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Regnault N, Lebreton E, Tang L, Fosse-Edorh S, Barry Y, Olié V, Billionnet C, Weill A, Vambergue A, Cosson E. Maternal and neonatal outcomes according to the timing of diagnosis of hyperglycaemia in pregnancy: a nationwide cross-sectional study of 695,912 deliveries in France in 2018. Diabetologia 2024; 67:516-527. [PMID: 38182910 PMCID: PMC10844424 DOI: 10.1007/s00125-023-06066-4] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/02/2023] [Indexed: 01/07/2024]
Abstract
AIMS/HYPOTHESIS We aimed to assess maternal-fetal outcomes according to various subtypes of hyperglycaemia in pregnancy. METHODS We used data from the French National Health Data System (Système National des Données de Santé), which links individual data from the hospital discharge database and the French National Health Insurance information system. We included all deliveries after 22 gestational weeks (GW) in women without pre-existing diabetes recorded in 2018. Women with hyperglycaemia were classified as having overt diabetes in pregnancy or gestational diabetes mellitus (GDM), then categorised into three subgroups according to their gestational age at the time of GDM diagnosis: before 22 GW (GDM<22); between 22 and 30 GW (GDM22-30); and after 30 GW (GDM>30). Adjusted prevalence ratios (95% CI) for the outcomes were estimated after adjusting for maternal age, gestational age and socioeconomic status. Due to the multiple tests, we considered an association to be statistically significant according to the Holm-Bonferroni procedure. To take into account the potential immortal time bias, we performed analyses on deliveries at ≥31 GW and deliveries at ≥37 GW. RESULTS The study population of 695,912 women who gave birth in 2018 included 84,705 women (12.2%) with hyperglycaemia in pregnancy: overt diabetes in pregnancy, 0.4%; GDM<22, 36.8%; GDM22-30, 52.4%; and GDM>30, 10.4%. The following outcomes were statistically significant after Holm-Bonferroni adjustment for deliveries at ≥31 GW using GDM22-30 as the reference. Caesarean sections (1.54 [1.39, 1.72]), large-for-gestational-age (LGA) infants (2.00 [1.72, 2.32]), Erb's palsy or clavicle fracture (6.38 [2.42, 16.8]), preterm birth (1.84 [1.41, 2.40]) and neonatal hypoglycaemia (1.98 [1.39, 2.83]) were more frequent in women with overt diabetes. Similarly, LGA infants (1.10 [1.06, 1.14]) and Erb's palsy or clavicle fracture (1.55 [1.22, 1.99]) were more frequent in GDM<22. LGA infants (1.44 [1.37, 1.52]) were more frequent in GDM>30. Finally, women without hyperglycaemia in pregnancy were less likely to have preeclampsia or eclampsia (0.74 [0.69, 0.79]), Caesarean section (0.80 [0.79, 0.82]), pregnancy and postpartum haemorrhage (0.93 [0.89, 0.96]), LGA neonate (0.67 [0.65, 0.69]), premature neonate (0.80 [0.77, 0.83]) and neonate with neonatal hypoglycaemia (0.73 [0.66, 0.82]). Overall, the results were similar for deliveries at ≥37 GW. Although the estimation of the adjusted prevalence ratio of perinatal death was five times higher (5.06 [1.87, 13.7]) for women with overt diabetes, this result was non-significant after Holm-Bonferroni adjustment. CONCLUSIONS/INTERPRETATION Compared with GDM22-30, overt diabetes, GDM<22 and, to a lesser extent, GDM>30 were associated with poorer maternal-fetal outcomes.
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Affiliation(s)
- Nolwenn Regnault
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Elodie Lebreton
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Luveon Tang
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | | | - Yaya Barry
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Valérie Olié
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | | | - Alain Weill
- EPI-PHARE Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Anne Vambergue
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Lille University Hospital, European Genomics Institute for Diabetes, University of Lille, Lille, France
| | - Emmanuel Cosson
- Department of Diabetology-Endocrinology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Bobigny, France.
- Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), Université Sorbonne Paris Nord and Université Paris CitéInserm, INRAE, CNAM, Bobigny, France.
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Tang L, Lebreton E, Vambergue A, Fosse-Edorh S, Olié V, Barry Y, Weill A, Cosson E, Regnault N. Cross-sectional study examining factors impacting on uptake of postpartum type 2 diabetes screening among women diagnosed with hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2024; 208:111116. [PMID: 38266823 DOI: 10.1016/j.diabres.2024.111116] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 01/26/2024]
Abstract
AIMS Early postpartum glucose screening of women with hyperglycaemia in pregnancy (HIP) can identify women who have the highest risk of developing impaired glucose tolerance and T2DM. This study examines the association between demographics, events during pregnancy, socioeconomic status and postpartum T2DM screening. METHODS Using the French National Health Data System, this cross-sectional study included all deliveries where the mother had HIP in France in 2015, (n = 76,862). The odds ratio (OR) for attending postpartum screening was calculated via multi-level logistic regression. RESULTS T2DM screening uptake at six months postpartum was 42·9% [95 % Confidence Interval: 42·6-43·3]. Several characteristics were associated with lower uptake: living in the most deprived area(OR = 0·78[0·74-0·83]); being < 25 years-old (reference age group 25-29;≤17: 0.53 [0·31-0·90];18-24: 0.73[0·69-0·78]); smoking (0·65[0·62-0·68]); obesity (0·93[0·89-0·97]); caesarean delivery (0·95[0·92-0·99]). Factors associated with higher uptake included primiparity (1·30[1·26-1·34]); having followed the French recommendations for HIP screening (1·24[1·20-1·28]); insulin prescription (1·75[1·69-1·81]) and pre-eclampsia (1·30[1·19-1·42]). p < 0.01 is justified due to sample size. CONCLUSION Improving identification of factors affecting postpartum T2DM screening uptake, such as demographics, socioeconomic context and events during pregnancy, may lead to development of target interventions to aide adherence to screening regime and thereby diagnosis of women with prediabetes or diabetes, for whom secondary and tertiary prevention is crucial.
