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Douillet D, Riou J, Morin F, Mahieu R, Chauvin A, Gennai S, Ferrant L, Lopez R, Sebbane M, Plantefeve G, Brice C, Cayeux C, Savary D, Moumneh T, Penaloza A, Roy PM. Derivation and validation of a risk-stratification model for patients with probable or proven COVID-19 in EDs: the revised HOME-CoV score. Emerg Med J 2024; 41:218-225. [PMID: 38365436 DOI: 10.1136/emermed-2022-212631] [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: 06/02/2022] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND The HOME-CoV (Hospitalisation or Outpatient ManagEment of patients with SARS-CoV-2 infection) score is a validated list of uniquely clinical criteria indicating which patients with probable or proven COVID-19 can be treated at home. The aim of this study was to optimise the score to improve its ability to discriminate between patients who do and do not need admission. METHODS A revised HOME-CoV score was derived using data from a previous prospective multicentre study which evaluated the original Home-CoV score. Patients with proven or probable COVID-19 attending 34 EDs in France, Monaco and Belgium between April and May 2020 were included. The population was split into a derivation and validation sample corresponding to the observational and interventional phases of the original study. The main outcome was non-invasive or invasive ventilation or all-cause death within 7 days following inclusion. Two threshold values were defined using a sensitivity of >0.9 and a specificity of >0.9 to identify low-risk and high-risk patients, respectively. The revised HOME-CoV score was then validated by retrospectively applying it to patients in the same EDs with proven or probable COVID-19 during the interventional phase. The revised HOME-CoV score was also tested against original HOME-CoV, qCSI, qSOFA, CRB65 and SMART-COP in this validation cohort. RESULTS There were 1696 patients in the derivation cohort, of whom 65 (3.8%) required non-invasive ventilation or mechanical ventilation or died within 7 days and 1304 patients in the validation cohort, of whom 22 (1.7%) had a progression of illness. The revised score included seven clinical criteria. The area under the curve (AUC) was 87.6 (95% CI 84.7 to 90.6). The cut-offs to define low-risk and high-risk patients were <2 and >3, respectively. In the validation cohort, the AUC was 85.8 (95% CI 80.6 to 91.0). A score of <2 qualified 73% of patients as low risk with a sensitivity of 0.77 (0.55-0.92) and a negative predictive value of 0.99 (0.99-1.00). CONCLUSION The revised HOME-CoV score, which does not require laboratory testing, may allow accurate risk stratification and safely qualify a significant proportion of patients with probable or proven COVID-19 for home treatment.
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Affiliation(s)
- Delphine Douillet
- Emergency Department, CHU Angers, University of Angers, CHU Angers, Angers, France
- UMR MitoVasc CNRS 6015 - INSERM 1083, Health Faculty, University of Angers; FCRIN, INNOVTE, Universite Angers Faculte des sciences, Angers, France
| | - Jérémie Riou
- Micro et Nano médecines Translationnelles, MINT, UNIV Angers, UMR INSERM 1066, UMR CNRS 6021, CHU Angers, Angers, France
- Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, Université Angers Faculté des Sciences, Angers, France
| | - François Morin
- Emergency Department, CHU Angers, University of Angers, CHU Angers, Angers, France
| | - Rafaël Mahieu
- Department of Infectious Disease, Angers University Hospital; University of Angers, CHU Angers, Angers, France
- CRCINA, Inserm U1232, University of Nantes-Angers, Universite Angers Faculte Des Sciences, Angers, France
| | - Anthony Chauvin
- Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Stéphane Gennai
- Emergency Department, Reims University Hospital, University Hospital Centre Reims, Reims, France
- UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Lionel Ferrant
- Emergency Department, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Raphaëlle Lopez
- Emergency Department, Sart Tilman University Hospital, Centre hospitalier universitaire de Liège, Liege, Belgium
| | - Mustapha Sebbane
- Emergency Department, Montpellier University Hospital, Montpellier, France
| | | | - Christian Brice
- Emergency Department, Centre Hospitalier de Saint Brieuc, Saint Brieuc, France
| | - Coralie Cayeux
- Emergency Department, Centre Hospitalier de Remiremont, Remiremont, France
| | - Dominique Savary
- Department of Emergency Medicine, University of Angers, ANGERS, France
- Inserm IRSET UMR_S1085, I, EHESP, Angers, France
| | | | - Andrea Penaloza
- Emergency, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Pierre Marie Roy
- Emergency Department, CHU Angers, University of Angers, CHU Angers, Angers, France
- UMR MitoVasc CNRS 6015 - INSERM 1083, Health Faculty, University of Angers; FCRIN, INNOVTE, Universite Angers Faculte des sciences, Angers, France
