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Schraen-Maschke S, Duhamel A, Vidal JS, Ramdane N, Vaudran L, Dussart C, Buée L, Sablonnière B, Delaby C, Allinquant B, Gabelle A, Bombois S, Lehmann S, Hanon O. The free plasma amyloid Aβ 1-42/Aβ 1-40 ratio predicts conversion to dementia for subjects with mild cognitive impairment with performance equivalent to that of the total plasma Aβ 1-42/Aβ 1-40 ratio. The BALTAZAR study. Neurobiol Dis 2024; 193:106459. [PMID: 38423192 DOI: 10.1016/j.nbd.2024.106459] [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: 04/25/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND AND PURPOSE Blood-based biomarkers are a non-invasive solution to predict the risk of conversion of mild cognitive impairment (MCI) to dementia. The utility of free plasma amyloid peptides (not bound to plasma proteins and/or cells) as an early indicator of conversion to dementia is still debated, as the results of studies have been contradictory. In this context, we investigated whether plasma levels of the free amyloid peptides Aβ1-42 and Aβ1-40 and the free plasma Aβ1-42/Aβ1-40 ratio are associated with the conversion of MCI to dementia, in particular AD, over three years of follow-up in a subgroup of the BALTAZAR cohort. We also compared their predictive value to that of total plasma Aβ1-42 and Aβ1-40 levels and the total plasma Aβ1-42/Aβ1-40 ratio. METHODS The plasma Aβ1-42 and Aβ1-40 peptide assay was performed using the INNO-BIA kit (Fujirebio Europe). Free amyloid levels (defined by the amyloid fraction directly accessible to antibodies of the assay) were obtained with the undiluted plasma, whereas total amyloid levels were obtained after the dilution of plasma (1/3) with a denaturing buffer. Free and total Aβ1-42 and Aβ1-40 levels were measured at inclusion for a subgroup of participants (N = 106) with mild cognitive impairment (MCI) from the BALTAZAR study (a large-scale longitudinal multicenter cohort with a three-year follow-up). Associations between conversion and the free/total plasma Aβ1-42 and Aβ1-40 levels and Aβ1-42/Aβ1-40 ratio were analyzed using logistic and Cox Proportional Hazards models. Demographic, clinical, cognitive (MMSE, ADL and IADL), APOE, and MRI characteristics (relative hippocampal volume) were compared using non-parametric (Mann-Whitney) or parametric (Student) tests for quantitative variables and Chi-square or Fisher exact tests for qualitative variables. RESULTS The risk of conversion to dementia was lower for patients in the highest quartile of free plasma Aβ1-42/Aβ1-40 (≥ 25.8%) than those in the three lower quartiles: hazard ratio = 0.36 (95% confidence interval [0.15-0.87]), after adjustment for age, sex, education, and APOE ε4 (p-value = 0.022). This was comparable to the risk of conversion in the highest quartile of total plasma Aβ1-42/Aβ1-40: hazard ratio = 0.37 (95% confidence interval [0.16-0.89], p-value = 0.027). However, while patients in the highest quartile of total plasma Aβ1-42/Aβ1-40 showed higher MMSE scores and a higher hippocampal volume than patients in the three lowest quartiles of total plasma Aβ1-42/Aβ1-40, as well as normal CSF biomarker levels, the patients in the highest quartile of free plasma Aβ1-42/Aβ1-40 did not show any significant differences in MMSE scores, hippocampal volume, or CSF biomarker levels relative to the three lowest quartiles of free plasma Aβ1-42/Aβ1-40. CONCLUSION The free plasma Aβ1-42/Aβ1-40 ratio is associated with a risk of conversion from MCI to dementia within three years, with performance comparable to that of the total plasma Aβ1-42/Aβ1-40 ratio. Threshold levels of the free and total plasma Aβ1-42/Aβ1-40 ratio could be determined, with a 60% lower risk of conversion for patients above the threshold than those below.
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Affiliation(s)
- S Schraen-Maschke
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France.
| | - A Duhamel
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - J S Vidal
- Université de Paris, EA 4468 and APHP, Hôpital Broca, Memory Resource and Research Centre of de Paris-Broca-Ile de France, Paris, France
| | - N Ramdane
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - L Vaudran
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France
| | - C Dussart
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France
| | - L Buée
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France
| | - B Sablonnière
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France
| | - C Delaby
- LBPC-PPC, Université de Montpellier, INM INSERM, IRMB CHU de Montpellier, Montpellier, France
| | - B Allinquant
- UMR-S1266, Université Paris Cité, Institute of Psychiatry and Neurosciences, Inserm, Paris, France
| | - A Gabelle
- CMRR, Université de Montpellier, INM INSERM, CHU de Montpellier, Montpellier, France
| | - S Bombois
- Univ. Lille, Inserm, CHU Lille, UMR-S1172, LiCEND, Lille Neuroscience & Cognition, LabEx DISTALZ, Lille, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Département de Neurologie, Centre des Maladies Cognitives et Comportementales, GH Pitié-Salpêtrière, Paris, France
| | - S Lehmann
- LBPC-PPC, Université de Montpellier, INM INSERM, IRMB CHU de Montpellier, Montpellier, France
| | - O Hanon
- Université de Paris, EA 4468 and APHP, Hôpital Broca, Memory Resource and Research Centre of de Paris-Broca-Ile de France, Paris, France.
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Denoyelle J, Dujardin C, Ramdane N, Leleu A, Ghesquière L, Garabedian C. [Can we predict intrauterine balloon tamponade failure according to the mode of delivery?]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00117-X. [PMID: 38556133 DOI: 10.1016/j.gofs.2024.03.013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE The intrauterine balloon tamponade (IUBT) is one of the major tool to manage the postpartum hemorrhage (PPH). Previous studies identified factors predicting IUBT failure regardless the mode of delivery. Our aim was to determine if IUBT predictive failure can be determined regarding the mode of delivery. MATERIALS AND METHODS This was a retrospective cohort study among women who had IUBT secondary to severe PPH after vaginal or cesarean delivery from 2012 until 2021 at Lille (France). We compared 2 groups: success or failure of the IUBT, which was defined as the need of additional invasive procedures (uterine embolization or surgical procedure). RESULTS We included 238 women, 83 who underwent cesarean and 155 vaginal delivery. The overall success of the IUBT was 78% (80% for vaginal delivery and 75% for cesarean delivery). In the vaginal delivery group with failed IUBT, coagulopathies were significantly more frequent (84.2 vs. 33.3% P=<0.001) with higher estimated blood loss at the use of the IUBT (1865.8 vs. 1580.8mL, P=0.015) compared with the vaginal delivery group with success of IUBT. In the cesarean delivery group, none factor was significant between the two groups. CONCLUSION It is possible to identify predictors of IUBT failure in case of vaginal delivery. In contrast, in case of cesarean delivery, there is no apparent predictive facto. It could be interesting to validate our findings in a multicentric study.
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Affiliation(s)
- Juliette Denoyelle
- Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - Clara Dujardin
- Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - Nassima Ramdane
- Département d'épidémiologie, CHU de Lille, 59000 Lille, France
| | - Astrid Leleu
- Département d'obstétrique, hôpital de Roubaix, Roubaix, France
| | - Louise Ghesquière
- Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; ULR 2694-METRICS, University Lille, 59000 Lille, France
| | - Charles Garabedian
- Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; ULR 2694-METRICS, University Lille, 59000 Lille, France.
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3
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Gruchala P, Keller L, Ducrocq-Caux B, Ramdane N, Robin G, Catteau-Jonard S. [Impact of donor parity on oocyte donation outcomes]. Gynecol Obstet Fertil Senol 2024; 52:81-85. [PMID: 37925104 DOI: 10.1016/j.gofs.2023.10.009] [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] [Received: 04/04/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES Since 2015, in France, men and women who have never procreated are allowed to donate their gametes. This has led to an increase in the number of female oocyte donors, whereas there are many couples waiting for gametes that have a long waiting time. The aim of this study is to compare the results of donation with oocytes from nulliparous and non-nulliparous donors. METHODS Monocentric retrospective observational study (Lille University Hospital) between January 1st, 2016 and December 31st, 2019. Phenotypic characteristics and clinical and biological outcomes of oocytes donations were compared according to donor parity (nulliparous versus primiparous or multiparous). RESULTS One hundred and eighty-five donors (66 nulliparous and 119 non-nulliparous) were included in the study, allowing 284 ICSI cycles to be performed in recipient couples. On average, 11.5 oocytes were obtained per donation cycle, of which 7.8 were mature. In total, 4.6 mature oocytes were obtained per attempt and per recipient couple. Nulliparous donors are younger than non-nulliparous ones. An early pregnancy was obtained in 55.6% of the nulliparous donors and in 50.8% of the non-nulliparous donors (P=0.55). A progressive pregnancy was obtained in 49.2% of the nulliparous women and in 42.1% of the non-nulliparous women (P=0.36). There was therefore no difference in terms of early pregnancy and ongoing pregnancy whether the donation came from a nulliparous or non-nulliparous woman. CONCLUSION Donor parity does not seem to have an impact on the success of oocyte donation attempts.
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Affiliation(s)
| | - Laura Keller
- Laboratoire de biologie de la reproduction, CECOS, spermiologie, CHU de Lille, 59000 Lille, France
| | - Bérengère Ducrocq-Caux
- Laboratoire de biologie de la reproduction, CECOS, spermiologie, CHU de Lille, 59000 Lille, France
| | - Nassima Ramdane
- Département de biostatistiques, CHU de Lille, 59000 Lille, France
| | - Geoffroy Robin
- Service d'AMP, CHU de Lille, université de Lille, 59000 Lille, France
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Fourel M, Hafez S, Ramdane N, Perrouin-Verbe MA, De Wachter S, Vermersch P, Biardeau X. Response to tibial and sacral nerve modulation in overactive bladder: Is there any correlation? Neurourol Urodyn 2024; 43:415-423. [PMID: 38078739 DOI: 10.1002/nau.25352] [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: 07/11/2023] [Revised: 10/26/2023] [Accepted: 11/26/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES To assess the correlation between the response to transcutaneous tibial nerve stimulation (TTNS) and subsequent response to sacral nerve modulation (SNM) to treat overactive bladder (OAB). MATERIALS AND METHODS All patients who consecutively received TTNS followed by a two-stage SNM between January 2016 and June 2022 to treat OAB in two university hospital centers were included. The response to each therapy was evaluated with success defined by a 50% or greater improvement in one or more bothersome urinary symptoms from baseline. The primary endpoint was the statistical relationship between the response to TTNS and the response to SNM, assessed by logistic regression. Secondary endpoints were the statistical relationship between the response to TTNS and the response to SNM when controlling for gender, age (<57 years vs. >57 years), presence of an underlying neurological disease, and presence of DO, adding the factor and interaction to the previous regression model. RESULTS Among the 92 patients enrolled in the study, 68 of them were women (73.9%), and the median age was 57.0 [41.0-69.0] years. The success was reported in 22 patients (23.9%) under TTNS and 66 patients (71.7%) during the SNM test phase. There was no statistical correlation between response to TTNS and response to SNM in the overall population (confidence interval: 95% [0.48-4.47], p = 0.51). Similarly, there was no statistical correlation when controlling for age <57 years or ≥57 years, with p = 1.0 and p = 0.69, respectively. No statistical study could be conducted for the other subpopulations due to small sample sizes. CONCLUSION The response to TTNS does not predict the response to SNM in the treatment of OAB. TTNS and SNM should be considered as separate therapies, and the decision-making process for OAB treatment should take this into account.
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Affiliation(s)
- Mathieu Fourel
- Department of Urology, Lille Academic Hospital, University of Lille, Lille, France
| | - Samy Hafez
- Centre Hospitalo-Universitaire de Nantes, Urology Department, Nantes Université, Nantes, France
| | | | | | - Stefan De Wachter
- Department of Urology, Antwerp University Hospital, Edegem, Belgium
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, Wlrijk, Belgium
| | - Patrick Vermersch
- Inserm U1172 LilNCog, CHU Lille, FHU Precise, University of Lille, Lille, France
| | - Xavier Biardeau
- Department of Urology, Lille Academic Hospital, University of Lille, Lille, France
- Inserm U1172 LilNCog, CHU Lille, FHU Precise, University of Lille, Lille, France
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Briand R, Lebouvier T, Lanvin L, Ramdane N, Skrobala E, Leroy M, Chenivesse C, Fry S, Le Rouzic O. Continuous positive airway pressure compliance in patients with mild cognitive impairment. Sleep Breath 2024:10.1007/s11325-024-02995-5. [PMID: 38225442 DOI: 10.1007/s11325-024-02995-5] [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: 09/28/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024]
Abstract
PURPOSE Sleep apnoea (SA) is associated with accelerated cognitive decline in patients with mild cognitive impairment (MCI). Treatment of SA by continuous positive airway pressure (CPAP) may slow this decline if patients comply with the treatment. The aim of this study was to assess the rate of CPAP compliance in this population. METHODS In this single-centre retrospective study conducted in a tertiary care institution, patients with a diagnosis of MCI and SA initiating CPAP between January 2015 and August 2021 were included. Data from the initial sleep recording, the 3-month follow-up and compliance with at least 12 months of CPAP were analysed. Compliance was defined as an average CPAP use of at least 4 h per night. RESULTS 55 patients were included (49% women, age 70.7 ± 8.9 years, body mass index 28.9 ± 6.5 kg/m2). Aetiology of MCI was vascular (45.5%), psychiatric (12.7%) and related to Alzheimer's disease (7.3%), with 47.3% of amnesic disorders and 45.5% of dysexecutive disorders. The MiniMentalState score was 26.7 ± 3.1. SA was mostly obstructive (81.8%) with a mean apnoea-hypopnoea index of 41.1 ± 16.4/h. At 3 months, 38 patients were compliant (69%) with a CPAP median use of 5.9 h per night and 83% of nights. Self-reported tolerance was better in compliant patients (75.7% vs 38.5% p = 0.017). Thirty-four patients remained compliant at 12 months (62%). CONCLUSION Our results suggest a high rate of CPAP compliance in patients suffering from MCI. Compliance was related to the device tolerance, emphasizing the need to closely monitor and improve this factor.
