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Neukamm MA, Pollak S, Thoma V, Vogt S, Huppertz LM, Auwärter V. A fatal case of aspiration due to consumption of the hallucinogenic tryptamine derivative dipropyltryptamine (DPT). J Pharm Biomed Anal 2024; 240:115959. [PMID: 38183731 DOI: 10.1016/j.jpba.2023.115959] [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: 10/31/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND AIM This case involves a 20-year-old man with prior hallucinogen-use experience, who sniffed an unknown amount of dipropyltryptamine in an apartment. Dipropyltryptamine, a hallucinogenic compound belonging to the tryptamine class is recognized for inducing effects similar to dimethyltryptamine (DMT) but with a longer duration. Ten to fifteen minutes later he experienced visual hallucinations, followed by increasing apathy. Two hours post consumption he developed abdominal pain, leading to collapse, seizure, and vomiting. Despite emergency medical resuscitation on site, transport to hospital 2.5 hours post consumption and extracorporeal life support he died 21 hours later. Relevant toxicological and morphological findings are presented. METHODS A serum sample was collected four hours post consumption. Autopsy was performed six days after death. Antemortem serum, as well as postmortem cardiac blood and urine were analyzed for alcohol and psychoactive drugs by systematic toxicological analyses employing gas chromatography-mass spectrometry (Maurer/Pfleger/Weber library among others), liquid chromatography-ion trap mass spectrometry (LC-MSn, Toxtyper™), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Dipropyltryptamine was quantified by LC-MS/MS after solid-phase extraction. RESULTS Autopsy revealed a state after deep aspiration of gastric contents with consecutive brain edema due to oxygen deprivation. Dipropyltryptamine concentrations were approximately 210 ng/ml, 110 ng/ml and 180 ng/ml in antemortem serum, postmortem cardiac blood and urine, respectively. To the best of our knowledge, these are the first reported concentrations of dipropyltryptamine in a fatal case. CONCLUSION Unlike typical tryptamine overdose reports, this case did not present with agitation, hyperthermia, or tachycardia. Despite the individual's prior experience with tryptamines and the generally low toxicity associated with this class of hallucinogens, death in this case was an indirect consequence of the nasal consumption of a high dose of dipropyltryptamine.
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Affiliation(s)
- Merja A Neukamm
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany.
| | - Stefan Pollak
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Vanessa Thoma
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Susanne Vogt
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
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Thoma V, Franchetti G, Geisenberger D, Glardon M, Kromeier J, Mierdel K, Pollak S, Wimmer S, Perdekamp MG. Gunshot wounds in parenchymatous organs: the morphology mainly depends on the physical properties of the affected tissues. Int J Legal Med 2023; 137:1463-1469. [PMID: 37410175 PMCID: PMC10421818 DOI: 10.1007/s00414-023-03058-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
In contrast to gunshot wounds in skin and bone, the medico-legal literature pays little attention to the appearance of bullet penetration sites in abdominal organs. It was only in 1983 that Metter and Schulz published an article entitled "Morphological features of gunshot wounds in the liver and spleen." According to their observations, the organs in question showed stellate tears at the bullet penetration sites resembling skin wounds from contact shots to body regions having a bony support. The study presented simulated the real conditions by means of test shots to composite models consisting of porcine organs embedded in ballistic gelatin. The ammunition used was pistol cartridges 9 mm Luger with full metal jacket round nose bullets. The shots were video-documented with a high-speed camera in order to record the bullet's travel through the target. In addition, the composite models fired at underwent CT examinations followed by a macroscopic assessment of the organs. The study confirmed the findings of Metter and Schulz with regard to the star-like appearance of gunshot wounds in the liver and spleen. Likewise, the kidney showed radiating tears originating from the bullet path, whereas the wound track in pulmonary tissue was tube-shaped and lacked additional cracks. The varying wound patterns in parenchymatous organs can reasonably be explained as a consequence of the respective viscoelastic tissue properties.
