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Prévot-Monsacré P, Hamaide-Defrocourt F, Guyonvarch O, Masse S, Souty C, Mamou T, Hamel J, Antona D, Mathieu P, Vasseur P, Lévy-Bruhl D, Baroux N, Rossignol L, Vaillant L, Guerrisi C, Hanslik T, Dina J, Blanchon T. What is the relevancy of a surveillance of mumps without a systematic laboratory confirmation in highly immunized populations? Epidemiology of suspected and biologically confirmed mumps cases seen in general practice in France between 2014 and 2020. Vaccine 2024; 42:1065-1070. [PMID: 38092609 DOI: 10.1016/j.vaccine.2023.12.017] [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] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 11/17/2023] [Accepted: 12/03/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND In France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique France. AIM The objective of this study was to estimate the incidence of suspected mumps in general practice, the proportion of laboratory confirmed cases and the factors associated with a virological confirmation. METHODS General practitioners (GPs) participating in the Sentinelles network should report all patients with suspected mumps according to a clinical definition in case of parotitis and a serological definition in case of clinical expression without parotitis. All suspected mumps cases reported between January 2014 and December 2020 were included. A sample of these cases were tested by real time reverse transcriptase polymerase chain reaction (RT-PCR) for mumps biological confirmation. RESULTS A total of 252 individuals with suspected mumps were included in the study. The average annual incidence rate of suspected mumps in general practice in France between 2014 and 2020 was estimated at 11 cases per 100,000 population [CI95%: 6-17]. A mumps confirmation RT-PCR test was performed on 146 cases amongst which 17 (11.5 %) were positive. Age (between 20 and 29 years old), the presence of a clinical complication and an exposure to a suspected mumps case within the 21 days prior the current episode were associated with a mumps biological confirmation. CONCLUSION If these results confirm the circulation of mumps virus in France, they highlight the limits of a surveillance without a systematic laboratory confirmation in highly immunized populations.
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Affiliation(s)
- Pol Prévot-Monsacré
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Florent Hamaide-Defrocourt
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Ophélie Guyonvarch
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Shirley Masse
- Laboratoire de Virologie, UR7310, Université de Corse Pascal Paoli, 20250 Corte, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Thomas Mamou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Justine Hamel
- Normandie Université, UNICAEN, INSERM UMR1311, National Reference Center for Measles, Mumps and Rubella, CHU Caen, Virology Department, Caen, France
| | - Denise Antona
- Direction des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Pauline Mathieu
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Pauline Vasseur
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Daniel Lévy-Bruhl
- Direction des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Noémie Baroux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France; Département de Médecine Générale, Université Paris Cité, F75018 Paris, France
| | - Laetitia Vaillant
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France; Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, APHP, Boulogne Billancourt, France; Université Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine Simone Veil, Versailles, France
| | - Julia Dina
- Normandie Université, UNICAEN, INSERM UMR1311, National Reference Center for Measles, Mumps and Rubella, CHU Caen, Virology Department, Caen, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France.
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Amrenova A, Ainsbury E, Baudin C, Giussani A, Lochard J, Rühm W, Scholz-Kreisel P, Trott K, Vaillant L, Wakeford R, Zölzer F, Laurier D. Consideration of hereditary effects in the radiological protection system: evolution and current status. Int J Radiat Biol 2024:1-13. [PMID: 38190433 DOI: 10.1080/09553002.2023.2295289] [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: 06/30/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE The purpose of this paper is to provide an overview of the methodology used to estimate radiation genetic risks and quantify the risk of hereditary effects as outlined in the ICRP Publication 103. It aims to highlight the historical background and development of the doubling dose method for estimating radiation-related genetic risks and its continued use in radiological protection frameworks. RESULTS This article emphasizes the complexity associated with quantifying the risk of hereditary effects caused by radiation exposure and highlights the need for further clarification and explanation of the calculation method. As scientific knowledge in radiation sciences and human genetics continues to advance in relation to a number of factors including stability of disease frequency, selection pressures, and epigenetic changes, the characterization and quantification of genetic effects still remains a major issue for the radiological protection system of the International Commission on Radiological Protection. CONCLUSION Further research and advancements in this field are crucial for enhancing our understanding and addressing the complexities involved in assessing and managing the risks associated with hereditary effects of radiation.
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Affiliation(s)
- A Amrenova
- Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | | | - C Baudin
- Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | - A Giussani
- BfS - Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - J Lochard
- Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - W Rühm
- BfS - Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - P Scholz-Kreisel
- BfS - Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - K Trott
- Deptartment Radiation Oncology, Technical University München, Fontenay-aux-Roses, France
| | | | - R Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - F Zölzer
- Department of Health and Social Sciences, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
| | - D Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
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Campana F, Lan R, Girard C, Rochefort J, Le Pelletier F, Leroux-Villet C, Mares S, Millot S, Zlowodzki AS, Sibaud V, Tessier MH, Vaillant L, Fricain JC, Samimi M. French guidelines for the management of oral lichen planus (excluding pharmacological therapy). Ann Dermatol Venereol 2022; 149:14-27. [PMID: 34238586 DOI: 10.1016/j.annder.2021.04.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific guidelines in France. Our objective was to develop French multidisciplinary guidelines for the management of oral lichen. MATERIALS AND METHODS Working groups from the Groupe d'Etude de la Muqueuse Buccale (GEMUB) formulated a list of research questions and the corresponding recommendations according to the "formal consensus" method for developing practice guidelines. These recommendations were submitted to a group of experts and the degree of agreement for each recommendation was assessed by a scoring group. RESULTS Twenty-two research questions, divided into 3 themes (nosological classification and initial assessment, induced oral lichenoid lesions, and follow-up) resulted in 22 recommendations. Initial biopsy for histology is recommended in the absence of reticulated lesions. Biopsy for direct immunofluorescence is recommended for ulcerated, erosive, bullous types and for diffuse erythematous gingivitis. Management should include a periodontal and dental check-up, and investigation for extra-oral lesions. Hepatitis C testing is recommended only if risk factors are present. Definitions, triggering factors and the management of "induced oral lichenoid lesions" were clarified. Oral lichen must be monitored by a practitioner familiar with the disease at least once a year, using objective tools. CONCLUSION This formalised consensus of multidisciplinary experts provides clinical practice guidelines on the management and monitoring of oral lichen.
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Affiliation(s)
- F Campana
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - R Lan
- Aix Marseille Univ, APHM, CNRS, EFS, ADES, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - C Girard
- Dermatologie, CHU de Montpellier, 34295 Montpellier cedex, France
| | - J Rochefort
- Odontologie, Hôpital La Pitié Salpetrière - Université Paris Diderot, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - F Le Pelletier
- Anatomie Pathologique, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - C Leroux-Villet
- Dermatologie, Hôpital Avicenne, 125 Rue de Stalingrad, 93000 Bobigny, France
| | - S Mares
- Chirurgie Maxillo-faciale, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Millot
- Chirurgie Orale, CHU de Montpellier, 34295 Montpellier cedex, France
| | | | - V Sibaud
- Dermatologie, IUCT Oncopôle, 31000 Toulouse, France
| | - M-H Tessier
- Dermatologie, CHU de Nantes, 44000 Nantes, France
| | - L Vaillant
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France
| | - J-C Fricain
- Université de Bordeaux, INSERM U1026, service de chirurgie orale, CHU Bordeaux, 33000 Bordeaux, France
| | - M Samimi
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France.