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Lefeuvre C, Pivert A, Przyrowski E, Bouthry E, Darviot E, Mahieu R, Lunel-Fabiani F, Ducancelle A, Le Guillou-Guillemette H. Comparison of performance between three SARS-CoV-2 molecular assays (Aptima™, Laboratory developed test-Fusion and R-GENE®) with a special attention on turn-around time, key point in the laboratory management. J Med Virol 2022; 94:3399-3403. [PMID: 35211992 PMCID: PMC9088664 DOI: 10.1002/jmv.27675] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 11/11/2022]
Abstract
The emergence of SARS-CoV-2 highlights the importance of rapid diagnostic testing to identify individuals with SARS-CoV-2 infections and to limit the spread of the virus. Many molecular assays have commercially available to cope with this surging demand for timely diagnosis of COVID-19 cases, but identifying individuals requires accurate diagnostic tools. We compared the performance of three molecular SARS-CoV-2 assays: Aptima™ SARS-CoV-2 assay running on the Panther system (Hologic), an in-house assay (Laboratory Developed Test) running on the Fusion module of the Panther-Fusion system (LDT-Fusion, Hologic) and the R-GENE® SARS-CoV-2 assay (bioMérieux). In addition, we also evaluated the turn-around time. This parameter is crucial to manage the SARS-CoV-2 diagnosis and represents a key point in the quality management at the laboratory. Aptima™ and LDT-Fusion assays exhibited an excellent positive percent agreement (PPA) (100.0%), while the R-GENE® assay showed a slightly decreased PPA (98.2%). The Hologic assays have a higher throughput with less hands-on time (HOT) than the R-GENE® assays (24-25 vs 71 min). Both Hologic assays are used on a fully automated random-access testing system with on-demand testing capabilities that avoids run series unlike R-GENE® assay. Automated random-access testing systems should be preferred during periods of high SARS-CoV-2 prevalence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | | | - Elise Bouthry
- Virology Department, Angers University Hospital, Angers, France
| | - Estelle Darviot
- Paediatric Department, Angers University Hospital, Angers, France
| | - Rafaël Mahieu
- Department of Infectious Diseases, Angers University Hospital, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Hélène Le Guillou-Guillemette
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
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3
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Lefeuvre C, Lefort C, Boyer F, Le Cam S, Mouna L, Roque-Afonso AM, Le Guillou-Guillemette H, Mahieu R. Transfusion-Transmitted Hepatitis A Virus, France, 2018. Emerg Infect Dis 2022; 28:219-223. [PMID: 34932935 PMCID: PMC8714218 DOI: 10.3201/eid2801.210403] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We report a transfusion-transmitted hepatitis A virus infection in an immunocompromised patient in France, detected shortly after a transfusion of pathogen-reduced pooled platelets. This case raises questions about the efficacy of donor screening methods. Additional safety measures, such as routine donation screening, should be considered.
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Declerck C, Mahieu R, Sanderink D, de la Chapelle M, Abgueguen P, Vandamme YM, Dubée V. Implementation of point-of-care ultrasonography in an infectious disease ward. Infect Dis Now 2021; 52:87-92. [PMID: 34896661 DOI: 10.1016/j.idnow.2021.11.008] [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: 07/28/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Point-of-care ultrasonography (POCUS) has emerged as an essential supplement to physical examination in many specialties. In contrast, its use by infectious diseases (ID) specialists remains anecdotal. Here, we report on the acquisition of an ultrasonography device in a French ID ward, and we describe its everyday use. METHODS A preliminary audit was conducted to evaluate the potential impact of the acquisition of an ultrasonography device. A second audit was performed during the first year following the acquisition of the device to quantify its everyday use. We also evaluated the impact of POCUS implementation on medical imaging requests by comparing the number of intra-hospital transports before and after the acquisition. RESULTS According to the first audit, 81 of the 199 (41%) imaging examinations that were prescribed during a two-month period could have been replaced by POCUS. During the first year following the acquisition of the ultrasonography device, POCUS was performed 240 times by 31 different operators. The operators were a senior physician, an intern, and a medical student in 94 (39%), 135 (57%), and 11 (5%) cases, respectively. The organs most frequently explored were the genito-urinary tract (n=74), the joints (n=35), and the lungs/pleura (n=35). Acquisition of the device was followed by a significant decrease in the number of transports to the ultrasonography room, whereas the total number of transports to the medical imaging ward did not change. CONCLUSION Opportunities to use POCUS in the ID ward are numerous. POCUS training should be part of the ID specialist's curriculum.