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Affiliation(s)
- Raphaël Briand
- CHU Lille, Pneumology and Immuno-Allergology, 59000, Lille, France.
| | - Thibaud Lebouvier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, 59000, Lille, France
| | - Lise Lanvin
- Clinical Neurophysiology, CHU Lille, 59000, Lille, France
| | - Nassima Ramdane
- Department of Biostatistics, CHU Lille, 59000, Lille, France
| | - Emilie Skrobala
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, 59000, Lille, France
| | - Mélanie Leroy
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, 59000, Lille, France
| | - Cécile Chenivesse
- CHU Lille, Pneumology and Immuno-Allergology, 59000, Lille, France
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U-1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, 59000, Lille, France
| | - Stéphanie Fry
- CHU Lille, Pneumology and Immuno-Allergology, 59000, Lille, France
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U-1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, 59000, Lille, France
| | - Olivier Le Rouzic
- CHU Lille, Pneumology and Immuno-Allergology, 59000, Lille, France
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U-1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, 59000, Lille, France
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Cathelain A, Simon V, Wattier JM, Robin G, Ramdane N, Decanter C, Plouvier P, Rubod C. Pain assessment in women with or without endometriosis during the IVF process: a prospective study. Reprod Biomed Online 2023; 47:103250. [PMID: 37748370 DOI: 10.1016/j.rbmo.2023.06.005] [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: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 09/27/2023]
Abstract
RESEARCH QUESTION How does the typology and effect of pain vary between infertile patients with or without endometriosis during the different stages of the IVF process? DESIGN A prospective, monocentric, observational cohort study was conducted at Lille University Hospital between November 2019 and June 2021. The study was proposed to all patients starting an IVF cycle. Pain assessment questionnaires using validated scales (about type of pain, without specific location), were completed by patients at key points during IVF: before starting treatment, at the end of stimulation and on the day of oocyte retrieval. RESULTS A total of 278 patients were analysed: 73 patients with endometriosis and 205 without. At the start of the IVF process, patients with endometriosis had higher pain scores than disease-free women (mean numerical scale score 3.47 versus 1.12 [P < 0.0001]) and 17.81% of patients with endometriosis had neuropathic pain. For mental disorders before starting treatment, 22% of patients with endometriosis had suspected or confirmed depression, and 33% had anxiety compared with 8% and 20% in patients without endometriosis, respectively. During IVF, for patients without endometriosis, pain increased significantly between the baseline, the end of stimulation and on the day of retrieval (P ≤ 0.05). In patients with endometriosis, however, pain did not significantly vary during these times. CONCLUSION Endometriosis is associated with higher pain scores, but no increase in pain was observed during IVF for these patients. It seems essential to screen and characterize pain phenotypes in all patients before starting treatment and during stimulation to improve pain management.
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Affiliation(s)
- Alice Cathelain
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France.
| | - Virginie Simon
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Jean Michel Wattier
- CHU Lille, Department of Anesthesiology and Intensive Care-Section of Pain, Claude Huriez University Hospital, F-59000, Lille, France
| | - Geoffroy Robin
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
| | - Nassima Ramdane
- CHU Lille, EA 2694, public health: epidemiology and quality of care, Lille University, F-59000 Lille, France
| | - Christine Decanter
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Pauline Plouvier
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Chrystele Rubod
- CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
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7
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Mutez E, Swiderski M, Devos D, Moreau C, Baille G, Degardin A, Ryckewaert G, Carriere N, Kreisler A, Simonin C, Rouaix N, Tir M, Krystkowiak P, Ramdane N, Génin M, Sablonnière B, Defebvre L, Huin V. Indication for molecular testing by multiplex ligation-dependent probe amplification in parkinsonism. Eur J Neurol 2023; 30:1667-1675. [PMID: 36916668 DOI: 10.1111/ene.15788] [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: 11/22/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND The monogenic forms of Parkinson's disease represent less than 10% of familial cases and a still lower frequency of sporadic cases. However, guidelines to orient genetic testing are lacking. We aim to establish the interest of multiplex ligation-dependent probe amplification as a primary screening test and to propose clinical criteria to guide genetic diagnostic tests for patients with suspected Mendelian Parkinson's disease. METHODS We recruited 567 patients with parkinsonism from 547 unrelated families and performed two multiplex ligation-dependent probe amplifications for each. We confirmed all pathogenic G2019S variants in the LRRK2 gene by Sanger sequencing and screened the PRKN gene for a second mutation in cases of one heterozygous structural variant in the PRKN gene. RESULTS The performance of multiplex ligation-dependent probe amplifications was 51/567 (9%) for the entire cohort and included 27 (4.8%) LRRK2 G2019S mutations, 19 (3.4%) PRKN mutations, and 5 (0.9%) SNCA locus duplications. The variables significantly associated with a positive test in the total cohort were North African ancestry (p < 0.0001), female sex (p = 0.004), and younger age at onset (p < 0.0008). CONCLUSIONS Retrospective analysis allowed us to refine our indication criteria: (i) North African ancestry, (ii) an age at onset < 40, or (iii) a familial history of parkinsonism with at least one affected first-degree relative. Our study highlights the interest of MLPA testing for other parkinsonisms cases with a family history, especially for patients with dementia with Lewy bodies or a multiple system atrophy-like phenotype.
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Affiliation(s)
- E Mutez
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - M Swiderski
- Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - D Devos
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France.,Medical Pharmacology Department, Univ Lille, Inserm, CHU Lille, UMR_S1172, Lille, F-59000, France
| | - C Moreau
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - G Baille
- Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - A Degardin
- Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France.,Department of Neurology, Hospital Center of Tourcoing, Tourcoing, France
| | - G Ryckewaert
- Department of Neurology, Hospital Center of Valenciennes, Valenciennes, France
| | - N Carriere
- Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - A Kreisler
- Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - C Simonin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - N Rouaix
- Univ. Lille, Inserm, CHU Lille, Department of Toxicology and Genopathies, UF Neurobiology, F-59000, Lille, France
| | - M Tir
- Department of Neurology and Expert Center for Parkinson's Disease, Amiens University Hospital, CHU Amiens-Picardie, F-80000, Amiens, France
| | - P Krystkowiak
- Department of Neurology and Expert Center for Parkinson's Disease, Amiens University Hospital, CHU Amiens-Picardie, F-80000, Amiens, France
| | - N Ramdane
- Univ. Lille, CHU Lille, Department of Biostatistics, F-59000, Lille, France
| | - M Génin
- Univ. Lille, CHU Lille, Department of Biostatistics, F-59000, Lille, France.,Univ. Lille, CHU Lille, ULR 2694 - METRICS : Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - B Sablonnière
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Univ. Lille, Inserm, CHU Lille, Department of Toxicology and Genopathies, UF Neurobiology, F-59000, Lille, France
| | - L Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Department of Neurology, CHU Lille, Expert Center for Parkinson's Disease, Lille, F-59000, France
| | - V Huin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neuroscience & Cognition, F-59000, Lille, France.,Univ. Lille, Inserm, CHU Lille, Department of Toxicology and Genopathies, UF Neurobiology, F-59000, Lille, France
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8
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Courtalin M, Verkindt H, Oukhouya Daoud N, Ramdane N, Cortet B, Pattou F, Paccou J. An Evaluation of the Implementation of the European Calcified Tissue Society Recommendations on the Prevention and Treatment of Osteoporosis Secondary to Bariatric Surgery. Nutrients 2023; 15:nu15041007. [PMID: 36839365 PMCID: PMC9964124 DOI: 10.3390/nu15041007] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
The purpose of this study was to evaluate the implementation of the European Calcified Tissue Society (ECTS) 2022 recommendations on the prevention and treatment of osteoporosis secondary to bariatric surgery. The ECTS 2022 recommendations were applied in a retrospective cohort of postmenopausal women and men aged 50 years and older who were undergoing or had already undergone bariatric surgery. Osteoporosis medication was indicated if any of the following criteria were met: (i) history of recent (within 2 years) fragility fracture after the age of 40 years, (ii) BMD T score ≤ -2 at any of the sites of measurement, and (iii) FRAX® ≥ 20% for major osteoporotic fractures and/or ≥3% for hip fractures. Of the 170 patients (144 women, mean age 59 (55 to 63) years) included between February 2019 and March 2022, 33 were eligible for osteoporosis medication based on the ECTS 2022 recommendations, i.e., a prevalence of 19.6% [CI95%: 13.9%; 26.5%]. Most patients met the BMD T score ≤ -2 criterion (n = 25/170, 14.7% [CI95%: 9.7%; 20.9%]) and/or the history of recent fragility fracture criterion (n = 12/170, 7.1% [CI95%: 3.7%; 12.0%]). In this study, a fifth of our population was found to be eligible for osteoporosis medication after the application of the ECTS 2022 recommendations.
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Affiliation(s)
- Marion Courtalin
- Department of Rheumatology, University of Lille, 59000 Lille, France
| | - Hélène Verkindt
- Department of Endocrine and Metabolic Surgery, University of Lille, 59000 Lille, France
| | - Naima Oukhouya Daoud
- Department of Endocrine and Metabolic Surgery, University of Lille, 59000 Lille, France
| | - Nassima Ramdane
- METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, 59000 Lille, France
| | - Bernard Cortet
- Department of Rheumatology, University of Lille, 59000 Lille, France
| | - François Pattou
- Department of Endocrine and Metabolic Surgery, University of Lille, 59000 Lille, France
| | - Julien Paccou
- Department of Rheumatology, University of Lille, 59000 Lille, France
- Correspondence:
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9
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Houeijeh A, Batteux C, Karsenty C, Ramdane N, Lecerf F, Valdeolmillos E, Lourtet-Hascoet J, Cohen S, Belli E, Petit J, Hascoët S. Long-term outcomes of transcatheter pulmonary valve implantation with melody and SAPIEN valves. Int J Cardiol 2023; 370:156-166. [PMID: 36283540 DOI: 10.1016/j.ijcard.2022.10.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Transcatheter pulmonary valve implantation (TPVI) is effective for treating right ventricle outflow tract (RVOT) dysfunction. Factors associated with long-term valve durability remain to be investigated. METHODS Consecutive patients successfully treated by TPVI with Melody valves (n = 32) and SAPIEN valves (n = 182) between 2008 and 2020 at a single tertiary centre were included prospectively and monitored. RESULTS The 214 patients had a median age of 28 years (range, 10-81). The RVOT was a patched native pulmonary artery in 96 (44.8%) patients. Median follow-up was 2.8 years (range, 3 months-11.4 years). Secondary pulmonary valve replacement (sPVR) was performed in 23 cases (10.7%), due to stenosis (n = 22, 95.7%) or severe regurgitation (n = 1, 4.3%), yielding an incidence of 7.6/100 patient-years with melody valves and 1.3/100 patient-years with SAPIEN valves (P = 0.06). The 5- and 10-year sPVR-freedom rates were 78.1% and 50.4% with Melody vs. 94.3% and 82.2% with SAPIEN, respectively (P = 0.06). The incidence of infective endocarditis (IE) was 5.5/100 patient-years with Melody and 0.2/100 patient-years with SAPIEN (P < 0.0001). Factors associated with sPVR by univariate analysis were RV obstruction before TPVI (P = 0.04), transpulmonary maximal velocity > 2.7 m/s after TPVI (p = 0.0005), valve diameter ≤ 22 mm (P < 0.003), IE (P < 0.0001), and age < 25 years at TPVI (P = 0.04). By multivariate analysis adjusted for IE occurrence, transpulmonary maximal velocity remained associated with sPVR. CONCLUSIONS TPVI is effective for treating RVOT dysfunction. Incidence of sPVR is higher in patients with residual RV obstruction or IE. IE add a substantial risk of TPVI graft failure and is mainly linked to the Melody valve. SOCIAL MEDIA ABSTRACT Transcatheter pulmonary valve implantation is effective for treating right ventricular outflow tract dysfunction in patients with congenital heart diseases. Incidence of secondary valve replacement is higher in patients with residual obstruction or infective endocarditis.
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Affiliation(s)
- Ali Houeijeh
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Department of Congenital Heart Disease, Lille University Hospital, Faculté de médecine, Laboratoire EA4489, Université Lille II, Lille, France.
| | - Clement Batteux
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Clement Karsenty
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Service de cardiologie pédiatrique, Hôpital des Enfants, CHU de Toulouse, 330 avenue de Grande-Bretagne, Toulouse, France.
| | - Nassima Ramdane
- Department of Congenital Heart Disease, Lille University Hospital, Faculté de médecine, Laboratoire EA4489, Université Lille II, Lille, France.
| | - Florence Lecerf
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, Faculté de médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Estibaliz Valdeolmillos
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, Faculté de médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Julie Lourtet-Hascoet
- Service de microbiologie Clinique, Hôpital Saint-Joseph, Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, Paris, France.
| | - Sarah Cohen
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Emre Belli
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Jérôme Petit
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
| | - Sébastien Hascoët
- Department of Congenital Heart Disease, Marie Lannelongue Hospital, BME lab, Centre Constitutif Réseau M3C Cardiopathies Congénitales Complexes, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, Faculté de médecine, Université Paris-Saclay, 133 avenue de la résistance, 92350 Le Plessis Robinson, France.
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10
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Tilmont R, Yakoub-Agha I, Ramdane N, Srour M, Coiteux V, Magro L, Odou P, Simon N, Beauvais D. Impact of Defibrotide in the Prevention of Acute Graft-Versus-Host Disease Following Allogeneic Hematopoietic Cell Transplantation. Ann Pharmacother 2022; 56:1007-1015. [PMID: 35016532 DOI: 10.1177/10600280211068177] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Defibrotide is indicated for patients who develop severe sinusoidal obstructive syndrome following allogeneic hematopoietic cell transplantation (allo-HCT). Preclinical data suggested that defibrotide carries a prophylactic effect against acute graft-versus-host disease (aGVHD). OBJECTIVE The purpose of this study was to investigate the effect of defibrotide on the incidence and severity of aGVHD. METHODS This single-center retrospective study included all consecutive transplanted patients between January 2014 and December 2018. A propensity score based on 10 predefined confounders was used to estimate the effect of defibrotide on aGVHD via inverse probability of treatment weighting (IPTW). RESULTS Of the 482 included patients, 64 received defibrotide (defibrotide group) and 418 did not (control group). Regarding main patient characteristics and transplantation modalities, the two groups were comparable, except for a predominance of men in the defibrotide group. The median age was 55 years (interquartile range [IQR]: 40-62). Patients received allo-HCT from HLA-matched related donor (28.6%), HLA-matched unrelated donor (50.8%), haplo-identical donor (13.4%), or mismatched unrelated donor (7.0%). Stem cell source was either bone marrow (49.6%) or peripheral blood (50.4%). After using IPTW, exposure to defibrotide was not significantly associated with occurrence of aGVHD (HR = 0.97; 95% CI 0.62-1.52; P = .9) or occurrence of severe aGVHD (HR = 1.89, 95% CI: 0.98-3.66; P = .058). CONCLUSION AND RELEVANCE Defibrotide does not seem to have a protective effect on aGVHD in patients undergoing allo-HCT. Based on what has been reported to date and on these results, defibrotide should not be considered for the prevention of aGVHD outside clinical trials.
