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Renaud E, Arthur B, Typhaine K, Clémentine R, Juan-Pablo RDC. Representation of Voice Hearing Groups by French Mental Health Professionals. Community Ment Health J 2024; 60:572-580. [PMID: 37976007 DOI: 10.1007/s10597-023-01209-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Hearing voices groups (HVGs) are an alternative way of treating acoustic-verbal hallucinations. Although they have been developing in France for the last decade, they have lagged behind their international expansion. The representations that circulate about their functioning and their effects are likely to influence the referral to these groups by mental health professionals. We created and used a questionnaire to survey mental health professionals' representations of voice hearing groups. We surveyed 79 French health professionals using a questionnaire with 19 closed items. 7 additional items allowed us to specify the professional status and familiarity of the participants with the HVGs. Professionals generally shared positive representations of HVGs but had very approximate knowledge of them. The subgroup of the most familiar professionals (N = 45) differed significantly on 7 items from the subgroup of non-familiars (N = 35). HVGs are represented as one medical offer among others, of little clinical use and indicated only for psychotic voice-hearing patients, which seems to be a misunderstanding in every case. However, our study also shows that these opinions evolve with the degree of familiarity with HVGs. Certain representations need to be corrected so that quality information can be circulated about HVGs and improve their integration into their ecosystem.
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Affiliation(s)
- Evrard Renaud
- Clinical Psychologist, University of Lorraine, Interpsy Laboratory, Co-Founder of the Center for Information, Research and Counseling on Exceptional Experiences. Campus Lettres et Sciences Humaines, 23 boulevard Albert 1er, Nancy, 54015, France.
| | - Braun Arthur
- Clinical Psychologist and Psychotherapist at the Centre Médico-Psychologique Pour Adolescents of Epinal, Centre Hospitalier Ravenel, University of Lorraine, Laboratory Interpsy, Nancy, 54015, France
| | - Krebs Typhaine
- Clinical Psychologist, University of Lorraine, Interpsy Laboratory, Co-Founder of the Center for Information, Research and Counseling on Exceptional Experiences. Campus Lettres et Sciences Humaines, 23 boulevard Albert 1er, Nancy, 54015, France
- University of Lorraine, Interpsy Laboratory, Nancy, France
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Bello Roufai D, Gonçalves A, De La Motte Rouge T, Akla S, Blonz C, Grenier J, Gligorov J, Saghatchian M, Bailleux C, Simon H, Desmoulins I, Tharin Z, Renaud E, Bertho M, Benderra MA, Delaloge S, Robert L, Cottu P, Pierga JY, Loirat D, Bertucci A, Renouf B, Bidard FC, Lerebours F. Correction: Alpelisib and fulvestrant in PIK3CA-mutated hormone receptor-positive HER2-negative advanced breast cancer included in the French early access program. Oncogene 2023; 42:1417. [PMID: 36922682 DOI: 10.1038/s41388-023-02615-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- D Bello Roufai
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.