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Affiliation(s)
- Luveon Tang
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France.
| | - Elodie Lebreton
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Anne Vambergue
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Lille University Hospital, European Genomics Institute for Diabetes, University of Lille, France
| | - Sandrine Fosse-Edorh
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Valérie Olié
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Yaya Barry
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Alain Weill
- EPI-PHARE Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France; Paris 13 University, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Department of Endocrinology, CRNH-IdF, CINFO, Bobigny, France
| | - Emmanuel Cosson
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA, France
| | - Nolwenn Regnault
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
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Ray CL, Lelong N, Cinelli H, Blondel B, Lelong N, Cinelli H, Blondel B, Regnault N, Demiguel V, Lebreton E, Salanave B, Fresson J, Vilain A, Deroyon T, Raynaud P, Rey S, Chemlal K, Rabier-Thoreau N. Results of the 2021 French National Perinatal Survey and trends in perinatal health in metropolitan France since 1995. J Gynecol Obstet Hum Reprod 2022; 51:102509. [PMID: 36410664 DOI: 10.1016/j.jogoh.2022.102509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To report results of the 2021 French National Perinatal Survey (ENP) in metropolitan France and assess trends in the main indicators of perinatal health, medical practices, and risk factors in France since 1995. POPULATION AND METHOD All the samples included all women giving birth at a gestational age of at least 22 weeks of gestation and/or to an infant weighing at least 500 grams in all maternity units in metropolitan France during one week in 1995 (N=13 048), 2003 (N=14 324), 2010 (N=14 546), 2016 (N=12 553), and 2021 (N=12 088). The data came from postpartum interviews of the women at the hospital and their medical records. Comparisons between surveys showed trends over time. RESULTS Between 1995 and 2021, maternal characteristics changed. Maternal age and the frequency of women with obesity rose: in 2021, 24.6% of women were 35 years or older (21.1% in 2016, 19.2% in 2010, 15.9% in 2003 and 12.4% in 1995) and 14.4% were obese (11.8% in 2016, 9.9% in 2010 and 7.4% in 2003). Some antenatal prevention behaviors that improved in 2021 were not smoking during the third trimester, acid folic administration before pregnancy, and vaccination against influenza. The percentage of women with an early prenatal appointment ("4th month appointment"), implemented to facilitate screening of maternal vulnerability during pregnancy, has continued to rise. The percentage of women receiving prenatal care by midwives has risen markedly (39.0% in 2021 versus 11.7% in 2016). Serum screening for Down syndrome continues to increase (91.8% of women in 2021). The rate of induction of labor has risen significantly (20.2% in 1995 and 25.8% in 2021). The mode of delivery has not varied significantly since 2003; in 2021, the cesarean rate was 21.4% and the instrumental vaginal delivery rate 12.4%. Episiotomy was increasingly rare, among both primiparous and multiparous women (16.5% and 2.9% in 2021, respectively). The prevalence of coronavirus (SARS-CoV2) infection during pregnancy was 5.7%. Preterm live births increased regularly, slightly but significantly over the 1995-2016 period and then remained stable between 2016 and 2021 (7.0%). In 2021, 56.3% of women exclusively breastfed during their hospital stay, a modest increase in comparison with 2016 (54.6%). CONCLUSION Routine national perinatal surveys highlight positive trends over time in some preventive practices, decreases in some medical interventions consistent with national guidelines, and the increasing role of midwives in prenatal care. Nonetheless, some indicators remain less than optimal and require more detailed analyses.
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Affiliation(s)
- Camille Le Ray
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, INRAE, Université Paris Cité, 75014 Paris, France; Maternité Port-Royal, Groupe hospitalier Paris Centre, AP-HP, Université Paris Cité, FHU Prema, 75014 Paris.