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Vanderbrugghe M, Moulin JP, Vaillant L. [Prevention of infectious risk: Covid iterative screening of professionals in hospitals]. Rev Infirm 2021; 70:41-44. [PMID: 34893177 DOI: 10.1016/j.revinf.2021.10.013] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In order to contribute to the prevention of the spread of Covid-19, the operational hygiene team of a Parisian geriatric hospital set up weekly iterative screening by saliva test among professionals. Collaboration with the Covisan system enabled epidemiological monitoring and highlighted a link between clusters and the contamination of carers who were then able to be evicted early thanks to the screening. The results, which are shared in this feedback document, show the support of the hospital staff and the interest of screening.
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Affiliation(s)
- Maud Vanderbrugghe
- Équipe opérationnelle d'hygiène, hôpital Bretonneau, AP-HP, université de Paris Nord, 23 rue Joseph-de-Maistre, 75018 Paris, France.
| | - Jean-Pierre Moulin
- Équipe opérationnelle d'hygiène, hôpital Bretonneau, AP-HP, université de Paris Nord, 23 rue Joseph-de-Maistre, 75018 Paris, France
| | - Laetitia Vaillant
- Équipe opérationnelle d'hygiène, hôpital Bretonneau, AP-HP, université de Paris Nord, 23 rue Joseph-de-Maistre, 75018 Paris, France
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Marescassier H, Dousset L, Hainaut E, Bedane C, Vaillant L, Celerier P, Beylot-Barry M, Masson Regnault M. Facteurs prédictifs de non réponse au vismodégib dans les carcinomes basocellulaires localement avancés. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.109] [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: 11/17/2022]
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Guyonvarch O, Vaillant L, Hanslik T, Blanchon T, Rouveix E, Supervie V. [HIV prevention with PrEP: Challenges and prospects]. Rev Med Interne 2020; 42:275-280. [PMID: 33127173 DOI: 10.1016/j.revmed.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/25/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
Pre-exposure prophlaxis (PrEP) is the use of antiretroviral drugs by uninfected people to prevent human immunodeficiency virus (HIV) infection. PrEP is used by people who are at substantial risk of being exposed to HIV. Numerous clinical trials have confirmed its effectiveness in reducing HIV acquisition and PrEP has been approved and allowed in several countries including France. However, PrEP uptake remains low as concerns about increase in sexual risk behaviour with PrEP use in the wake of a growing epidemic of sexually transmitted infections, and fear of drug resistance have been expressed. As a result, the difference between the proportion of people on PrEP and the proportion of people who would be very likely to use PrEP if they could access it -otherwise known as the PrEP gap- remains high. Nowadays, studies continue to explore long-term effects of PrEP as well as expand the array of available technologies and regimens.
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Affiliation(s)
- O Guyonvarch
- Inserm, unité mixte de recherche en santé 1136, Institut Pierre Louis d'épidémiologie et de Santé publique, Sorbonne université, 27, rue de Chaligny, 75012 Paris, France.
| | - L Vaillant
- Inserm, unité mixte de recherche en santé 1136, Institut Pierre Louis d'épidémiologie et de Santé publique, Sorbonne université, 27, rue de Chaligny, 75012 Paris, France
| | - T Hanslik
- Inserm, unité mixte de recherche en santé 1136, Institut Pierre Louis d'épidémiologie et de Santé publique, Sorbonne université, 27, rue de Chaligny, 75012 Paris, France; Service de médecine interne, centre hospitalo-universitaire Ambroise-Paré, Assistance Publique-Hôpitaux de Paris, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; UFR Simone Veil - Santé, université de Versailles Saint-Quentin-en-Yvelines, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France
| | - T Blanchon
- Inserm, unité mixte de recherche en santé 1136, Institut Pierre Louis d'épidémiologie et de Santé publique, Sorbonne université, 27, rue de Chaligny, 75012 Paris, France
| | - E Rouveix
- Service de médecine interne, centre hospitalo-universitaire Ambroise-Paré, Assistance Publique-Hôpitaux de Paris, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; UFR Simone Veil - Santé, université de Versailles Saint-Quentin-en-Yvelines, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France; COREVIH Île-de-France Ouest, centre hospitalo-universitaire Ambroise-Paré, Assistance Publique-Hôpitaux de Paris, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - V Supervie
- Inserm, unité mixte de recherche en santé 1136, Institut Pierre Louis d'épidémiologie et de Santé publique, Sorbonne université, 27, rue de Chaligny, 75012 Paris, France
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Perozziello A, Lescure FX, Truel A, Routelous C, Vaillant L, Yazdanpanah Y, Lucet JC. Prescribers' experience and opinions on antimicrobial stewardship programmes in hospitals: a French nationwide survey. J Antimicrob Chemother 2020; 74:2451-2458. [PMID: 31167027 DOI: 10.1093/jac/dkz179] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 03/19/2019] [Accepted: 04/04/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To assess prescribers' experiences and opinions regarding antimicrobial stewardship programme (ASP) activities. METHODS A cross-sectional paper-based survey was conducted among prescribers in 27 out of 35 randomly selected large hospitals in France. RESULTS All 27 investigated hospitals (20 non-university public, 4 university-affiliated and 3 private hospitals) had an ASP and an appointed antibiotic advisor (AA), with a median of 0.9 full-time equivalents per 1000 acute-care beds (IQR 0-1.4). Of the 1963 distributed questionnaires, 920 were completed (46.9%). Respondents were mainly attending physicians (658/918, 71.7%) and medical specialists (532/868, 61.3%). Prescribers identified two main ASP objectives: to limit the spread of resistance (710/913, 77.8%) and to improve patient care and prognosis (695/913, 76.1%). The presence of an AA constituted a core element of ASP (96.2% agreement between answers of ASP leader and respondents). Respondents acknowledged an AA's usefulness especially on therapeutic issues, i.e. choosing appropriate antibiotic (agreement 84.7%) or adapting treatment (89.6%), but less so on diagnostic issues (31.4%). Very few respondents reported unsolicited counselling and post-prescription controls. Three-quarters of prescribers identified local guidelines (692/918, 75.4%). Prescribers did not approve of measures counteracting their autonomy, i.e. automatic stop orders (agreement 23.4%) or pre-approval by AAs (28.8%). They agreed more with educational interventions (73.0%) and clinical staff meetings (70.0%). CONCLUSIONS Prescribers perceived ASP mainly through its 'on-demand' counselling activities. They preferred measures that did not challenge their clinical autonomy. High levels of antibiotic consumption in French hospitals bring into question the effectiveness of such an approach. However, limited ASP staffing and resources may preclude extended activities.
