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Caboche-Salouhi P, Le Seac'h A, Lionnet F, Santin A, Mattioni S, Tamboura F, Steichen O, Barbaud A, Senet P. "SCULP" study: The benefits of skin graft pellets on the pain of sickle cell leg ulcers (SCLU). J Med Vasc 2023; 48:100-104. [PMID: 37914454 DOI: 10.1016/j.jdmv.2023.09.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Leg ulcers associated with major sickle cell disease (SCLU) are a chronic, painful complication, often treated by autologous skin graft. The analgesic effect of skin grafting in SCLU is poorly studied. The aim of this study was to evaluate the effect of skin grafting on the pain and healing of SCLU. METHODS Patients hospitalized for SCLU skin grafting were included in a retrospective and prospective observational cohort, between 2019 and 2023: 53 autologous pinch grafts were performed on a total of 35 SCLUs in 25 sickle cell patients. The primary endpoint was the evaluation of the analgesic effect of the skin graft, measured by visual analog scale (VAS) and weekly cumulative analgesic consumption between day (D)0, D7 and D30. Wound healing was assessed by variation in wound areas between D0 and D30. RESULTS Twenty-five patients with a median age range of 45.5years old were included, 68% were men, SS genotype was present in 96% of the cases. At D7, a significant decrease in VAS and consumption of analgesics of all classes was observed. At D30, only a significant decrease in VAS and consumption of mild opioids was present, as well as a significant reduction in wound surface area compared with D0. CONCLUSION Pinch grafts have a significant early analgesic effect in the management of patients with SCLU, and significantly notice reduction of wound surface area within one month.
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Affiliation(s)
- P Caboche-Salouhi
- Paris Cité University, Faculty of Medicine, Paris, France; Dermatology-Allergology and Vascular Medicine Department, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - A Le Seac'h
- Dermatology-Allergology and Vascular Medicine Department, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France; Sorbonne University, Faculty of Medicine, Paris, France
| | - F Lionnet
- Department of Internal Medicine, Sickle Cell Reference Center, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
| | - A Santin
- Department of Internal Medicine, Sickle Cell Reference Center, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
| | - S Mattioni
- Department of Internal Medicine, Sickle Cell Reference Center, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
| | - F Tamboura
- Dermatology-Allergology and Vascular Medicine Department, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
| | - O Steichen
- Sorbonne University, Faculty of Medicine, Paris, France; Department of Internal Medicine, Sickle Cell Reference Center, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
| | - A Barbaud
- Dermatology-Allergology and Vascular Medicine Department, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France; Sorbonne University, Faculty of Medicine, Paris, France
| | - P Senet
- Dermatology-Allergology and Vascular Medicine Department, Hôpital Tenon, Assistance publique-Hôpitaux de Paris, Paris, France
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Dimancea A, Mattioni S, Nouet A, Drir M, Santin A, Marrot B, Shotar E, Corcy C, Bottin L, Sourour NA, Premat K, Alamowitch S, Carpentier A, Degos V, Clarençon F, Lionnet F, Lenck S. Preventive treatment of unruptured intracranial aneurysms in adult patients with sickle cell anemia: A cohort study. J Neuroradiol 2023; 50:511-517. [PMID: 36781119 DOI: 10.1016/j.neurad.2023.02.003] [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: 09/15/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND PURPOSE Intracranial aneurysms are frequent in patients with sickle cell anemia, while subarachnoid hemorrhage is a major cause of death and disability in young adult patients. Several characteristics, such as younger age and smaller size at rupture, may incline therapeutic decision towards exclusion treatments. Clinical guidelines on treatment of unruptured intracranial aneurysms in this population are still missing. We aimed to assess the safety and efficacy of the treatment of unruptured intracranial aneurysm in patients with sickle cell anemia, using an adapted hematological preparation regimen. PATIENTS AND METHODS Adult patients with sickle cell anemia and treated unruptured aneurysms by endovascular therapy or neurosurgery were included in this retrospective cohort study. Treatment decision was reached after multi-disciplinary assessment. A pre-operative blood transfusion protocol was undertaken targeting a HbS below 30%. Demographic data, hematological preparation parameters and clinical and radiological outcomes were documented. RESULTS AND CONCLUSIONS Twenty-five procedures were performed in 18 patients encompassing 19 aneurysms treated by embolization and 6 by surgery. Median age at treatment was 34 years-old and median aneurysm dome size was 4.4 mm. Immediate aneurysm exclusion rate was 85.7% after endovascular therapy and 100% after neurosurgery. Median follow-up was 6 months, with all patients being asymptomatic at last follow-up. Two transitory ischemic neurological deficits, as well as four cases of iodine-induced encephalopathy were identified after embolization. No complication occurred after surgery. Endovascular therapy by coiling and neurosurgical treatment of unruptured intracranial aneurysms appears to be safe in patients with sickle cell anemia and should be considered given the specific hemorrhagic risk observed in this population. A rigorous hematological preparation, associated with a dedicated peri‑operative protocol and an adequate therapeutic strategy are essential prerequisites.