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Affiliation(s)
- C Declerck
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France.
| | - R Mahieu
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
| | - D Sanderink
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
| | - M de la Chapelle
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
| | - P Abgueguen
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
| | - Y M Vandamme
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
| | - V Dubée
- Infectious Disease and Tropical Medicine Ward, Angers University Hospital, Angers, France
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Douillet D, Riou J, Penaloza A, Moumneh T, Soulie C, Savary D, Morin F, Mahieu R, Roy PM. Risk of symptomatic venous thromboembolism in mild and moderate COVID-19: A comparison of two prospective European cohorts. Thromb Res 2021; 208:4-10. [PMID: 34653718 PMCID: PMC8498792 DOI: 10.1016/j.thromres.2021.10.001] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Severely ill patients with SARS-CoV-2 have an increased risk of venous thromboembolism (VTE) i.e., deep vein thrombosis and pulmonary embolism. However, the VTE risk in patients with mild and moderate COVID-19, hospitalized or managed at home, remain uncertain. The aims of this study were to assess the rate and the risk factors symptomatic VTE, in patients with mild and moderate COVID-19 and to compare them to a cohort of similar patients without COVID-19. METHODS Patients presenting to the emergency department (ED) of participating centers for confirmed or probable mild or moderate COVID-19 and not having acute VTE were included. This COVID-19 cohort was retrospectively compared to a prospective cohort of similar ED patients using propensity score matching. The main outcome was the rate of symptomatic VTE within the 28 days after ED presentation. RESULTS A total of 2292 patients were included in the COVID-19 cohort. The 28-day incidence of symptomatic VTE was 1.3% (n = 29/2292, 95%CI: 0.9 to 1.8), 2.3% (n = 20/866, 95%CI: 1.5 to 3.5) in moderate COVID-19 patients and 0.6% (n = 9/1426; 95%CI: 0.3 to 1.2) in mild COVID-19 patients managed as outpatients. An age over 65 years and hospitalization were independent risk factors of VTE. After adjustment, patients in the COVID-19 cohort had an absolute increase in over symptomatic VTE risk of +1.69% (95%CI, 0.88 to 2.51) versus patients in the comparison cohort (n = 1539). CONCLUSIONS Patients with moderate COVID-19 presenting to the ED had a high risk of subsequent VTE. TRIAL REGISTRATION Ethics committee of the CHU of Angers (N°2020/87).
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Affiliation(s)
- Delphine Douillet
- Emergency Department, Angers University Hospital, Angers, France,UNIV Angers, UMR MitoVasc CNRS 6015 - INSERM 1083, Angers, France,FCRIN, INNOVTE, Saint Etienne, France,Corresponding author at: Département de Médecine d'Urgence, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49100 Angers, France
| | - Jérémie Riou
- UNIV Angers, UMR MINT, INSERM 1066 - CNRS 6021, Angers, France,Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, Angers, France
| | - Andrea Penaloza
- FCRIN, INNOVTE, Saint Etienne, France,Emergency Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Thomas Moumneh
- Emergency Department, Angers University Hospital, Angers, France,UNIV Angers, UMR MitoVasc CNRS 6015 - INSERM 1083, Angers, France,FCRIN, INNOVTE, Saint Etienne, France
| | | | - Dominique Savary
- Emergency Department, Angers University Hospital, Angers, France,EHESP, Irset, UMR INSERM S1085, CAPTV CDC, University of Rennes, Rennes, France
| | - Francois Morin
- Emergency Department, Angers University Hospital, Angers, France
| | - Rafaël Mahieu
- Department of Infectious Diseases, Angers University Hospital, Angers, France,UNIV Angers, UMR CRCINA, INSERM 1232, SFR ICAT, Angers, France
| | - Pierre-Marie Roy
- Emergency Department, Angers University Hospital, Angers, France,UNIV Angers, UMR MitoVasc CNRS 6015 - INSERM 1083, Angers, France,FCRIN, INNOVTE, Saint Etienne, France
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6
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Traversat P, Lauzeral A, Michalak S, Mahieu R, Berteau F, Dubée V. Exacerbation of acrodermatitis chronica atrophicans under antiretroviral treatment in an HIV-infected patient. J Eur Acad Dermatol Venereol 2021; 36:e107-e109. [PMID: 34487606 DOI: 10.1111/jdv.17647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- P Traversat