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Affiliation(s)
- Rémi Tilmont
- Service des Maladies du Sang, Hôpital Huriez, CHU Lille, Lille, France
| | | | - Nassima Ramdane
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, CHU Lille, University of Lille, Lille, France
| | - Micha Srour
- Service des Maladies du Sang, Hôpital Huriez, CHU Lille, Lille, France
| | - Valérie Coiteux
- Service des Maladies du Sang, Hôpital Huriez, CHU Lille, Lille, France
| | - Léonardo Magro
- Service des Maladies du Sang, Hôpital Huriez, CHU Lille, Lille, France
| | - Pascal Odou
- Institut de Pharmacie, CHU Lille, Lille, France.,ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, France
| | - Nicolas Simon
- Institut de Pharmacie, CHU Lille, Lille, France.,ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, France
| | - David Beauvais
- CHU de Lille, Université de Lille, INSERM Infinite U1285, Lille, France
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11
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Fialek M, Dezoteux F, Le Moing A, Karimova E, Ramdane N, Pape E, Azib-Meftah S, Staumont-Sallé D. Omalizumab in chronic inducible urticaria: A retrospective, real-life study. Ann Dermatol Venereol 2021; 148:262-265. [PMID: 34247853 DOI: 10.1016/j.annder.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Affiliation(s)
- M Fialek
- Service de dermatologie, CHU de Lille, 59000 Lille, France.
| | - F Dezoteux
- Service de dermatologie, CHU de Lille, 59000 Lille, France; Inserm, U1286 - INFINITE - Institute for Translational Research in Inflammation, CHU de Lille, University Lille, 59000 Lille, France
| | - A Le Moing
- Service de dermatologie, CHU de Lille, 59000 Lille, France
| | - E Karimova
- Service de dermatologie, CHU de Lille, 59000 Lille, France
| | - N Ramdane
- ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, 59000 Lille, France
| | - E Pape
- Service de dermatologie, CHU de Lille, 59000 Lille, France
| | - S Azib-Meftah
- Service de dermatologie, CHU de Lille, 59000 Lille, France
| | - D Staumont-Sallé
- Service de dermatologie, CHU de Lille, 59000 Lille, France; Inserm, U1286 - INFINITE - Institute for Translational Research in Inflammation, CHU de Lille, University Lille, 59000 Lille, France
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12
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Beret M, Nicot R, Roland-Billecart T, Ramdane N, Ferri J, Schlund M. Impacted lower third molar relationship with mandibular angle fracture complications. J Stomatol Oral Maxillofac Surg 2021; 123:149-154. [PMID: 34000436 DOI: 10.1016/j.jormas.2021.05.004] [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] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Mandibular angle fractures are very common and are associated with the highest risk of complications. The aim of this study is to evaluate the correlation between impacted lower third molar and mandibular angle fracture complications. MATERIAL AND METHODS All patients presenting with a mandibular angle fracture and at least 2 months follow up were retrospectively included. The following complications were recorded: post-traumatic malocclusion, mouth opening limitation, inferior alveolar nerve hypoesthesia, infection, delayed union, hardware loosening. The patients were divided in two groups: impacted lower third molar or erupted/absent lower third molar. RESULTS A total of 68 patients were included, lower third molar was impacted in 36 cases and erupted/absent in 32 cases. 40 complications were recorded in 27 patients at 2 months. No statistically significant difference could be found about malocclusion, mouth opening limitation and inferior alveolar nerve hypoesthesia. A lower rate of persistent inferior alveolar nerve hypoesthesia (p = 0.0557) in patients with impacted lower third molar (19.4%) was observed compared to patients without impacted lower third molar (40.6%). There was no occurrence of delayed union and hardware loosening in impacted lower third molar group, whereas 5 delayed unions and 4 hardware loosening were recorded in erupted/absent lower third molar group. Finally, the rate of patients with at least one of the 6 complications is significantly higher in the erupted/absent lower third molar group (17/32, 53.1%) than in the impacted lower third molar group (10/36, 27.8%), p = 0.033. DISCUSSION The risk of overall complication is decreased when lower third molar is impacted in mandibular angle fracture. This supports the idea of a role of the impacted lower third molar in fracture reduction and stability.
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Affiliation(s)
- Marie Beret
- Univ. Lille, CHU Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, F-59000 Lille, France.
| | - Romain Nicot
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
| | | | - Nassima Ramdane
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Joël Ferri
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
| | - Matthias Schlund
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
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13
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Paccou J, Bavière W, Sornay-Rendu E, Szulc P, Ramdane N, Cortet B, Chapurlat R, Flipo RM. Body composition in patients with psoriatic arthritis and changes during interleukin 12/23 inhibition. Arthritis Care Res (Hoboken) 2021; 74:1608-1613. [PMID: 33973385 DOI: 10.1002/acr.24623] [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: 11/16/2020] [Revised: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Little is known about body composition in patients with PsA. We compared body composition parameters in PsA patients and healthy controls, and then investigated the effects of ustekinumab (UST) on body composition in patients with PsA. METHODS At baseline, 30 PsA patients were compared cross-sectionnally with 60 non-PsA healthy controls matched for age, sex, menopausal status and body mass index. Thirty active PsA patients treated with UST were included in a 6-month open follow-up study. Body composition parameters were measured at baseline and 6 months of treatment. RESULTS Body composition parameters were different in PsA patients compared to healthy controls: in PsA patients, total and appendicular lean mass were lower (p=0.013 and p=0.010 respectively), whereas total fat mass was higher (p<0.001). In 30% of the PsA patients, skeletal muscle mass was below the cut-off for low muscle quantity (men 7.26 kg/m2, women 5.5 kg/m2), whereas no such change was observed in the control group. After 6 months of treatment with UST, there was no significant change in BMI in 18 of the PsA patients. Total lean mass decreased slightly (p=0.046), whereas fat mass tended to increase, but not significantly. No significant changes in appendicular lean mass and skeletal muscle mass index were observed. CONCLUSION In this study, we found that PsA patients had higher fat mass and lower lean mass than healthy controls. At 6-months of treatment, total lean mass decreased slightly, whereas fat mass tended to increase, but not significantly.
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Affiliation(s)
- Julien Paccou
- Univ. Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000, Lille, France
| | - Wallis Bavière
- Univ. Lille, CHU Lille, Department of Rheumatology, 59000, Lille, France
| | | | - Pawel Szulc
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | - Nassima Ramdane
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France
| | - Bernard Cortet
- Univ. Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000, Lille, France
| | - Roland Chapurlat
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | - René-Marc Flipo
- Univ. Lille, CHU Lille, Department of Rheumatology, 59000, Lille, France
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14
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Bourry J, Courteville H, Ramdane N, Drumez E, Duhamel A, Subtil D, Deruelle P, Vambergue A. Progression of Diabetic Retinopathy and Predictors of Its Development and Progression During Pregnancy in Patients With Type 1 Diabetes: A Report of 499 Pregnancies. Diabetes Care 2021; 44:181-187. [PMID: 33177172 DOI: 10.2337/dc20-0904] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/19/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Pregnancy has been associated with development and progression of diabetic retinopathy (DR), but incidence of DR remains unclear. We assessed DR progression rate and its predictors during pregnancies in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS We report the retrospective data from pregnancies in patients with type 1 diabetes followed in Lille, France (1997-2015). Eye examination was performed every 3 months or every month in case of severe nonproliferative retinopathy or progression. Progression was defined by DR degradation (≥1 stage of the Early Treatment Diabetic Retinopathy Study [ETDRS] classification); it included DR development and worsening in patients without and with prepregnancy DR, respectively. RESULTS A total of 499 pregnancies in 375 patients were included; prepregnancy retinopathy was present in 30.3%. Progression, development, and worsening rates were 21.8%, 24.4% of those without retinopathy, and 15.9% of those with retinopathy, respectively. Development of sight-threatening retinopathy was rare. Progression mainly occurred in early or midpregnancy. Elevated prepregnancy HbA1c and duration of diabetes ≥10 years were predictors of DR progression. Among pregnancies with prepregnancy DR, continuous subcutaneous insulin infusion (CSII) tended to decrease the risk of DR progression. Among CSII-treated patients, those with prepregnancy DR had a significantly decreased risk of DR progression. Among the 270 pregnancies of women with any DR during pregnancy who returned for a postpartum ophthalmologic examination, the rate of progression was only 4.1% and the rate of regression was 9.3%. CONCLUSIONS This study provides epidemiologic data on progression of retinopathy during pregnancy and will be useful for future guidelines for retinopathy screening.
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Affiliation(s)
- Julien Bourry
- Department of Diabetology, Endocrinology and Metabolism, Lille University Hospital, Lille, France
| | | | - Nassima Ramdane
- EA 2694 - Santé publique: épidémiologie et qualité des soins, CHU Lille, University Lille, Lille, France
| | - Elodie Drumez
- EA 2694 - Santé publique: épidémiologie et qualité des soins, CHU Lille, University Lille, Lille, France
| | - Alain Duhamel
- EA 2694 - Santé publique: épidémiologie et qualité des soins, CHU Lille, University Lille, Lille, France.,European Genomic Institute for Diabetes, University School of Medicine, Lille, France
| | - Damien Subtil
- European Genomic Institute for Diabetes, University School of Medicine, Lille, France.,Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - Philippe Deruelle
- European Genomic Institute for Diabetes, University School of Medicine, Lille, France.,Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology and Metabolism, Lille University Hospital, Lille, France .,European Genomic Institute for Diabetes, University School of Medicine, Lille, France.,Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
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15
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Grabarz A, Ghesquière L, Debarge V, Ramdane N, Delporte V, Bodart S, Deruelle P, Subtil D, Garabedian C. Cesarean section complications according to degree of emergency during labour. Eur J Obstet Gynecol Reprod Biol 2020; 256:320-325. [PMID: 33264691 DOI: 10.1016/j.ejogrb.2020.11.047] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Evaluate the complications rate of cesarean section delivery based on degree of labour emergency. STUDY DESIGN Monocentric (Lille, France), retrospective study of all term, singleton, and cesarean deliveries during labour. Three groups were categorized based on the degree of emergency according to a color code: green (no time limit between surgical decision and birth), orange (birth within 30 min), and red (birth within 20 min). Scheduled cesareans were excluded. Complications were defined as minor/major and intra-/post-operative. RESULTS A total of 881 patients were included. Among these, 303 (34.5 %) were in the green group, 353 (40.1 %) in the orange group, and 225 (25.4 %) in the red group. Major intra-operative complications, mainly postpartum hemorrhage, were more frequent in the red group compared with the green group (16.9 % vs. 9.9 %, p = 0.05; OR 1.9; 95 % CI [1.1-3.1]). Among the minor complications, there was no difference on moderate postpartum hemorrhage and four times uterine artery wounds in the red group (1.7 % vs. 7.1 %, respectively; p = 0.007; OR 4.6; 95 % CI [1.6-12.6]). The overall major post-operative complication rate, mainly infectious morbidity, was 6.1 % and this was more frequent in the red group compared with the green group (12.4 % vs. 1.7 %, respectively; p < 0.0001; OR 8.5; 95 % CI [3.2-22.3]). CONCLUSION Pre- and post-operative complications of cesarean section delivery during labour (i.e., emergency cesarean) increase with the degree of labour emergency. It would be ideal to identify women in labour who are at increased risk of emergency cesarean earlier, so that the situation does not escalate to a red code cesarean.
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Affiliation(s)
- A Grabarz
- CHU Lille, Department of Obstetrics, F-59000 Lille, France
| | - L Ghesquière
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
| | - V Debarge
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - N Ramdane
- CHU Lille, Studies and Research in Medical Informatics Center, F-59045 Lille cedex, France
| | - V Delporte
- CHU Lille, Department of Obstetrics, F-59000 Lille, France
| | - S Bodart
- CHU Lille, Department of Obstetrics, F-59000 Lille, France
| | - P Deruelle
- CHU Lille, Department of Obstetrics, F-59000 Lille, France
| | - D Subtil
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - C Garabedian
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
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16
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Barbotin AL, Dauvergne A, Dumont A, Ramdane N, Mitchell V, Rigot JM, Boitrelle F, Robin G. Bilateral versus unilateral cryptorchidism in nonobstructive azoospermia: Testicular sperm extraction outcomes. Asian J Androl 2020; 21:445-451. [PMID: 30880688 PMCID: PMC6732891 DOI: 10.4103/aja.aja_2_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia (NOA) in adulthood. Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism, previous studies have only described small cohorts or inhomogeneous population. Consequently, we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA, and compared testicular sperm extraction (TESE) outcomes between men with bilateral versus unilateral cryptorchidism. Our results show no difference in follicle-stimulating hormone (FSH) levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism (median: 21.3 IU l−1vs 19.3 IU l−1, P = 0.306; and 7.2 ml vs 7.9 ml, P = 0.543, respectively). In addition, sperm retrieval rates were similar (66.2% vs 60.0%, P = 0.353). Using multivariate analysis, we have found that only a low inhibin B level (above the assay's detection limit) was positively associated with successful sperm retrieval (P < 0.05). Regarding intracytoplasmic sperm injection outcomes, we found that cumulative pregnancy rate and live birth rate per cycle were not statistically different between the two groups (17.4% vs 27.8%, P = 0.070; and 16.1% vs 26.4%, P = 0.067, respectively). Unexpectedly, there was no significant difference in hormonal profiles (FSH, luteinizing hormone [LH], testosterone, and inhibin B levels) and TESE outcomes between unilateral versus bilateral cryptorchidism. This suggests that a history of unilateral cryptorchidism could reflect a bilateral testicular impairment. Interestingly, inhibin B level might be a predictor of successful TESE.
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Affiliation(s)
- Anne-Laure Barbotin
- CHU Lille, Reproductive Biology-Spermiology- CECOS Institute, Jeanne de Flandre Hospital, F-59000 Lille, France.,EA4308: Gametogenesis and Gamete Quality, Lille University, F-59000 Lille, France
| | - Anaïs Dauvergne
- CHU Lille, Department of Andrology, Calmette Hospital, F-59000 Lille, France
| | - Agathe Dumont
- CHU Lille, Department of Endocrine Gynaecology and Reproductive Medicine, Jeanne de Flandre Hospital, F-59000 Lille, France
| | - Nassima Ramdane
- CHU Lille, Department of Biostatistics, EA2694, Lille University, F-59000 Lille, France
| | - Valérie Mitchell
- CHU Lille, Reproductive Biology-Spermiology- CECOS Institute, Jeanne de Flandre Hospital, F-59000 Lille, France.,EA4308: Gametogenesis and Gamete Quality, Lille University, F-59000 Lille, France
| | - Jean-Marc Rigot
- EA4308: Gametogenesis and Gamete Quality, Lille University, F-59000 Lille, France.,CHU Lille, Department of Andrology, Calmette Hospital, F-59000 Lille, France
| | - Florence Boitrelle
- Fertility Unit, Poissy-Saint-Germain-en-Laye General Hospital, 78303 Poissy, France
| | - Geoffroy Robin
- EA4308: Gametogenesis and Gamete Quality, Lille University, F-59000 Lille, France.,CHU Lille, Department of Andrology, Calmette Hospital, F-59000 Lille, France.,CHU Lille, Department of Endocrine Gynaecology and Reproductive Medicine, Jeanne de Flandre Hospital, F-59000 Lille, France
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17
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Delsart P, Soquet J, Ramdane N, Ramond C, Mugnier A, Rousse N, Ledieu G, Bical A, Loobuyck V, Jegou B, Modine T, Hysi I, Fabre O, Juthier F, Vincentelli A, Mounier-Vehier C. Aortic morphology post type A acute aortic syndrome: Prognosis significance and association with 24-hour blood pressure-monitoring parameters. J Card Surg 2020; 35:981-987. [PMID: 32176383 DOI: 10.1111/jocs.14512] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome. METHODS The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis. RESULTS The population included 79 males, with an overall mean age of 60 ± 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg ± 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P < .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24). CONCLUSION The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
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Affiliation(s)
| | - Jérôme Soquet
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Nassima Ramdane
- METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, CHU Lille, ULR 2694, Lille, France
| | | | | | - Natacha Rousse
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | | | - Antoine Bical
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
| | - Valentin Loobuyck
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Bruno Jegou
- CHU Lille, Institut Cœur Poumon, Lille, France
| | | | - Ilir Hysi
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Olivier Fabre
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Francis Juthier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Andre Vincentelli
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Claire Mounier-Vehier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
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18
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Leclerc X, Guillaud O, Reyns N, Hodel J, Outteryck O, Bala F, Bricout N, Bretzner M, Ramdane N, Pruvo JP, Hacein-Bey L, Kuchcinski G. Follow-Up MRI for Small Brain AVMs Treated by Radiosurgery: Is Gadolinium Really Necessary? AJNR Am J Neuroradiol 2020; 41:437-445. [PMID: 32029465 DOI: 10.3174/ajnr.a6404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/17/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Follow-up MR imaging of brain AVMs currently relies on contrast-enhanced sequences. Noncontrast techniques, including arterial spin-labeling and TOF, may have value in detecting a residual nidus after radiosurgery. The aim of this study was to compare noncontrast with contrast-enhanced MR imaging for the differentiation of residual-versus-obliterated brain AVMs in radiosurgically treated patients. MATERIALS AND METHODS Twenty-eight consecutive patients with small brain AVMs (<20 mm) treated by radiosurgery were followed with the same MR imaging protocol. Three neuroradiologists, blinded to the results, independently reviewed the following: 1) postcontrast images alone (4D contrast-enhanced MRA and postcontrast 3D T1 gradient recalled-echo), 2) arterial spin-labeling and TOF images alone, and 3) all MR images combined. The primary end point was the detection of residual brain AVMs using a 5-point scale, with DSA as the reference standard. RESULTS The highest interobserver agreement was for arterial spin-labeling/TOF (κ = 0.81; 95% confidence interval, 0.66-0.93). Regarding brain AVM detection, arterial spin-labeling/TOF had higher sensitivity (sensitivity, 85%; specificity, 100%; 95% CI, 62-97) than contrast-enhanced MR imaging (sensitivity, 55%; specificity, 100%; 95% CI, 27-73) and all MR images combined (sensitivity, 75%; specificity, 100%; 95% CI, 51-91) (P = .008). All nidus obliterations on DSA were detected on MR imaging. In 6 patients, a residual brain AVM present on DSA was only detected with arterial spin-labeling/TOF, including 3 based solely on arterial spin-labeling images. CONCLUSIONS In this study of radiosurgically treated patients with small brain AVMs, arterial spin-labeling/TOF was found to be superior to gadolinium-enhanced MR imaging in detecting residual AVMs.