| | - A Gonçalves
- Aix-Marseille Univ, CNRS, INSERM, Department of Medical Oncology, Institut Paoli Calmettes, CRCM, Marseille, France
| | | | - S Akla
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - C Blonz
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Sait-Herblain and Angers, France
| | - J Grenier
- Department of Medical Oncology, Institut du Cancer d'Avignon, Avignon, France
| | - J Gligorov
- Department of Medical Oncology, Hôpital Tenon, AP-HP, Paris, France.,INSERM U938, Institut Universitaire de Cancérologie, AP-HP Sorbonne Université, Paris, France
| | - M Saghatchian
- Breast Cancer Unit, American Hospital of Paris, Neuilly-sur-Seine, France
| | - C Bailleux
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - H Simon
- Department of Medical Oncology, University Hospital of Brest, Brest, France
| | - I Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Z Tharin
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - E Renaud
- Department of Medical Oncology, University Hospital of Brest, Brest, France
| | - M Bertho
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Sait-Herblain and Angers, France
| | - M-A Benderra
- Department of Medical Oncology, Hôpital Tenon, AP-HP, Paris, France
| | - S Delaloge
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - L Robert
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - P Cottu
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - J Y Pierga
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.,Paris Cité University, Paris, France
| | - D Loirat
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - A Bertucci
- Aix-Marseille Univ, CNRS, INSERM, Department of Medical Oncology, Institut Paoli Calmettes, CRCM, Marseille, France
| | - B Renouf
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - F C Bidard
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.,UVSQ, Paris-Saclay University, Saint Cloud, France
| | - F Lerebours
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
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Bello Roufai D, Gonçalves A, De La Motte Rouge T, Akla S, Blonz C, Grenier J, Gligorov J, Saghatchian M, Bailleux C, Simon H, Desmoulins I, Tharin Z, Renaud E, Bertho M, Benderra MA, Delaloge S, Robert L, Cottu P, Pierga JY, Loirat D, Bertucci A, Renouf B, Bidard FC, Lerebours F. Alpelisib and fulvestrant in PIK3CA-mutated hormone receptor-positive HER2-negative advanced breast cancer included in the French early access program. Oncogene 2023:10.1038/s41388-022-02585-3. [PMID: 36611120 DOI: 10.1038/s41388-022-02585-3] [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: 10/08/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023]
Abstract
SOLAR-1 and BYLieve trials documented the efficacy of the PI3K-inhibitor alpelisib in pre-treated PIK3CA-mutant, hormone receptor-positive, HER2-negative (HR+/HER2-) advanced breast cancer (ABC) patients. We report here real-life data of patients prospectively registered in the French alpelisib early access program (EAP) opened to PIK3CA-mutant HR+/HER2- ABC patients treated with alpelisib and fulvestrant. Primary endpoint was PFS by local investigators using RECIST1.1. Eleven centers provided individual data on 233 consecutive patients. Patients had received a median number of 4 (range: 1-16) prior systemic treatments for ABC, including CDK4/6 inhibitor, chemotherapy, fulvestrant and everolimus in 227 (97.4%), 180 (77.3%), 175 (75.1%) and 131 (56.2%) patients, respectively. After a median follow-up of 7.1 months and 168 events, median PFS was 5.3 months (95% CI: 4.7-6.0). Among 186 evaluable patients, CBR at 6 months was 45.3% (95% CI: 37.8-52.8). In multivariable analysis, characteristics significantly associated with a shorter PFS were age < 60 years (HR = 1.5, 95% CI = 1.1-2.1), >5 lines of prior treatments (HR = 1.4, 95% CI = 1.0-2.0) and the C420R PI3KCA mutation (HR = 4.1, 95% CI = 1.3-13.6). N = 91 (39.1%) patients discontinued alpelisib due to adverse events. To our knowledge, this is the largest real-life assessment of alpelisib efficacy. Despite heavy pre-treatments, patients derived a clinically relevant benefit from alpelisib and fulvestrant.
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Affiliation(s)
- D Bello Roufai
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.
| | - A Gonçalves
- Aix-Marseille Univ, CNRS, INSERM, Department of Medical Oncology, Institut Paoli Calmettes, CRCM, Marseille, France
| | | | - S Akla
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - C Blonz
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Sait-Herblain and Angers, France
| | - J Grenier
- Department of Medical Oncology, Institut du Cancer d'Avignon, Avignon, France
| | - J Gligorov
- Department of Medical Oncology, Hôpital Tenon, AP-HP, Paris, France.,INSERM U938, Institut Universitaire de Cancérologie, AP-HP Sorbonne Université, Paris, France
| | - M Saghatchian
- Breast Cancer Unit, American Hospital of Paris, Neuilly-sur-Seine, France
| | - C Bailleux
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - H Simon