| | - Nathalie Lelong
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, INRAE, Université Paris Cité, 75014 Paris, France
| | - Hélène Cinelli
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, INRAE, Université Paris Cité, 75014 Paris, France
| | - Béatrice Blondel
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, INRAE, Université Paris Cité, 75014 Paris, France
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Lebreton E, Menguy C, Fresson J, Egorova NN, Crenn Hebert C, Zeitlin J. Measuring severe neonatal morbidity using hospital discharge data in France. Paediatr Perinat Epidemiol 2022; 36:190-201. [PMID: 34797588 DOI: 10.1111/ppe.12816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/11/2021] [Accepted: 08/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Measuring infant health at birth is key for surveillance and research in obstetrics and neonatology, but there is no international consensus on morbidity indicators. The Neonatal Adverse Outcome Indicator (NAOI) is a composite indicator, developed in Australia, which measures the burden of severe neonatal morbidity using hospital discharge data. OBJECTIVE To evaluate the applicability of the NAOI in France for surveillance and research. METHODS We constituted a cohort of live births ≥24 weeks' gestational age in Metropolitan France from 2014 to 2015 using hospital discharge, insurance claims and cause of death data. Outlier hospitals were identified using funnel plots of standardised morbidity ratios (SMR), and their coding patterns were assessed. We compared the NAOI and its component codes with published Australian and English data and estimated unadjusted and adjusted risk ratios for known risk factors for neonatal morbidity. RESULTS We included 1,459,123 births (511 hospitals). Twenty-eight hospitals had SMR above funnel plot control limits. Newborns with NAOI morbidities in these hospitals had lower mortality and shorter stays than in other hospitals. Amongst within-limit hospitals, NAOI prevalence was 4.8%, comparable to Australia (4.6%) and England (5.4%). Most individual components had a similar prevalence, with the exception of respiratory support, intravenous fluid procedures and infection. NAOI was lowest at 39 weeks (2.2%) with higher risks for maternal age ≥40 (relative risk [RR] 1.47, 95% confidence interval [CI] 1.42, 1.51), state medical insurance (RR 1.60, 95% CI 1.52, 1.68), male sex (RR 1.21, 95% CI 1.19, 1.23) and birthweight <3rd percentile (RR 4.60, 95% CI 4.51, 4.69). CONCLUSIONS The NAOI provides valuable information on population prevalence of severe neonatal morbidity and its risk factors. Whilst the prevalence was similar in high-income countries with comparable neonatal mortality levels, ensuring valid comparisons between countries and hospitals will require further work to harmonize coding procedures, especially for infection and respiratory morbidity.
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Affiliation(s)
- Elodie Lebreton
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.,Non Communicable Diseases and Trauma Division, Santé publique France, The National Public Health Agency, Saint-Maurice, France.,Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Saint-Denis, France
| | - Claudie Menguy
- Non Communicable Diseases and Trauma Division, Santé publique France, The National Public Health Agency, Saint-Maurice, France.,Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Saint-Denis, France
| | - Jeanne Fresson
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.,Department of Medical Information, Maternity of University Hospital - CHRU Nancy, Nancy, France
| | - Natalia N Egorova
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Catherine Crenn Hebert
- Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Saint-Denis, France.,Maternity Unit, University Hospital (APHP), Hôpital Louis Mourier, Colombes, France
| | - Jennifer Zeitlin
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Lebreton E, Crenn-Hebert C, Menguy C, Howell EA, Gould JB, Dechartres A, Zeitlin J. Composite neonatal morbidity indicators using hospital discharge data: A systematic review. Paediatr Perinat Epidemiol 2020; 34:350-365. [PMID: 32207172 PMCID: PMC7418783 DOI: 10.1111/ppe.12665] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/13/2020] [Accepted: 02/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neonatal morbidity is associated with lifelong impairments, but the absence of a consensual definition and the need for large data sets limit research. OBJECTIVES To inform initiatives to define standard outcomes for research, we reviewed composite neonatal morbidity indicators derived from routine hospital discharge data. DATA SOURCES PubMed (updated on October 12, 2018). The search algorithm was based on three components: "morbidity," "neonatal," and "hospital discharge data." STUDY SELECTION AND DATA EXTRACTION Studies investigating neonatal morbidity using a composite indicator based on hospital discharge data were included. Indicators defined for specific conditions (eg congenital anomalies, maternal addictions) were excluded. The target population, objectives, component morbidities, diagnosis and procedure codes, validation methods, and prevalence of morbidity were extracted. SYNTHESIS For each study, we assessed construct validity by describing the methods used to select the indicator components and evaluated whether the authors assessed internal and external validity. We also calculated confidence intervals for the prevalence of the morbidity composite. RESULTS Seventeen studies fulfilled inclusion criteria. Indicators targeted all (n = 4), low-/moderate-risk (n = 9), and very preterm (VPT, n = 4) infants. Components were similar for VPT infants, but domains and diagnosis codes within domains varied widely for all and low-/moderate-risk infants. Component selection was described for 8/17 indicators and some form of validation reported for 12/17. Neonatal morbidity prevalence ranged from 4.6% to 9.0% of all infants, 0.4% to 8.0% of low-/moderate-risk infants, and 17.8% to 61.0% of VPT infants. CONCLUSIONS Multiple neonatal morbidity indicators based on hospital discharge data have been used for research, but their heterogeneity limits comparisons between studies. Standard neonatal outcome measures are needed for benchmarking and synthesis of research results.