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | - A Lauzeral
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | - S Michalak
- Pathology lab, Angers University Hospital, Angers, France
| | - R Mahieu
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | - F Berteau
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | - V Dubée
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France.,CRCINA, Inserm, Université de Nantes, Université d'Angers, Angers, France
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Matta S, Rousseau A, Chenouard R, Lemarié C, Eveillard M, Kempf M, Mahieu R, Pailhoriès H. Cerebral epidural empyema due to Bartonella henselae: a case report. BMC Infect Dis 2021; 21:765. [PMID: 34362324 PMCID: PMC8344196 DOI: 10.1186/s12879-021-06488-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cat scratch disease frequently involves a benign, self-limited disease. Neurological forms associated with Bartonella henselae are uncommon, consisting mostly in neuroretinitis, encephalitis and meningitis. Cerebral epidural empyema has never described. CASE PRESENTATION An adult patient was hospitalized for isolated headaches. Magnetic Resonance Imaging (MRI) identified typical features of cerebral epidural empyema. The diagnosis of B. henselae was performed incidentally by 16S rDNA gene sequencing on the abscess fluid, and confirmed by specific qPCR. We report here the first case, to our knowledge, of cerebral epidural empyema associated with B. henselae. Further follow-up visits allowed identifying frequent cat scratches on the scalp as the presumptive source of infection. CONCLUSIONS This case report alerts about such atypical clinical presentation, which requires an extensive clinical investigation. It also emphasizes on the usefulness of additional molecular diagnosis techniques in such CNS infection cases.
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Affiliation(s)
- Stéphanie Matta
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France
| | - Audrey Rousseau
- Département de Pathologie Cellulaire et Tissulaire, CHU d'Angers, 4, rue Larrey, 49933, Angers, France
| | - Rachel Chenouard
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France
| | - Carole Lemarié
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France
| | - Matthieu Eveillard
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Marie Kempf
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Rafaël Mahieu
- Service de Maladies Infectieuses et Tropicales, CHU Angers, CHU, 4 rue Larrey, 49933, Angers cedex, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Hélène Pailhoriès
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU Angers, 4 rue Larrey, 49933, Angers cedex, France. .,Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France.
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Danneels P, Descolas A, Touré A, Chabrun F, Declerck C, Ravaïau C, Despre M, Crochette N, Mahieu R, Dubée V. Faisabilité et reproductibilité de deux scores cliniques prédictifs d’endocardite à Enterococcus faecalis. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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den Toom I, Mahieu R, van Rooij R, van Es R, de Keizer B, de Bree R. P-124 Sentinel lymph node detection in oral cancer: a head to head comparison between 99mTc-Tilmanocept and 99mTc-Nanocoll. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00411-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mahieu R, Thomeer HGXM, Straatman LV. [Persistent otorrhoea caused by cerebrospinal fluid leakage]. Ned Tijdschr Geneeskd 2021; 165:D5456. [PMID: 34346583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Persistent otorrhoea is a common issue for both children and adults, which can be caused by leakage of cerebrospinal fluid from the lateral skull base. Bacterial superinfection of the chronically humid middle ear, arising from continuous cerebrospinal fluid leakage, may contribute to an atypical clinical presentation. That is, otogenous cerebrospinal fluid leakage may mimic serious otitis media with concomitant conductive hearing loss, leading to a serious diagnostic delay in some patients. On the basis of three cases with cerebrospinal fluid leakage, resulting in persistent otorrhoea, we underline the importance of its timely diagnosis and treatment.