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Affiliation(s)
- X Leclerc
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France .,Inserm U1171, Degenerative and Vascular Cognitive Disorders (X.L., O.O., J.-P.P., G.K.), University of Lille, Lille, France
| | - O Guillaud
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France
| | - N Reyns
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France.,Inserm U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology (N. Reyns), University of Lille, Lille, France
| | - J Hodel
- Department of Neuroradiology (J.H.), Hôpital Henri Mondor, Créteil, France; EA 2694-Public Health: Epidemiology and Quality of Care (N. Ramdane), University of Lille, Centre Hospitalier Universitaire Lille, Lille, France
| | - O Outteryck
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France.,Inserm U1171, Degenerative and Vascular Cognitive Disorders (X.L., O.O., J.-P.P., G.K.), University of Lille, Lille, France
| | - F Bala
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France
| | - N Bricout
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France
| | - M Bretzner
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France
| | - N Ramdane
- Department of Neuroradiology (J.H.), Hôpital Henri Mondor, Créteil, France; EA 2694-Public Health: Epidemiology and Quality of Care (N. Ramdane), University of Lille, Centre Hospitalier Universitaire Lille, Lille, France
| | - J-P Pruvo
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France.,Inserm U1171, Degenerative and Vascular Cognitive Disorders (X.L., O.O., J.-P.P., G.K.), University of Lille, Lille, France
| | - L Hacein-Bey
- Neuroradiology, Radiology Department (L.H.-B.), University of California Davis School of Medicine, Sacramento, California
| | - G Kuchcinski
- From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France.,Inserm U1171, Degenerative and Vascular Cognitive Disorders (X.L., O.O., J.-P.P., G.K.), University of Lille, Lille, France
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19
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Maugendre E, Gadisseux B, Chantelot C, Clavert P, Ramdane N, Werthel JD, Boileau P. Epidemiology and mortality in older patients treated by reverse shoulder arthroplasty for displaced proximal humerus fractures. Orthop Traumatol Surg Res 2019; 105:1509-1513. [PMID: 31732395 DOI: 10.1016/j.otsr.2019.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/27/2019] [Accepted: 07/16/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Reverse shoulder arthroplasty (RSA) is rapidly becoming the preferred treatment for displaced proximal humerus fractures in older patients. However, few studies have analyzed the target population and the effect of RSA on survival, although the socioeconomic impact of this type of surgery is considerable. PATIENTS AND METHODS This was a retrospective epidemiological study of all patients with a displaced proximal humeral fracture treated by RSA in 14 public and private hospitals throughout France between 1995 and 2016. The French hospital discharge database (PMSI) was analyzed to isolate an 898-patient cohort who underwent RSA within 6 weeks of the fracture event. In 87% of cases, this was a 3- or 4-fragment fracture. We analyzed the epidemiological characteristics of the patients at the time of fracture, their survival (Kaplan-Meier estimate) and factors that may impact survival. RESULTS The mean age at the time of fracture and surgery was 79 years (46-98 years). Eighty percent of the cohort was female (sex ratio: 0.18 [p=0.0042], with 21% obesity rate [BMI>30]) and 60% of patients were ASA 1-2. The most common comorbidities were cardiovascular and neurological. The survival rate after RSA was 94% at 1 year and 73% at 5years. At the latest follow-up of 19 years, 42% of patients were still alive. In 18% of cases, the patient died within the first 15 days. The presence of comorbidities (ASA score>3-4) (p<0.004) and/or cognitive disorders (p<0.0001) were risk factors for early mortality. The time to surgery, type of fracture, associated fractures and discharge destination (return home, transfer to nursing home) had no effect on postoperative mortality in our cohort. CONCLUSION Despite being older (79 years) at the time of proximal humerus fracture, patients who underwent RSA treatment had a high survival rate (94% at 1 year, 73% at 5years), which is better than the survivorship reported after surgical treatment of femoral neck fractures (81-87% at 1 year, 38% at 5years). The presence of comorbidities (ASA>3-4) and/or cognitive disorders are risk factors for early mortality and should be taken into account to prevent early death. LEVEL OF EVIDENCE IV, Retrospective study.
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Affiliation(s)
- Emmanuel Maugendre
- Service de traumatologie, CHRU de Lille, hôpital Roger Salengro, 2, avenue Oscar-Lambret, 59037 Lille, France
| | - Benjamin Gadisseux
- Service de traumatologie, CHRU de Lille, hôpital Roger Salengro, 2, avenue Oscar-Lambret, 59037 Lille, France
| | - Christophe Chantelot
- Service de traumatologie, CHRU de Lille, hôpital Roger Salengro, 2, avenue Oscar-Lambret, 59037 Lille, France
| | - Philippe Clavert
- Service d'orthopédie-traumatologie, centre de chirurgie orthopédique et de la main, service de chirurgie orthopédique, avenue Baumann, 67400 Illkirch, France
| | - Nassima Ramdane
- EA 2694 - santé publique: épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - Jean-David Werthel
- Hôpital Ambroise-Paré Paris, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France
| | - Pascal Boileau
- iULS - Institut universitaire locomoteur and sport, CHU de Nice, hôpital Pasteur 2, 30, voie Romaine, 06000 Nice, France.
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- Société française de chirurgie orthopédique et traumatologique, 56, rue Boissonade, 75014 Paris, France
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Pouessel G, Jean-Bart C, Deschildre A, Van der Brempt X, Tanno LK, Beaumont P, Dumond P, Sabouraud-Leclerc D, Beaudouin E, Ramdane N, Liabeuf V, Renaudin JM. Food-induced anaphylaxis in infancy compared to preschool age: A retrospective analysis. Clin Exp Allergy 2019; 50:74-81. [PMID: 31651059 DOI: 10.1111/cea.13519] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Little is known regarding food anaphylaxis in infancy. We aimed to describe specificities of food anaphylaxis in infants (≤12 months) as compared to preschool children (1-6 years). METHODS We conducted a retrospective study of all food anaphylaxis cases recorded by the Allergy Vigilance Network from 2002 to 2018, in preschool children focusing on infants. RESULTS Of 1951 food anaphylaxis reactions, 61 (3%) occurred in infants and 386 (20%) in preschool children. Two infants had two anaphylaxis reactions; thus, we analyzed data among 59 infants (male: 51%; mean age: 6 months [SD: 2.9]); 31% had a history of atopic dermatitis, 11% of previous food allergy. The main food allergens were cow's milk (59%), hen's egg (20%), wheat (7%) and peanut (3%) in infants as compared with peanut (27%) and cashew (23%) in preschool children. Anaphylaxis occurred in 28/61 (46%) cases at the first cow's milk intake after breastfeeding discontinuation. Clinical manifestations were mainly mucocutaneous (79%), gastrointestinal (49%), respiratory (48%) and cardiovascular (21%); 25% of infants received adrenaline. Hives, hypotension and neurologic symptoms were more likely to be reported in infants than in preschool children (P = .02; P = .004; P = .002, respectively). Antihistamines and corticosteroids were more often prescribed in preschool children than in infants (P = .005; P = .025, respectively). CONCLUSION Our study found that in infants presenting with their first food allergy, in a setting with a high rate of infant formula use, the most predominant trigger was cow's milk. As compared to older preschool children, hives, hypotonia and hypotension were more likely to be reported in infants. We believe that this represents a distinct food anaphylaxis phenotype that can further support developing the clinical anaphylaxis criteria in infants.
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Affiliation(s)
- Guillaume Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, CHU Lille, Lille, France.,Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
| | | | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, CHU Lille, Lille, France.,Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
| | - Xavier Van der Brempt
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Allergopôle, Clinique Saint-Luc, Bouge, Belgium
| | - Luciana Kase Tanno
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,University Hospital, Montpellier, France.,INSERM UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Université, Paris, France.,Hospital Sírio Libanês, São Paulo, Brazil
| | - Pascale Beaumont
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Medical office, Saint-Maur des Fossés, France
| | - Pascale Dumond
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Allergology Department, Children's hospital, University Hospital Nancy, Vandoeuvre-lès-Nancy, France
| | - Dominique Sabouraud-Leclerc
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Department, American Memorial Hospital, Reims, France
| | - Etienne Beaudouin
- Department of Allergology and Clinical Immunology, Mercy Hospital, Metz-Thionville, France
| | - Nassima Ramdane
- EA 2694, Public health epidemiology and quality of care, University of Lille, Lille, France
| | - Valérie Liabeuf
- Department of Dermatology, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - Jean-Marie Renaudin
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Allergy Care Unit University Hospital, Vandoeuvre-lès-Nancy, France
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- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
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21
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Delporte V, Grabarz A, Ramdane N, Bodart S, Debarge V, Subtil D, Garabedian C. Cesarean during labor: Is induction a risk factor for complications? J Gynecol Obstet Hum Reprod 2019; 48:757-761. [PMID: 31479772 DOI: 10.1016/j.jogoh.2019.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Evaluate the impact of labor induction on maternal complications following caesarean section during labor. MATERIAL AND METHODS Retrospective, single-center study between 2015 and 2017. Were included singleton pregnancies who had cesarean section during labor after 37WG. Labor induction procedures included either transcervical balloon catheters or prostaglandins. Degree of emergency of the cesarean was decided according to color code (green, orange and red). We identified and compared intra and postoperative complications according to the mode of labor onset, and then to the mode of labor induction. RESULTS 882 patients were included, 416 with spontaneous labor and 464 with labor induction. No significant difference was found for postoperative complications between the two groups. Patients with spontaneous labor had fewer green-code caesareans than patients with elective induction (29.3% vs. 40.3% p<0.001) and had more uterine pedicle injuries (6.3% vs. 3.0% p=0.022). Nevertheless, no difference was found for postpartum hemorrhage (PPH) between these two groups (41.59% vs. 43.32% p=0.60). The subgroup study of patients with labor induction showed that those necessitating 2 methods of labor induction had more severe PPH (22.2% vs. 8.1% p after Bonferroni correction = 0.002). CONCLUSIONS Elective induction does not result in an increased risk of cesarean section during labor complications. Only the use of prostaglandin following transcervical balloon catheter increased the risk of severe postpartum hemorrhage.
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Affiliation(s)
- Victoire Delporte
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France.
| | - Anne Grabarz
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France
| | - Nassima Ramdane
- Univ. Lille, CHU Lille, EA 2694 - Public Health: Epidemiology and Quality of Patient Care, F-59000 Lille, France
| | - Sophie Bodart
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France
| | - Véronique Debarge
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France; University of Lille, EA 4489 - Perinatal Health and Environment, F-59000 Lille, France
| | - Damien Subtil
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France
| | - Charles Garabedian
- CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France
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22
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Erivan R, Matthieu PA, Boyer B, Reina N, Rhame M, Rouchy RC, Moreau S, Sanchez T, Roche O, Caton J, Rouvillain JL, Missenard G, Ramdane N, Mulliez A, Descamps S, Boisgard S. Use of morselized allografts for acetabular reconstruction during THA revision: French multicenter study of 508 cases with 8 years' average follow-up. Orthop Traumatol Surg Res 2019; 105:957-966. [PMID: 31147251 DOI: 10.1016/j.otsr.2019.02.025] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/29/2019] [Accepted: 02/11/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the context of acetabular reconstruction, bone defects can be filled with processed or unprocessed bone allografts. Published data are often contradictory on this topic and few studies have been done comparing processed allografts to fresh-frozen ones. This led us to conduct a large study to measure the factors impacting the survival of THA revision: (1) type of allograft and cup, (2) technical factors or patient-related factors. HYPOTHESIS Acetabular reconstruction can be performed equally well with frozen or processed morselized allografts. MATERIALS AND METHODS This retrospective, multicenter study of acetabular reconstruction included 508 cases with a minimum follow-up of 5 years. The follow-up for the frozen grafts was shorter (7.86 years±1.89 [5-12.32]) than that of the processed grafts (8.22 years±1.77 [5.05-15.48]) (p=0.029). However, the patients were younger at the time of the primary THA procedure in the frozen allograft group (51.5 years±14.2 [17-80]) than in the processed group (57.5 years±13.0 [12-94]) (p<0.001) and were also younger at the time of THA revision (67.8 years±12.2 [36.9-89.3] versus 70 years±11.7 [25-94.5]) (p=0.041). RESULTS There were more complications overall in the frozen allograft group (46/242=19.0%) than the processed allograft group (35/256=13.2%) (p=0.044) with more instances of loosening in the frozen group (20/242 [8.2%]) than in the processed group (6/266 [3.3%])(p=0.001). Conversely, the dislocation rate (16/242=6.6% vs. 17/266=6.4%) (p=0.844) and infection rate (18/242=7.4% vs. 15/266=5.7%) (p=0.264) did not differ between groups. The subgroup analysis reveal a correlation between the occurrence of a complication and higher body mass index (BMI) (p=0.037) with a higher overall risk of complications in patients with a BMI above 30 or under 20 (p=0.006) and a relative risk of 1.95 (95% CI: 1.26-2.93). Being overweight was associated with a higher risk of dislocation (relative risk of 2.46; 95% CI: 1.23-4.70) (p=0.007). Loosening was more likely to occur in younger patients at the time of the procedure (relative risk of 2.77; 95% CI: 1.52-6.51) (p=0.040) before 60 years during the revision. Lastly, patients who were less active preoperatively based on the Devane scale had an increased risk of dislocation (relative risk of 2.51; 95% CI: 1.26-8.26) (p=0.022). DISCUSSION Our hypothesis was not confirmed. The groups were not comparable initially, which may explain the differences found since the larger number of loosening cases in the frozen allograft group can be attributed to group heterogeneity. Nevertheless, morselized allografts appear to be suitable for acetabular bone defect reconstruction. A randomized study would be needed to determine whether frozen or processed allografts are superior. LEVEL OF EVIDENCE III, comparative retrospective study.