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Affiliation(s)
- Elodie Lebreton
- Data Science and Analytics Department, SESAN, Paris, France,Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, F-75004 Paris, France,Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Paris, France
| | - Catherine Crenn-Hebert
- Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Paris, France,Maternity unit, Louis Mourier University Hospital, APHP, Colombes, France
| | - Claudie Menguy
- Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), Paris, France,Department of Medical Information, André Grégoire Hospital, Montreuil, France
| | - Elizabeth A. Howell
- Women’s Health Research Institute, Department of Obstetrics, Gynecology, and Reproductive Science, and Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey B. Gould
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Agnès Dechartres
- Sorbonne Université, Inserm U1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Département Biostatistique, santé publique, information médicale - Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, F-75004 Paris, France
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Zeitlin J, Egorova NN, Janevic T, Hebert PL, Lebreton E, Balbierz A, Howell EA. The Impact of Severe Maternal Morbidity on Very Preterm Infant Outcomes. J Pediatr 2019; 215:56-63.e1. [PMID: 31519443 PMCID: PMC6981241 DOI: 10.1016/j.jpeds.2019.07.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/08/2019] [Accepted: 07/24/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate the prevalence of severe maternal morbidity among very preterm births and determine its association with very preterm infant mortality and morbidity. STUDY DESIGN This study used New York City Vital Statistics birth and death records linked with maternal and newborn discharge abstract data for live births between 2010 and 2014. We included 6901 infants without congenital anomalies born between 240/7 and 326/7 weeks of gestation. Severe maternal morbidity was identified as life-threatening conditions or life-saving procedures. Outcomes were first-year infant mortality, severe neonatal morbidity (bronchopulmonary dysplasia, severe necrotizing enterocolitis, stage 3-5 retinopathy of prematurity, and intraventricular hemorrhage grades 3-4), and a combined outcome of death or morbidity. RESULTS Twelve percent of very preterm live-born infants had a mother with severe maternal morbidity. Maternal and pregnancy characteristics associated with occurrence of severe maternal morbidity were multiparity, being non-Hispanic black, and preexisting health conditions, but gestational age and the percentage small for gestational age did not differ. Infants whose mothers experienced severe maternal morbidity had higher first-year mortality, 11.2% vs 7.7% without severe maternal morbidity, yielding a relative risk of 1.39 (95% CI: 1.14-1.70) after adjustment for maternal characteristics, preexisting comorbidities, pregnancy complications, and hospital factors. Severe neonatal morbidity was not associated with severe maternal morbidity. CONCLUSIONS Severe maternal morbidity is an independent risk factor for mortality in the first year of life among very preterm infants after consideration of other maternal and pregnancy risk factors.
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Affiliation(s)
- Jennifer Zeitlin
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Biostatistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.
| | - Natalia N Egorova
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Teresa Janevic
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Paul L Hebert
- University of Washington School of Public Health, Seattle, WA
| | - Elodie Lebreton
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Biostatistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France; Data Science and Analytics Department, SESAN, Paris, France
| | - Amy Balbierz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Elizabeth A Howell
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY
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Menguy C, Crenn-Hebert C, Lebreton E, Devaux E, Martinowsky M. Place de l’hospitalisation à domicile (HAD) dans le parcours des nouveau-nés en Île-de-France (IDF). Un travail multidisciplinaire piloté par l’Agence régionale de santé d’Île-de-France (ARS-IDF). Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.01.065] [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: 10/17/2022] Open
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Lebreton E, Blondel B, Bonet M, Zeitlin J. Impact du volume d’admissions néonatales sur la mortalité hospitalière des grands prématurés en Europe : résultats de la cohorte EPICE. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.01.028] [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] Open
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Ego A, Prunet C, Lebreton E, Blondel B, Kaminski M, Goffinet F, Zeitlin J. Courbes de croissance in utero ajustées et non ajustées adaptées à la population française. I – Méthodes de construction. ACTA ACUST UNITED AC 2016; 45:155-64. [DOI: 10.1016/j.jgyn.2015.08.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/13/2015] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
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Tran TC, Boumendil A, Bussieres L, Lebreton E, Ropers J, Rozenberg P, Aegerter P. Are Meteorological Conditions within the First Trimester of Pregnancy Associated with the Risk of Severe Pre-Eclampsia? Paediatr Perinat Epidemiol 2015; 29:261-70. [PMID: 26053449 DOI: 10.1111/ppe.12196] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Severe pre-eclampsia (SPE) is the second cause of maternal death in developed countries. The literature suggests different risk factors for early- and late-onset pre-eclampsia. SPE is usually related to the early-onset type. Pre-eclampsia rate exhibits seasonal variation. However, the weather-SPE association is still unknown. We examined the associations between maternal exposure to meteorological parameters after conception and SPE. METHODS From 2008 to 2011, all deliveries of women living in the Yvelines area, France, have been prospectively registered. Meteorological measurements from weather stations scattered inside Yvelines were averaged on two exposure windows: early-pregnancy (30 days after conception) and first-trimester (90 days after conception). The relationship between SPE and season of conception was also examined. Hierarchical complementary log-log regression models were used to estimate the weather-SPE association. RESULTS SPE was diagnosed in 526 (0.8%) out of 63,633 singleton pregnancies. Increasing temperature or sunshine across both windows was associated with increased SPE risk. Early-pregnancy minimum temperature showed the strongest effect with adjusted odds ratio (OR) per 1 degree Celsius: 1.03 [95% confidence interval (CI) 1.01, 1.04]. The risk of SPE was higher when conception was in summer as compared to winter (OR 1.53, 95% CI 1.27, 1.85). Effect estimates showed only small variations in sensitivity analyses. CONCLUSIONS Our findings of a weather impact during early pregnancy on SPE may provide a new clue for understanding the causes of pre-eclampsia. Further investigation into the biologic mechanisms for this finding is required.