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Affiliation(s)
- V Thoma
- Institute of Forensic Medicine, University of Freiburg, Faculty of Medicine, Albertstraße 9, 79104, Freiburg, Germany.
| | - G Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - D Geisenberger
- Institute of Forensic Medicine, University of Freiburg, Faculty of Medicine, Albertstraße 9, 79104, Freiburg, Germany
| | - M Glardon
- Forensic Medicine and Imaging, Institute of Legal Medicine, University of Berne, Bühlstraße 20, 3012, Berne, Switzerland
| | - J Kromeier
- Department of Radiology, St. Josef's Hospital, Sautierstraße 1, 79104, Freiburg, Germany
| | - K Mierdel
- State Office of Criminal Investigation of Baden-Württemberg, Taubenheimstraße 85, 70372, Stuttgart, Germany
| | - S Pollak
- Institute of Forensic Medicine, University of Freiburg, Faculty of Medicine, Albertstraße 9, 79104, Freiburg, Germany
| | - S Wimmer
- Institute of Precision Medicine, Medical and Life Sciences Faculty, University of a Furtwangen, Jakob-Kienzle-Straße 17, 78054, VS-Schwenningen, Germany
| | - M Große Perdekamp
- Institute of Forensic Medicine, University of Freiburg, Faculty of Medicine, Albertstraße 9, 79104, Freiburg, Germany
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Thoma V, Geisenberger D, Schuldis D, Lickert A, Pollak S, Thierauf-Emberger A, Franchetti G. Incomplete decapitation with exenteration of the brain in a motorcyclist run over by a semitrailer. Leg Med (Tokyo) 2023; 62:102246. [PMID: 36947910 DOI: 10.1016/j.legalmed.2023.102246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/04/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/22/2023]
Abstract
Although decapitation is a well-known traumatic mechanism in road traffic deaths, incomplete decapitation of a motorcyclist with exenteration of the brain has not yet been reported in the forensic literature in a victim run over by a vehicle. This paper deals with an autopsy case of a 69-year-old motorcyclist, who had been run over by a semitrailer, as a result of which flattening of the head with extrusion of the brain and incomplete decapitation occurred at the level of the fourth cervical vertebra. This constellation allows to define a special mechanism of accident-related decapitation. Moreover, the case underlines the importance of a multidisciplinary approach for the reconstruction of the accident as well as for the assessment of its judicial consequences. On the suspicion of a hit-and-run accident, simulation tests were performed by technical experts. These tests revealed that the motorcycle may not have been conspicuous for the truck driver prior to and during the accident. Consequently, the charge of manslaughter and failure to render assistance against the truck driver was dropped.
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Affiliation(s)
- Vanessa Thoma
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany.
| | - Dorothee Geisenberger
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany
| | - Dominik Schuldis
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany
| | - Andreas Lickert
- DEKRA Automobil GmbH, Gündlinger Str. 22, 79111 Freiburg, Germany
| | - Stefan Pollak
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany
| | - Annette Thierauf-Emberger
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany
| | - Giorgia Franchetti
- University of Freiburg, Faculty of Medicine, Institute of Forensic Medicine, Albertstraße 9, 79104 Freiburg, Germany; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
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Franchetti G, Thierauf-Emberger A, Franz A, Thoma V, Auwärter V, Huppertz LM. Detection of methadone and buprenorphine in urine samples from inmates of German prisons. Front Psychiatry 2023; 14:1139370. [PMID: 36926464 PMCID: PMC10011066 DOI: 10.3389/fpsyt.2023.1139370] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/02/2023] [Indexed: 03/04/2023] Open
Abstract
The use of non-prescribed opioid substitution drugs is a serious public health problem, involving general population as well as vulnerable populations such as prisoners. The estimation of the prevalence of opioid substitution drug misuse in prisoners is crucial to suggest strategies to contrast this phenomenon and reduce the associated morbidity and mortality. The present study aimed to provide an objective estimation of the prevalence of illicit use of methadone and buprenorphine in two German prisons. Urine samples were collected from inmates of Freiburg and Offenburg prisons at random times and tested for the detection of methadone, buprenorphine and their metabolites. Analyses were performed by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. In total 678 inmates participated in this study. The participation rate was about 60% of all permanent inmates. Of the 675 samples suitable for the analysis, 70 samples (10.4%) tested positive for methadone, 70 samples (10.4%) for buprenorphine, and 4 samples (0.6%) for both drugs. At least 100 samples (14.8%) were not associated with reported prescribed-opioid substitution treatment (OST). Buprenorphine was the most common illicitly used drug. In one of the prisons, buprenorphine was brought in from the outside. The present cross-sectional experimental study was able to provide reliable information regarding the illicit use of opioid substitution drugs in prisons.
