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Deriaz S, Serratrice C, Lidove O, Noël E, Masseau A, Lorcerie B, Jaussaud R, Marie I, Lavigne C, Cabane J, Kaminsky P, Chérin P, Maillot F. [Diagnostic journey of type 1 Gaucher Disease patients: A survey including internists and hematologists]. Rev Med Interne 2019; 40:778-784. [PMID: 31500934 DOI: 10.1016/j.revmed.2019.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 06/22/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Gaucher disease (GD) is a rare genetic lysosomal storage disorder caused by a beta-glucocerebrosidase deficiency and responsible for a lysosomal storage disorder. GD is characterized by haematological, visceral and bone involvements. The aim of this study was to describe the diagnostic journey of type 1 GD patients as well as the role of the internist. METHODS A retrospective multicentric study involving type 1 GD patients has been conducted in 16 centers, between 2009 and 2011. RESULTS Fifty-five type 1 GD patients were included, under the care of an internist or an haematologist. They were originally hospitalized in 8 different specialized units. Diagnosis was established by bone-marrow aspiration in 22 patients (40%), by enzymatic assay of glucocerebrosidase activity in 15 patients (27%), and by bone-marrow biopsy in 9 patients (16%). The use of enzymatic assay became more frequent after 1990. The delay between first hospitalization due to GD symptoms and definitive diagnosis was less than one year for 38 patients. Patients with suspected GD were mainly referred to an internist physician. CONCLUSION GD seems to be better recognized and quickly diagnosed since 1990 in spite of the multiplicity of journeys. The role of the internist seems important.
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Affiliation(s)
- S Deriaz
- CHRU, université de Tours, service de médecine interne, Tours, France
| | - C Serratrice
- Service de médecine interne, hôpital Saint-Joseph, Marseille, France; Département de médecine interne et réhabilitation, hôpital universitaire de Genève, Suisse
| | - O Lidove
- Service de médecine interne, hôpital de la Croix Saint-Simon, Paris, France
| | - E Noël
- Service de médecine interne, CHRU de Strasbourg, Strasbourg, France
| | - A Masseau
- Service de médecine interne, CHRU de Nantes, Nantes, France
| | - B Lorcerie
- Service de médecine interne, CHRU de Dijon, Dijon, France
| | - R Jaussaud
- Service de médecine interne, CHRU de Reims, Reims, France
| | - I Marie
- Service de médecine interne, CHRU de Rouen, Rouen, France
| | - C Lavigne
- Service de médecine interne, CHRU d'Angers, Angers, France
| | - J Cabane
- Service de médecine interne, hôpital Saint-Antoine, Paris, France
| | - P Kaminsky
- Service de médecine interne, CHRU de Nancy, Nancy, France
| | - P Chérin
- Service de médecine interne, hôpital de la Pitié-Salpétrière, Paris, France
| | - F Maillot
- CHRU, université de Tours, service de médecine interne, Tours, France.
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Noël E, Mourot-Cottet R, Andres E. Intérêt du Migalastat, molécule chaperonne, dans le traitement de la maladie de Fabry. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.126] [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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Noël E, Van Der Linden P. [Awareness in paediatric anaesthesia: Review of the literature]. Rev Med Brux 2016; 37:476-482. [PMID: 28525175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Awareness, or unwanted recall of intraoperative events during general anesthesia, is not a frequent complication. For adul ts, this complication can lead to adverse psychological consequences like post-traumatic stress disorder (PTSD). The incidence of awareness seems to be higher in children than in adults, although in this population, the causes and consequences of awareness remain difficult to define. Compared to adults, there are less psychological effects and complications after awareness and no PTSD has been declared in children. The revival of interest concerning awareness has been stimulated by the availability of new technologies to assess the depth of anesthesia. These monitoring seem to be more accurate in children older than 1 year. More studies are needed to evaluate these monitoring, their ability to detect awareness and, finally, to explore long term consequences of awareness in children.
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Affiliation(s)
- E Noël
- C.H.U. Tivoli, Service D'Anesthésie, Avenue Max Buset 34, La Louvière, Belgium
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Thaunat M, Chatellard R, Noël E, Sonnery-Cottet B, Nové-Josserand L. Endoscopic repair of partial-thickness undersurface tears of the gluteus medius tendon. Orthop Traumatol Surg Res 2013; 99:853-7. [PMID: 24075011 DOI: 10.1016/j.otsr.2013.06.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 06/16/2013] [Accepted: 06/21/2013] [Indexed: 02/02/2023]
Abstract
UNLABELLED Partial-thickness tear of the gluteus medius and minimus muscles has recently been recognized as a cause of chronic trochanteric pain resistant to medical treatment. The present article reports an original endoscopic technique of identification and repair. It uses a standard arthroscope at 30°, with the patient in lateral decubitus, without fluoroscopy. In case of partial-thickness undersurface tear, careful hook palpation followed by bursa exploration enables the pathological tendon to be diagnosed. A trans-tendinous approach then allows debridement, with systematic resection of the bone structures implicated in the impingement, followed by side-to-side tendon suture. LEVEL OF EVIDENCE Level IV (case series).