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Affiliation(s)
- Thi-Chien Tran
- UPRES EA 2506 (Santé-Environnement Vieillissement), UFR Sciences de la Santé Paris Île-de-France Ouest, Université Versailles St-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - Ariane Boumendil
- UPRES EA 2506 (Santé-Environnement Vieillissement), UFR Sciences de la Santé Paris Île-de-France Ouest, Université Versailles St-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - Laurence Bussieres
- Département Gynécologie-Obstétrique, Hôpital Poissy-Saint-Germain, Poissy, France
| | - Elodie Lebreton
- Réseau Périnatal de l'Agence Régionale de Santé Île-de-France (Périnat-ARS-IDF), Paris, France
| | - Jacques Ropers
- Unité de Recherche Clinique Hôpital Universitaire Paris Île-de-France Ouest, Boulogne-Billancourt, France
| | - Patrick Rozenberg
- Département Gynécologie-Obstétrique, Hôpital Poissy-Saint-Germain, Poissy, France
| | - Philippe Aegerter
- UPRES EA 2506 (Santé-Environnement Vieillissement), UFR Sciences de la Santé Paris Île-de-France Ouest, Université Versailles St-Quentin-en-Yvelines, Boulogne-Billancourt, France
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11
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Menguy C, Crenn-Hebert C, Lebreton E. Besoins en lits de néonatalogie pour le nouveau schéma régional d’organisation des soins (SROS) d’Île-de-France (IDF). Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Benatar M, Dumas P, Cardio-Leccia N, Lebreton E, Chignon-Sicard B. [Interest and reliability of frozen section biopsy in the treatment of skin tumors]. ANN CHIR PLAST ESTH 2012; 57:125-31. [PMID: 22475479 DOI: 10.1016/j.anplas.2012.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 02/16/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Association of surgical treatment combined to frozen section biopsies appears to be one of the most appropriate therapeutic solution for the treatment of skin carcinomas. We report our experience on 269 tumors assessed with frozen sections. Our goal was to first study the benefit of a one-time surgical approach, then to better target the tumors eligible for this examination and finally to number the difference between frozen section and final histology studies. MATERIALS AND METHODS This is a retrospective analysis of 269 tumors, operated on an outpatient basis with frozen section followed later by a final histology study. All being performed by the same team of surgeons and pathologist. Only previously biopsied and diagnosed basal cell or squamous cell tumors were included. The recorded data were: location of tumor; histological type; involved margins; number of cuts; differences between frozen section and final histological studies, which conduct to a two-time surgical approach; number of tumors for which frozen section was impossible during surgery and that lead to a two-time surgical approach; type of reconstruction; number of recurrence. RESULTS The follow up was 48 months (26.6 to 78.1). Histogical analyses were carried on basal cell carcinoma (92%), squamous cell carcinoma (8%) with a topographic distribution mainly in face and neck (72%). Of the 269 tumors excised, 207 representing 77% had a sufficient safety margin, 62 representing 23% had at least one invaded bank that required further surgical resection. We found seven cases of two-time surgical approach. In three cases, it was secondary to medical decision because of a technical difficulty of histologists. In one case, histological diagnosis can't be obtained by frozen section study. In three cases, we found a difference between frozen section and final study. CONCLUSION The benefit provided by the frozen section takes its value in the treatment of face and neck tumors, whose optimal margins are sometimes difficult to obtain and minimal scar ransom necessary. A one-time surgery was made possible to us thanks to this fast examination. The low rate of second surgery and recurrence allows us to demonstrate the reliability of this technique.
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Affiliation(s)
- M Benatar
- Service de chirurgie plastique, CHU Nice Sophia-Antipolis, Nice, France.
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13
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Lebreton E, Rozenberg P, Chalavoux K, Cotte B, Marier A, Goffinet F. Évaluation d’un réseau périnatal à partir des premiers certificats de santé, Yvelines, France. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2011.12.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Dumas P, Chignon-Sicard B, Médard de Chardon V, Balaguer T, Lebreton E. Le syndrome du marteau hypothénarien : analyse de la littérature et cas clinique. ACTA ACUST UNITED AC 2010; 29:289-93. [DOI: 10.1016/j.main.2010.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 04/05/2010] [Accepted: 06/30/2010] [Indexed: 10/19/2022]
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15
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Abstract
The hypothenar eminence is of great surgical interest yet its complex anatomy is yet to be fully discovered. This review focuses on: the osteoligamentous floor and topography of the Guyon's canal and the carpal ulnar neurovascular space. The canal under the Pisohamate ligament must be individualized. It corresponds to the zone 2 of Shea and McClain where the deep branch of the ulnar nerve is particularly vulnerable. Usually described as a hole, it is a real canal that circumvents the hamulus; the hypothenar muscles are extremely variable. The short abductor of the little finger may be harvested for opposition transfer but its absence penalizes abduction of the little finger if an independent flexor digiti minimi brevis inserts on the head of the fifth metacarpal; the termination of the ulnar nerve distribution to the hypothenar muscles and medio-ulnar anastomoses. The ulnar artery, its close relationship with the hook of the hamate and its variable course that may put it at risk during endoscopic carpal tunnel release. Finally, blood supply of fat pads and skin and their use as flaps to cover the palm and fingers.