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Affiliation(s)
- A Perozziello
- IAME, UMR 1137, DeSCID team, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - F X Lescure
- IAME, UMR 1137, DeSCID team, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - A Truel
- IAME, UMR 1137, DeSCID team, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - C Routelous
- Institut du Management/EA 7348 MOS Management des organisations en santé, Ecole des hautes études en santé publique, EHESP, Rennes, Sorbonne Paris Cité, Paris, France
| | - L Vaillant
- UHLIN, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Y Yazdanpanah
- IAME, UMR 1137, DeSCID team, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - J C Lucet
- IAME, UMR 1137, DeSCID team, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,UHLIN, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
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Samimi M, Le Gouge A, Boralevi F, Passeron T, Pascal F, Bernard P, Agbo-Godeau S, Leducq S, Fricain JC, Vaillant L, Francès C. Topical rapamycin versus betamethasone dipropionate ointment for treating oral erosive lichen planus: a randomized, double-blind, controlled study. J Eur Acad Dermatol Venereol 2020; 34:2384-2391. [PMID: 32128907 DOI: 10.1111/jdv.16324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 02/18/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although superpotent topical corticosteroids are the first-line treatment for oral erosive lichen planus (OELP), topical rapamycin was found efficient in a previous case series. OBJECTIVES To compare the efficacy and safety of topical rapamycin and betamethasone dipropionate ointment for OELP in a randomized, double-blind trial. METHODS Patients were randomized to receive treatment with betamethasone dipropionate ointment 0.05% in Orabase® or topical rapamycin solution (1 mg/mL) on lesions twice daily for 3 months, followed by 3 months of observation. The primary outcome was clinical remission after 3 months of treatment. Secondary outcomes were clinical remission after 1 and 2 months, reduced oral pain and reduced impact on food intake after 3 months, clinical recurrence after treatment withdrawal, and adverse events. RESULTS During a 4-year period, 76 patients were randomized and 75 received treatment (rapamycin, n = 39; betamethasone, n = 36). At 3 months, 39.4% of patients with betamethasone and 27.3% with rapamycin showed clinical remission (odds ratio 0.68, 95% CI [0.24; 1.89]; P = 0.46). Rates of remission after 1 and 2 months, reduction in pain and impact on food intake after 3 months, were higher with betamethasone than rapamycin. Recurrence of oral erosions was similar between groups. Adverse events occurred in 43.6% of patients with rapamycin (mostly burning sensation, impaired taste) and 27.8% with betamethasone (mostly oral candidiasis). CONCLUSION Although the study was limited by insufficient recruitment, we did not find any superiority of topical rapamycin over betamethasone dipropionate ointment for OELP. Given the rapid remission and pain improvement in the betamethasone group, it appears that superpotent topical corticosteroids should remain the first-line treatment for OELP.
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Affiliation(s)
- M Samimi
- Department of Dermatology, University Hospital of Tours, University of Tours, Tours, France.,ISP 1282 INRA University of Tours, Tours, France
| | - A Le Gouge
- Biometrical Department, Centre d'Investigation Clinique, INSERM CIC1415, University Hospital of Tours, Tours, France
| | - F Boralevi
- Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux and INSERM U1035, Bordeaux, France
| | - T Passeron
- Department of Dermatology, CHU Nice, INSERM U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), Université Côte d'Azur, Nice, France
| | - F Pascal
- Department of Dermatology and Stomatology, Saint-Louis Hospital, AP-HP, Université Paris 7-Diderot, Paris, France
| | - P Bernard
- Department of Dermatology, Reims University Hospital, University of Reims-Champagne-Ardenne, Reims, France
| | - S Agbo-Godeau
- Department of Stomatology and Maxillo-Facial Surgery, Groupe hospitalier Pitié-Salpêtrière-Charles-Foix, AP-HP, Paris, France
| | - S Leducq
- Department of Dermatology, University Hospital of Tours, University of Tours, Tours, France.,Biometrical Department, Centre d'Investigation Clinique, INSERM CIC1415, University Hospital of Tours, Tours, France
| | - J C Fricain
- Department of Dentistry and Oral Health, Inserm U1026 Bioingénierie Tissulaire - BioTis, Bordeaux, University Hospital of Bordeaux, France
| | - L Vaillant
- Department of Dermatology, University Hospital of Tours, University of Tours, Tours, France
| | - C Francès
- Department of Dermatology and Allergology, Hospital Tenon, Université Paris VI Pierre et Marie Curie, Sorbonnes Universités, Paris, France
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Vaillant L, Birgand G, Esposito-Farese M, Astagneau P, Pulcini C, Robert J, Zahar JR, Sales-Wuillemin E, Tubach F, Lucet JC. Awareness among French healthcare workers of the transmission of multidrug resistant organisms: a large cross-sectional survey. Antimicrob Resist Infect Control 2019; 8:173. [PMID: 31749961 PMCID: PMC6852912 DOI: 10.1186/s13756-019-0625-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background Much effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs. Methods A multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception. Results Between June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation. Conclusions We found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions. Trial registration Clinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.