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Affiliation(s)
- M Thaunat
- Centre orthopédique Santy, hôpital privé Jean Mermoz, 24, avenue Paul-Santy, 69008 Lyon, France.
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Maristany FB, Grigoriadis A, Noël E, Gazinska P, de Rinaldis E, Pinder S, Marra P, Tutt A. The PIM1 Kinase Shows Genome Driven Upregulation, Suppresses Apoptosis, Enables Colony Formation and Cell Migration and is a Potential Target in Triple-Negative Breast Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt082.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Javier RM, Hachulla E, Rose C, Gressin V, Chérin P, Noël E, de Roux-Serratrice C, Dobbelaere D, Hartmann A, Jaussaud R, Clerson P, Grosbois B, Roux C. Vertebral fractures in Gaucher disease type I: data from the French "Observatoire" on Gaucher disease (FROG). Osteoporos Int 2011; 22:1255-61. [PMID: 20683713 DOI: 10.1007/s00198-010-1342-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 12/21/2009] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED Gaucher disease type 1 (GD1), results in a range of skeletal complications including osteopenia, osteoporosis, and osteonecrosis, but there is little published information regarding vertebral fractures. Findings from this observational study indicated that the prevalence of vertebral fractures in a cohort of adult French GD1 patients is approximately 15%. INTRODUCTION The aim of the study was to assess the prevalence and characteristics of vertebral fractures in a cohort of adult patients with GD1. METHODS This study was performed in adult patients with GD1 based on a detailed and complete clinical examination. For all patients for whom vertebral fractures were reported, a specific questionnaire was sent to physicians, and imaging data were collected, when available, for centralized analysis. RESULTS Data were collected from a total of 105 adult GD1 patients. Bone complications were reported in 85% of patients, among whom vertebral fractures were diagnosed in 16 (15%); seven women and nine men (mean age, 45 years). We observed five patients with multiple vertebral fractures and one patient in whom the T3 vertebra was fractured. Most of these patients did not report fracture-related back pain. CONCLUSIONS The prevalence of vertebral fractures in this cohort of adult patients with GD1 was 15%. Greater awareness of the natural history of vertebral fractures in GD1, and rigorous monitoring of bone fragility and spine involvement in affected patients, should allow earlier detection and initiation of treatment tailored toward improving bone status.
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Affiliation(s)
- R-M Javier
- Department of Rheumatology, Hôpital de Hautepierre, 67000 Strasbourg, France.
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Chérin P, Rose C, de Roux-Serratrice C, Tardy D, Dobbelaere D, Grosbois B, Hachulla E, Jaussaud R, Javier RM, Noël E, Clerson P, Hartmann A. The neurological manifestations of Gaucher disease type 1: the French Observatoire on Gaucher disease (FROG). J Inherit Metab Dis 2010; 33:331-8. [PMID: 20532983 DOI: 10.1007/s10545-010-9095-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 02/10/2010] [Accepted: 03/31/2010] [Indexed: 01/02/2023]
Abstract
BACKGROUND Gaucher disease (GD), the most prevalent inherited lysosomal storage disorder, is caused by deficient glucocerebrosidase activity. Type 1 GD (GD1), the most common variant, is classically considered non-neuronopathic. METHODS We performed a national cross-sectional observational survey-the French Observatoire on Gaucher Disease (FROG)-in patients with GD1 between March 2005 and September 2006. The study included all patients over 18 years of age with confirmed GD1 who attended participating centers for regular follow-up. RESULTS One hundred and five patients were included, in whom we studied the prevalence and characteristics of relevant neurological symptoms associated with the neuraxis. Of these, 51 (49%) GD1 patients presented at least one neurological symptom. Four patients (4%) had Parkinson disease and 22 (21%) presented with at least one parkinsonian sign or at least one sign frequently associated with Parkinson disease. Five patients (5%) had a previous diagnosis of peripheral neuropathy. Other central nervous system symptoms were recorded in 20 (19%) patients and other peripheral nervous system symptoms in 39 (37%) patients. CONCLUSIONS These data challenge the current classification of GD, and suggest that the three forms of GD each involve a different profile of neurological manifestations.