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Affiliation(s)
- A Dimancea
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - S Mattioni
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - A Nouet
- Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France
| | - M Drir
- Department of Neuro-anesthesia and Critical Care, Pitié-Salpêtrière University Hospital, Paris, France
| | - A Santin
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - B Marrot
- Department of Radiology, Tenon University Hospital, Paris, France
| | - E Shotar
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - C Corcy
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - L Bottin
- Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France
| | - N A Sourour
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - K Premat
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - S Alamowitch
- Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - A Carpentier
- Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - V Degos
- Department of Neuro-anesthesia and Critical Care, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - F Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France; GRC BioFast. Paris VI University. Paris. France
| | - F Lionnet
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - S Lenck
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France; Inserm UMR 1127, Paris Brain Institute, Paris, France.
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Degroote T, Capron J, Santin A, Mattioni S, Rech J, Lionnet F, Steichen O. Dépistages des troubles cognitifs chez les adultes drépanocytaires avec le test du Montreal Cognitive Assessment (MoCA). Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.279] [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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Rolland-Debord C, Canellas A, Choinier P, Milon A, Debrix I, Blin E, Belaube N, Mattioni S, Millet F, Nadal M, Petit-Hoang C, Rigaud P, Rech JS, Siguier M, Sroussi D, Denis M, Amiel C, Fartoukh M, Georgin-Lavialle S, Lassel L, Parrot A, Cadranel J. Daily multidisciplinary COVID-19 meeting: Experiences from a French university hospital. Respir Med Res 2021; 79:100828. [PMID: 34023794 PMCID: PMC8103735 DOI: 10.1016/j.resmer.2021.100828] [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: 01/09/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022]
Abstract
Objectives In March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. In absence of official recommendations, implementing daily multidisciplinary team (MDT) COVID-19 meetings was urgently needed. Our aim was to describe our initial institutional standard operating procedures for implementing these meetings, and their impact on daily practice. Methods All consecutive patients who were hospitalized in our institution due to COVID 19, from March 31 to April 15, 2020, were included. Criteria to be presented at MDT meetings were defined as a proven COVID-19 by PCR or strongly suspected on CT scan, requiring hospitalization and treatment not included in the standard of care. Three investigators identified the patients who met the predefined criteria and compared the treatment and outcomes of patients with predefined criteria that were presented during MDT meeting with those not presented during MDT meeting. COVID-19 MDT meeting implementation and adhesion were also assessed by a hospital medical staff survey. Results In all, 318 patients with confirmed or suspected COVID-19 were examined in our hospital. Of these, 230 (87%) were hospitalized in a COVID-19 unit, 91 (40%) of whom met predefined MDT meeting criteria. Fifty (55%) patients were presented at a MDT meeting versus 41 (45%) were not. Complementary exploration and inclusion in the CorImmuno cohort were higher in MDT meeting group (respectively 35 vs. 15%, P = 0.03 and 80 versus 49%, P = 0.0007). Prescription of hydrocortisone hemisuccinate was higher in group of patients not presented during MDT meeting (24 vs. 51%, P = 0.007). Almost half of the patients fulfilling the inclusion criteria were not presented at MDT meeting, which can be partly explained by technical software issues. Conclusions Multidisciplinary COVID-19 meetings helped implementing a single standard of care, avoided using treatments that were untested or currently being tested, and facilitated the inclusion of patients in prospective cohorts and therapeutic trials.