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Affiliation(s)
- Roger Erivan
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
| | - Pierre-Alain Matthieu
- Département d'orthopédie-traumatologie, CHU Limoges, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - Bertrand Boyer
- Inserm, U1059, 42270 Saint-Étienne, France; Université Saint-Étienne, 42270 Saint-Étienne, France; Service d'orthopédie, hôpital La Charité, hôpital Nord, CHU Saint-Étienne, 44, rue Pointe Cadet, 42055 Saint-Étienne, France
| | - Nicolas Reina
- Hôpital Pierre-Paul-Riquet, Institut Locomoteur, CHU de Toulouse, Allée Jean Dausset, 31059 Toulouse, France
| | - Michel Rhame
- Department of orthopaedic surgery and traumatology, Hautepierre hospital, Strasbourg university hospitals group, 1, avenue Molière, 67098 Strasbourg, France
| | - René-Christopher Rouchy
- Service de chirurgie orthopédique et de traumatologie du sport, urgences, hôpital Sud, CHU de Grenoble, 19, avenue de Kimberley, 38130 Échirolles, France
| | - Sébastien Moreau
- Hôpital Raymond Poincaré, CHU Paris Garches, 104, boulevard Raymond Poincaré, 92380 Garches, France
| | - Thomas Sanchez
- Chirurgie orthopédique et traumatologie du membre inférieur, CHU Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34000 Montpellier, France
| | - Olivier Roche
- Centre Chirurgical Emile Gallé, CHRU Nancy, 49, rue Hermite, 54000 Nancy, France
| | - Jacques Caton
- Institut de chirurgie orthopédique Lyon, 103, rue Coste, 69300 Caluire-et-Cuire, France
| | - Jean-Louis Rouvillain
- Service de chirurgie orthopédique et traumatologique, CHU La Meynard CS90632, 97261 Fort-de-France, Martinique, France
| | - Gilles Missenard
- Orthopaedic department, tumor and spine unit, Bicêtre university hospital, AP-HP, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France; JE 2494 université Paris-Sud Orsay, 01405 Orsay, France
| | - Nassima Ramdane
- Unité de méthodologie - biostatistique et Data Management, CHRU de Lille, 59037 Lille, France
| | - Aurélien Mulliez
- Délégation à la recherche clinique et aux innovations (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Stéphane Descamps
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Stéphane Boisgard
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France
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- 56, rue Boissonnade, 75014 Paris, France
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Putman S, Ehlinger M, Tillie B, Puliero B, Ramdane N, Remy F, Pasquier G. Total knee replacement on more than 20° valgus: A case control study. Orthop Traumatol Surg Res 2019; 105:613-617. [PMID: 30930092 DOI: 10.1016/j.otsr.2018.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Lower-limb valgus deformity exceeding 20° is a particular case, with few publications assessing the impact of the severity of the valgus. The present retrospective case control study compared a series of>20° valgus versus a series of 10-20° valgus, assessing (1) operative data [approach, type of total knee replacement (TKR)], (2) complications and implant survival, and (3) clinical and radiological results. HYPOTHESIS Severe valgus deformity requires TKR with greater constraint, incurring a higher rate of complications and poorer implant survival. MATERIAL AND METHOD A multicenter retrospective study for the period January 2006 to December 2010 included 53 patients, with a mean age of 72±10 years, presenting>20° valgus. The study series was matched for age and gender with a series of 53 cases of 10-20° valgus. Convexity laxity was greater in the>20° group (p=0.004). RESULTS There was no significant inter-group difference in approach (p=0.13). Greater constraint was more frequent in the>20° group (7/53 versus 1/53; p=0.03), independently of convexity laxity or Krackow grade (p=0.14). There were 7 complications (13.2%) in the>20° group and 7 in the 10-20° group (NS). Eight-year survivorship was 95.12% in the>20° group and 94.9% in the 10-20° group (p=0.63). There were no significant differences in Oxford score (p=0.30) or HKA angle (p=0.78) at last follow-up. CONCLUSION The study hypothesis was partially confirmed: greater constraint was more frequent in>20° valgus. The number of complications was low, and survival was identical to that of a control group with less severe deformity. LEVEL OF EVIDENCE III, retrospectivecase controlstudy.
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Affiliation(s)
- Sophie Putman
- Département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille, France.
| | - Matthieu Ehlinger
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France; Laboratoire ICube, CNRS UMR 7357, 30, boulevard Sébastien-Brant, 67400 Ilkirch, France
| | - Bruno Tillie
- Hôpital privé Les Bonnettes, 2, rue du Dr Forgeois, BP 990, 62012 Arras, France
| | - Benjamin Puliero
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Nassima Ramdane
- University Lille, CHU Lille, EA 2694 - santé publique: epidémiologie et qualité des soins, 59000 Lille, France
| | - Franck Remy
- Clinique chirurgicale de Saint-Omer, 71, rue Ambroise-Paré, 62575 Blendecques, France
| | - Gilles Pasquier
- Département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille, France
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- Société française de chirurgie de la hanche et du genou (SFHG), 56, rue Boissonade, 75014 Paris cedex, France
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Mesli V, Le Garff E, Marchand E, Labreuche J, Ramdane N, Maynou C, Delannoy Y, Hédouin V. Determination of the age of bruises using a bilirubinometer. Forensic Sci Int 2019; 302:109831. [PMID: 31255841 DOI: 10.1016/j.forsciint.2019.05.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/22/2018] [Revised: 03/22/2019] [Accepted: 05/22/2019] [Indexed: 11/29/2022]
Abstract
The dating of bruises can be of crucial interest in clinical forensic medicine, but the macroscopic or photographic evaluation of a bruise has not been regarded as reliable. Several methods have thus been regularly evaluated for this purpose, with reflectance spectrometry yielding promising results. The objective of this study is to evaluate the value of a bilirubinometer as a tool for dating bruises on living victims. A clinical follow-up was carried out on patients presenting a bruise with a known onset. Using a bilirubinometer, we obtained daily measurements of the bruise (bili-bruise) and of healthy skin (bili-skin). Potential confounding factors were collected: age, sex, body mass index, trauma mechanism and Fitzpatrick skin phototype. We followed 20 patients for a total of 88 measurements of bruises. Bili-skin values showed significant differences according to skin phototype. Differences between the bili-bruise and bili-skin values (Δ-bili) followed an increase phase, peaking between 3 and 5 days, and then there was a decrease phase. No significant Δ-bili value differences were observed based on the suspected confounding factors. Our results are in favour of a peak Δ-bili value generally at day 4 or 5 post-trauma. Notably, decreasing values were not observed before day 3. Decreasing Δ-bili values would then indicate a bruise resulting from an injury formed at least 3 days before the first measurement. Complementary work confirming such data would enable improvement of the performance of bruise dating in forensic medicine.
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Affiliation(s)
- Vadim Mesli
- Univ. Lille, EA 7367 - UTML - Unité de Taphonomie Médico-Légale, F-59000 Lille, France; CHU Lille, Service de Médecine Légale, F-59000, France.
| | - Erwan Le Garff
- Univ. Lille, EA 7367 - UTML - Unité de Taphonomie Médico-Légale, F-59000 Lille, France; CHU Lille, Service de Médecine Légale, F-59000, France
| | - Elodie Marchand
- Univ. Lille, EA 7367 - UTML - Unité de Taphonomie Médico-Légale, F-59000 Lille, France; CHU Lille, Service de Médecine Légale, F-59000, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Nassima Ramdane
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Carlos Maynou
- CHU Lille, Service d'orthopédie, F-59000 Lille, France
| | - Yann Delannoy
- CHU Lille, Service de Médecine Légale, F-59000, France
| | - Valéry Hédouin
- Univ. Lille, EA 7367 - UTML - Unité de Taphonomie Médico-Légale, F-59000 Lille, France; CHU Lille, Service de Médecine Légale, F-59000, France
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Pouessel G, Cerbelle V, Lejeune S, Leteurtre S, Ramdane N, Deschildre A. Anaphylaxis admissions in pediatric intensive care units: Follow-up and risk of recurrence. Pediatr Allergy Immunol 2019; 30:341-347. [PMID: 30589462 DOI: 10.1111/pai.13015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow-up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis. METHODS We conducted a telephone survey of 166 children (≤18 years) hospitalized from 2003 to 2013. RESULTS In all, 106 (64%) completed the survey (boys, 59%; mean age [SD]: 15.3 years [5.5]). The main index triggers were drugs (45%) and foods (37%). The mean duration follow-up was of 7.7 years (SD: 2.4). Thirty-eight (36%) children experienced 399 new allergic reactions during a follow-up period of 282 patient-years (incidence rate: 1.4/100 patients/y; 95% CI: 0.64-2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/y; 95% CI non-calculable). Food was the trigger for 79% of recurrent reactions and drugs for 8%. The food trigger was previously known in 83%, the same as the index trigger in 69%. Overall, 1.5% of the recurrent reactions were treated with adrenaline injection and 8% an emergency hospital admission. Patients with recurrence had more likely a history of food allergy (P < 10-4 ), asthma (P < 0.005), atopic dermatitis (P < 0.05) than those without. 31% of the 50 children with food allergy did not see an allergist, 23% had no adrenaline auto-injector, and 26% lacked a school individual healthcare plan. CONCLUSIONS Following a PICU admission for anaphylaxis, recurrence is high in children with food allergy compared with drug allergy. Allergic comorbidities increase the risk. Medical follow-up has to be improved for these at-risk children.
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Affiliation(s)
- Guillaume Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Valentine Cerbelle
- Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Stephanie Lejeune
- Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Stephane Leteurtre
- Pediatric Intensive Care Unit, CHU Lille, Lille, France.,EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, University of Lille, Lille, France
| | | | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
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Ohl X, Bonnevialle N, Gallinet D, Ramdane N, Valenti P, Decroocq L, Boileau P. How the greater tuberosity affects clinical outcomes after reverse shoulder arthroplasty for proximal humeral fractures. J Shoulder Elbow Surg 2018; 27:2139-2144. [PMID: 30082121 DOI: 10.1016/j.jse.2018.05.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Our purpose was to evaluate the clinical and radiologic outcomes of reverse shoulder arthroplasty for proximal humeral fractures in a large cohort of elderly patients and compare the results in the case of tuberosity excision, failed fixation, or anatomic healing. METHODS In this retrospective multicenter study, 420 patients underwent review and radiography with a minimum follow-up period of 12 months. The patients were divided into 3 groups according to the status of the greater tuberosity (GT) on the last anteroposterior radiographs: anatomic GT healing (group A, n = 169); GT resorption, malunion, or nonunion (group B, n = 131); and GT excision (group C, n = 120). Complications were recorded; shoulder function, active mobility, and subjective results were assessed. RESULTS At a mean follow-up of 28 months, the mean Simple Shoulder Value in group A (75%) outperformed the results found in groups B (69%, P < .001) and C (56%, P < .001). Overall, the mean adjusted Constant-Murley score was significantly higher in group A (93% ± 22%) than in group B (82% ± 22%) and group C (80% ± 24%) (P < .001), but there was no difference between groups B and C (P = .88). Anterior active elevation and external rotation were significantly better in group A than in groups B and C (P < .001). The instability rate was significantly higher in group C (n = 15 [12.5%], P < .001) than in group A (n = 2) or group B (n = 3). CONCLUSION In elderly patients who have undergone a reverse shoulder arthroplasty for acute proximal humeral fractures, anatomic tuberosity healing improves objective and subjective outcomes. GT excision is associated with the worst functional results and increases the risk of postoperative shoulder instability.
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Affiliation(s)
- Xavier Ohl
- Orthopaedic Department, University Hospital, Reims, France
| | - Nicolas Bonnevialle
- Department of Orthopaedic Surgery, Riquet Hospital, University of Toulouse, Toulouse, France.
| | | | - Nassima Ramdane
- Unité de Méthodologie-Biostatistique et Data Management, Lille, France
| | | | - Lauryl Decroocq
- Department of Orthopaedic Surgery, iULS (Institut Universitaire Locomoteur & Sport), University of Nice Sophia Antipolis, Nice, France
| | - Pascal Boileau
- Department of Orthopaedic Surgery, iULS (Institut Universitaire Locomoteur & Sport), University of Nice Sophia Antipolis, Nice, France
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- French Society of Orthopedic Surgery and Traumatology, Paris, France
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Boyer B, Pailhé R, Ramdane N, Eichler D, Remy F, Ehlinger M, Pasquier G. Under-corrected knees do not fail more than aligned knees at 8 years in fixed severe valgus total knee replacement. Knee Surg Sports Traumatol Arthrosc 2018; 26:3386-3394. [PMID: 29594324 DOI: 10.1007/s00167-018-4906-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/21/2018] [Indexed: 11/21/2022]
Abstract
PURPOSES A fixed severe valgus knee is a surgical challenge. A safe post-operative Hip-Knee-Ankle angle (HKA) range of 180° ± 4 was recommended, but recent studies mentioned equal results from outliers of this range. Nevertheless, no distinction was made between varus and valgus knees, as well as over-corrected or under-corrected knees. Did post-operative nonaligned total knee replacements (TKR) from fixed severe valgus knees behave differently from the properly aligned population? Did over-corrected knees behave differently from under-corrected knees? METHODS Through a multi-center retrospective cohort study, we provided 557 knees of at least 10° of minimal pre-operative valgus; in this population 75 presented a post-operative Hip-Knee-Ankle angle (HKA) outside of the 180° ± 4 range; 23 of them had at least 5° of varus; 52 of them had at least 5° of valgus. Median pre-operative HKA of the entire cohort was 194° (range 190-198). Median follow-up was 8 years (range 5-11); Knee Society Score (KSS) results, HKA, Femoral and Tibial Mechanical Angles (FMA, TMA) and complication rates were obtained. The outlier group (HKA ≤ 175 or ≥ 185) was compared to the control group (HKA 180 ± 4); over-corrected (HKA ≤ 175) and under-corrected (HKA ≥ 185) sub-groups were individually tested against the control group. RESULTS The outlier group had a lower Final Knee Score than the aligned group (p = 0.023). In the over-corrected sub-group, median post-operative FMA was 88° (SD 4°) and median TMA was 87° (SD 4°). The complication rate was higher (p = 0.019). Knee (p = 0.018), Function (p = 0.034) and Final Knee Scores (p = 0.03) were statistically lower than in the control group. In the under-corrected sub-group, mean post-operative FMA was 93° (SD 2°) and mean TMA was 91° (SD 2°). The complication rate was lower (p = 0.019) and there was no difference with the control group concerning KSS. CONCLUSIONS In case of pre-operative fixed severe valgus knee, one should avoid over-correcting HKA angle and especially the TMA. Over-correction of a severe preoperative valgus in a post-operative varus was prejudicial for TKA survival. Keeping a severe valgus knee in low valgus to avoid using a more constrained implant and/or ligament releases will not decrease the 5-10 year implant survival and functional scores. LEVEL OF EVIDENCE Level IV-Case series.