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Affiliation(s)
- P Chérin
- Médecine Interne, Hôpital de la Pitié-Salpêtrière, Paris, France
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Kuhnert C, Zeca E, Fischer J, Canuet M, Noël E, Rondeau-Lutz M, Weber JC. [Pulmonary hypertension due to tumor embolism]. Rev Med Interne 2010; 31:e6-8. [PMID: 20627477 DOI: 10.1016/j.revmed.2009.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 09/28/2009] [Accepted: 11/08/2009] [Indexed: 10/19/2022]
Abstract
We report a 46-year-old woman with a metastatic breast cancer who developed a subacute pulmonary hypertension. The final diagnosis was microscopic pulmonary neoplastic emboli. She presented with the typical clinical picture of a pulmonary hypertension with a normal pulmonary angiographic computer tomography and multiple sub-segmental perfusion defects on radionuclide imaging. This serious condition must be known by physicians, because of an opportunity to obtain the diagnosis by the cytologic analysis of sampled microvascular blood obtained with a pulmonary artery catheterization. The prognosis is poor and there is no efficient therapy.
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Affiliation(s)
- C Kuhnert
- Service de médecine interne A, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 67091 Strasbourg cedex, France
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Jaussaud R, Javier RM, Rose C, Tardy D, Cherin P, Noël E, de Roux Serratrice C, Dobbelaere D, Hartmann A, Hachulla E, Clerson P, Grosbois B. Observatoire français de la maladie de Gaucher : qualité de vie de 105 patients de type 1. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.377] [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: 10/20/2022]
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Abstract
BACKGROUND Musculotendinous infraspinatus ruptures belong to the category of "muscle strain injuries". They differ from a classic rotator cuff tear by the following features: tendon attachment remains intact and the acute initial stage typically undergoes an intense muscular edema, replaced, 6 to 12 months later, by complete and permanent fatty infiltration of this muscle. METHODS Between 1993 and 2007, we prospectively identified 59 musculotendinous ruptures of the infraspinatus muscle tendon complex. Fifty-eight percent of these patients were females. The average age at presentation was 50 years old. Onset was non traumatic in 78% of these cases. Twenty-nine patients were seen at the acute lesion stage with pain and, on T2 fat saturated MRI sequences, muscular edema. A second group of 30 patients presented with a stage 4 fatty infiltration of the infraspinatus muscle associated with a musculotendinous disruption. Twenty-three patients underwent EMG testing which was normal in all cases. None of these patients had a full thickness tear of the rotator cuff tendons, 21% of the patients presenting in the acute phase had a partial thickness tear of the supraspinatus, which increased to 70% in patients presenting in the chronic phase suggesting a more degenerative etiology. Calcific tendonitis was seen in 61% of patients. RESULTS Twenty-four patients underwent surgery, while the remaining 35 were treated conservatively. The average follow-up, for all of them, was 46 months (12-125). The Constant score increased from 51.7 to 69.4 (p<0.001). There was no significant difference between the operated and the non-operated groups (p=0.325). All the patients seen at the acute painful edematous stage progressed to stage 4 complete fatty infiltrations, irrespective of selected treatment. None of the patients who underwent surgery had any regression of their fatty infiltration. CONCLUSIONS Early diagnosis of this lesion can be made using T2 fat saturated MRI imaging. We hypothesize that early tendon repair which restores muscle tension in the infraspinatus may halt the progression of this entity and prevent complete functional loss of this muscle. LEVEL OF EVIDENCE Level IV: Therapeutic study.
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Affiliation(s)
- G Walch
- Santy Orthopaedic Center, 24, avenue Paul-Santy, 69008 Lyon, France.
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Walch G, Nové-Josserand L, Liotard JP, Noël E. Les ruptures musculotendineuses de l’infraépineux. Diagnostic, évolution et traitement. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.rcot.2009.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Archinard M, Rondeau-Lutz M, Noël E, Besançon A, Weber J. La décision de transférer en réanimation des patients âgés hospitalisés en médecine. A propos d'une étude rétrospective de 107 cas. Rev Med Interne 2006. [DOI: 10.1016/j.revmed.2006.10.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cartier N, Rondeau-Lutz M, Noël E, Besançon AF, Weber JC. Apport du bilan étiologique à la décision thérapeutique devant un premier accident vasculaire cérébral ischémique constitué ou transitoire après 60 ans. Etude rétrospective de 50 cas en médecine interne. Rev Med Interne 2006. [DOI: 10.1016/j.revmed.2006.10.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Javier RM, Jaussaud R, Grosbois B, Hartmann A, Noël E, Dobbelaere D, Rose C, Cherin P, de Roux-Serratrice C, Hachulla E. Manifestations ostéoarticulaires de la maladie de Gaucher (MG). Données des 101 patients de l'Observatoire français de la MG. Rev Med Interne 2006. [DOI: 10.1016/j.revmed.2006.10.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Noël E, Hardy P, Laprelle E, Hagena FW, Goebel F, Goupille P. Etude prospective de la tolérance et de l'efficacité d'Hylane G-F 20 dans l'omarthrose symptomatique sans rupture de coiffe. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.rhum.2006.10.388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kaltenbach G, Andrès E, Barnier-Figue G, Noblet-Dick M, Noël E, Vogel T, Perrin AE, Berthel M. [Low vitamin B12 levels in elderly patients cured within one week by oral cobalamin therapy]. Presse Med 2005; 34:358-62. [PMID: 15859569] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE Non-dissociation of vitamin B12 from its carrying proteins is the most frequent cause of vitamin B12 deficiency in the elderly. The aim of this study was to determine the initial dose of oral cyanocobalamin that would correct the B12 vitamin deficiency within one week. METHODS This was an open, prospective, study on 30 elderly patients suffering from vitamin deficiency (B12 < 0.20 microg/L) induced by food-cobalamin malabsorption. Ten patients (group I) were treated with a daily dose of 1000 microg of oral cyanocobalamin (from D1 to D8), 10 (group II) with 1000 microg every other day (D1, D3, D5 and D7), 5 (group III) with 1000 microg every 4 days (D1 and D5) and 5 (group IV) with 1000 microg only on D1. The biological response was assessed by control measurement of vitamin B12 serum levels on the 8th day. RESULTS Mean vitamin B12 serum levels had significantly increased (p < 0.01) in groups I, II and III, but not in group IV. The dose-effect, assessed by the mean increase in vitamin B12 serum levels, was significantly greater (p < 0.05) in groups I (0.25 microg/L) and II (0.18 microg/L), than in groups III and IV (0.09 microg/L). CONCLUSION This prospective study shows that an oral dose of 1000 microg of cyanocobalamin every 4 days, which corresponds to 250 microg per day, was sufficient to correct B12 vitamin deficiency induced by food-cobalamin malabsorption within one week. However, initial doses of 1000 microg per day or every other day would be preferable because of the greater dose-effect with daily doses higher than 500 microg. A randomised study is warranted to validate these preliminary results.
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Affiliation(s)
- G Kaltenbach
- Centre de gérontologie, Hôpital de la Robertsau, Strasbourg.
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Abstract
This study compared the analgesic efficacy and safety of the cyclo-oxygenase-2 specific inhibitor celecoxib with the non-specific non-steroidal anti-inflammatory drug, naproxen, in patients with acute shoulder pain. Adult patients with shoulder pain, onset within the previous 14 days and shoulder pain of > or = 40 mm on a 100 mm visual analogue scale (VAS), were treated with oral doses of celecoxib or naproxen for 14 days and followed by a visit at day 42 in a double-blind, randomized study. The primary efficacy assessment was change in maximum pain at rest on a 100 mm VAS at day 14 compared with baseline. In addition, secondary efficacy pain and functional assessments were analysed at baseline, day 14 and day 42. A total of 202 patients were included in the trial (99 celecoxib 400 mg/day; 103 naproxen 1 g/day). The difference in change from baseline at day 14 in maximum pain at rest was not statistically significant between the two treatment groups, but was numerically higher for celecoxib than for naproxen (-47.9 +/- 2.5 versus -42.3 +/- 2.5, respectively). According to the limits of the 95% confidence interval of the difference between groups (-12.52; 1.38), celecoxib appeared to be at least as effective as naproxen. All secondary efficacy measures followed the same pattern, showing similarity between the two treatments with a trend in favour of celecoxib. The incidences of adverse events were similar for both groups. Fewer patients experienced epigastric pain with celecoxib (seven patients versus 14 with naproxen). This adverse event led to discontinuation in two patients receiving celecoxib and five receiving naproxen. Celecoxib 400 mg/day was at least as effective as naproxen 1 g/day in managing pain in this condition.
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Affiliation(s)
- P Bertin
- Department of Rheumatology, Dupuytren Hospital, Limoges, France.
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Noël E, Andrès E, Coumaros D, Brogard J, Blicklé J. Bilan des saignements d'origine digestive par microcapsule. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80676-2] [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: 11/28/2022]
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Noël E, Andrès E, Brogard J, Blicklé J. Dermatomyosite sous traitement par interféron. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80570-7] [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: 11/28/2022]
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Andrès E, Noël E, Kaltenbach G, Noblet-Dick M. [Vitamin B12 deficiencies in adults: current data]. Ann Biol Clin (Paris) 2002; 60:744-5. [PMID: 12484362] [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: 02/28/2023]
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Legrand E, Flipo RM, Guggenbuhl P, Masson C, Maillefert JF, Soubrier M, Noël E, Saraux A, Di Fazano CS, Sibilia J, Goupille P, Chevalie X, Cantagrel A, Conrozier T, Ravaud P, Lioté F. Management of nontuberculous infectious discitis. treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine 2001; 68:504-9. [PMID: 11808988 DOI: 10.1016/s1297-319x(01)00315-3] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The optimal management of pyogenic discitis is not agreed on. No randomized clinical trials of short-course or oral antibiotic regimens have been published to date. To shed light on this issue, we reviewed the management of patients admitted for pyogenic discitis to one of 12 networked rheumatology departments. In this cross-sectional observational study, each department included the first ten patients admitted starting in January 1997 for treatment of pyogenic discitis. One hundred ten patients met the inclusion criteria, 67 men and 43 women, with a mean age of 60.6 +/- 13.7 years (range, 17-86 years). Mean time from symptom onset to diagnosis was 39.6 +/- 39.8 days (range, 24 h-240 days). Blood cultures were positive in 47.3% of patients, and the percutaneous discal and vertebral biopsy in 63.6% of cases; these two investigations identified the causative organism in 79 cases (72.8%). Mean duration of the rheumatology department stay was 31.3 +/- 14.1 days (range, 4-78 days). Antibiotics were given intravenously to 103 (93.6%) patients, for a mean of 25.5 +/- 17.6 days (range, 4-124 days); duration of intravenous antibiotic therapy was longer than 4 weeks in 36.5% of patients. Only seven (6.4%) patients received primary oral antibiotics with no parenteral antibiotics. One hundred patients were given oral antibiotics at the same time as and after intravenous antibiotics, for a mean duration of 87.2 +/- 43.6 day (range, 20-278 days); Bracing was used in 98 (89.1%) patients. Although antibiotic selection was rational and in agreement with current recommendations, wide differences were noted across centers regarding intravenous treatment duration, hospital stay duration, and total treatment duration.