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Affiliation(s)
- L Vaillant
- AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, 48 rue Henri Huchard, F-75018 Paris, France
| | - G Birgand
- 2Department of Medicine, NIHR, Imperial College London, Health Protection Research Unit in Antimicrobial Resistance and Healthcare Associated Infection Imperial College London, South Kensington Campus, London, SW7 2AZ UK
| | - M Esposito-Farese
- AP-HP, Bichat-Claude Bernard Hospital, Unité de Recherche Clinique Paris Nord Val de Seine and CIC-EC 1425, 48 rue Henri Huchard, F-75018 Paris, France
| | - P Astagneau
- 4Medecine Sorbonne University, AP-HP, Regional centre for Prevention of Healthcare-associated infections, 8 rue Maria Helena Vieira da Silva, 75014 Paris, France
| | - C Pulcini
- 5EA 4360 APEMAC, CHRU de Nancy, University of Lorraine, Infectious and Tropical Diseases Unit, 34 Cours Léopold, 54000 Nancy, France
| | - J Robert
- Sorbonne University, U1135, Team E13, CR7 INSERM, AP-HP, Pitié-Salpêtrière Hospital, Bactériologie-Hygiène, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - J R Zahar
- 7AP-HP, Avicenne Hospital, Infection Control Unit, 125 Rue de Stalingrad, 93000 Bobigny, France.,8University of Paris, INSERM, IAME, UMR 1137, Paris, France
| | | | - F Tubach
- INSERM, UMR 1123, AP-HP, Pitié-Salpêtrière Hospital, Centre de Pharmacoépidémiologie (Cephepi), 75013 Paris, France
| | - J C Lucet
- AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, 48 rue Henri Huchard, F-75018 Paris, France.,8University of Paris, INSERM, IAME, UMR 1137, Paris, France
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Collarino R, Lescure X, Vaillant L, de Villelongue C, Cabras O. Conseil infectieux en gériatrie : une année de collaboration transversale. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.157] [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: 10/14/2022]
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11
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Perozziello A, Lescure F, Truel A, Routelous C, Vaillant L, Yazdanpanah Y, Lucet J. Programme hospitalier de bon usage des antibiotiques : le point de vue des prescripteurs, une enquête nationale. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.129] [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: 10/14/2022]
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12
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Nadal M, Levy M, Bakhsh A, Joly A, Maruani A, Vaillant L, Erra B, Samimi M. Salivary scintigraphy for Sjögren's syndrome in patients with xerostomia: A retrospective study. Oral Dis 2018; 24:552-560. [DOI: 10.1111/odi.12802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/27/2017] [Accepted: 10/18/2017] [Indexed: 01/03/2023]
Affiliation(s)
- M Nadal
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - M Levy
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - A Bakhsh
- Department of Nuclear Medicine Imaging; University Hospital of Tours; Tours France
- Medical Imaging Department; KAMC-HC; Mecca Saudi Arabia
| | - A Joly
- Department of Stomatology and Maxillofacial Surgery; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - A Maruani
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- UMR INSERM 1246; SPHERE; Universities of Tours and Nantes; France
| | - L Vaillant
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- INSERM U930; University François Rabelais; Tours France
| | - B Erra
- Department of Nuclear Medicine Imaging; University Hospital of Tours; Tours France
| | - M Samimi
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- Laboratoire “Biologie des Polyomavirus” ISP 1282; UMR INRA-University of Tours; Tours France
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Garnier M, Champeaux-Orange E, Laurent E, Vaillant L, Bens G, Machet L. Modifications cutanées aiguës induites par la radiothérapie (étude Mocura) : apport de l’échographie cutanée au score clinique de radiodermite. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.253] [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: 11/17/2022]
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14
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Walter Lepage A, Ciron J, Lepage D, Verboux D, Mathis S, Vaillant L. Toxicité cutanée retardée des immunoglobulines intraveineuses dans une population de polyradiculoneuropathie inflammatoire démyélinisante chronique. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Garnier M, Champeaux E, Laurent E, Boehm A, Briard O, Wachter T, Vaillant L, Patat F, Bens G, Machet L. High-frequency ultrasound quantification of acute radiation dermatitis: pilot study of patients undergoing radiotherapy for breast cancer. Skin Res Technol 2017; 23:602-606. [PMID: 28513053 DOI: 10.1111/srt.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acute radiation dermatitis (ARD) is a frequent complication after breast cancer radiotherapy and is usually assessed by semi-quantitative clinical scores, which may be subject to inter-observer variability. High-frequency ultrasound imaging of the skin can reliably quantify thickness and edema in diseased skin. We aimed to compare the relative increase in dermal thickness of the irradiated zone in breast-cancer patients undergoing radiotherapy, with clinical severity. METHODS A consecutive series of patients undergoing treatment for breast cancer by lumpectomy and radiotherapy in a 6-month period also underwent clinical and ultrasound evaluation of ARD. RESULTS We included 34 female patients 17 had grade 1 (group 1), 17 had grade 2 or grade 3 ARD (group 2). The mean relative increase in dermal thickness in irradiated skin (RIDTIS) was greater for group 2 than 1: 0.53 vs 0.29 mm (P=.023). On univariate analysis, ARD was associated with skin phototype, breast volume and RIDTIS, and on multivariable analysis, breast volume and age remained predictive of the disease. CONCLUSION Patients with more severe dermatitis showed significantly increased dermal thickness. Dermal thickness is a quantitative variable that could help quantify the efficacy of drugs and improve the treatment of this disease in patients undergoing radiotherapy.
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Affiliation(s)
- M Garnier
- Department of Dermatology, CHRU Tours, Tours, France.,Department of Radiotherapy, CHR Orléans, Orléans, France
| | - E Champeaux
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - E Laurent
- Department of Epidemiology, CHRU Tours, Tours, France
| | - A Boehm
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - O Briard
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - T Wachter
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - L Vaillant
- Department of Dermatology, CHRU Tours, Tours, France.,Inserm U930, Université François-Rabelais de Tours, Tours, France
| | - F Patat
- Inserm U930, Université François-Rabelais de Tours, Tours, France
| | - G Bens
- Department of Dermatology, CHR Orléans, Orléans, France
| | - L Machet
- Department of Dermatology, CHRU Tours, Tours, France.,Inserm U930, Université François-Rabelais de Tours, Tours, France
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Schneider T, Lochard J, Vaillant L. Focal role of tolerability and reasonableness in the radiological protection system. Ann ICRP 2016; 45:309-320. [PMID: 27012845 DOI: 10.1177/0146645316634565] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The concepts of tolerability and reasonableness are at the core of the International Commission on Radiological Protection (ICRP) system of radiological protection. Tolerability allows the definition of boundaries for implementing ICRP principles, while reasonableness contributes to decisions regarding adequate levels of protection, taking into account the prevailing circumstances. In the 1970s and 1980s, attempts to find theoretical foundations in risk comparisons for tolerability and cost-benefit analysis for reasonableness failed. In practice, the search for a rational basis for these concepts will never end. Making a wise decision will always remain a matter of judgement and will depend on the circumstances as well as the current knowledge and past experience. This paper discusses the constituents of tolerability and reasonableness at the heart of the radiological protection system. It also emphasises the increasing role of stakeholder engagement in the quest for tolerability and reasonableness since Publication 103.