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Affiliation(s)
- R Mahieu
- UMC Utrecht, afd. KNO-heelkunde, Utrecht
| | | | - L V Straatman
- UMC Utrecht, afd. KNO-heelkunde, Utrecht
- Contact: L.V. Straatman
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11
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Lemarié C, Legeay C, Mahieu R, Moal F, Ramont C, Kouatchet A, Eveillard M. Long-term contamination of sink drains by carbapenemase-producing Enterobacterales in three intensive care units: characteristics and transmission to patients. J Hosp Infect 2021; 112:16-20. [PMID: 33636255 DOI: 10.1016/j.jhin.2021.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/19/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to describe the contamination of sink drains (SDs) with carbapenemase-producing Enterobacterales (CPE) in three intensive care units (ICUs), and to assess the risk of transmission to hospitalized patients. All SDs were sampled monthly for CPE screening by culture. Rectal screening for CPE carriage was conducted weekly for hospitalized patients. CPE were isolated from 22% of SD samples. Some SDs remained colonized with the same strain for several months. No CPE acquisition occurred among hospitalized patients during the study. Certain strategies, such as systematic sampling of SDs in ICUs for screening for contamination by CPE, should be discouraged apart from during outbreaks.
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Affiliation(s)
- C Lemarié
- Laboratoire de Bactériologie, Département des Agents Infectieux, Centre Hospitalier Universitaire, Angers, France
| | - C Legeay
- Unité d'hygiène et de Prévention des Infections Nosocomiales, Centre Hospitalier Universitaire, Angers, France
| | - R Mahieu
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, Angers, France; CRCINA, Inserm, Université de Nantes, Université d'Angers, Angers, Nantes, France
| | - F Moal
- Service Pharmacie, Centre Hospitalier Universitaire, Angers, France
| | - C Ramont
- Laboratoire de Bactériologie, Département des Agents Infectieux, Centre Hospitalier Universitaire, Angers, France
| | - A Kouatchet
- Service de Médecine Intensive-réanimation et Médecine Hyperbare, Centre Hospitalier Universitaire, Angers, France
| | - M Eveillard
- Laboratoire de Bactériologie, Département des Agents Infectieux, Centre Hospitalier Universitaire, Angers, France; CRCINA, Inserm, Université de Nantes, Université d'Angers, Angers, Nantes, France.
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Douillet D, Mahieu R, Boiveau V, Vandamme YM, Armand A, Morin F, Savary D, Dubée V, Annweiler C, Roy PM. Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule. Intern Emerg Med 2020; 15:1525-1531. [PMID: 32888112 PMCID: PMC7550768 DOI: 10.1007/s11739-020-02483-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023]
Abstract
In the context of the COVID-19 pandemic and overloaded hospitals, a central issue is the need to define reliable and consensual criteria for hospitalization or outpatient management in mild cases of COVID-19. Our aim was to define an easy-to-use clinical rule aiming to help emergency physicians in hospitalization or outpatient management decision-making for patients with suspected or confirmed SARS-CoV-2 infection (the HOME-CoV rule). The Delphi method was used to reach a consensus of a large panel of 51 experts: emergency physicians, geriatricians, infectious disease specialists, and ethical consultants. A preliminary list of eligible criteria was compiled based on a literature review. Four rounds of anonymized expert consultations were performed. The experts were asked to score each item as relevant, possibly relevant and non-relevant, as major or minor, and to choose the cut-off. They were also able make suggestions and remarks. Eight criteria constituting the HOME-CoV were selected: six correspond to the severity of clinical signs, one to the clinical course (clinically significant worsening within the last 24 h), and the last corresponds to the association of a severe comorbidity and an inadequate living context. Hospitalization is deemed necessary if a patient meets one or more of the criteria. In the end, 94.4% of the experts agreed with the defined rule. Thanks to the Delphi method, an absolute consensus was obtained of a large panel of experts on the HOME-CoV rule, a decision-making support mechanism for clinicians to target patients with suspected or confirmed COVID-19 requiring hospitalization.Trial registration: NCT04338841.
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Affiliation(s)
- Delphine Douillet
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France.
- UMR (CNRS 6015-INSERM 1083) et Institut MitoVasc, Université d'Angers, Angers, France.