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Affiliation(s)
- Bertrand Boyer
- Service de chirurgie orthopédique, Centre Hospitalier Universitaire de Saint Etienne, 25 bld Pasteur, 42055, Saint-Étienne, France. .,Faculté de Médecine, J. Lisfranc Mines de Saint Etienne, INSERM U1059, Saint-Étienne, France.
| | - Régis Pailhé
- Orthopédie et traumatologie du sport, centre hospitalier universitaire Grenoble Alpes, Hôpital Sud, BP 217X, 38043, Grenoble cedex, France
| | - Nassima Ramdane
- Service de Biostatistiques du CHRU de Lille, rue Emile Laine, 59037, Lille, France.,Université de Lille, Hauts de France, Lille, France
| | - David Eichler
- Service de chirurgie orthopédique et traumatologique, centre hospitalier universitaire de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | - Franck Remy
- Clinique de Saint Omer, 71 rue Ambroise Paré, 62575, Blendecques, France
| | - Matthieu Ehlinger
- Service de chirurgie orthopédique et traumatologique, centre hospitalier universitaire de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | - Gilles Pasquier
- Université de Lille, Hauts de France, Lille, France.,Service d'Orthopédie, centre hospitalier universitaire de Lille, rue Emile Laine, 59037, Lille, France
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Deltombe-Bodart S, Grabarz A, Ramdane N, Delporte V, Depret S, Deruelle P, Garabedian C. [Compliance to the color codes protocol according to the indication of cesarean and to the decision-to-delivery interval]. ACTA ACUST UNITED AC 2018; 46:575-579. [PMID: 29983276 DOI: 10.1016/j.gofs.2018.06.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Evaluation of the compliance of the color codes protocol according to the indication of ceasarean section and on the decision-to-delivery interval according to the color code, the operator and the period. METHODS This is a retrospective monocentric study including women who had to undergo an emergency cesarean section after 37 weeks of amenorrhea in the Jeanne-de-Flandre hospital between 2015 and 2017. Three groups were created: cesarean section with green code, orange code and red code. We compared population characteristics and obstetrical data, then drew up a reassessed color code and analyzed the correspondence between the initial color code and the reassessed one. Finally, we considered the respect of decision-to-delivery interval according to color code, operator level and period. RESULTS Eight hundred and eighty-one patients were included, amongst which 303 (34%) fell into the green c-section, 353 (40%) into the orange c-section and 225 (26%) into the red c-section. In the three groups, there was a significant consistency between the initial color code and the reassessed one, with a kappa agreement test of 95% 0.95 (0.93-0.97). The average decision-to-delivery interval was 37±20min for the green c-section, 20±6min for the orange c-section and 12±3min for the red c-section with a significant respect of the decision-to-delivery interval according to color code P<0.001. The decision-to-delivery interval was similar considering the operator level and the period. CONCLUSION In our study, we observed the compliance with color code regarding the indication of ceasarean section and the respect of the decision-to-delivery interval whatever the time of occurrence and the operator.
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Affiliation(s)
- S Deltombe-Bodart
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France.
| | - A Grabarz
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - N Ramdane
- EA 2694, département de biostatistiques, université de Lille, centre hospitalier universitaire de Lille, santé publique, épidémiologie et qualité de la santé, 59000 Lille, France
| | - V Delporte
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - S Depret
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - P Deruelle
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France; EA 4489, université de Lille, santé périnatale et environnement, 59000 Lille, France
| | - C Garabedian
- Département d'obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier universitaire de Lille, 59000 Lille, France; EA 4489, université de Lille, santé périnatale et environnement, 59000 Lille, France
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Girard E, Lacour A, Abi Rached H, Ramdane N, Templier C, Dziwniel V, Desmedt E, Le Rhun E, Mortier L. Occurrence of vismodegib-induced cramps (muscular spasms) in the treatment of basal cell carcinoma: A prospective study in 30 patients. J Am Acad Dermatol 2018; 78:1213-1216.e2. [PMID: 29203435 DOI: 10.1016/j.jaad.2017.11.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 11/02/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Edwina Girard
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France.
| | - Arnaud Lacour
- Center for Rare Neuromuscular Disorders, CHU Lille, Lille, France
| | - Henry Abi Rached
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France
| | - Nassima Ramdane
- Public Health, Epidemiology, and Quality Management, University of Lille, CHU Lille, Lille, France
| | - Carole Templier
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France
| | - Véronique Dziwniel
- Modern Languages Department, University of Lille, Centrale Lille, Villeneuve d'Ascq, France
| | - Eve Desmedt
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France
| | - Emilie Le Rhun
- Neurooncology, Department of Neurosurgery, CHU Lille, France; Breast unit, Department of Medical Oncology, Oscar Lambret Center, University of Lille, Institut National de la Santé et de la Recherche Médicale (INSERM) U1192, Laboratory of Proteomics, Inflammatory Response and Mass Spectrometry, Lille, France
| | - Laurent Mortier
- Department of Dermatology, University of Lille, INSERM U1189, CHU Lille, Lille, France
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Girard J, Lons A, Ramdane N, Putman S. Hip resurfacing before 50years of age: A prospective study of 979 hips with a mean follow-up of 5.1years. Orthop Traumatol Surg Res 2018; 104:295-299. [PMID: 29277514 DOI: 10.1016/j.otsr.2017.10.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/11/2017] [Accepted: 10/27/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA) for the treatment of hip osteoarthritis in patients younger than 50 years. Data on revision rates after HRA are conflicting. The National Institute for Health and Care Excellence (NICE) recommends performing only those hip arthroplasty procedures associated with 10-year revision rates no greater than 5% (0.5% per year). Follow-up studies can rapidly determine whether this criterion is met. The uncertainties surrounding revision rates after HRA prompted us to design a study of prospectively enrolled patients aiming (1) to determine the revision rate after HRA performed before 50years of age and (2) to assess the functional, radiological, and biological outcomes of HRA. HYPOTHESIS The revision rate after HRA performed before 50years of age meets the NICE criterion. MATERIAL AND METHODS Consecutive patients undergoing HRA before 50years of age were enrolled prospectively. The same implant was used in all patients. Functional outcomes were assessed based on the Harris Hip Score (HHS), Postel-Merle d'Aubigné (PMA) score, 12-item Oxford Hip Score (OHS), and UCLA activity score. Radiographic outcomes were assessed, and blood levels of chromium and cobalt were assayed. RESULTS The study included 936 patients (979 HRAs) with a mean age of 42.7years (16.4-50.0years) at surgery and a mean follow-up of 5.1years (range: 3.1-9.0 years). All four mean functional scores were significantly improved at last follow-up vs. baseline: HHS, 95.9 (39.0-100) vs. 44.3 (18.0-83.0); PMA score, 17.6 (6.0-18.0) vs. 11.7 (3.0-16.0); OHS, 14.3 (12.0-37.0) vs. 40.6 (25.0-60.0); and UCLA activity score, 7.8 (2.0-10.0) vs. 5.6 (1.0-10.0) (p<0.0001). Mean cup inclination in the coronal plane was 42.1° (25.0°-68.0°). Mean blood cobalt level was significantly higher at last follow-up than at baseline (1.36μg/L [0.05-8.2μg/L] vs. 0.61μg/L [0.01-3.6]) (p<0.001). No patient experienced dislocation. Revision was required for 17 hips and involved changing the implant in 12 (1.2%). The 10-year survival rate with implant change, as the endpoint was 98.7% (95%CI, 97.6%-99.3%), indicating that the NICE criterion was easily met. DISCUSSION The NICE criterion allows the rapid identification of prostheses with insufficient survival. HRA is theoretically associated with a high risk of aseptic mechanical loosening, as it is performed in young patients who have a high level of physical activity. Nevertheless, our study showed that implant survival after HRA was better than required by the NICE criterion. Thus, HRA is a valid alterative to THA in patients younger than 50years. LEVEL OF EVIDENCE IV, prospective study with no control group.
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Affiliation(s)
- J Girard
- Université Lille Nord de France, 59000 Lille, France; Département de médecine du sport, faculté de médecine de Lille, université de Lille 2, 59000 Lille, France; Service d'orthopédie, hôpital salengro, CHU Lille, place de Verdun, 59000 Lille, France.
| | - A Lons
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital salengro, CHU Lille, place de Verdun, 59000 Lille, France
| | - N Ramdane
- Unité de biostatistiques, EA 2694, Santé publique : épidémiologie et qualité des soins, centre hospitalier universitaire Lille, université Lille, 59000 Lille, France
| | - S Putman
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital salengro, CHU Lille, place de Verdun, 59000 Lille, France
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Putman S, Argenson JN, Bonnevialle P, Ehlinger M, Vie P, Leclercq S, Bizot P, Lustig S, Parratte S, Ramdane N, Colmar M. Ten-year survival and complications of total knee arthroplasty for osteoarthritis secondary to trauma or surgery: A French multicentre study of 263 patients. Orthop Traumatol Surg Res 2018; 104:161-164. [PMID: 29292123 DOI: 10.1016/j.otsr.2017.11.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/15/2017] [Accepted: 11/19/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous surgical procedures raise technical challenges in performing total knee arthroplasty (TKA) and may affect TKA outcomes. Survival rates of TKA done after trauma or surgery to the knee have not been accurately determined in large populations. The objectives of this retrospective study in 263 patients with TKA after knee trauma or surgery and a follow-up of 10 years were to assess survival, functional outcomes, and the nature and frequency of complications. HYPOTHESIS Knee trauma or surgery before TKA increases the risk of complications and decreases implant survival. MATERIAL AND METHODS Two hundred and sixty-three patients (122 [47%] females and 141 [53%] males) underwent TKA between 2005 and 2009 at nine centres in France. Mean age at surgery was 61 years. The patients had knee osteoarthritis secondary to a fracture (n=66), osteotomy (n=131), or ligament injury (n=66). Mean time from trauma or surgery to TKA was 145 months (range, 72-219 months). RESULTS Major complications were infection (n=12, 4.5%), skin problems (n=8, 3%), and stiffness (n=8, 3%). Ten-year survival to implant exchange for any reason was 89%±2.8%. Flexion range increased by 2.5°±17° (p=0.02) to a mean of 110° (range, 30° to 140°); extension range increased by 4°±7° (p<0.001) to a mean of -1.19 (range, -20° to 0°). Of the 263 patients, 157 (60%) reported little or no pain at last follow-up. Mean postoperative hip-knee-ankle angle was 179°±3.2° (range, 171°-188°). CONCLUSION TKA performed after knee injury or surgery carries a risk of specific complications (infection, skin problems, and stiffness) and may have a lower survival rate compared to primary TKA. LEVEL OF EVIDENCE IV, retrospective cohort study.
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Affiliation(s)
- S Putman
- Département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, rue Emile-laine, 59037 Lille, France.
| | - J-N Argenson
- Département de chirurgie orthopédique, hôpital Sainte-Marguerite, hôpital universitaire de Marseille, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - P Bonnevialle
- Département d'orthopédie et de traumatologie, hôpital P.P.-Riquet, place Baylac, 31052 Toulouse cedex, France
| | - M Ehlinger
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Vie
- Clinique du Cèdre, 950, rue de la Haie, 76230 Bois-Guillaume, France
| | - S Leclercq
- CHP Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France
| | - P Bizot
- Service de chirurgie orthopédique et traumatologique, hôpital Lariboisière, université Paris Diderot, 3, rue Amboise-Paré, 75010 Paris, France
| | - S Lustig
- Département de chirurgie orthopédique, centre Albert-Trillat, hôpital de la Croix-Rousse, 103, boulevard de la Croix-Rousse, 69004 Lyon, France
| | - S Parratte
- Département de chirurgie orthopédique, hôpital Sainte-Marguerite, hôpital universitaire de Marseille, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - N Ramdane
- EA 2694 - Santé publique : épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - M Colmar
- Hôpital privé des Côtes-d'Armor, 12, rue François-Jacob, 22198 Plerin, France
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- 56, rue Boissonade, 75014 Paris cedex, France
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Phung TV, Houfflin-Debarge V, Ramdane N, Ghesquière L, Delsalle A, Coulon C, Subtil D, Vaast P, Garabedian C. Maternal red blood cell alloimmunization requiring intrauterine transfusion: a comparative study on management and outcome depending on the type of antibody. Transfusion 2018; 58:1199-1205. [DOI: 10.1111/trf.14542] [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: 05/03/2017] [Revised: 01/11/2018] [Accepted: 01/13/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Thanh-Vy Phung
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
| | - Véronique Houfflin-Debarge
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
- Perinatal Environment and Growth; EA 4489, University of Lille North of France; Lille France
| | - Nassima Ramdane
- Department of Biostatistics; EA 2694, UDSL, CHU Lille; Lille France
| | - Louise Ghesquière
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
- Perinatal Environment and Growth; EA 4489, University of Lille North of France; Lille France
| | - Anne Delsalle
- Etablissement français du Sang, Nord Pas de Calais; France
| | - Capucine Coulon
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
| | - Damien Subtil
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
- Perinatal Environment and Growth; EA 4489, University of Lille North of France; Lille France
| | - Pascal Vaast
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
| | - Charles Garabedian
- Department of Obstetrics, Jeanne de Flandre Hospital, CHU Lille; Lille France
- Perinatal Environment and Growth; EA 4489, University of Lille North of France; Lille France
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Fessy MH, Putman S, Viste A, Isida R, Ramdane N, Ferreira A, Leglise A, Rubens-Duval B, Bonin N, Bonnomet F, Combes A, Boisgard S, Mainard D, Leclercq S, Migaud H. Erratum to "What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips" [Orthop. Traumatol. Surg. Res. 103 (2017) 663-8]. Orthop Traumatol Surg Res 2017; 103:1137. [PMID: 28923403 DOI: 10.1016/j.otsr.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M H Fessy
- Université de Lyon, 69622 Lyon, France; Service de chirurgie orthopédique et traumatologique, centre hospitalier Lyon Sud, hospices civils de Lyon, 165, chemin Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - S Putman
- Service d'orthopédie C, hôpital Roger-Salengro, université de Lille Nord de France, centre hospitalier régional universitaire de Lille (CHRU de Lille), place de Verdun, 59000 Lille cedex, France; EA 2694, santé publique, épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - A Viste
- Université de Lyon, 69622 Lyon, France; Service de chirurgie orthopédique et traumatologique, centre hospitalier Lyon Sud, hospices civils de Lyon, 165, chemin Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - R Isida
- Service d'orthopédie C, hôpital Roger-Salengro, université de Lille Nord de France, centre hospitalier régional universitaire de Lille (CHRU de Lille), place de Verdun, 59000 Lille cedex, France.
| | - N Ramdane
- EA 2694, santé publique, épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - A Ferreira
- Clinique du Parc-Lyon, 155 ter, boulevard de Stalingrad, 69006 Lyon, France
| | - A Leglise
- Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France
| | - B Rubens-Duval
- Clinique universitaire de chirurgie orthopédique et de traumatologie du sport, hôpital Sud, CHU de Grenoble, 38130 Échirolles, France
| | - N Bonin
- Lyon-ortho-clinic, 29B, avenue des Sources, 69009 Lyon, France
| | - F Bonnomet
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Combes
- Centre othopédique Flemming, 30C, avenue Fleming, 38300 Bourgoin-Jallieu, France
| | - S Boisgard
- Service de chirurgie orthopédique et traumatologique, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - D Mainard
- Service de chirurgie orthopédique et traumatologique, hôpitaux universitaires de Nancy, 29, avenue Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - S Leclercq
- CHP Saint-Martin, 18, rue des Roquemonts, 14050 Caen, France
| | - H Migaud
- Service d'orthopédie C, hôpital Roger-Salengro, université de Lille Nord de France, centre hospitalier régional universitaire de Lille (CHRU de Lille), place de Verdun, 59000 Lille cedex, France
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- Société française de chirurgie de la hanche et du genou (SFHG), 56, rue Boissonade, 75014 Paris, France
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Fessy MH, Putman S, Viste A, Isida R, Ramdane N, Ferreira A, Leglise A, Rubens-Duval B, Bonin N, Bonnomet F, Combes A, Boisgard S, Mainard D, Leclercq S, Migaud H. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips. Orthop Traumatol Surg Res 2017. [PMID: 28629944 DOI: 10.1016/j.otsr.2017.05.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. HYPOTHESIS Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. PATIENTS AND METHODS A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). RESULTS The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with an OR of 3.9 (95% CI: 2.15-7.1), history of spinal disease (lumbar stenosis, spinal fusion, discectomy, scoliosis and injury sequelae) with an OR of 1.89 (95% CI: 1.0-3.6), unrepaired joint capsule (all approaches) with an OR of 4.1 (95% CI: 2.3-7.37), unrepaired joint capsule (posterior approach) with an OR of 6.0 (95% CI: 2.2-15.9), and cup inclination outside Lewinnek's safe zone (30°-50°) with OR of 2.4 (95% CI: 1.4-4.0). DISCUSSION This large comparative study isolated important patient-related factors for dislocation that surgeons must be aware of. We also found evidence that implanting the cup in 30° to 50° inclination has a major impact on preventing dislocation. LEVEL OF EVIDENCE Level III; case-control study.