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16
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Crenn-Hebert C, Menguy C, Lebreton E, Echardour G, Muray JM, Scherer S. Le système d’information en périnatalité d’Île de France (IDF) et l’évaluation des pratiques professionnelles dans l’hémorragie du postpartum. Rev Epidemiol Sante Publique 2010. [DOI: 10.1016/j.respe.2010.02.019] [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] Open
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17
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Lebreton E, Crenn-Hebert C, Menguy C, Echardour G, Lefebvre A, Cessateur A. PERINAT-ARHIF : un système d’information en périnatalité dans la région d’Île-de-France (IDF). Rev Epidemiol Sante Publique 2010. [DOI: 10.1016/j.respe.2010.02.084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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18
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Riah Y, Balaguer T, Médard de Chardon V, Chignon-Sicard B, Dannan E, Lebreton E. [The use of the "spare-parts tissue bank" concept in emergency hand surgery]. Chir Main 2009; 29:23-31. [PMID: 20031472 DOI: 10.1016/j.main.2009.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 10/23/2009] [Accepted: 11/08/2009] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In the case of multidigital hand trauma, the tissue of the amputated parts can be used for the reconstruction of the defected tissue localized on the other fingers. PATIENTS AND METHODS A series of seven patients has been reviewed in this paper; the authors illustrate the different possibilities of using the "spare-parts concept" in the emergency hand trauma surgery. RESULTS The functional results are presented. DISCUSSION The different techniques of reconstruction using the "spare-parts concept" are discussed. CONCLUSION In the cases of multidigital lesions, the surgeon should choose the best opportunity to use the tissue of the amputated digits, or the non-conservable ones, to reconstruct the neighboring preserved segments.
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Affiliation(s)
- Y Riah
- Service de chirurgie plastique reconstructrice et chirurgie de main, hôpital St-Roch, CHU de Nice, 5, rue Dévoluy, 06000 Nice, France.
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19
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Médard de Chardon V, Balaguer T, Chignon-Sicard B, Ihrai T, Lebreton E. Les asymétries constitutionnelles en chirurgie d’augmentation mammaire esthétique : incidence, satisfaction et applications chirurgicales. ANN CHIR PLAST ESTH 2009; 54:340-7. [DOI: 10.1016/j.anplas.2009.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2008] [Accepted: 01/16/2009] [Indexed: 11/29/2022]
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20
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Balaguer T, David S, Ihrai T, Cardot N, Daideri G, Lebreton E. Histological staging and Dupuytren's disease recurrence or extension after surgical treatment: a retrospective study of 124 patients. J Hand Surg Eur Vol 2009; 34:493-6. [PMID: 19675030 DOI: 10.1177/1753193409103729] [Citation(s) in RCA: 28] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Dupuytren's disease has a high rate of recurrence after treatment. In this study we have assessed the usefulness of histological staging in the prediction of recurrence. We have also verified whether there is a correlation between histological staging and features of Dupuytren's diathesis. We studied 139 hands in 124 Caucasian patients treated between 1997 and 2004. There was a significant difference in the recurrence rate between the three histological types (P = 0.04). Histological staging was independent of features of Dupuytren's diathesis. This study confirms that histological staging is a reliable method for predicting recurrence. However, it should be used in association with clinical data to determine precisely the prognosis of patients suffering from Dupuytren's contracture.
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Affiliation(s)
- T Balaguer
- Nice Sophia Antipolis University, Nice, France
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21
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Norat F, Poissonnet G, Dassonville O, Dreant N, Lebreton E. [Planned reconstruction after broad carcinological demolition of the face: case report]. Rev Laryngol Otol Rhinol (Bord) 2009; 130:181-184. [PMID: 20345075] [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: 05/29/2023]
Abstract
UNLABELLED The authors present their approach in face reconstruction after carcinological demolition. CASE REPORT A 40-years-old patient presented an epidermoid carcinoma starting at the level of the right jawbone, few differentiated, massively destroying the roof of the maxillary sinus with subcutaneous and cutaneous infiltration in front and extension to the orbit. A broad right hemifacial right amputation was decided with ocular exenteration, cutaneo-palpebral sacrifice, parotidectomy with conservation of the facial nerve and standard cervical neck. After study and 3D simulation the reconstruction was carried out by an osteocutaneous parascapular flap using the external columna of the scapula for the repair of the lower orbital edge in order to accomodate an epithesis. CONCLUSION We think that the planning step and preoperative three-dimensional measurement is of primary importance. It defines the size and type of flap to be taken in order to rebuild as well as possible the face while respecting the aesthetic units.
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Affiliation(s)
- F Norat
- Hôpital Saint Roch, Service de Chirurgie Réparatrice, 5 rue P. Dévoluy, 06300 Nice, France.