| | - Rafaël Mahieu
- Department of Infectious Disease, CHU Angers, Université d'Angers, Angers, France
- CRCINA, Inserm, Université de Nantes, Nantes, France
| | - Violette Boiveau
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France
| | - Yves-Marie Vandamme
- Department of Infectious Disease, CHU Angers, Université d'Angers, Angers, France
| | - Aurore Armand
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France
| | - Francois Morin
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France
| | - Dominique Savary
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France
- EHESP, Irset, Inserm, UMR S1085, CAPTV CDC, Université Rennes, Rennes, France
| | - Vincent Dubée
- Department of Infectious Disease, CHU Angers, Université d'Angers, Angers, France
- CRCINA, Inserm, Université de Nantes, Nantes, France
| | - Cédric Annweiler
- Geriatric Department, CHU Angers, Angers, France
- Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, ON, Canada
| | - Pierre-Marie Roy
- Emergency Department, CHU Angers, 4 rue Larrey, 49100, Angers, France
- UMR (CNRS 6015-INSERM 1083) et Institut MitoVasc, Université d'Angers, Angers, France
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13
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Mahieu R, Tillard L, Le Guillou-Guillemette H, Vinatier E, Jeannin P, Croué A, Le Corre Y, Vandamme YM. No antibody response in acral cutaneous manifestations associated with COVID-19? J Eur Acad Dermatol Venereol 2020; 34:e546-e548. [PMID: 32488946 PMCID: PMC7301014 DOI: 10.1111/jdv.16688] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R Mahieu
- Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France.,Université d'Angers, INSERM, CRCINA, Angers, France
| | - L Tillard
- Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France
| | - H Le Guillou-Guillemette
- Virology Department, University Hospital of Angers, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - E Vinatier
- Université d'Angers, INSERM, CRCINA, Angers, France.,Immunology Department, University Hospital of Angers, Angers, France
| | - P Jeannin
- Université d'Angers, INSERM, CRCINA, Angers, France.,Immunology Department, University Hospital of Angers, Angers, France
| | - A Croué
- Pathology Department, University Hospital of Angers, Angers, France
| | - Y Le Corre
- Dermatology Department, LUNAM Université, University Hospital of Angers, Angers, France
| | - Y-M Vandamme
- Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France
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14
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Lemarié C, Legeay C, Lasocki S, Mahieu R, Kouatchet A, Bahier L, Onillon L, Corre M, Kempf M, Eveillard M. Extended-spectrum β-lactamase Enterobacteriaceae (ESBLE) in intensive care units: strong correlation with the ESBLE colonization pressure in patients but not same species. J Hosp Infect 2020; 104:53-56. [DOI: 10.1016/j.jhin.2019.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 08/06/2019] [Indexed: 01/06/2023]
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15
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Mahieu R, Pailhoriès H, Kouatchet A, Dubée V. Re: 'Estimation of missed bloodstream infections without the third blood culture set' by Collazos et al. Clin Microbiol Infect 2019; 25:1574-1575. [PMID: 31306795 DOI: 10.1016/j.cmi.2019.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
Affiliation(s)
- R Mahieu
- Médecine Intensive Réanimation, CHU d'Angers, France; CRCINA, Inserm, France; Equipe ATIP AVENIR, CRCINA, Inserm, Université de Nantes, Université d'Angers, France.
| | - H Pailhoriès
- Laboratoire de Bactériologie, Institut de Biologie en Santé-PBH, Centre Hospitalier Universitaire d'Angers, France
| | - A Kouatchet
- Médecine Intensive Réanimation, CHU d'Angers, France
| | - V Dubée
- CRCINA, Inserm, France; Equipe ATIP AVENIR, CRCINA, Inserm, Université de Nantes, Université d'Angers, France; Service de maladies infectieuses et tropicales, CHU Angers, Angers, France
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16
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Turmel J, Le Moal G, Arvieux C, Pasdeloup T, Dubée V, Mahieu R, Vandamme Y, Rabier V, Abgueguen P. Infections de prothèses articulaires à Candida spp. : étude descriptive de 10 cas. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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De la Chapelle M, Holescka P, Mahieu R, Rabier V, Sanderink D, Vandamme Y, Pailhories H, Kempf M, Abgueguen P, Dubée V. Impact d’un conseil en antibiothérapie sur la prise en charge des patients et la mortalité intra-hospitalière. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Sanderink D, Cassisa V, Chenouard R, Mahieu R, Pailhoriès H, Kempf M, Dubée V, Eveillard M. Étude de l’efficacité d’associations colistine et glycopeptides sur Acinetobacter baumannii multi-résistant dans un modèle de pneumopathie murine. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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19
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Mahieu R, Colletti G, Bonomo P, Parrinello G, Iavarone A, Dolivet G, Livi L, Deganello A. Head and neck reconstruction with pedicled flaps in the free flap era. Acta Otorhinolaryngol Ital 2018; 36:459-468. [PMID: 28177328 PMCID: PMC5317124 DOI: 10.14639/0392-100x-1153] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/19/2016] [Indexed: 01/30/2023]
Abstract
Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed. A total of 93 patients, the majority with oral cancer (n = 59), were included, of which 64 were pedicled flap reconstructions (69%). The results showed no significant differences in terms of functional outcome, flap necrosis and complications in each type of reconstruction. Multivariate regression analysis of flap necrosis and functional impairments showed no associated factors. Multivariate regression analysis of complicated flap healing showed that only comorbidities remained an explaining factor (p = 0.019). Survival analysis and proportional hazard regression analysis regarding cancer relapse or distant metastasis, showed no significant differences in prognosis of patients concerning both types of reconstruction. In this retrospective, non-randomised study cohort, pedicled flaps were not significantly inferior to free flaps for reconstruction of head and neck defects, considering functionality, complications and prognosis.