- Department of Medical Oncology, University Hospital of Brest, Brest, France
| | - I Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Z Tharin
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - E Renaud
- Department of Medical Oncology, University Hospital of Brest, Brest, France
| | - M Bertho
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Sait-Herblain and Angers, France
| | - M-A Benderra
- Department of Medical Oncology, Hôpital Tenon, AP-HP, Paris, France
| | - S Delaloge
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - L Robert
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - P Cottu
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - J Y Pierga
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.,Paris Cité University, Paris, France
| | - D Loirat
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - A Bertucci
- Aix-Marseille Univ, CNRS, INSERM, Department of Medical Oncology, Institut Paoli Calmettes, CRCM, Marseille, France
| | - B Renouf
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
| | - F C Bidard
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France.,UVSQ, Paris-Saclay University, Saint Cloud, France
| | - F Lerebours
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud, France
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Hauet-Wiedemann M, Wiedemann A, Gatin A, Renaud E, Lapp L, Franchi A, Martrille L, Borsa-Dorion A. [Child sexual abuse: Description of a French population having consulted in a forensic medical service between 2011 and 2015]. Arch Pediatr 2018; 25:247-250. [PMID: 29656040 DOI: 10.1016/j.arcped.2018.03.004] [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: 09/14/2016] [Revised: 11/10/2017] [Accepted: 03/14/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND When child sexual abuse (CSA) is suspected, the detection of anogenital anomalies is rare. In France, since 2011, most clinical examinations of children for whom CSA is suspected take place in the forensic medical service (FMS). OBJECTIVES To describe a population of children examined for suspected CSA in the FMS of the Nancy Regional University Hospital Center. PATIENTS AND METHODS Children under the age of 18 who consulted for suspected CSA in the Nancy FMS between 2011 and 2015 were included. Demographic data as well as data from questioning, the physical examination, any further examination, and the medical conclusions were collected. RESULTS Three hundred and twenty-five girls and 79 boys were enrolled. The average age at the time the abuse was committed was 118.9 months. Two hundred sixty-nine (66.6%) children alleged fondling and 59 (14.6%) fellatio. Two hundred twelve victims (52.5%) described a penetration, 163 (76.9%) in the vagina and 73 (34.4%) in the anus. Significant bruises were found at the examination of 13 children, accounting for 2.5% of all victims. Thirty-four (11.7%) girls had lesions in the external genitalia and 28 (9.8%) lesions of the virginal membrane. One boy (1.3%) had a nonspecific lesion of the external genitalia. Six (8.2%) children alleging anal penetrations showed injury. The examiner concluded that clinical examinations were compatible with alleged facts for 253 (62.6%) victims. It was impossible to conclude for 116 (28.7%) children. CONCLUSION In the case of suspected CSA, the clinical examination is frequently normal. This examination must be performed by physicians trained in child abuse, under appropriate conditions. It is important not to jump to conclusions about the reality of the alleged facts. A multidisciplinary approach, with the cooperation of the medical, social, and forensics sector is necessary.
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Affiliation(s)
- M Hauet-Wiedemann
- Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France.
| | - A Wiedemann
- Service de médecine infantile, hôpital d'Enfants, CHRU de Nancy, rue du Morvan, 54000 Nancy, France
| | - A Gatin
- Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France
| | - E Renaud
- Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France
| | - L Lapp
- Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France
| | - A Franchi
- Service de médecine légale, CHRU de Nancy, rue du Morvan, 54000 Nancy, France
| | - L Martrille
- Service de médecine légale, CHRU de Nancy, rue du Morvan, 54000 Nancy, France
| | - A Borsa-Dorion
- Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France
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Abstract
ABSTRACTElectroplating is one of the most technologically advanced methods to synthesize nanophase materials both as coatings and in bulk form. This paper demonstrates the formulation of a processing “window” for nanocrystalline Co-W alloys using factorial design. The microstructural evolution from polycrystalline to nanocrystalline to amorphous Co-W microstructures is shown for electrodeposits produced from a bath containing cobalt sulphate, sodium tungstate, Rochelle salt and ammonium chloride. The effect of operating variables such as temperature and current density is discussed.