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Affiliation(s)
- Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Padova, Italy.,Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Annette Thierauf-Emberger
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Anette Franz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Vanessa Thoma
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
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Geisenberger D, Große Perdekamp M, Pollak S, Thierauf-Emberger A, Thoma V. Differing sizes of bullet entrance holes in skin of the anterior and posterior trunk. Int J Legal Med 2022; 136:1597-1603. [PMID: 36006518 PMCID: PMC9576652 DOI: 10.1007/s00414-022-02879-x] [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: 05/17/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to establish whether the size (diameter and area) of bullet entrance holes in skin varies between distant shots to the anterior and posterior trunk, respectively, when using the same ammunition (in concreto pistol cartridges 9 mm Luger). For that purpose, specimens of porcine skin from the belly region and the back were taken (10 samples each) and shot at from a distance of 1.6 m. The entrance holes were photo-documented under standardised conditions. After image processing for contrast enhancement, the maximum diameter and the area of each skin defect were measured automatically by means of an image analysis system. Both size parameters differed significantly depending on the body region affected. On the back with its comparatively thick dermis, the skin defects were considerably smaller than those on the ventral trunk where the corium is less thick. This difference can be explained by the fact that the elastic properties of skin are strongly determined by the connective tissue which is especially rich in fibres. The study results were consistent with the authors’ casework experience and support the assumption that the entrance site of gunshot wounds has a major influence on the size of the bullet hole in skin.
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Affiliation(s)
- D Geisenberger
- Institute of Forensic Medicine, Faculty of Medicine, University of Freiburg, Albertstraße 9, 79104, Freiburg, Germany
| | - M Große Perdekamp
- Institute of Forensic Medicine, Faculty of Medicine, University of Freiburg, Albertstraße 9, 79104, Freiburg, Germany
| | - S Pollak
- Institute of Forensic Medicine, Faculty of Medicine, University of Freiburg, Albertstraße 9, 79104, Freiburg, Germany
| | - A Thierauf-Emberger
- Institute of Forensic Medicine, Faculty of Medicine, University of Freiburg, Albertstraße 9, 79104, Freiburg, Germany
| | - V Thoma
- Institute of Forensic Medicine, Faculty of Medicine, University of Freiburg, Albertstraße 9, 79104, Freiburg, Germany.
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Giorgetti A, Mogler L, Halter S, Haschimi B, Alt A, Rentsch D, Schmidt B, Thoma V, Vogt S, Auwärter V. Four cases of death involving the novel synthetic cannabinoid 5F-Cumyl-PEGACLONE. Forensic Toxicol 2019. [DOI: 10.1007/s11419-019-00514-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abstract
Purpose
Cumyl-PEGACLONE was the first synthetic cannabinoid (SC) with a γ-carbolinone core structure detected in forensic casework and, since then, it has dominated the German SC-market. Here the first four cases of death involving its fluorinated analog, 5F-Cumyl-PEGACLONE, a recently emerged γ-carbolinone derived SC, are reported.
Methods
Complete postmortem examinations were performed. Postmortem samples were screened by immunoassay, gas chromatography mass spectrometry (GC–MS) or liquid chromatography tandem mass spectrometry. For quantification of SCs, the standard addition method was employed. Herbal blends were analyzed by GC–MS. In each case of death, the Toxicological Significance Score (TSS) was assigned to the compound.