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Affiliation(s)
- T Schneider
- Nuclear Evaluation Protection Centre, 28 rue de la Redoute, 92260 Fontenay-aux-Roses, France
| | - J Lochard
- Nuclear Evaluation Protection Centre, 28 rue de la Redoute, 92260 Fontenay-aux-Roses, France
| | - L Vaillant
- Nuclear Evaluation Protection Centre, 28 rue de la Redoute, 92260 Fontenay-aux-Roses, France
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Nadal M, Levy M, Joly A, Maruani A, Vaillant L, Samimi M. Intérêt diagnostique et pronostique de la scintigraphie des glandes salivaires dans le syndrome de Gougerot-Sjögren. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.078] [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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18
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Riccardo F, Shigematsu M, Chow C, McKnight CJ, Linge J, Doherty B, Dente MG, Declich S, Barker M, Barboza P, Vaillant L, Donachie A, Mawudeku A, Blench M, Arthur R. Interfacing a biosurveillance portal and an international network of institutional analysts to detect biological threats. Biosecur Bioterror 2015; 12:325-36. [PMID: 25470464 DOI: 10.1089/bsp.2014.0031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Early Alerting and Reporting (EAR) project, launched in 2008, is aimed at improving global early alerting and risk assessment and evaluating the feasibility and opportunity of integrating the analysis of biological, chemical, radionuclear (CBRN), and pandemic influenza threats. At a time when no international collaborations existed in the field of event-based surveillance, EAR's innovative approach involved both epidemic intelligence experts and internet-based biosurveillance system providers in the framework of an international collaboration called the Global Health Security Initiative, which involved the ministries of health of the G7 countries and Mexico, the World Health Organization, and the European Commission. The EAR project pooled data from 7 major internet-based biosurveillance systems onto a common portal that was progressively optimized for biological threat detection under the guidance of epidemic intelligence experts from public health institutions in Canada, the European Centre for Disease Prevention and Control, France, Germany, Italy, Japan, the United Kingdom, and the United States. The group became the first end users of the EAR portal, constituting a network of analysts working with a common standard operating procedure and risk assessment tools on a rotation basis to constantly screen and assess public information on the web for events that could suggest an intentional release of biological agents. Following the first 2-year pilot phase, the EAR project was tested in its capacity to monitor biological threats, proving that its working model was feasible and demonstrating the high commitment of the countries and international institutions involved. During the testing period, analysts using the EAR platform did not miss intentional events of a biological nature and did not issue false alarms. Through the findings of this initial assessment, this article provides insights into how the field of epidemic intelligence can advance through an international network and, more specifically, how it was further developed in the EAR project.
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Vaillant L, Boralevi F, Passeron T, Bernard P, Le Gouge A, Hüttenberger B, Pascal F, Fricain JC, Agbo-Godeau S, Samimi M, Giraudeau B, Francès C. Traitement du lichen érosif buccal par rapamycine topique vs bétaméthasone topique. Étude randomisée en double insu de 75 patients. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.086] [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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20
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Raffin D, Georgescou G, Mourtada Y, Maruani A, Ossant F, Patat F, Vaillant L, Machet L. Caractérisation par échographie cutanée haute résolution des neurofibromes cutanés au cours de la neurofibromatose de type 1. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.243] [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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21
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Blein M, Baulieu F, Vaillant L, Lorette G, Samimi M, Maruani A. Fréquence des anomalies lymphoscintigraphiques infracliniques controlatérales et évolution des lymphœdèmes primaires unilatéraux de l’enfant. Ann Dermatol Venereol 2014; 141:663-70. [DOI: 10.1016/j.annder.2014.06.022] [Citation(s) in RCA: 3] [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: 02/14/2014] [Revised: 05/15/2014] [Accepted: 06/19/2014] [Indexed: 12/20/2022]
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22
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Baulieu F, De Pinieux G, Maruani A, Vaillant L, Lorette G. Serial lymphoscintigraphic findings in a patient with Gorham's disease with lymphedema. Lymphology 2014; 47:118-122. [PMID: 25420304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Gorham's disease is a rare disorder characterized by vascular, "lymphangio- matous" and/or "hemangiomatous" lesions in bone and surrounding soft tissues. Associated lymphedema has not been reported and clinical evolution is unpredictable. Plain radiographs, CT, MRI, and occasionally bone scintigraphy, are used to detect the bone and soft tissues changes. Biopsy is a major component of the diagnostic process. We report the findings of serial lymphoscintigraphy in a young boy with a polyostotic Gorham's disease associated with lymphangioma of the thigh and lower limb lymphedema. In this patient, lymphoscintigraphy was useful for diagnosis and follow-up of primary lymphedema. It provided valuable information concerning the occurrence, location, and progression of lymphatic lesions in both bone and soft tissues.
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Quéré I, Presles E, Coupé M, Vignes S, Vaillant L, Eveno D, Laporte S, Leizorovicz A. Prospective multicentre observational study of lymphedema therapy: POLIT study. ACTA ACUST UNITED AC 2014; 39:256-63. [DOI: 10.1016/j.jmv.2014.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/20/2014] [Indexed: 11/29/2022]
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Barboza P, Vaillant L, Le Strat Y, Hartley DM, Nelson NP, Mawudeku A, Madoff LC, Linge JP, Collier N, Brownstein JS, Astagneau P. Factors influencing performance of internet-based biosurveillance systems used in epidemic intelligence for early detection of infectious diseases outbreaks. PLoS One 2014; 9:e90536. [PMID: 24599062 PMCID: PMC3944226 DOI: 10.1371/journal.pone.0090536] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/01/2014] [Indexed: 11/19/2022] Open
Abstract
Background Internet-based biosurveillance systems have been developed to detect health threats using information available on the Internet, but system performance has not been assessed relative to end-user needs and perspectives. Method and Findings Infectious disease events from the French Institute for Public Health Surveillance (InVS) weekly international epidemiological bulletin published in 2010 were used to construct the gold-standard official dataset. Data from six biosurveillance systems were used to detect raw signals (infectious disease events from informal Internet sources): Argus, BioCaster, GPHIN, HealthMap, MedISys and ProMED-mail. Crude detection rates (C-DR), crude sensitivity rates (C-Se) and intrinsic sensitivity rates (I-Se) were calculated from multivariable regressions to evaluate the systems’ performance (events detected compared to the gold-standard) 472 raw signals (Internet disease reports) related to the 86 events included in the gold-standard data set were retrieved from the six systems. 84 events were detected before their publication in the gold-standard. The type of sources utilised by the systems varied significantly (p<0001). I-Se varied significantly from 43% to 71% (p = 0001) whereas other indicators were similar (C-DR: p = 020; C-Se, p = 013). I-Se was significantly associated with individual systems, types of system, languages, regions of occurrence, and types of infectious disease. Conversely, no statistical difference of C-DR was observed after adjustment for other variables. Conclusion Although differences could result from a biosurveillance system's conceptual design, findings suggest that the combined expertise amongst systems enhances early detection performance for detection of infectious diseases. While all systems showed similar early detection performance, systems including human moderation were found to have a 53% higher I-Se (p = 00001) after adjustment for other variables. Overall, the use of moderation, sources, languages, regions of occurrence, and types of cases were found to influence system performance.