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Rosselli F, Renaud E, Guervilly J. 658 USP1-regulated FANCD2/FANCI monoubiquitination controls the DDB1-dependent degradation of phosphorylated CHK1. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71457-9] [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: 10/19/2022] Open
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Hariharan S, Chen D, Merritt-Charles L, Bobb N, De Freitas L, Esdelle-Thomas A, Mohamed J, Charles D, Colley K, Renaud E. An evaluation of the intensive care unit resources and utilization in Trinidad. W INDIAN MED J 2007; 56:144-51. [PMID: 17910145 DOI: 10.1590/s0043-31442007000200008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 11/22/2022]
Abstract
OBJECTIVES To evaluate resources and utilization of Intensive Care Units in Trinidad and Tobago. DESIGN AND METHODS This was a prospective observational study to evaluate Intensive Care Units (ICU) of three public and two private hospitals in Trinidad with respect to their infrastructure, process of care and patient outcome. Structure of ICUs was assessed by interviews and personal observations. A Cost Block Model was used to determine the expenditure for ICUs. The process of ICU was assessed by Therapeutic Intervention Scoring System (TISS-28). For outcome evaluation, two prognostic scoring systems namely Simplified Acute Physiology Score (SAPS II) and Paediatric Index of Mortality-2 (PIM-2) were used RESULTS The total number of ICU beds was 27. The overall bed occupancy was 66.2%. One hundred and eighteen patients consecutively admitted to ICU during a two-month period were enrolled for process and outcome evaluation. The overall median age of patients was 44 years [Interquartile range (IQR) 25, 59]. The mean cost per patient in the public hospitals was TT $64,746 compared to $77,000 in a private hospital. The average total daily TISS per patient was 27.01 +/- 5.4 (SD). The median length of stay was five days (IQR 2, 9). The overall predicted mortality was 32.9%, the observed mortality was 29.7% and thus the standardized mortality ratio (SMR) was 0.9. CONCLUSIONS The overall bed availability in ICUs with respect to Trinidad and Tobago's population and case-mix is low compared to developed countries, although the process of ICU care is comparable. Outcome of patients was good in terms of risk-adjusted mortality. The study highlights the need to further increase bed-strength and optimize the resource utilization of ICUs in Trinidad and Tobago.
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Affiliation(s)
- S Hariharan
- Anaesthesia and Intensive Care Unit, Faculty of Medical Sciences, The University of the West Indies, Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago, West Indies.
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Abstract
A postal survey of the use of cuffed or uncuffed tracheal tubes for tracheal intubation in children and infants was performed to investigate the criteria used for deciding the choice of tube and the manner of inflating the cuff in the case of use of a cuffed tracheal tube (CTT). From 200 questionnaires despatched, replies were received from 130 paediatric anaesthesiologists (response rate 65%). In paediatric practice, the CTT was routinely used by 25% of respondents for more than 80% of their patients, while more than 37% of respondents use them in less than 20% of the cases. The three main criteria used for inflating a cuff were: (i) the presence of a leak, (ii) the type of surgery associated with the presence of a leak and (iii) the patient's age associated with the type of surgery and the presence of a leak. These criteria were specified, respectively, by 32%, 24% and 18% of the respondents. The cuff was inflated in response to a leak in 18% of the cases and as a response to a pressure manometer in 15% of the cases. Few paediatric anaesthesiologists use a cuffed tracheal tube routinely for tracheal intubation in children, and fewer actually use a pressure monitoring device, while it is suggested that the cuff pressure should be monitored in case of CTT.
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Affiliation(s)
- G A Orliaguet
- Département d'Anesthésie-Réanimation, Groupe Hospitalier Necker-Enfants Malades, 149 rue de Sèvres, 75743 Paris cedex 15, France.
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Felt BT, Mollen E, Diaz S, Renaud E, Zeglis M, Wheatcroft G, Mendelow D. Behavioral interventions reduce infant distress at immunization. Arch Pediatr Adolesc Med 2000; 154:719-24. [PMID: 10891025 DOI: 10.1001/archpedi.154.7.719] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the effectiveness of simple behavioral interventions at immunization on behavioral and biochemical indicators of distress in infants and parents in a primary care setting. DESIGN Subjects were enrolled sequentially to control (standard care) and intervention groups. Intervention parents (n=57) were provided information about techniques to help their infants at immunization. Standard care parents (n=45) did not receive this information. Immunizations were videotaped and coded for infant and parent behaviors. Using a visual analog scale, parents rated their infant's and their own comfort at study enrollment, immediately after immunization, and at check-out. Saliva samples collected from infants and parents at study enrollment and at 15, 30, and 60 minutes after immunization were assayed for cortisol concentration by standard radioimmunoassay. Data were analyzed using chi2, analysis of variance, and general linear modeling. Patterns of salivary cortisol change after immunization were analyzed using hierarchical linear modeling. SETTING A single, urban pediatric practice during 2 summers (1997 and 1998). SUBJECTS Infants 2 to 24 months of age (n= 102) and their parents. MAIN OUTCOME MEASURES Duration of infant distress (in seconds); parent use of behavioral intervention; infant and parent salivary cortisol concentrations (in nanomoles per liter). RESULTS Intervention parents were more likely to use a behavioral technique with their infants before immunization (P<.05). Total infant distress was shorter for intervention infants at immunization (P<.01), and these infants were rated as more comfortable by their parents (P<.001) immediately after immunization. Salivary cortisol levels were lower for intervention infants at 15, 30, and 60 minutes after immunization (P<.05). CONCLUSION Simple behavioral interventions before immunization are associated with reductions in behavioral and biochemical indicators of infant distress.