Results
5F-Cumyl-PEGACLONE was identified at concentrations ranging 0.09–0.45 ng/mL in postmortem femoral blood. In case 1, signs of hypothermia and kidney bleedings were noted. Despite a possible tolerance due to long term SC use, a TSS of 3 was assigned. In case 2, an acute heroin intoxication occurred and a contributory role (TSS = 1) of 5F-Cumyl-PEGACLONE was suggested. In case 3, a prisoner was found dead. GC–MS analysis of herbal blends, retrieved in his cell together with paraphernalia, confirmed the presence of 5F-Cumyl-PEGACLONE and a causative role was deemed probable (TSS = 2). In case 4, the aspiration of gastric content due to a SC-induced coma was observed (TSS = 3).
Conclusions
5F-Cumyl-PEGACLONE is an emerging and extremely potent SC which raises serious public health concerns. A comprehensive analysis of circumstantial, clinical, and postmortem findings, as well as an in-depth toxicological analysis is necessary for a valid interpretation and for the assessment of the toxicological significance.
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Lecointre L, Akladios CY, Averous G, Lefebvre F, Baulon E, Thoma V, Fender M, Baldauf JJ. [Reliability of endocervical curettage after conservative treatment of intraepithelial neoplasia of the cervix]. ACTA ACUST UNITED AC 2014; 44:145-53. [PMID: 24485807 DOI: 10.1016/j.jgyn.2014.01.002] [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: 08/10/2013] [Revised: 12/21/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the reliability of endocervical curettage (ECC) in patients previously treated for CIN. PATIENTS AND METHODS Retrospective analysis of data from 85 patients between January 1985 and December 2011 who received an ECC during monitoring after treatment of CIN. The reliability of the ECC was evaluated by comparison with the final histological analysis of the surgical specimen or the data for subsequent cyto-colpo-histological follow-up. RESULTS Patients were referred to colposcopy either within the immediate post-treatment monitoring (n=42), meanly 9.7±5.3 months after treatment, or if cytological abnormalities were detected during long-term monitoring, meanly 78.6±52.4 months after treatment. Colposcopy was unsatisfactory in 75.3% of patients and normal colposcopic findings were found in 80% of patients. A perfect agreement between the ECC and the endocervical final diagnosis was noted in 68 patients (80%). For the diagnosis of severe cervical lesions (CIN 2+) ECC had a sensitivity of 86.2% (68.3-96.1), a specificity of 94.6% (85.1-98.9) and positive and negative predictive values of 61.4% (47.6-74.0) and 93% (83.0-98.1), respectively. CONCLUSION The high sensitivity and negative predictive value of ECC for the diagnosis of severe post-therapeutic endocervical lesions avoid iterative treatment without increasing the risk of progression of a lesion to cancer.
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Affiliation(s)
- L Lecointre
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - C-Y Akladios
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - G Averous
- Service de pathologie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
| | - F Lefebvre
- Pôle de santé publique et de santé au travail, secteur méthodologie et biostatistique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - E Baulon
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - V Thoma
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - M Fender
- Association EVE, 67400 Illkirch-Graffenstaden, France
| | - J-J Baldauf
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
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Baldauf JJ, Baulon E, Thoma V, Akladios CY. [Prevention of obstetrical complications following LEEP, is it possible?]. ACTA ACUST UNITED AC 2013; 43:19-25. [PMID: 24332739 DOI: 10.1016/j.jgyn.2013.08.015] [Citation(s) in RCA: 4] [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: 02/08/2013] [Revised: 07/12/2013] [Accepted: 08/13/2013] [Indexed: 11/17/2022]
Abstract
Recent epidemiological data suggest an increase of the incidence and prevalence of CIN as well as a decrease of the mean age of the patients presenting these lesions. Large loop electrosurgical procedure (LEEP) is the most commonly used treatment method. According to recent studies LEEP provides a 1.4 to 7.0 fold increase of preterm delivery. Cervical cerclage does not show efficiency in reducing this risk, even if cervical shortening is measured by transvaginal ultrasound. Considering histological severity of lesions and the age of patients, number of currently conducted conizations in France could be avoided and so their obstetrical consequences prevented, just because no treatment is necessary or could be done by ablative procedures.