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Affiliation(s)
- Philippe Barboza
- International Department, French Institute for Public Health Surveillance (Institut de Veille Sanitaire), Saint Maurice, France
- * E-mail:
| | - Laetitia Vaillant
- International Department, French Institute for Public Health Surveillance (Institut de Veille Sanitaire), Saint Maurice, France
| | - Yann Le Strat
- Infectious Department, French Institute for Public Health Surveillance (Institut de Veille Sanitaire), Saint Maurice, France
| | - David M. Hartley
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, D.C, United States of America
- Imaging Science and Information Systems Center, Georgetown University School of Medicine, Washington, D.C, United States of America
| | - Noele P. Nelson
- Department of Pediatrics, Georgetown University Medical Center, Washington, D.C, United States of America
| | - Abla Mawudeku
- Centre for Emergency Preparedness and Response, Public Health Agency of Canada, Ottawa, Canada
| | - Lawrence C. Madoff
- ProMED-mail, International Society for Infectious Diseases, Boston, Massachusetts, United States of America
| | - Jens P. Linge
- Joint Research Centre of the European Commission, Ispra, Italy
| | - Nigel Collier
- National Institute of Informatics, Tokyo, Japan
- The European Bioinformatics Institute, Cambridge, United Kingdom
| | - John S. Brownstein
- Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Pascal Astagneau
- École des Hautes Études en Santé Publique (EHESP), University school of public Health, PRES Sorbonne Cité, Paris, France
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Berton M, Perrinaud A, Samimi M, Delaplace M, Vaillant L, Machet L. Utilité d’une fiche de conseils pour la photoprotection et le dépistage des patients et de leur famille après un diagnostic de mélanome. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.100] [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: 10/26/2022]
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Samimi M, Picon L, de Muret A, Vaillant L. Macrochéilite granulomateuse sévère d’aggravation progressive sous-infliximab puis adalimumab, au cours d’une maladie de Crohn. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.393] [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: 11/29/2022]
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Hacard F, Machet L, Caille A, Tauveron V, Georgescou G, Rapeneau I, Samimi M, Patat F, Vaillant L. Measurement of skin thickness and skin elasticity to evaluate the effectiveness of intensive decongestive treatment in patients with lymphoedema: a prospective study. Skin Res Technol 2013; 20:274-81. [DOI: 10.1111/srt.12116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
- F. Hacard
- Service de dermatologie; CHRU; Tours France
| | - L. Machet
- Service de dermatologie; CHRU; Tours France
- Université François-Rabelais; INSERM U930 Tours France
| | - A. Caille
- Université François-Rabelais; INSERM U930 Tours France
- INSERM; CIC 202 Tours France
| | | | | | | | - M. Samimi
- Service de dermatologie; CHRU; Tours France
| | - F. Patat
- Université François-Rabelais; INSERM U930 Tours France
- CIC-IT; CHRU; Tours France
| | - L. Vaillant
- Service de dermatologie; CHRU; Tours France
- Université François-Rabelais; INSERM U930 Tours France
- INSERM; CIC 202 Tours France
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Khashoggi M, Machet L, Perrinaud A, Brive D, Machet MC, Maruani A, Vaillant L. [D-penicillamine-induced pemphigus: changes in anti-32-2B immunostaining patterns]. Ann Dermatol Venereol 2013; 140:531-4. [PMID: 24034638 DOI: 10.1016/j.annder.2013.04.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 03/26/2013] [Accepted: 04/10/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND It has been reported that D-penicillamine causes pemphigus that is typically superficial. Immunostaining with monoclonal anti-32-2B antibody targeting desmoglein 1 and 3 can help differentiate between drug-induced and classical auto-immune pemphigus. Absence of specific staining militates in favour of drug-induced pemphigus whilst positive staining suggests an auto-immune aetiology that is ongoing despite discontinuation of drug therapy. PATIENTS AND METHODS A 59-year-old male patient was referred for management of superficial pemphigus 1 year after starting D-penicillamine treatment for scleroderma. The diagnosis of pemphigus was confirmed histologically (intra-epidermal cleavage, acantholysis and perikeratinocytes, deposition of IgG and complement C3). Immunochemical staining with anti-32-2B antibody was initially normal, in keeping with drug-induced pemphigus. Despite discontinuation of D-penicillamine, pemphigus recurred in 2008. A further skin biopsy was undertaken and anti-32-2B staining was abnormal, which is consistent with auto-immune pemphigus. DISCUSSION Numerous cases of drug-induced pemphigus have been described in the literature. In approximately half of all cases, the pemphigus recedes after cessation of the causative drug. However, there have been no previous reports that changes over time in the immunostaining with anti-32-2B antibodies can mirror a change in form of pemphigus from a drug-induced type to an idiopathic type as well as the associated clinical feature of persistence after drug withdrawal. CONCLUSION Normal staining with anti-32-2B antibody is associated with a favourable prognosis as regards resolution of drug-induced pemphigus. When, as in this case, status changes to abnormal staining, there is a risk that the pemphigus may become chronic despite discontinuation of therapy.
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Affiliation(s)
- M Khashoggi
- Service de dermatologie, université François-Rabelais, CHRU, 37044 Tours cedex 9, France
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Baulieu F, Bourgeois P, Maruani A, Belgrado JP, Tauveron V, Lorette G, Vaillant L. Contributions of SPECT/CT imaging to the lymphoscintigraphic investigations of the lower limb lymphedema. Lymphology 2013; 46:106-119. [PMID: 24645534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lymphoscintigraphy is a safe and reliable technique for investigating lymphedema. However, interpretation of delayed planar conventional imaging may be questionable due to the superimposition of soft tissues. Therefore, the aim of this retrospective study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) to lymphoscintigraphic investigation in a selected population with abnormal interstitial activity. Forty one patients with lower limb lymphedema either primary (n=17) or secondary (n=5), or associated with chronic venous insufficiency (n=19) underwent lymphoscintigraphy according to a standard protocol. SPECT/CT imaging that started immediately after planar imaging covered the part of the lower limbs with the most significant interstitial activity. The CT images were also analyzed separately to identify the typical honeycomb pattern of lymphedema. SPECT/CT identified additional abnormalities in vessels and soft tissues in 19 patients (46%). The additional information, primarily related to dermal collateralization of flow, dermal backflow, lymphangioma, and lymphorrhea, aided in understanding the physiopathology of edema and may have influenced management in 35 patients (85%). The honeycomb appearance of the soft tissues was noted on CT in most patients (90%). This study suggests that SPECT/CT is a promising addition to planar imaging in lymphoscintigraphic investigations of lymphedema.
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Hartley DM, Nelson NP, Arthur RR, Barboza P, Collier N, Lightfoot N, Linge JP, van der Goot E, Mawudeku A, Madoff LC, Vaillant L, Walters R, Yangarber R, Mantero J, Corley CD, Brownstein JS. An overview of internet biosurveillance. Clin Microbiol Infect 2013; 19:1006-13. [PMID: 23789639 DOI: 10.1111/1469-0691.12273] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Internet biosurveillance utilizes unstructured data from diverse web-based sources to provide early warning and situational awareness of public health threats. The scope of source coverage ranges from local media in the vernacular to international media in widely read languages. Internet biosurveillance is a timely modality that is available to government and public health officials, healthcare workers, and the public and private sector, serving as a real-time complementary approach to traditional indicator-based public health disease surveillance methods. Internet biosurveillance also supports the broader activity of epidemic intelligence. This overview covers the current state of the field of Internet biosurveillance, and provides a perspective on the future of the field.