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Affiliation(s)
- B T Felt
- Center for Human Growth and Development, University of Michigan, Ann Arbor 48109-0406, USA
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Abstract
We identified 20 throwing athletes who continued to have pain after articular debridement for posterosuperior impingement syndrome. These patients were unable to resume sports, and we subsequently performed a derotational humeral osteotomy with a myorraphy of the subscapularis muscle. Patients were observed for an average of 46 months (range, 12 to 69). Eleven patients were able to resume the same sport at the same level, five resumed the same sport at a lower level, three changed sport secondary to persistent pain, and the last patient did not resume any sport and was worse after surgery. Patients returned to sports at an average of 6 months postoperatively (range, 4 to 44) and to their previous level of sports at an average of 12 months (range, 8 to 18). The mean increase in humeral retroversion was 29 degrees (range, 18 degrees to 44 degrees) Three women with preoperative multidirectional hyperlaxity were considered to have failed results. Derotational humeral osteotomy can be considered in the throwing athlete with posterosuperior impingement after failure of all other means of treatment. Careful patient selection and preoperative evaluation of humeral retroversion is important. Best results can be achieved in a motivated patient with low retroversion (< 10 degrees). If retroversion is normal (20 degrees to 30 degrees), the surgical indication is unclear. We do not recommend this surgery for patients with hyperlaxity.
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Affiliation(s)
- N Riand
- Clinique Orthopédique Emilie de Vialar, Lyon, France
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Roszak AW, Renaud E, Baird MC. Bis{[3-(diphenylphosphino)propyl]trimethylphosphonium-P}[(2,3,5,6-η)-norbornadiene]rhodium(I) Tris(tetrafluoroborate). Acta Crystallogr C 1996. [DOI: 10.1107/s0108270195017069] [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: 11/10/2022] Open
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Paiement GD, Renaud E, Dagenais G, Gosselin RA. Double-blind randomized prospective study of the efficacy of antibiotic prophylaxis for open reduction and internal fixation of closed ankle fractures. J Orthop Trauma 1994; 8:64-6. [PMID: 8169699 DOI: 10.1097/00005131-199402000-00014] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [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
Antibioprophylaxis has been proven to be efficient for some orthopaedic procedures. However, its efficacy for clean limited procedures with metallic implants is not clear. One hundred twenty-two closed ankle fracture patients undergoing open reduction and internal fixation were randomized, double-blindly, to receive either cephalothin (1 g i.v. every 6 h x four doses) or a placebo starting before tourniquet application. Mean trauma-surgery delay was 30.2 h, and average tourniquet duration was 65.4 min. Four patients (three of 62 on placebo and one of 60 on cephalothin) developed a superficial wound infection. One of the patients in the placebo group was hospitalized and treated with i.v. antibiotics. However, there was no osteomyelitis or premature hardware removal. The difference between the two groups was not statistically significant (chi 2 test of appreciation p = 0.33, two-tailed probabilities). Therefore, cephalothin prophylaxis does not seem justified in this patient population. A larger series is needed to avoid a type II error.
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Affiliation(s)
- G D Paiement
- San Francisco General Hospital, University of California
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Hallé JP, Lambert J, Renaud E, Toupin A, Legault C, Lalumiere G. A precision index for evaluation of techniques for self-monitoring of blood glucose. Diabetes Care 1986; 9:319-20. [PMID: 3732004 DOI: 10.2337/diacare.9.3.319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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