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Affiliation(s)
- E Legrand
- Rheumatology Department in the Teaching Hospitals of Angers, France.
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Poiraudeau S, Chevalier X, Conrozier T, Flippo RM, Lioté F, Noël E, Lefevre-Colau MM, Fermanian J, Revel M, Rhumato R. Reliability, validity, and sensitivity to change of the Cochin hand functional disability scale in hand osteoarthritis. Osteoarthritis Cartilage 2001; 9:570-7. [PMID: 11520171 DOI: 10.1053/joca.2001.0422] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the reliability, validity and sensitivity to change of the Cochin hand functional scale in hand osteoarthritis (OA). BACKGROUND The Cochin hand functional disability scale has been validated in rheumatoid arthritis. DESIGN Patients with hand OA according to Altman's criteria were included. Impairment outcome measures (VAS of pain, hand score of tenderness, clinical hand score of impairment, Kallman's radiographic scale), functional disability measures [Cochin scale, Revel's functional index (RFI), Dreiser's functional index (DFI)] and patients' perceived handicap (VAS) were recorded twice, at baseline and at a 6-month follow-up visit. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct (convergent and divergent) validity was investigated using the Spearman rank correlation coefficient and a factor analysis was performed. Sensitivity to change was assessed using the effect size (ES) and the standardized response mean (SRM), and the non-parametric Spearman rank correlation coefficient (r) was used to assess the correlation between quantitative variable changes and patient's overall opinion. RESULTS 89 patients (8 males, mean age 63 years) were included. Interobserver reliability was excellent (ICC=0.96). The Bland and Altman method showed no systematic trend. Correlations of the Cochin scale score with RFI (r=0.86), DFI (r=0.87), VAS of handicap (r=0.67), VAS of pain (r=0.54), tenderness (r=0.51), clinical impairment (r=0.32), and Kallman's radiographic scale (r=0.13) indicated a good construct validity. Factor analysis extracted four main factors, accounting for 65% of the total variance. 51 patients were evaluated at the 6-month visit. The Cochin scale score had worsened with SRM and ES values of -0.26 and -0.17 respectively. Changes in the score had one of the highest correlation (r=0.47) with the patient's overall opinion. CONCLUSION The Cochin hand functional disability scale which was first developed to assess the rheumatoid hand can be used to evaluate functional disability in hand OA.
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Noël E, Thomas T, Schaeverbeke T, Thomas P, Bonjean M, Revel M. Frozen shoulder. Joint Bone Spine 2001; 67:393-400. [PMID: 11143905] [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: 02/18/2023]
Abstract
Stiffness is a consistent but nonspecific symptom of primary frozen shoulder, a condition defined by restriction of passive motion in all planes without glenohumeral abnormalities on plain radiographs. Since the first description by Duplay in 1872, theories and descriptions of the lesions have varied over time and across authors, with the main target of the condition being reported as the subacromial bursa in some studies and the rotator interval in others. Recent publications have pointed out similarities with Dupuytren's contracture. Magnetic resonance imaging has helped to understand the lesions by showing a specific pattern of postgadolinium enhancement during the first few months after symptom onset. Pain relief is the main objective of therapy. Oral medications have not been adequately evaluated, with the exception of glucocorticoids, which hasten the resolution of nighttime pain to a modest degree. Intra-articular glucocorticoid injections are effective and are best performed under arthrographic control. It has been suggested that intra-articular glucocorticoid injections should be combined with joint capsule distension. An additional injection into the subacromial bursa has been found useful in patients with refractory pain. Motion range recovery is not always complete after 18 to 24 months and can be improved by physiotherapy. Methodological difficulties have precluded demonstration in formal studies of the undeniable benefits of physiotherapy. Joint capsule distension, and even more so arthroscopic capsulotomy with gentle mobilization, have provided promising results in patients with persistent stiffness, although the optimal time for performing these techniques remains to be determined.