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Affiliation(s)
- R Mahieu
- Department of Surgery and Translational Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy.,University of Groningen, University Medical Center Groningen, the Netherlands
| | - G Colletti
- Department of Maxillo-facial Surgery, University of Milan, Milan, Italy
| | - P Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - G Parrinello
- Department of Surgery and Translational Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - A Iavarone
- Department of Surgery and Translational Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - G Dolivet
- Department of Oncologic Surgery l'institut de Cancérologie de Lorraine, Nancy, France
| | - L Livi
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - A Deganello
- Department of Surgery and Translational Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
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Rousseau G, Signolet I, Denis MC, Chao de la Barca JM, Mahieu R, Letournel F, Reynier P, Simard G. 5-Oxoprolinuria in hyperammonemic encephalopathy: Coincidence or worsening factor? Clin Biochem 2017; 50:1115-1117. [PMID: 28974423 DOI: 10.1016/j.clinbiochem.2017.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Guillaume Rousseau
- Department of Biochemistry and Genetics, University Hospital, Angers, France
| | - Isabelle Signolet
- Department of Biochemistry and Genetics, University Hospital, Angers, France
| | | | | | - Rafaël Mahieu
- Department of Medical Intensive Care and Hyperbaric Medicine, University Hospital, Angers, France
| | - Franck Letournel
- Department of Neuropathology, University Hospital, Angers, France
| | - Pascal Reynier
- Department of Biochemistry and Genetics, University Hospital, Angers, France
| | - Gilles Simard
- Department of Biochemistry and Genetics, University Hospital, Angers, France.
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21
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Douillet D, Mahieu R, Delori M, Baudry E, Griffiths K, Roy PM, Vandamme YM. Screening and infectious diseases of new migrants in France: A retrospective cross-sectional study. Travel Med Infect Dis 2017; 17:64-65. [DOI: 10.1016/j.tmaid.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 10/19/2022]
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22
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Mahieu R, Cassisa V, Godefroy A, Joly-Guillou ML, Eveillard M. Effect of faecal microbiota transplantation on mouse gut colonization with carbapenemase-producing Escherichia coli. J Antimicrob Chemother 2017; 72:1260-1262. [PMID: 28039277 DOI: 10.1093/jac/dkw540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Mahieu R, Coenen MNO, van Bemmel T, van der Zaag-Loonen HJ, Theuvenet WJ. Detecting intrinsic muscle weakness of the hallux as an addition to early-stage screening of the feet in patients with diabetes. Diabetes Res Clin Pract 2016; 119:83-7. [PMID: 27497143 DOI: 10.1016/j.diabres.2016.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/16/2016] [Indexed: 12/25/2022]
Abstract
AIMS Present-day screening of the diabetic foot involves the Semmes Weinstein Monofilament Test for evaluating loss of sensibility, while testing for intrinsic muscle weakness is not implied. Just as with the early detection of sensibility loss, early detection of intrinsic muscle weakness might have important implications for the prevention of both ulceration and deformity in patients with diabetes. The purpose of this study is to investigate the prevalence of patients with diabetes presenting intrinsic muscle weakness of the hallux, but with a normal sensibility of the sole of the foot. METHODS A cross-sectional study design was applied. Intrinsic muscle function of the hallux was measured with the Paper Grip Test, while sensibility of the sole of the foot was measured with the Semmes Weinstein Monofilament Test 5.07/10-g. RESULTS In a period of three months a total of 266 patients with diabetes (mean age 60, 134 females (50%), 177 type 2 diabetes mellitus (67%)) met the inclusion criteria and were examined for both intrinsic muscle weakness of the hallux and sensibility of the soles of the feet. The results showed that intrinsic muscle weakness was present more frequent in patients with impaired sensibility (P=0.001), also 20% of the population had intrinsic muscle weakness in the presence of normal sensibility. Multivariate regression analysis showed that only age is associated with patients with diabetes presenting normal sensibility but impaired intrinsic muscle function (P=0.017). CONCLUSIONS The Paper Grip Test could have added value to current physical examination of the feet in patients with diabetes.