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Affiliation(s)
- D M Hartley
- Imaging Science and Information Systems Center, Georgetown University School of Medicine, Washington, DC, USA; Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
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31
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Rabodonirina M, Vaillant L, Taffé P, Nahimana A, Gillibert RP, Vanhems P, Hauser PM. Pneumocystis jirovecii genotype associated with increased death rate of HIV-infected patients with pneumonia. Emerg Infect Dis 2013; 19:21-8; quiz 186. [PMID: 23260763 PMCID: PMC3557975 DOI: 10.3201/eid1901.120140] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Comorbidities might predict presence of specific fungal genotypes.
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Samimi M, Maruani A, Vaillant L, Lorette G. Angiosarcoma as a Potential Consequence of Autologous Lymph Node Transplantation for Lymphoedema. Eur J Vasc Endovasc Surg 2013; 45:521-2; discussin 528. [DOI: 10.1016/j.ejvs.2013.01.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 01/20/2013] [Indexed: 10/27/2022]
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33
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Lefaure C, Vaillant L. Radiation protection of outside workers. KERNTECHNIK 2013. [DOI: 10.3139/124.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C. Lefaure
- Centre d'etude sur la protection dans le domain nucléaire (CEPN), Bâtiment Expansion 10000, New address 28, rue de la Redoute, BP 48, F-92263 Fontenay-aux-Roses Cedex, France. E-mail:
| | - L. Vaillant
- Centre d'etude sur la protection dans le domain nucléaire (CEPN), Bâtiment Expansion 10000, New address 28, rue de la Redoute, BP 48, F-92263 Fontenay-aux-Roses Cedex, France. E-mail:
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Barboza P, Vaillant L, Mawudeku A, Nelson NP, Hartley DM, Madoff LC, Linge JP, Collier N, Brownstein JS, Yangarber R, Astagneau P. Evaluation of epidemic intelligence systems integrated in the early alerting and reporting project for the detection of A/H5N1 influenza events. PLoS One 2013; 8:e57252. [PMID: 23472077 PMCID: PMC3589479 DOI: 10.1371/journal.pone.0057252] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 01/18/2013] [Indexed: 11/18/2022] Open
Abstract
The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI) Early Alerting and Reporting (EAR) project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7-13.8). This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users.
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Affiliation(s)
- Philippe Barboza
- International Department, French Institute for Public Health Surveillance (Institut de Veille Sanitaire), Saint Maurice, France.
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Hacard F, Perrinaud A, Bernez A, Vaillant L, Machet L. Pustulose exanthématique aiguë disséminée au Diamox®, avec patch tests négatifs, mais affirmée par l’IDR avec lecture retardée. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.546] [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: 10/27/2022]
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Khashoggi M, de Muret A, Samimi M, Maruani A, Vaillant L, Machet L. Régression complète et rapide des lésions d’un lymphome cutané primitif centro-folliculaire à quatre reprises après la prise d’acitrétine. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.471] [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]
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Blein M, Martin L, Lorette G, Vaillant L, Baulieu F, Maruani A. Lymphœdème primaire de l’enfant. Réponses au pré-test. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.07.004] [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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39
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Barboza P, Vaillant L, Gastellu-Etchegorry M, Gauthier V, Giese C, Astagneau P. Mondialisation des risques sanitaires et intelligence épidémiologique en France. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.024] [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: 10/28/2022] Open
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40
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Samimi M, Maruani A, Le Fourn E, Quignon R, De Pinieux G, Vaillant L, Lorette G. Angiosarcome épithélioïde métastatique compliquant un lymphoedème congénital de membre sur le site d’une greffe ganglionnaire autologue : rôle procarcinogène par néoangiogenèse ? Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.221] [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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Le Fourn E, Duhard E, Tauveron V, Maruani A, Samimi M, Lorette G, Vaillant L, Machet L. Changes in the nail unit in patients with secondary lymphoedema identified using clinical, dermoscopic and ultrasound examination. Br J Dermatol 2011; 164:765-70. [DOI: 10.1111/j.1365-2133.2010.10179.x] [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] [Indexed: 11/27/2022]
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Samimi M, Perrinaud A, Naouri M, Maruani A, Perrodeau E, Vaillant L, Machet L. High-resolution ultrasonography assists the differential diagnosis of blue naevi and cutaneous metastases of melanoma. Br J Dermatol 2010; 163:550-6. [PMID: 20545694 DOI: 10.1111/j.1365-2133.2010.09903.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Metastases of cutaneous melanoma may simulate benign blue naevi clinically. OBJECTIVES To investigate the value of ultrasonography in the differential diagnosis of lesions that look similar clinically, i.e. blue naevi and cutaneous metastases of melanoma. METHODS Participants were invited for inclusion in the study if they had a cutaneous blue lesion clinically suggestive of a blue naevus or cutaneous metastasis of melanoma. After obtaining signed consent, the lesion was photographed and studied using dermoscopy and high-resolution ultrasonography before being removed for histological examination. Clinical, dermoscopic and ultrasonographic images were reviewed anonymously by four dermatologists to assign the diagnosis of blue naevus or metastasis of melanoma. The diagnostic performance of clinical examination, dermoscopy and sonography was assessed for the ability of each to differentiate between metastases of melanoma and blue naevi with reference to the histological diagnosis. Moreover, experts undertook a semeiological description of each ultrasonographic image according to seven items: location of the lesion, echogenicity, homogeneity, shape of the lesion, definition of margins, posterior acoustic shadow and increased posterior echogenicity. RESULTS Twenty-eight patients were included with a total of 39 blue skin lesions, and 17 of the 28 patients had a previous history of melanoma. Interobserver agreement in the semeiological description of the sonographic images was good (κ≥0·6) for five of seven items. Sonography was more specific (94%) than clinical examination (77%) and dermoscopy (74%). The sonographic features contributing to the differential diagnosis were: location of the lesion (P=0·027), shape of the lesion (P<0·001), homogeneity (P=0·001) and increased posterior echogenicity (P=0·007). CONCLUSIONS Ultrasonography is a reproducible and specific tool that can assist the differential diagnosis between blue naevi and metastases of melanoma. A blue naevus is a homogeneous, hypoechoic, 'dish-shaped' lesion, located in the superficial dermis, whereas metastases of melanoma are 'potato-shaped', hypoechoic, heterogeneous lesions, located in the hypodermis.
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Affiliation(s)
- M Samimi
- Université François Rabelais, Tours, France.