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Affiliation(s)
- E Noël
- Service de rhumatologie, h pital Edouard-Herriot, Lyons, France
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25
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Faure C, Noël E, Girod S, Streichenberger F, Peyret-Didier S, Bochu M. [Value of CT bursography in the evaluation of rotator cuff tears]. J Radiol 2001; 82:51-4. [PMID: 11223629] [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: 02/19/2023]
Abstract
PURPOSE To describe the technique and assess the value of subacromial CT bursography in patients with partial surface tear of the rotator cuff tendon. MATERIALS AND METHODS 15 patients with shoulder pain suggestive of tendinopathy or tear of the rotator cuff were evaluated with subacromial CT bursography. RESULTS Subacromial CT bursography was normal in 4 patients. Partial surface tear was detected in 7 patients [irregularities (n=2), defect (n=2), superficial tear (n=3)]. Full thickness tear was detected in 4 patients. CONCLUSION The authors described the technique for subacromial CT bursography to visualize partial surface tears of the rotator cuff tendon. This simple and reliable technique could be an alternative to MR imaging, especially when MR evaluation is not possible.
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Affiliation(s)
- C Faure
- Hôpital Edouard Herriot, Pavillon B Radiologie, Place d'Arsonval, 69437 Lyon Cedex 03
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26
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Noël E. [Pathology of the rotator cuff]. Rev Prat 1999; 49:1398-405. [PMID: 10526487] [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: 02/14/2023]
Abstract
In daily practice painful shoulder is frequent. Rotator cuff pathology (traumatic, microtraumatic or both) is frequently involved. Treatment is closely related to diagnosis, which directly depends on features given by the triad "questioning, clinical exam, standard X-rays". In some very precise cases this triad will be completed by more complex exams (arthro CT, MRI). Rotator cuff pathology is diversified: either tendinopathies (calcifying or not) or tears (partial or transfixiant). Rotator cuff tear's natural evolution is a slow aggravation to a final subacromial arthrosis or an excentrated omarthrosis in a certain term which tolerance may vary.
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Affiliation(s)
- E Noël
- Service de rhumatologie, hôpital Edouard-Herriot, Lyon
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27
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Michez D, Quintart C, Noël E, Lepage P. [Peripheral thrombopenic purpura associated with acquired toxoplasmosis]. Rev Med Brux 1998; 19:135-7. [PMID: 9697396] [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: 02/08/2023]
Abstract
Acquired Toxoplasma Gondii infection has a benign course in adults and children immunologically competent. Thrombocytopenia is much more common during congenital toxoplasma infection and the rare cases of purpura associated with acquired toxoplasmosis are usually not thrombocytopenic. We report a case of thrombocytopenic purpura in an immunocompetent child, associated with active acquired toxoplasmosis. In rare circumstances, acquired toxoplasmosis in an immunocompetent patient may be associated with severe thrombocytopenia. However, the low incidence of such cases makes a therapeutic consensus difficult.
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Affiliation(s)
- D Michez
- Service de Pédiatrie, C.I.U. Ambroise Paré, Mons
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28
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Noël E. Treatment of calcific tendinitis and adhesive capsulitis of the shoulder. Rev Rhum Engl Ed 1997; 64:619-28. [PMID: 9413886] [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: 02/05/2023]
Affiliation(s)
- E Noël
- Rheumatology Department, E. Herriot Hospital, Lyon, France
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29
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Noël E. [Sciatica (L5 or S1). Etiology, physiopathology, diagnosis, treatment]. Rev Prat 1997; 47:1383-9. [PMID: 9248107] [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: 02/04/2023]
Affiliation(s)
- E Noël
- Service de rhumatologie, Hôpital Edouard-Herriot, Lyon
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30
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31
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Van Gossum A, Closset P, Noël E, Mignon C, Cremer M, Neve J. O.52 Antioxidant status in patients with alcohol-related chronic pancreatitis. Clin Nutr 1995. [DOI: 10.1016/s0261-5614(95)80124-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Chéron B, Gilles H, Hamel J, Leduc M, Moreau O, Noël E. 3He Nuclear Spin Relaxation in Cesium Coated Cells at Room Temperature. ACTA ACUST UNITED AC 1995. [DOI: 10.1051/jp3:1995104] [Citation(s) in RCA: 6] [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: 11/14/2022]
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33
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Tavernier T, Walch G, Noël E, Lapra C, Bochu M. [MRI of the rotator cuff: evaluation of a new symptomatologic classification]. J Radiol 1995; 76:251-7. [PMID: 7783037] [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: 01/27/2023]
Abstract
The different classifications use for the rotator cuff pathology seem to be incomplete. We propose a new classification with many advantages: 1) Differentiate the tendinopathy between less serious (grade 2A) and serious (grade 2B). 2) Recognize the intra-tendinous cleavage of the infra-spinatus associated with complete tear of the supra-spinatus. 3) Differentiate partial and complete tears of the supra-spinatus. We established this classification after a retrospective study of 42 patients operated on for a rotator cuff pathology. Every case had had a preoperative MRI. This classification is simple, reliable, especially for the associated intra tendinous cleavage.