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Affiliation(s)
- C Rolland-Debord
- Service des explorations fonctionnelles de la respiration de l'exercice et de la dyspnée, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - A Canellas
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - P Choinier
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - A Milon
- Department of radiology, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - I Debrix
- Department of pharmacy, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - E Blin
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - N Belaube
- Department of infectious and tropical diseases, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - S Mattioni
- Department of internal medicine, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - F Millet
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - M Nadal
- Department of infectious and tropical diseases, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - C Petit-Hoang
- Department of nephrology, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - P Rigaud
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - J S Rech
- Department of internal medicine, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - M Siguier
- Department of infectious and tropical diseases, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - D Sroussi
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - M Denis
- Department of infectious and tropical diseases, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - C Amiel
- Department of virology, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - M Fartoukh
- Intensive care unit, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - S Georgin-Lavialle
- Department of internal medicine, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - L Lassel
- Department of infectious and tropical diseases, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - A Parrot
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France
| | - J Cadranel
- Department of pneumology and thoracic oncology, centre constitutif maladies pulmonaires rares, hôpital Tenon, GRC n(o) 04, Theranoscan Sorbonne université, AP-HP, Paris, France.
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Bourguiba R, Santin A, Mattioni S, Stankovic K, Lionnet F, Steichen O. Variation intra-individuelle de l’hémoglobine chez les patients drépanocytaires à l’état stable. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.108] [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: 10/25/2022]
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Roger C, Lionnet F, Kyheng M, Mattioni S, Livrozet M, Steichen O, Letavernier E, Hammoudi N, Duhamel A, Haymann J. Facteurs prédictifs de dégradation de la fonction rénale dans une population de patients drépanocytaires homozygotes adultes. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Conan P, Steichen O, Santin A, Bachmeyer C, Bappé P, Lionnet F, Mattioni S. Ostéomyélites chez les adultes drépanocytaires : étude descriptive en pays à haut revenu. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.215] [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: 11/27/2022]
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Bachmeyer C, Moguelet P, Marciano S, Georgin-Lavialle S, Monfort JB, Gkalea V, Mattioni S. Extensive purpuric lesions due to vitamin C deficiency and leucocytoclastic vasculitis as the initial sign of lung adenocarcinoma. Clin Exp Dermatol 2019; 44:e53-e54. [PMID: 30687951 DOI: 10.1111/ced.13918] [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] [Accepted: 12/12/2018] [Indexed: 11/24/2022]
Affiliation(s)
- C Bachmeyer
- Department of Internal Medicine, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - P Moguelet
- Department of Pathology, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - S Marciano
- Department of Internal Medicine, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - S Georgin-Lavialle
- Department of Internal Medicine, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - J B Monfort
- Department of Dermatology, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - V Gkalea
- Department of Biological Hematology, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
| | - S Mattioni
- Department of Internal Medicine, Tenon Hospital (AP-HP), 4, rue de la Chine, 75020, Paris, France
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Conan P, Steichen O, Santin A, Bachmeyer C, M’bappe P, Lionnet F, Mattioni S. Ostéomyélites chez les adultes drépanocytaires : étude descriptive en pays à haut revenu. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Allali S, Lionnet F, Mattioni S, Bachmeyer C, Arlet J, Brousse V, De Montalembert M, Chalumeau M, Grateau G, Hermine O, Launay J, Georgin Lavialle S. Augmentation des taux plasmatiques d’histamine chez les patients atteints de drépanocytose. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bachmeyer C, Moguelet P, Mattioni S, Senet P, Lionnet F. Cover Image: Blisters owing to dermal capillary occlusion by sickle cells. Br J Dermatol 2018; 178:305-306. [PMID: 29357598 DOI: 10.1111/bjd.16090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Bachmeyer
- Service de Médecine Interne - Centre de la Drépanocytose, Hôpital Tenon (AP-HP), Paris, France
| | - P Moguelet
- Service d'Anatomie Pathologique, Hôpital Tenon (AP-HP), Paris, France
| | - S Mattioni
- Service de Médecine Interne - Centre de la Drépanocytose, Hôpital Tenon (AP-HP), Paris, France
| | - P Senet
- Service de Dermatologie, Hôpital Tenon (AP-HP), Paris, France
| | - F Lionnet
- Service de Médecine Interne - Centre de la Drépanocytose, Hôpital Tenon (AP-HP), Paris, France