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Ihrai T, Balaguer T, Monteil MC, Chignon-Sicard B, Médard de Chardon V, Riah Y, Lebreton E. [Surgical management of traumatic ear amputations: literature review]. ANN CHIR PLAST ESTH 2008; 54:146-51. [PMID: 19042071 DOI: 10.1016/j.anplas.2008.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Accepted: 08/07/2008] [Indexed: 11/28/2022]
Abstract
Traumatic ear amputation (TEA) is a complete avulsion of a part or of the total auricular tissue. TEA are rare (only 74 cases have been described in the literature) and their handling is complex. The surgeon's objective is to obtain the best cosmetic result without demolishing the auricular area in order to allow future ear reconstruction in case of replantation failure. Many techniques of ear replantation have been described in the literature during the last 30 years: microsurgical replantation, pocket techniques and reattachment techniques. Microsurgical replantation should be achieved every time it is possible. When it is not possible, the surgeon can choose between ear reattachment and a pocket technique according to two clinical features: the size of the amputated part and the involvement of the ear lobe. Ear reattachment can be achieved when the amputated part is smaller than 15 mm or when amputation involves the earlobe. Pocket techniques, which are appropriate for the replantation of the auricular cartilage, can be used when the amputated part is bigger than 15 mm and does not comprise the earlobe.
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Affiliation(s)
- T Ihrai
- Service de chirurgie plastique et réparatrice, chirurgie de la main, hôpital Saint-Roch, CHU de Nice, université de Nice Sophia-Antipolis, 5, rue Pierre-Devoluy, 06000 Nice, France.
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23
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Médard de Chardon V, Guevara N, Lattes L, Converset-Viethel S, Riah Y, Lebreton E, Santini J, Balaguer T. Dermohypodermite bactérienne nécrosante avec fasciite nécrosante : complication d’une installation opératoire ? ANN CHIR PLAST ESTH 2008; 53:372-7. [DOI: 10.1016/j.anplas.2007.07.009] [Citation(s) in RCA: 3] [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] [Received: 04/04/2007] [Accepted: 07/08/2007] [Indexed: 10/22/2022]
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24
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Martinage A, Balaguer T, Chignon-Sicard B, Monteil MC, Dréant N, Lebreton E. Luxations et fractures-luxations périlunaires du carpe, étude rétrospective d’une série de 14 cas. ACTA ACUST UNITED AC 2008; 27:31-9. [PMID: 18164230 DOI: 10.1016/j.main.2007.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 09/21/2007] [Accepted: 10/09/2007] [Indexed: 10/22/2022]
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25
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Monteil MC, Balaguer T, Chignon-Sicard B, Lebreton E. Pseudoboutonnière traumatique de l'articulation métacarpophalangienne du cinquième doigt : à propos d'un cas et revue de la littérature. ACTA ACUST UNITED AC 2006; 25:92-5. [PMID: 16841771 DOI: 10.1016/j.main.2006.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dislocation of the extensor tendon over the metacarpophalangeal joint is common among patients with rheumatoid arthritis. Patients without arthritis are exceptionally involved. The authors describe a new case of traumatic boutonniere-like of the metacarpophalangeal joint of the little finger. This lesion is a rarely, only eleven cases are described in literature. Patients are usually young adults and dislocation is related to a direct axial trauma on their fifth metacarpophalangeal joint. Diagnosis is clinical and relies on an incomplete active extension of the metacarpophalangeal joint, secondary to the dislocation of the extensor apparatus. Diagnosis is often delayed the lesion remaining unnoticed with the occurrence of others hand lesions. Proper treatment is surgery, based on suturing side to side both extensor digiti minimi and common extensor tendon over the fifth metacarpophalangeal joint. Results are excellent, with a complete range of motion and the absence of recurrence.
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Affiliation(s)
- M C Monteil
- Service de chirurgie de la main, centre hospitalier universitaire de Nice, hôpital Saint-Roch, 5, rue Pierre-Dévoluy, 06000 Nice, France.
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Abstract
The authors report a case of amputation of the first, second and third fingers of the left hand in an 80-year old man. As the thumb was not replantable, a pollicization by hetero-replantation of the index was performed as an emergency. With a 1-year follow-up, the functional result was satisfactory. Analysis of the case report again shows that in the case of thumb amputation, hetero-replantation according to the principles of "finger-bank" is the solution of choice and demonstrates its feasibility in the elderly. The authors discuss the recovery of sensation.
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Affiliation(s)
- N Dreant
- Service de chirurgie plastique et chirurgie de la main, hôpital Saint-Roch, CHU de Nice, 5, rue Pierre-Devoluy, 06006 Nice, France.
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27
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Abstract
Vascularized free nerve grafts make possible the repair of extensive defects of large nerve trunks. Since the original observations of Taylor and Ham in 1976 many cases have been published. The ulnar nerve in the upper arm in most cases has a simple arteriovenous pedicle the anatomy of which has been precisely defined by cadaver dissections and intravascular injections. The arterial supply, 47 times out of 50, is the proximal ulnar collateral and 2 times the distal collateral ulnar artery. It takes its origin from the medial side of the brachial artery in the upper or middle third of the arm. Its external diameter is on the average 1.8 mm at its origin. The accompanying vein enters a brachial vein 2 to 3 cm below the origin of the artery. The removal of the graft is done through a straight incision on the inner aspect of the arm. The brachial artery is dissected from above downward and its medial branches noted. The nerve and its arteriovenous pedicle are separated in a block along with adjacent cellular tissue by dissection from below upwards. The average length of the pedicle thus produced is 13 cm, but a much longer section of the nerve can certainly be taken. A case report illustrates the procedure.