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Affiliation(s)
- T Tavernier
- Service de Radiologie Ostéoarticulaire, Hôpital E-Herriot, Lyon
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34
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Bouvier M, Tebib J, Noël E. [Double foci of spinal vacuum phenomenon in bone mastocytosis]. Rev Rhum Ed Fr 1994; 61:860-3. [PMID: 7858583] [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: 01/27/2023]
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35
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Boileau P, Walch G, Noël E, Liotard JP. [Neer's shoulder prosthesis: results according to etiology]. Rev Rhum Ed Fr 1994; 61:607-18. [PMID: 7858594] [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: 01/27/2023]
Abstract
The outcome of 80 glenohumeral arthroplasties with the Neer prosthesis in 77 patients with degenerative or inflammatory shoulder disease was evaluated after a mean follow-up of three years five months. The arthroplasties were performed because of intractable pain and functional disability due to destruction of the glenohumeral joint. The postoperative rehabilitation program focused on full recovery of joint motion and function in 65 cases and on joint stability with partial recovery of joint motion and function in 15 cases. According to the criteria developed by Neer, the outcome was excellent or satisfactory in 75% of cases and unsatisfactory in 25%. Constant's scores adjusted for age and gender varied widely across diagnostic categories, from a high of 76% in centered glenohumeral osteoarthritis (n = 40) to lows of 59% in rheumatoid arthritis (n = 21) and 45% in posttraumatic osteoarthritis (n = 10) or eccentric osteoarthritis due to cuff disruption (n = 9). At reevaluation, 70% of patients had little or no pain and 90% were satisfied with the outcome. The mean increase in flexion of the arm (39 degrees) was markedly influenced by the diagnosis. The increases in lateral rotation (mean 35 degrees) and medial rotation (four vertebral levels) of the arm were especially appreciated by the patients as having a very beneficial effect on the ability to perform everyday tasks. Complications included instability in three cases (two anterior dislocations and one posterior dislocation), glenoid component loosening in 11 cases (of which only four required reoperation) and rotator cuff tear in eight cases. Our results add to the existing evidence that nonconstrained shoulder implants, such as the Neer prosthesis, are both safe and effective in alleviating pain and improving joint function. They should be used in patients with refractory pain, disability due to restrictions in external and medial rotation of the arm and roentgenographic evidence of glenohumeral joint space loss.
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Affiliation(s)
- P Boileau
- Service d'Orthopédie et Traumatologie, CHU Nice, Hôpital Saint-Roch
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36
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Walch G, Liotard JP, Boileau P, Noël E. [Postero-superior glenoid impingement. Another impingement of the shoulder]. J Radiol 1993; 74:47-50. [PMID: 8483151] [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: 01/31/2023]
Abstract
An impingement occurring between the deep side of the supraspinatus tendon and the postero-superior edge of the glenoid cavity was evidenced in a young sports thrower presenting with a partial tear of the deep side of the tendon. This impingement occurred when the arm was in abduction-retropulsion and in forced lateral rotation. It was visualized on arthroscopy. The semiology was mixed, including signs of anterior instability and cuff impairment. The possible causes of partial tears of the deep side of the supraspinatus are discussed: sub-acromial impingement of NEER, anterior instability with secondary impingement, postero-superior glenoid impingement.
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Affiliation(s)
- G Walch
- Clinique de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Lyon-Sud, Pierre-Bénite
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37
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Bouysset M, Tébib J, Noël E, Eulry F, Bonnin M, Némoz C, Bouvier M. When should orthopaedic treatment be prescribed to avoid the flattening of the rheumatoid foot? Clin Rheumatol 1992; 11:580-2. [PMID: 1486759 DOI: 10.1007/bf02283128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Bouysset M, Tébib J, Noël E, Nemoz C, Schnepp J, Ducarme F, Bouvier M. [Rheumatoid metatarsals, original development of the first metatarsals]. Rev Rhum Mal Osteoartic 1992; 59:408-12. [PMID: 1411206] [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: 12/26/2022]
Abstract
Weight-bearing roentgenograms of 308 feet of rheumatoid arthritis patients were analyzed. Several angles were determined, including the metatarsus primus adductus angle (between the first and second metatarsals, > or = 10 degrees) and the forefoot spread angle (between the first and fifth metatarsals, > or = 30 degrees). Pes planus was diagnosed when the internal arch angle was equal to or greater than 130 degrees. Tarsal arthritis was defined as the presence of joint space narrowing. Varus of the first metatarsal was correlated with tarsal arthritis and pes planus but not with duration of the disease. Forefoot spread was correlated with duration of the disease and erosive metatarsal disease but not with involvement of the midfoot. These data demonstrate that orthopedic treatment should be initiated as soon as involvement of the first metatarsal is detected and should be directed at the hindfoot, midfoot, and first metatarsal whose deformations occur concomitantly.
