Affiliation(s)
- C Dangoisse
- Service de Dermatologie, C.H.U. Saint-Pierre et Brugmann-HUDERF, Bruxelles
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28
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Dangoisse C, Lambeau C, Van Esse R, Barroy JP, Deschamps P, Jaspar N, Praet JP. [Physiopathology of bedsores]. Rev Med Brux 1997; 18:257-60. [PMID: 9411657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Pressure is the primary pathogenic factor in the development of decubitus ulcers. Other major factors are shearing forces, friction and moisture. Significant intrinsic risk factors are immobility, age-related diseases, nutritional status, medications and smoking. The morbidity and mortality related to the complications of pressure sores are quite significant. Prevention is essential and is best achieved by identification of high risk patients. The therapeutic approach is based on the grade of pressure ulcer.
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Affiliation(s)
- C Dangoisse
- Service de Dermatologie, C.H.U. Saint-Pierre, Bruxelles
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29
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Boone M, Dangoisse C, André J, Sass U, Song M, Ledoux M. Eosinophilic pustular folliculitis in three atopic children with hypersensitivity to Dermatophagoides pteronyssinus. Dermatology 1995; 190:164-8. [PMID: 7727841 DOI: 10.1159/000246670] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Three children will be described who present recurrent episodes of pruritic papulopustular follicular lesions on the face, the extremities and the trunk. The episodes lasted for 1-3 months with intermittent remission. Each flare was accompanied by hypereosinophilia and an increased total IgE titer. RAST and prick tests were positive for Dermatophagoides pteronyssinus (DPT). Laboratory tests disclosed no infectious or parasitic etiology. Histological examination showed eosinophilic pustular folliculitis (EPF) in each of the 3 cases. The lesions responded well to topical corticosteroids. The aim of this article is to underline the importance of hypersensitivity reactions (in these particular cases to DPT) in the pathogenesis of EPF.
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Affiliation(s)
- M Boone
- Clinic of Dermatology, University Hospital Saint-Pierre, University of Brussels, Belgium
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30
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Dangoisse C, Goossens C. [Pruritus in children]. Rev Med Brux 1994; 15:161-5. [PMID: 7938981] [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: 01/28/2023]
Abstract
Itching is usually manifested by scratching. It is lacking before three months of age. The practitioner must determine whether itching is generalised or localised and whether a skin disease is present. The main skin diseases responsible for generalised itching are scabies, atopic dermatitis, urticaria and papular urticaria. When itching is localised, contact dermatitis or pediculosis are usually responsible. Diagnosis rests on careful analysis of symptoms. In patients without skin lesions, an external cause (irritation, environment) or an internal cause (cholestasis, chronic uraemia, lymphoma, drug and psychological problems) should be considered. Therapy should be causal when possible. If not, antihistaminic drugs should be used.
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Affiliation(s)
- C Dangoisse
- Hôpital des Enfants Reine Fabiola, Bruxelles
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Abstract
Junctional epidermolysis bullosa letalis type Herlitz Pearson is a genetically determined, life-threatening disease. Effective therapy has been lacking to date. Therefore any therapy that improves wound healing would be beneficial for these patients. Cultured epidermal grafts are known to enhance wound epithelialization and have been used with success in some epidermolysis bullosa disorders. Encouraged by these reports, we grafted cultured allogeneic keratinocytes to an infant with a junctional epidermolysis bullosa letalis type.
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Affiliation(s)
- D Roseeuw
- Department of Dermatology, Academic Hospital, Vrije Universiteit, Brussel, Belgium
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Abstract
A 68-year-old woman presents multiple keratoacanthoma of the Witten and Zak type associated with immunity disorders. A dramatic regression of the lesions is noticed while the patient is treated with an association of loratadine and ranitidine. Hypotheses are proposed in view of a possible role of ranitidine, an anti-H2 antihistaminic.
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Affiliation(s)
- C Dangoisse
- Clinic of Dermatology, University Hospital Saint-Pierre and Brugmann, University of Brussels, Belgium
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Dangoisse C, Ledoux M. [Prevention and treatment of pressure ulcers]. Rev Med Brux 1991; 12:257-66. [PMID: 1925176] [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: 12/29/2022]
Abstract
Pressure is the primary pathogenic factor in the development of ulcers but other major factors are shearing forces, friction and moisture. Significant risk factors are immobility, nutritional status and age-related diseases. Complications of pressure ulcers can be life threatening. The authors wish to stress preventive measures and also recommend a therapeutic approach based on the grade of ulcer present. Prevention is best achieved by identification of high risk patients, alleviation of causative and predisposing factors and early detection of ischemic skin changes. The treatment includes local wound care that eliminates necrotic tissue, decreases bacterial load and provides a physiologic environment allowing the wound to heal, and systemic treatment: adequate nutrition, correction of underlying illnesses and systemic antibiotics (in case of sepsis, cellulitis, osteomyelitis or the prevention of bacterial endocarditis).
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Affiliation(s)
- C Dangoisse
- Clinique Dermatologique, Hôpitaux universitaire Saint-Pierre
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34
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Dangoisse C. [Condylomata acuminata]. Rev Med Brux 1989; 10:167-72. [PMID: 2662316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A review of the recent literature concerning the C.A. has been made. Two major facts appear to be confirmed: the rising incidence of the disease for adults as in other S.T.D. and the oncogenicity of some of the HPV's (Human Papillomavirus) isolated from the C.A.: HPV 16, 18, 31, 33 and 35. A peculiar attention has been paid to the para-clinical evaluation of the patient and his partner. The different therapeutic modalities are reviewed: their choice should be based on duration, spreading and localization of the lesions, age and immunological status of the patient. The problem of treating condylomata acuminata during pregnancy is also discussed.
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