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Affiliation(s)
- E Lebreton
- Laboratoire d'Anatomie, UER Médecine, Nice
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28
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Orset G, Lebreton E, Assouline A, Giordano P, Denis F, Pomel G. [The axial orientation of the phalanges following the curling up of the fingers]. Ann Chir Main Memb Super 1991; 10:101-7. [PMID: 1716120 DOI: 10.1016/s0753-9053(05)80187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study follows and modestly completes those by Dubousset and Kapandji concerning the phenomena of axial (or longitudinal) rotation of the phalanges combined with flexion-extension of the fingers. Our analysis of the orientation of axial rotation of the skeletal elements of the digital chain, in relation to each other and during digito-palmar flexion was supported by simple observation, impressions in silicone paste, study of anatomical preparations, three-dimensional computed tomography. The index finger and middle finger tend to supinate. The ring finger undergoes virtually no rotation and the distal end of the little finger tends to pronate. These phenomena, essential for good adaptation to grip and fine manipulation must be taken into account by rehabilitation physicians when the amplitude of these movements are limited by immobilisation or disease.
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Affiliation(s)
- G Orset
- Centre de Rééducation Fonctionelle et d'Orthèse de la Main, Cannes
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29
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Abstract
The antegrade transosseous injection of the digital veins, followed by dissection enables the authors to analyse the role of various networks in drainage of the pulp. The satellite veins of the digital artery in the finger are probably not involved. The venous return of the pulp is constituted by an anatomical continuity between the superficial palmar network and the common digital veins. A narrow anastomotic channel is demonstrated in the commissure between these two systems.
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Affiliation(s)
- E Lebreton
- Service de Chirurgie plastique et réparatrice et Chirurgie générale, Hôpital Pasteur, NICE
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30
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Lebreton E, Legout A, Bourgeon Y, Lascombes P, Grosdidier G. [Vascularization of the ulnar nerve of the arm]. Bull Assoc Anat (Nancy) 1983; 67:111-5. [PMID: 6640124] [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: 01/21/2023]
Abstract
A review of 53 dissections associated with injections and radiographs was performed (by the authors) to specify the arteriovenous vascularization of the ulnar nerve of the arm. An arteriovenous pedicle is constantly to be found. The artery "collateralis ulnaris superior" arises from the inferior border of the "pectoralis major" at an average distance of 6,7 cm. The arterial depending vein most often directly rejoins the "vena brachialis" lower than "vena basilica" does, but usually more distally than the arterial emergence level. Thus constituted, the pedicle can be anastomosed, measuring generally more than 1 mm in diameter. The arterial distribution originates from an arcade parallel to the nerve from which arise some extremely fine ladderlike vessels. Finally, this pedicle vascularizes the whole brachial part of the nerve (roughly 23,6 cm).
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31
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Pulcini A, Berre A, Macchi P, Roger-Clément R, Lebreton E, Maestracci P. [Technic of continuous axillary plexus block]. Ann Fr Anesth Reanim 1982; 1:551-3. [PMID: 7184351 DOI: 10.1016/s0750-7658(82)80102-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A technique of continuous axillary brachial plexus block, using an epidural Tuohy needle and an epidural catheter, is described. Studies were carried out in ten patients using this technique with bupivacaine as a local anesthetic drug. The catheter remained indwelling during a mean period of five days. Good analgesia was obtained in nine out of the ten patients. Thus this technique allows pain-free postoperative period in hand surgery.
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32
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Hallopé Y, Lebreton E, Penhoat M, Perchec A, Robelet HF, Delacroix P. [Michel--or from nomadism to the creation of spatial exchange. From the cultural association of sector II]. Soins Psychiatr 1981:39-41. [PMID: 6917422] [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: 01/22/2023]
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Coussement A, Lebreton E, Boutte P, Kaufmann HJ. Posterior perineal hernias in the newborn. Ann Radiol (Paris) 1978; 21:199-203. [PMID: 677747] [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: 12/23/2022]
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34
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Lebreton E, Boutte P, Coussement A, Rey MH, Bourgeon A. [Congenital perineal hernia]. Nouv Presse Med 1977; 6:3005. [PMID: 593847] [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: 12/23/2022]
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35
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Abbes M, Bourgeon A, Lebreton E, Khiem TD, Richelme H. [Role of total thyroidectomy in the treatment of thyroid cancer]. Ann Chir 1974; 28:753-62. [PMID: 4447336] [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: 01/10/2023]
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36
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Abbes M, Lebreton E, Pierotti T, Bourgeon A, Richelme H. [Protocol of thyroid cancer treatment (72 cases)]. JFORL J Fr Otorhinolaryngol Audiophonol Chir Maxillofac 1972; 21:609-14. [PMID: 4263735] [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: 01/09/2023]
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