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Affiliation(s)
- M H Fessy
- Clinique du Parc-Lyon, 155 ter, boulevard de Stalingrad, 69006 Lyon, France
| | - S Putman
- Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France
| | - A Viste
- Clinique du Parc-Lyon, 155 ter, boulevard de Stalingrad, 69006 Lyon, France
| | - R Isida
- Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France.
| | - N Ramdane
- Clinique universitaire de chirurgie orthopédique et de traumatologie du sport, hôpital Sud, CHU de Grenoble, 38130 Échirolles, France
| | - A Ferreira
- Lyon-Ortho-Clinic, 29B, avenue des Sources, 69009 Lyon, France
| | - A Leglise
- Service de chirurgie orthopédique et de traumatologie, CHU Hautepierre, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - B Rubens-Duval
- Centre orthopédique Flemming, 30C, avenue Fleming, 38300 Bourgoin Jallieu, France
| | - N Bonin
- Service de chirurgie orthopédique et traumatologique, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - F Bonnomet
- Service de chirurgie orthopédique et traumatologique, hôpitaux universitaires de Nancy, 29, avenue Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - A Combes
- CHP Saint-Martin, 18, rue des Roquemonts, 14050 Caen, France
| | - S Boisgard
- Société française de chirurgie de la hanche et du genou (SFHG), 56, rue Boissonade, 75014 Paris, France
| | - D Mainard
- Service de chirurgie orthopédique et traumatologique, hôpitaux universitaires de Nancy, 29, avenue Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - S Leclercq
- CHP Saint-Martin, 18, rue des Roquemonts, 14050 Caen, France
| | - H Migaud
- Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France
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Reina N, Putman S, Desmarchelier R, Sari Ali E, Chiron P, Ollivier M, Jenny JY, Waast D, Mabit C, de Thomasson E, Schwartz C, Oger P, Gayet LE, Migaud H, Ramdane N, Fessy MH. Can a target zone safer than Lewinnek's safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls. Orthop Traumatol Surg Res 2017. [PMID: 28629942 DOI: 10.1016/j.otsr.2017.05.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Various factors contribute to instability of total hip arthroplasty (THA), with implant orientation being a major contributor. We performed a case-control study with computed tomography (CT) data to determine whether: 1) orientation contributes to THA instability and 2) a safer target zone for stability than Lewinnek's classic safe zone can be defined. MATERIAL AND METHODS We included prospectively 363 cases of THA dislocation that occurred during the calendar 2013 year in 24 participating hospitals. Of the 128 dislocations that occurred in patients who underwent THA at these centers, 56 (24 anterior, 32 posterior) had CT scans, thus were included in the analysis. The control group was matched 4:1 based on implant type, year of implantation, age, sex, bearing types and THA indication. Of the 428 matched control THA cases, 93 had CT scans. In all, the CT scans from 149 cases (56 unstable, 93 stable) were analyzed to determine the acetabular cup's inclination and anteversion, and the femoral stem's anteversion. RESULTS In the unstable THA group, cup inclination was 46.9°±7.4°, cup anteversion was 20.4°±10.8° and stem anteversion was 14.2°±9.9°. In the stable THA group, cup inclination was 44.9°±5.3° (P=0.057), cup anteversion was 22.1°±5.1° (P=0.009) and stem anteversion was 13.4°±4.4° (P=0.362). The optimal total anteversion (cup+stem) of 40-60° was achieved in 16.5% of unstable THA cases and 13.9% of stable THA cases, thus this parameter does not predict stability (odds ratio [OR] of 0.40, P=0.144). The cup was positioned in Lewinnek's safe zone in 44.6% of patients in the unstable group and 68.2% of those in the stable group (OR 3.74, P=0.003). A target zone defined as 40-50° inclination and 15-30° anteversion was better able to distinguish between unstable cases (23.2%) and stable cases (71.6%) resulting in an OR of 13.91 (P<0.001). DISCUSSION Implant positioning was the only risk factor for instability found in this study. Moreover, our findings reinforce the theory put forward by other authors that Lewinnek's safe zone is not specific enough to differentiate between stable and unstable THA implantations. The target zone for acetabular cups proposed here (40-50° inclination and 15°-30° anteversion) is related to a lower risk of instability. This orientation can be used as a guide, but must be combined with other technical elements to optimize stability. By balancing stability and biomechanics, the 40-50° inclination and 15°-30° anteversion target zone redefines the optimal positioning window. LEVEL OF EVIDENCE III case-control study.
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Affiliation(s)
- N Reina
- Institut locomoteur (ILM), hôpital Pierre-Paul-Riquet, CHU de Toulouse, 31059 Toulouse, France.
| | - S Putman
- Hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France
| | - R Desmarchelier
- Service de chirurgie orthopédique et traumatologique, hospices civils de Lyon, centre hospitalier Lyon-Sud, université de Lyon, 69002 Pierre-Bénite, France
| | - E Sari Ali
- Service de chirurgie orthopédique et traumatologique, hôpital la Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - P Chiron
- Institut locomoteur (ILM), hôpital Pierre-Paul-Riquet, CHU de Toulouse, 31059 Toulouse, France
| | - M Ollivier
- Service de chirurgie orthopédique et traumatologique, hôpital St. Marguerite, 13009 Marseille, France
| | - J Y Jenny
- Service de chirurgie orthopédique et traumatologique, hôpital de Hautepierre, CHU de Strasbourg, 67091 Strasbourg, France
| | - D Waast
- Service de chirurgie orthopédique et traumatologique, Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - C Mabit
- Service de chirurgie orthopédique et traumatologique, CHU Dupuytren, avenue M.-Luther-King, CHU de Limoges, 87000 Limoges, France
| | - E de Thomasson
- Institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - C Schwartz
- Centre d'orthopédie clinique des 3-frontières, 68300 Saint-Louis, France
| | - P Oger
- Hopital A.-Mignot, 177, route De-Versailles, 78150 Le Chesnay, France
| | - L E Gayet
- Service de chirurgie orthopédique et traumatologique, CHU de Poitiers, 86021 Poitiers, France
| | - H Migaud
- Hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France
| | - N Ramdane
- Unité de biostatistique, pôle de santé publique, CHRU de Lille, 59000 Lille, France
| | - M H Fessy
- Service de chirurgie orthopédique et traumatologique, hospices civils de Lyon, centre hospitalier Lyon-Sud, université de Lyon, 69002 Pierre-Bénite, France
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Delsart P, Ledieu GJ, Ramdane N, Sobocinski JP, Clough RE, Azzaoui RO, Mounier-vehier C, Nienaber CA, Haulon S. Impact of the Management of Type B Aortic Dissection on the Long-Term Blood Pressure. Am J Cardiol 2017; 120:484-488. [PMID: 28583684 DOI: 10.1016/j.amjcard.2017.04.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 01/16/2023]
Abstract
Ambulatory blood pressure (BP) measurement (ABPM) is recommended to assess optimal BP control, and we studied its influence after an acute type B aortic dissection (ATBAD). We retrospectively collected data from 111 patients with ATBAD from January 2004 to September 2014. Controlled BP group was defined according to a 24-hour BP under 130/80 mm Hg during chronic phase. The population consisted of 85 men, with a mean age of 61 ± 13 years and mean body mass index of 28 ± 6 kg/m2. The median delay between ambulatory BP measurement and ATBAD was 2 (0.3 to 4) months. The mean 24-hour BP of the entire population was 124/71 ± 15/8.8 mm Hg. BP was not controlled in 41 patients (37%). The treatment score at discharge was 3.9 ± 1.4. The mean glomerular filtration rate was 83 ± 28 ml/min/1.73 m2, with no difference between groups. Visceral stent implantation in the acute phase (odds ratio [OR] 3.857 [1.199 to 12.406], p = 0.023), higher left ventricular ejection fraction (OR 1.092 [1.005 to 1.187], p = 0.038), and higher platelet count at discharge (OR 1.064 [1.018 to 1.112], p = 0.006) were identified as predictors of good BP control by multivariate analysis. The analysis showed that nighttime systolic BP was associated with aortic events during follow-up (hazard ratio [HR] 5.2 [1.01 to 27.2], p = 0.049), particularly for a threshold of 124 mm Hg or more (HR 1.967 [1.052 to 3.678], p = 0.0341). Nighttime pulse pressure showed also its significance (HR 20.1 [1.4 to 282.7], p = 0.026). In conclusion, subclinical renal malperfusion revascularization seems to improve BP control. A greater nighttime systolic BP was associated with the risk of new aortic events during follow-up.
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Weisenburger-Lile D, Lopez D, Russel S, Kahn JE, Veiga Hellmann A, Scherrer A, Ramdane N, Wang A, Evrard S, Decroix JP, Mellot F, Bourdain F, Lapergue B. IRMA study: Prevalence of subdiaphragmatic visceral infarction in ischemic stroke and atrial fibrillation. Int J Stroke 2016; 12:421-424. [PMID: 28093965 DOI: 10.1177/1747493016677983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/16/2022]
Abstract
Background Occult atrial fibrillation (AF) may, in part, explain cryptogenic stroke. A 22% prevalence of subdiaphragmatic visceral infarction (SDVI) among patients with ischemic stroke (IS) due to AF has been reported, using abdominal MRI. We sought to assess the reproducibility of this method and to confirm that SDVI is more prevalent in cases of AF-caused IS than in IS of other etiologies. Methods In consecutive patients admitted to our hospital, we compared SDVI prevalence in three groups: patients with IS due to AF (IS+/AF+ group), patients with stroke of another determined cause (IS+/AF- group) and patients with AF without stroke (IS-/AF+ group). Results A total of 111 patients were included. The median time between inclusion and abdominal MRI was six days. SDVI was more frequent in the IS+/AF+ group ( n = 10; 21.3%), than in IS+/AF- ( n = 1; 3.3%) and IS-/AF+ ( n = 0) groups, p = 0.002. The most frequent localization was the kidney. Conclusions The prevalence of SDVI was higher among patients with AF-caused IS. In cases of cryptogenic stroke, a positive abdominal MRI may suggest occult AF as the cause and identify a high risk of AF in this subgroup of patients.
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Affiliation(s)
- David Weisenburger-Lile
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Delphine Lopez
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Stephanie Russel
- 2 Department of Cardiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Jean-Emmanuel Kahn
- 3 Department of Internal Medicine, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Ana Veiga Hellmann
- 4 Department of Geriatrics, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Antoine Scherrer
- 5 Department of Radiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Nassima Ramdane
- 6 Department of Biostatistics, Univ. Lille, épidémiologie et qualité des soins, Lille, France
| | - Adrien Wang
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Serge Evrard
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Jean-Pierre Decroix
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Francois Mellot
- 5 Department of Radiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Frederic Bourdain
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
| | - Bertrand Lapergue
- 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
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Gonzales F, Ramdane N, Delebarre-Sauvage C, Modiano P, Duhamel A, Lasek A. Monitoring of topical corticosteroid phobia in a population of parents with children with atopic dermatitis using the TOPICOP®scale: prevalence, risk factors and the impact of therapeutic patient education. J Eur Acad Dermatol Venereol 2016; 31:e172-e174. [DOI: 10.1111/jdv.13961] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Gonzales
- Unité de dermatopédiatrie; Hôpital Saint Vincent de Paul; GHICL Lille; Lille France
| | - N. Ramdane
- Département de Biostatistiques; Université Lille Nord de France; Lille France
| | - C. Delebarre-Sauvage
- Service d'allergologie adultes et enfants; Hôpital Saint Vincent de Paul; GHICL Lille; Lille France
| | - P. Modiano
- Service de dermatologie; Hôpital Saint Vincent de Paul; GHICL Lille; Lille France
| | - A. Duhamel
- Département de Biostatistiques; Université Lille Nord de France; Lille France
| | - A. Lasek
- Service de dermatologie; Hôpital Saint Vincent de Paul; GHICL Lille; Lille France
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Moitrel G, Roumazeille T, Arnould A, Migaud H, Putman S, Ramdane N, Pasquier G. Does severity of femoral trochlear dysplasia affect outcome in patellofemoral instability treated by medial patellofemoral ligament reconstruction and anterior tibial tuberosity transfer? Orthop Traumatol Surg Res 2015; 101:693-7. [PMID: 26362043 DOI: 10.1016/j.otsr.2015.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 05/21/2015] [Accepted: 06/01/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Medial patellofemoral ligament (MPFL) reconstruction associated to anterior tibial tuberosity transfer (ATTT) is recommended in objective patellofemoral instability (PFI). Efficacy, however, has not been precisely determined in trochlear dysplasia with spur. A case-control study was performed in a PFI population, comparing groups with trochlear dysplasia with and without spur (S+ vs. S-) to assess the impact of trochlear dysplasia on (1) patellofemoral stability, (2) functional results and complications, and (3) patellofemoral cartilage status on MRI. HYPOTHESIS Trochlear spur does not affect outcome in PFI managed by MPFL reconstruction and ATTT. MATERIAL AND METHODS Twenty-eight knees (26 patients) with PFI were analyzed retrospectively and divided into 2 groups of 14 knees each according to presence of trochlear spur (S+ vs. S-). All 28 knees had undergone ATTT and MPFL reconstruction by semitendinosus autograft. Results were assessed on Lille and IKDC functional scores, and cartilage status was determined on MRI at last follow-up. RESULTS At a mean 24 months' follow-up (range, 12-52 months), there was no recurrence of dislocation. IKDC and Lille scores tended to improve in both groups, although the only significant improvement was in IKDC score (S- gain, 21.3±16; S+ gain, 18.1±14) (P=0.01). IKDC scores at last follow-up were better in the S+ than S- group (79±19 [range, 21-92] vs. 68±13 [range, 35-84], respectively; P=0.012). Lille scores showed no significant inter-group differences in mean gain (P=0.492) or mean value (P=0.381). The S+ group showed more cartilage lesions (n=14/14 knees, including 12/14 with grade≥2 lesions) than the S- group (n=9/14 knees, all grade≤2). CONCLUSION MPFL reconstruction with ATTT provided good short-term patellofemoral stability independently of the severity of trochlear dysplasia. Functional results and gain on IKDC, however, were poorer in case of dysplasia with trochlear spur. This is probably due to cartilage lesions, observed more frequently pre- and post-operatively in the spur group, especially as there was no significant difference in Lille Score, which highlights stability. LEVEL OF EVIDENCE III, retrospective case-control study.