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Affiliation(s)
- M Bouysset
- Centre Hospitalier Lyon-Sud, Service de Rhumatologie, Pierre-Bénite
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39
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Walch G, Boileau P, Noël E, Liotard JP, Dejour H. [Surgical treatment of painful shoulders caused by lesions of the rotator cuff and biceps, treatment as a function of lesions. Reflections on the Neer's concept]. Rev Rhum Mal Osteoartic 1991; 58:247-57. [PMID: 2057714] [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: 12/30/2022]
Abstract
On the basis of their clinical and surgical experience of 480 shoulders operated upon for rotator cuff pathology, together with a review of the literature, the authors undertake a critical analysis of the Neer impingement syndrome. Since this syndrome cannot explain all lesions and above all cover all rotator cuff pathology, they suggest an anatomical classification based upon a description of lesions. They describe their indications for surgery on the basis of their results and of those from the literature.
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Affiliation(s)
- G Walch
- Clinique de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Lyon-Sud
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40
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Nortier J, Vandenabeele P, Noël E, Bosseloir Y, Goldman M, Deschodt-Lanckman M. Enzymatic degradation of tumor necrosis factor by activated human neutrophils: role of elastase. Life Sci 1991; 49:1879-86. [PMID: 1745103 DOI: 10.1016/0024-3205(91)90288-m] [Citation(s) in RCA: 28] [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: 12/28/2022]
Abstract
Although the role of tumor necrosis factor-alpha (TNF) as mediator of inflammation is now well established, its interactions with polymorphonuclear neutrophils (PMN) are not fully understood. Therefore, we investigated the possible hydrolytic action on TNF of intra-lysosomal enzymes released by activated PMN in the extracellular medium. We first incubated 125I radiolabeled TNF in vitro with activated PMN and by HPLC analysis, we observed a degradation process completely blocked by the previous addition of alpha 1-Antitrypsin (AT) to the incubation medium. By comparing several degradative patterns of TNF obtained with purified leukocyte proteases and supernatant of activated PMN, we identified elastase as the major enzyme involved in this catabolic process of TNF. In a second part, we determined the bioactivity of the cleavage fragments of recombinant human TNF (rhTNF) by a cytotoxicity assay. None of the fragments was found biologically active. Our results suggest that, at inflammatory sites, an enzymatic degradation of TNF may occur in the pericellular area of activated PMN. This new catabolic pathway leading to inactivation of TNF might be regarded as an effective local negative feed-back process limiting the potentially toxic effects of this cytokine.
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Affiliation(s)
- J Nortier
- Laboratoire Pluridisciplinaire de Recherche Expérimentale Biomédicale, Faculté de Médecine, Université Libre de Bruxelles, Belgium
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41
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Walch G, Noël E, Tebib J. [The role of arthroscopy in pathology of the rotator cuff]. Presse Med 1990; 19:544-6. [PMID: 2139213] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- G Walch
- Service d'Orthopédie, Centre Hospitalier Lyon Sud, Pierre-Bénite
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42
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Noël E, Walch G, Tebib JG. [Recurrent anterior luxation of the shoulder occurring after 40 years of age and rupture of the rotator cuff]. Rev Rhum Mal Osteoartic 1990; 57:189-91. [PMID: 2339266] [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: 12/31/2022]
Affiliation(s)
- E Noël
- Service de Rhumatologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite
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43
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Walch G, Noël E, Tebib JG. [Role of arthroscopy in pathology of the rotator cuff]. Rev Rhum Mal Osteoartic 1989; 56:831-3. [PMID: 2617091] [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: 01/01/2023]
Affiliation(s)
- G Walch
- Service d'Orthopédie, Centre Hospitalier Lyon-Sud
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44
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Noël E, Walch G, Bochu M. [Jobe's maneuver. Apropos of 227 cases]. Rev Rhum Mal Osteoartic 1989; 56:803-4. [PMID: 2617088] [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: 01/01/2023]
Affiliation(s)
- E Noël
- Service d'Orthopédie, Centre Hospitalier, Lyon-Sud
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45
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Tebib J, Colson F, Noël E, Bouvier M. [A new case of gold-induced hepatitis during the treatment of rheumatoid polyarthritis]. Rev Rhum Mal Osteoartic 1988; 55:705-7. [PMID: 3142032] [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: 01/04/2023]
Affiliation(s)
- J Tebib
- Service de Rhumatologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite
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