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Affiliation(s)
- R Mahieu
- Department of Internal Medicine, Gelre Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands; University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - M N O Coenen
- Department of Internal Medicine, Gelre Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands; University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - T van Bemmel
- Department of Internal Medicine, Gelre Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands
| | - H J van der Zaag-Loonen
- Department of Epidemiology, Gelre Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands
| | - W J Theuvenet
- Department of Plastic Surgery, Gelre Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands.
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24
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Douillet D, Baudry E, Delo M, Rehaiem S, Mahieu R, Pichard E, Vandamme Y. MIG-03 - Situation sanitaire des réfugiés : quelle pris en charge dans une grande agglomération française ? Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30446-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Mahieu R, Russo S, Gualtieri T, Colletti G, Deganello A. Oral cavity reconstruction with the masseter flap. Acta Otorhinolaryngol Ital 2016; 36:139-43. [PMID: 27196079 PMCID: PMC4907161 DOI: 10.14639/0392-100x-890] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 12/02/2015] [Indexed: 11/23/2022]
Abstract
The purpose of this report is to highlight how an unusual, outdated, unpopular and overlooked reconstructive method such as the masseter flap can be a reliable, straightforward and effective solution for oral reconstruction in selected cases. We report the transposition of the masseter crossover flap in two previously pre-treated patients presenting a second primary oral squamous cell carcinoma; excellent functional results with satisfactory cosmetic appearance were obtained in both cases. In the literature, only 60 cases of oral cavity and oropharyngeal reconstructions using the masseter flap have been reported. The possible clinical utility of this flap, even in modern head and neck reconstructive surgery, is presented and discussed. We believe that the masseter flap should enter in the armamentarium of every head and neck surgeon and be kept in mind as a possible solution since it provides an elegant and extremely simple procedure in suboptimal cases for microvascular reconstruction.
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Affiliation(s)
- R Mahieu
- Department of Surgery and Translational Medicine, University of Florence, Italy;,University Medical Center, Groningen, The Netherlands
| | - S Russo
- National Cancer Institute Giovanni Paolo II, Bari, Italy
| | - T Gualtieri
- Department of Surgery and Translational Medicine, University of Florence, Italy
| | - G Colletti
- Department of Maxillo-facial Surgery, University of Milan, Italy
| | - A Deganello
- Department of Surgery and Translational Medicine, University of Florence, Italy
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Mahieu R, Gardembas M, Kempf M, Abgueguen P, Fontaine C. Un vent de panique et de questions. Rev Med Interne 2014; 35:621-3. [DOI: 10.1016/j.revmed.2014.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
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27
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Delemotte M, Abgueguen P, Joly-Guillou ML, Crochette N, Mahieu R, Rabier V, Vandamme YM. F-02: Antibiothérapies anti-SARM dans le traitement probabiliste des bactériémies à Staphylococcus aureus au CHU d’Angers. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Mahieu R, Urbanski G, Goumy L, Beucher A, Lavigne C. Une méningo-encéphalite chez un enfant de 7ans révélant une maladie de Takayasu. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Mahieu R, Vandamme YM, Le Clec'h C, Ducancelle A, Kempf M, Pichard E, Abgueguen P. A 59-Year-Old Woman With Chronic Skin Lesions of the Leg. Clin Infect Dis 2013. [DOI: 10.1093/cid/cit667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Mahieu R, Dernis E, Sandrini J, Blanchi S. Une spondylodiscite aiguë révélant une première poussée de rhumatisme goutteux. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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Mahieu R, Vandamme YM, Le Clec'h C, Ducancelle A, Kempf M, Pichard E, Abgueguen P. Photo Quiz. A 59-year-old woman with chronic skin lesions of the leg. Clin Infect Dis 2013; 57:1751, 1782. [PMID: 24280663 DOI: 10.1093/cid/cit661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Mahieu R, Vandamme YM, Pichard E, Leclech C, Abgueguen P. Acrodermatite chronique atrophiante de la cheville et du pied à trois ans d’un épisode d’érythème chronique migrant documenté. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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