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Affiliation(s)
- G Moitrel
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France.
| | - T Roumazeille
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - A Arnould
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - H Migaud
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - S Putman
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - N Ramdane
- Laboratoire de biostatistique, pôle de santé publique, CHRU de Lille, pôle de santé publique, 154, rue du Docteur-Yersin, Lille, France
| | - G Pasquier
- Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
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Lapergue B, Decroix JP, Evrard S, Wang A, Bendetowicz D, Offroy MA, Graveleau P, Russel S, Ramdane N, Mellot F, Scherrer A, Bourdain F. Diagnostic Yield of Venous Thrombosis and Pulmonary Embolism by Combined CT Venography and Pulmonary Angiography in Patients with Cryptogenic Stroke and Patent Foramen Ovale. Eur Neurol 2015; 74:69-72. [PMID: 26228469 DOI: 10.1159/000437261] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/28/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Paradoxical embolism via a patent foramen ovale (PFO) has been suggested as a potential stroke mechanism. Combined CT venography and pulmonary angiography (CVPA) is a simple, validated and accurate technique to diagnose deep venous thrombosis (DVT) or pulmonary embolism (PE). We sought to assess the prevalence of DVT or PE among patients with PFO and cryptogenic stroke (CS) by CVPA. METHODS Patients were identified retrospectively from a clinical registry of consecutive patients with stroke admitted to our Stroke Unit. The following criteria were required for inclusion in this study: CS, PFO identified by transthoracic echography using contrast medium and CVPA performed during the hospitalization following stroke. RESULTS A total of 114 patients with PFO underwent a CVPA within 7 days (interquartile range 4-9) from stroke symptom onset. On cerebral imaging, 11% had multiple infarcts. CVPA documented deep vein thrombosis (DVT) in 10 patients (8.8%) and PE in 5 patients (4.4%), that is, a total of 12 patients with prevalence of 10.5% (95% CI 5.5-17.7). Patients with PE-DVT had higher <smlcap>D</smlcap>-dimers and C reactive protein level than patients without PE-DVT (p < 0.05). CONCLUSION CVPA may be used by the stroke team in the work-up of suspected paradoxical embolism among cryptogenic ischemic stroke patients with PFO.
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Affiliation(s)
- Bertrand Lapergue
- Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France
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Desurmont T, Skrypek N, Duhamel A, Jonckheere N, Millet G, Leteurtre E, Gosset P, Duchene B, Ramdane N, Hebbar M, Van Seuningen I, Pruvot FR, Huet G, Truant S. Overexpression of chemokine receptor CXCR2 and ligand CXCL7 in liver metastases from colon cancer is correlated to shorter disease-free and overall survival. Cancer Sci 2015; 106:262-9. [PMID: 25580640 PMCID: PMC4376434 DOI: 10.1111/cas.12603] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 12/18/2014] [Accepted: 12/24/2014] [Indexed: 12/21/2022] Open
Abstract
Our aim was to analyze the potential role of chemokine receptors CXCR2 and CXCR4 signalling pathways in liver metastatic colorectal cancer (CRC) relapse. CXCR2, CXCR4, and their chemokine ligands were evaluated in liver metastases of colorectal cancer in order to study their correlation with overall and disease-free survival of patients having received, or not received, a neoadjuvant chemotherapy regimen. Quantitative RT-PCR and CXCR2 immunohistochemical staining were carried out using CRC liver metastasis samples. Expression levels of CXCR2, CXCR4, and their ligands were statistically analyzed according to treatment with neoadjuvant chemotherapy and patients’ outcome. CXCR2 and CXCL7 overexpression are correlated to shorter overall and disease-free survival. By multivariate analysis, CXCR2 and CXCL7 expressions are independent factors of overall and disease-free survival. Neoadjuvant chemotherapy increases significantly the expression of CXCR2: treated group 1.89 (0.02–50.92) vs 0.55 (0.07–3.22), P = 0.016. CXCL7 was overexpressed close to significance, 0.40 (0.00–7.85) vs 0.15 (0.01–7.88), P = 0.12. We show the involvement of CXCL7/CXCR2 signalling pathways as a predictive factor of poor outcome in metastatic CRC. 5-Fluorouracil-based chemotherapy regimens increase the expression of these genes in liver metastasis, providing one explanation for aggressiveness of relapsed drug-resistant tumors. Selective blockage of CXCR2/CXCL7 signalling pathways could provide new potential therapeutic opportunities.
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Affiliation(s)
- Thibault Desurmont
- Inserm, U837, Team-5 (Mucins, Epithelial Differentiation, and Carcinogenesis), Jean-Pierre Aubert Research Centre, Université Lille, France; Department of Digestive and Visceral Surgery, GHICL, Saint-Vincent de Paul Hospital, Lille, France
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Ehlinger M, Delaunay C, Karoubi M, Bonnomet F, Ramdane N, Hamadouche M. Revision of primary total hip arthroplasty for peri-prosthetic fracture: A prospective epidemiological study of 249 consecutive cases in France. Orthop Traumatol Surg Res 2014; 100:657-62. [PMID: 25172019 DOI: 10.1016/j.otsr.2014.03.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/11/2014] [Accepted: 03/27/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Revision total hip arthroplasty (reTHA) for peri-prosthetic fracture (PPF) is increasingly performed but still ranks fourth among reasons for reTHA in registries. In France, no specific registry is available and the frequency of PPF among reasons for THA revision is therefore unknown. Here, our objectives were to determine the relative frequency of PPF as a reason for reTHA, to identify patient-related and primary-THA-related factors associated with reTHA for PPF, to describe reTHA modalities for PPF, and to determine the morbidity and mortality associated with reTHA for PPF. HYPOTHESIS PPF is the second most common reason for reTHA, after loosening. METHODS Consecutive reTHA procedures performed in 30 French centres over a 2-year period were collected prospectively. Repeat revisions and revisions of hemi-arthroplasties were excluded. The epidemiological, clinical, and surgical data needed to answer the questions of the study were collected. RESULTS PPF was the second leading reason for reTHA (249/2107, 11.8%). Vancouver type B2 fractures were the most common (n=127 [51.5%]). Compared to patients who underwent reTHA for reasons other than PPF, those with reTHA for PPF were older at primary THA (67.9 years versus 57.7 years) and more often had intra-operative complications (16.9% versus 11.6%); furthermore, the primary THA was more often cementless (62.7% versus 42.7%) with a dual-mobility cup (20.6% versus 11.1%). At reTHA, the patients with PPF were older (77.6 years versus 69.2 years), had worst medical condition (mean ASA score, 2.4 versus 2.1) and less physically active (mean Devane score, 2.1 versus 2.4). The patients with reTHA for PPF had a shorter time to revision (9.8 years versus 11.4 years), a longer operative time (144 minutes versus 128 minutes), and more frequent use of the posterior approach (77% versus 67%) with a cementless dual-mobility cup (78% versus 60%) and a cementless revision femoral stem (72% versus 50%). Morbidity and mortality rates were high (5.9% operative complication rate and 12% of surgical complications with 4.8% mortality within the first 3 months) however, these results were similar to those in the rest of the cohort. DISCUSSION AND CONCLUSION PPF is the second most common reason for reTHA, a result that is at variance with data in national registries. LEVEL OF EVIDENCE Level IV, prospective observational cohort study.
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Affiliation(s)
- M Ehlinger
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - C Delaunay
- Clinique de l'Yvette, 67-69, route de Corbeil, 91160 Longjumeau, France
| | - M Karoubi
- Service de chirurgie orthopédique, centre hospitalo-universitaire Cochin-Port-Royal, 75014 Paris cedex 14, France
| | - F Bonnomet
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - N Ramdane
- Unité de biostatistiques, pôle de santé publique, CHRU de Lille, 59037 Lille, France
| | - M Hamadouche
- Service de chirurgie orthopédique, centre hospitalo-universitaire Cochin-Port-Royal, 75014 Paris cedex 14, France
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Renaud F, Gnemmi V, Devos P, Aubert S, Crépin M, Coppin L, Ramdane N, Bouchindhomme B, d'Herbomez M, Van Seuningen I, Do Cao C, Pattou F, Carnaille B, Pigny P, Wémeau JL, Leteurtre E. MUC1 expression in papillary thyroid carcinoma is associated with BRAF mutation and lymph node metastasis; the latter is the most important risk factor of relapse. Thyroid 2014; 24:1375-84. [PMID: 25012490 DOI: 10.1089/thy.2013.0594] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The incidence of papillary thyroid carcinoma (PTC) has increased over the past 30 years in Western countries. PTC is usually associated with a good prognosis, but there is a wide range of aggressiveness, and some patients develop distant metastasis and/or resistance to standard treatment. Early identification of these high-risk tumors is a current challenge for appropriate patient management. MUC1 expression has been studied previously in thyroid cancer, but its prognostic value remains controversial. Here, we correlated MUC1 expression in PTC with clinical and pathological features and with the presence of the BRAF(V600E) mutation. METHODS We performed a clinical and morphological analysis of 190 thyroid tumors (95 PTCs and 95 adenomas). MUC1 immunohistochemistry was carried out on a tissue microarray using different antibodies. The presence of the BRAF(V600E) mutation was investigated by pyrosequencing. MUC1 mRNA levels were assessed by quantitative reverse transcription polymerase chain reaction on a subset of PTC. RESULTS MUC1 expression was observed in 49% of PTCs and was found to correlate with the presence of papillary architecture, a stromal lymphoid infiltrate, aggressive histological subtypes, extrathyroidal extension, lymph node metastasis, nuclear pseudoinclusions, lymphovascular invasion, and the presence of the BRAF(V600E) mutation (p<0.0001). MUC1 was abundant in nuclear pseudoinclusions. Multivariate analysis showed a strong association of MUC1 expression with the presence of the BRAF(V600E) mutation and lymph node metastasis (p<0.0001). Lymph node metastasis was the most important risk factor of relapse. CONCLUSIONS Our study shows an association between MUC1 expression and the presence of the BRAF(V600E) mutation in PTC. Analysis of MUC1 expression could improve the risk stratification of PTCs.
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Affiliation(s)
- Florence Renaud
- 1 Institute of Pathology, Lille University Hospital , Lille, France
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Prasivoravong J, Marcelli F, Lemaître L, Pigny P, Ramdane N, Peers MC, Mitchell V, Rigot JM. Beneficial effects of varicocele embolization on semen parameters. Basic Clin Androl 2014; 24:9. [PMID: 25780583 PMCID: PMC4349315 DOI: 10.1186/2051-4190-24-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/28/2014] [Indexed: 11/18/2022] Open
Abstract
Background The value of varicocele repair and the latter's impact on semen parameters are still subject to debate. Methods We analyse changes over time in initially abnormal sperm parameters and serum concentrations of testosterone, FSH and inhibin B after embolization treatment of males with high-grade varicocele. From 2007 to 2012, we recruited 47 male infertile patients with clinically visible left varicocele in the resting patient and at least one abnormal semen parameter. Sperm parameters and serum levels of total testosterone, FSH and inhibin B were measured prior to retrograde embolization (M0) and then 3 (M3) and 6 (M6) months afterwards. Results At M0, the median sperm concentration was 5.78 [0.84-37.70] × 106/ejaculate. The mean ± SD sperm progressive motility, vitality and percentage of normal sperm were respectively, 21.83 ± 16.48%, 61.88 ± 15.98% and 12.88 ± 7.15%. The corresponding values at M3 were significantly higher (38.75 [3.96-95] × 106/ejaculate, 29.32 ± 14.21%, 69.14 ± 14.86% and 19.03 ± 11.02%, respectively). The mean percentage of spermatozoa with a thin head was significantly lower at M6 (6.35 ± 5.29%) than at M0 (14.03 ± 13.09%). The mean serum testosterone, FSH and inhibin B levels did not change significantly over time. Conclusions Embolization treatment in men with clinically visible left varicocele, abnormal sperm parameters and documented infertility is associated with a significant improvement in semen parameters including sperm head morphology.
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Affiliation(s)
- Julie Prasivoravong
- Department of Andrology, Lille University Hospital, Lille Cedex, France ; Department of Andrology, CHRU Lille, Hôpital Calmette, Boulevard du Professeur Leclercq, 59037 Lille Cedex, France
| | - François Marcelli
- Department of Andrology, Lille University Hospital, Lille Cedex, France
| | - Laurent Lemaître
- Department of Radiology, Lille University Hospital, Lille Cedex, France
| | - Pascal Pigny
- Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille Cedex, France
| | - Nassima Ramdane
- Department of Biostatistics, Lille University Hospital, Lille Cedex, France
| | - Marie-Claire Peers
- Biology of Reproduction Unit, Lille University Hospital, Lille Cedex, France
| | - Valérie Mitchell
- Biology of Reproduction Unit, Lille University Hospital, Lille Cedex, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille Cedex, France
| | - Jean-Marc Rigot
- Department of Andrology, Lille University Hospital, Lille Cedex, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille Cedex, France
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Reina N, Delaunay C, Chiron P, Ramdane N, Hamadouche M. Infection as a cause of primary total hip arthroplasty revision and its predictive factors. Orthop Traumatol Surg Res 2013; 99:555-61. [PMID: 23891660 DOI: 10.1016/j.otsr.2013.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Infection is a serious complication of total hip arthroplasty (THA) and is one of the most frequent causes of failure. The goal of this study was to evaluate the importance of infection among the different causes of revision THA and identify any risk factors specifically associated with this cause of revision. MATERIALS AND METHODS All patients who underwent a first revision of THA were included in a prospective multicenter study. Postoperative clinical and radiological evaluation and follow-up of morbidity and mortality were performed at 3 months. RESULTS Two hundred forty out of 2107 revisions (11.4%) were performed for infected THA, which was the third cause after aseptic loosening (42.3%) and peri-prosthetic fractures (11.8%). These patients had a higher BMI associated with co-morbidities and lower clinical scores than patients with other causes of revision. One-stage revision was performed in most cases (66%) with replacement of the complete implant in 86% of cases, resulting in longer surgery compared to that for other causes. Male gender (OR 2.3), avascular necrosis (OR 2.4), arthroplasties with dual mobility cups (OR 2.5) and a Rottinger anterolateral approach (OR 3.4) were all associated with an increased risk of infection. DISCUSSION Some of these risk factors are not or have rarely been reported in the literature. They should be taken into consideration to help in the prevention and continuing battle against THA infection. LEVEL OF EVIDENCE Level IV, prospective cohort study.
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Affiliation(s)
- N Reina
- ILM Institut locomoteur, Clinique Pierre-Paul-Riquet, Hôpital Purpan, CHU de Toulouse, Toulouse, France.
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