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Galmiche S, Amiot X, Georgin-Lavialle S, Chantalat C, Stankovic K, Bachmeyer C, Santin A, Cheddani H, Mattioni S, Lionnet F. Maladies inflammatoires chroniques de l’intestin chez des patients atteints de syndrome drépanocytaire majeur : à propos de 6 cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Galmiche S, Georgin-Lavialle S, Lionnet F, M’bappe P, Stankovic K, Mattioni S, Girot R, Grateau G, Arlet J, Bachmeyer C. Maladies auto-immunes au cours des syndromes drépanocytaires majeurs : étude de 26 cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.314] [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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Scheifer C, Georgin-Lavialle S, Dzierzynski N, Mattioni S, Bachmeyer C, Garandeau E, Bouvard E, Grateau G, Steichen O. Intrication des problèmes psychiatriques et somatiques en médecine d’aval des urgences : étude transversale de 104 séjours. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.309] [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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Garandeau E, Georgin-Lavialle S, Steichen O, Stankovic K, Mattioni S, Bachmeyer C, Girot R, Grateau G, Lionnet F. Syndrome de la houppe mentonnière chez patients drépanocytaires : étude de 35 cas. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.331] [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: 10/22/2022]
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Chezel J, Stankovic K, Georgin-Lavialle S, Mattioni S, Bachmeyer C, Garandeau E, Girot R, Grateau G, Lionnet F. Survenue d’une paralysie faciale chez des patients drépanocytaires : étude de 8 cas. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.330] [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: 11/27/2022]
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Georgin-Lavialle S, Grateau G, Mattioni S, Steichen O. Prescriptions pédagogiques pour favoriser l’apprentissage actif des connaissances par les étudiants hospitaliers en stage de médecine interne : à propos de 150 situations. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.241] [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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Savenkoff B, Benzerara L, Stankovic K, Avellino V, Mattioni S, Girot R, Grateau G, Letavernier E, Haymann J, Lionnet F. Hyperphosphatémie chez les patients drépanocytaires homozygotes : une hyperréabsorption primitive du tube contourné proximal et un marqueur de risque cardiovasculaire. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.044] [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: 11/30/2022]
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Mattioni S, Develoux M, Brun S, Martin A, Jaureguy F, Naggara N, Bouchaud O. Management of mycetomas in France. Med Mal Infect 2013; 43:286-94. [PMID: 23916308 DOI: 10.1016/j.medmal.2013.06.004] [Citation(s) in RCA: 17] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 04/02/2013] [Accepted: 06/17/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE OF THE STUDY Mycetomas are chronic sub-cutaneous tropical infections in which exogenous causative agents, fungal (eumycetes) or bacterial (actinomycetes), generate grains. The typical presentation is multi-fistulized pseudotumors. This disease, particularly eumycetoma, is difficult to treat. It is a major health problem in tropical and subtropical countries. In France, the disease is rare, but patients have access to a broader range of treatments. The authors had for objective to present the cases of mycetomas diagnosed in developed country and their management. PATIENTS AND METHODS A retrospective study was made on the clinical presentation and management of mycetomas from 1995 to 2011, in the Bobigny Avicenne teaching hospital. RESULTS Six patient files were studied. The patients were men with a median age of 31 years (16-70). Five patients were from Sub Saharan Africa, one from Sri Lanka. The etiologies were one actinomycetoma and five eumycetomas. There was bone involvement in five cases. There was one atypical presentation: a primary intra-osseous mycetoma. Three patients were cured including two by surgical management and one by medical treatment (actinomycetoma). Antifungal therapy failed (four patients) in every case (voriconazole, itraconazole, ketoconazole, terbinafine, caspofungin). CONCLUSION The results of this study made in a non-epidemic zone revealed that despite a typical clinical presentation, the diagnosis and management were delayed because this imported disease is rare in France. The patients received new broad-spectrum triazole and caspofungin, but none were cured with antifungal therapy alone.
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Affiliation(s)
- S Mattioni
- Service de maladies infectieuses et tropicales, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93000 Bobigny, France.
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Mattioni S, Roulin L, Mauhin W, Chabrol A. Thrombopénie profonde lors d’un accès palustre à Plasmodium vivax, une fièvre tierce pas si bénigne. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mattioni S, Valin N, Cracco C, Thellier M, Danis M, Caumes E. Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment. Ann Trop Med Parasitol 2008; 102:693-8. [PMID: 19000386 DOI: 10.1179/136485908x337616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There are no established guidelines for the treatment of disseminated strongyloidiasis in immunosuppressed patients, and many different treatment regimens have been used. Here, the case of a 48-year-old, HIV-positive, Congolese man, who was hospitalized for disseminated tuberculosis but developed life-threatening disseminated strongyloidiasis, is described. This patient died, with relapsing disseminated strongyloidiasis, 3 months after being treated with ivermectin. The reasons for this poor outcome and the various treatment options for strongyloidiasis in HIV-infected patients are discussed.
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Affiliation(s)
- S Mattioni
- Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
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