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Naouri M, Samimi M, Atlan M, Perrodeau E, Vallin C, Zakine G, Vaillant L, Machet L. High-resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema. Br J Dermatol 2010; 163:296-301. [PMID: 20408836 DOI: 10.1111/j.1365-2133.2010.09810.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High-resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema. OBJECTIVES The purpose of our study was to demonstrate that high-resolution ultrasound imaging of the skin can differentiate lipoedema from lymphoedema. METHODS Sixteen patients with lymphoedema (22 legs), eight patients with lipoedema (16 legs) and eight controls (16 legs) were included. Patients with lipolymphoedema were excluded. Ultrasound examinations were carried out with a real-time high-resolution ultrasound device on three different sites for each lower limb. The images were then anonymized and examined by an independent dermatologist who was blind to the clinical diagnosis. A new series of images was examined by three dermatologists to check interobserver agreement. RESULTS A significant difference in dermal thickness was observed between patients with lymphoedema and those with lipoedema and between patients with lymphoedema and controls. No significant difference in dermal thickness was shown between patients with lipoedema and controls at the thigh or ankle. Dermal hypo-echogenicity was found in at least one of the three sites in 100% of patients with lymphoedema, 12.5% of cases with lipoedema and 6.25% of the controls. Hypoechogenicity affected the entire dermis in all cases of lymphoedema except one. In cases of lipoedema and controls, hypoechogenicity was localized at the ankle and prevailed in the upper dermis. The expert correctly diagnosed all lower limbs with lymphoedema. No cases of lipoedema were diagnosed as lymphoedema. Exact interobserver agreement was excellent (0.98). CONCLUSIONS High-resolution cutaneous ultrasonography makes it possible to differentiate lymphoedema from lipoedema. Obtaining a reliable diagnosis through high-resolution cutaneous ultrasonography might be valuable for improving the treatment of lipoedema and lymphoedema.
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Affiliation(s)
- M Naouri
- Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France
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Randrianirina F, Vaillant L, Ramarokoto CE, Rakotoarijaona A, Andriamanarivo ML, Razafimahandry HC, Randrianomenjanahary J, Raveloson JR, Hariniana ER, Carod JF, Talarmin A, Richard V. Antimicrobial resistance in pathogens causing nosocomial infections in surgery and intensive care units of two hospitals in Antananarivo, Madagascar. J Infect Dev Ctries 2010; 4:74-82. [PMID: 20212337 DOI: 10.3855/jidc.454] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 11/03/2009] [Accepted: 11/10/2009] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND In developing countries, knowledge of antimicrobial resistance patterns is essential to define empirical therapy. METHODOLOGY All the surgery and intensive care wards of two hospitals in Antananarivo were included to study the antimicrobial susceptibility of the pathogenic bacteria causing nosocomial infections. A repeated cross-sectional survey was conducted between September 2006 and March 2008, one day per week. Isolates were identified using classical methods, and resistance to antibiotics was assessed according to the recommendations of the Antibiogram Committee of the French Microbiology Society. RESULTS Clinical specimens from 706 from 651 patients were collected. Of the 533 bacterial pathogens, 46.7% were Enterobacteriaceae, 19.3% were Staphylococcus aureus, and 19.1% were pathogens from the hospital environment (Pseudomonas aeruginosa and Acinetobacter baumannii).Frequencies of resistance were high, particularly in Enterobacteriaceae; however, the rate of Staphylococcus aureus isolates resistant to oxacillin (13.6 %) was moderate and all these isolates were susceptible to glycopeptids. The percentages of isolates susceptible to ceftazidim were 81.8% for E. coli, 60.9% for Klebsiella, and 52.5% for Enterobacter spp. Resistance to third-generation cephalosporins was due to extended spectrum betalactamases (ESBL). Multivariate analysis showed that diabetes (adjusted OR: 3.9) and use of an invasive procedures (adjusted OR: 3.5) were independent risk factors for resistance to third-generation cephalosporins. CONCLUSION A nationwide surveillance programme is needed to monitor the microbial trends and antimicrobial resistance in Madagascar.
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Catala-Pétavy C, Machet L, Georgesco G, Pétavy F, Maruani A, Vaillant L. Contribution of skin biometrology to the diagnosis of the Ehlers-Danlos syndrome in a prospective series of 41 patients. Skin Res Technol 2009; 15:412-7. [DOI: 10.1111/j.1600-0846.2009.00379.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [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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46
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Vignes S, Coupé M, Baulieu F, Vaillant L. [Limb lymphedema: Diagnosis, explorations, complications. French Lymphology Society]. J Mal Vasc 2009; 34:314-322. [PMID: 20050179] [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: 05/28/2023]
Abstract
Lymphedema results from impaired lymphatic transport with increased limb volume. Primary and secondary forms can be distinguished. Secondary lymphedema of the upper limb is the most frequent in France. A 2-cm difference on any segment of the limb confirms the diagnosis of lymphedema. Calculated lymphedema volume using the formula for a truncated cone is required to assess the efficacy of treatment and to monitor follow-up. Primary lymphedema is sporadic but rarely familial. Lymphoscintigraphy is useful in the primary form to evaluate precisely lymphatic function of the two limbs. Erysipelas is the main complication,but psychological or functional discomfort may occur throughout the course of lymphedema. Lipedema is the main differential diagnosis, defined as an abnormal accumulation of fat from hip to ankle and occurs almost exclusively in obese women.
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Affiliation(s)
- S Vignes
- Unité de lymphologie, hôpital Cognacq-Jay, Centre national de référence des maladies vasculaires rares, 15, rue Eugène-Millon,75015 Paris, France
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La Ruche G, Tarantola A, Barboza P, Vaillant L, Gueguen J, Gastellu-Etchegorry M. The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific. ACTA ACUST UNITED AC 2009; 14. [PMID: 19883543 DOI: 10.2807/ese.14.42.19366-en] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There are few structured data available to assess the risks associated with pandemic influenza A(H1N1)v infection according to ethnic groups. In countries of the Americas and the Pacific where these data are available, the attack rates are higher in indigenous populations, who also appear to be at approximately three to six-fold higher risk of developing severe disease and of dying. These observations may be associated with documented risk factors for severe disease and death associated with pandemic H1N1 influenza infection (especially the generally higher prevalence of diabetes, obesity, asthma, chronic obstructive pulmonary disease and pregnancy in indigenous populations). More speculative factors include those associated with the risk of infection (e.g. family size, crowding and poverty), differences in access to health services and, perhaps, genetic factors. Whatever the causes, this increased vulnerability of indigenous populations justify specific immediate actions in the control of the current pandemic including primary prevention (intensified hygiene promotion, chemoprophylaxis and vaccination) and secondary prevention (improved access to services and early treatment following symptoms onset) of severe pandemic H1N1 influenza infection.
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Affiliation(s)
- G La Ruche
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), St Maurice, France.
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Abstract
This article describes the characteristics of 574 deaths associated with pandemic H1N1 influenza up to 16 July 2009. Data (except from Canada and Australia) suggest that the elderly may to some extent be protected from infection. There was underlying disease in at least half of the fatal cases. Two risk factors seem of particular importance: pregnancy and metabolic condition (including obesity which has not been considered as risk factor in previous pandemics or seasonal influenza).
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Affiliation(s)
- L Vaillant
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), St Maurice, France
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Vaillant L, Ramarokoto C, Randrianasolo L, Andrianirina F, Richard V. E-02 Étude épidémiologique de la multirésistance aux antibiotiques des entérobactéries à Madagascar en milieu hospitalier. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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