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Affiliation(s)
- J-J Baldauf
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg cedex, France.
| | - E Baulon
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg cedex, France
| | - V Thoma
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg cedex, France
| | - C Y Akladios
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg cedex, France
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Baldauf JJ, Averous G, Baulon E, Thoma V, Talha-Vautravers A, Sananes N, Akladios Y. Neoplasias intraepiteliales del cuello uterino. EMC - Ginecología-Obstetricia 2013; 49:1-23. [DOI: 10.1016/s1283-081x(13)65435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Baldauf JJ, Averous G, Baulon E, Thoma V, Talha-Vautravers A, Sananes N, Akladios Y. Néoplasies intraépithéliales du col. EMC - Gynécologie 2013; 8:1-21. [DOI: 10.1016/s0246-1064(12)54837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Souabni H, Thoma V, Bizouarn T, Chatgilialoglu C, Siafaka-Kapadai A, Baciou L, Ferreri C, Houée-Levin C, Ostuni M. trans Arachidonic acid isomers inhibit NADPH-oxidase activity by direct interaction with enzyme components. Biochimica et Biophysica Acta (BBA) - Biomembranes 2012; 1818:2314-24. [DOI: 10.1016/j.bbamem.2012.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 04/23/2012] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
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Thoma V, Davidoff J. Priming for depth-rotated objects depends on attention. J Vis 2010. [DOI: 10.1167/2.7.42] [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: 11/24/2022] Open
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Weingertner AS, Rodriguez B, Ziane A, Gibon E, Thoma V, Osario F, Haddad C, Wattiez A. The use of JJ stent in the management of deep endometriosis lesion, affecting or potentially affecting the ureter: a review of our practice. BJOG 2008; 115:1159-64. [DOI: 10.1111/j.1471-0528.2008.01795.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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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Thoma V. 461: Laparoscopic Promontofixation. J Minim Invasive Gynecol 2007. [DOI: 10.1016/j.jmig.2007.08.671] [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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Abstract
Today, hysterectomy is, after caesarean section, the most frequent surgical intervention performed in fertile women. Introduced in 1989, laparoscopic hysterectomy remains poorly diffused: today, less than 5% of all hysterectomies remain done by laparoscopy. Nevertheless after a correct learning curve, laparoscopic hysterectomy finds perfect indications in benign and even some malignant indications. In these conditions, the complication rate is similar to those of the other surgical routes. Currently the limitations of this technique are the very bulky uterus, contraindicated uterine morcellation, the lengthening of the operative time potentially generated by this technique, and the lack of experienced instructors.
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Affiliation(s)
- V Thoma
- IRCAD/EITS, 1, place de l'Hôpital, B.P. 426, 67091 Strasbourg, France.
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Thoma V, Idrissi B, Kohler M, Becmeur F, Viville B, Favre R. Prenatal Diagnosis of Congenital Epulis. Fetal Diagn Ther 2006; 21:321-5. [PMID: 16757904 DOI: 10.1159/000092458] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Accepted: 06/02/2005] [Indexed: 11/19/2022]
Abstract
Congenital granular epulis is a rare benign tumour situated on the alveolar ridge, which usually presents as a single tumour of variable size. Prenatal diagnosis of epulis has rarely been reported in medical literature. A possible complication is airway obstruction, which is essentially determined by the size of the tumour. Because of the potential risk of neonatal respiratory distress, prenatal diagnosis is valuable in the organization of a safe delivery. The case presented here is the prenatal diagnosis of a congenital epulis discovered in the 32nd week of pregnancy.
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Affiliation(s)
- V Thoma
- Department of Obstetrics, CMCO-SIHCUS, Haguenau, France.
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Thoma V, Chua I, Favre R, Roy C, Wattiez A. 126. J Minim Invasive Gynecol 2005. [DOI: 10.1016/j.jmig.2005.07.125] [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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Chua I, Thoma V, Garbin O, Wattiez A. 11. J Minim Invasive Gynecol 2005. [DOI: 10.1016/j.jmig.2005.07.014] [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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Tuech JJ, Pessaux P, Moutel G, Thoma V, Schraub S, Herve C. Methodological quality and reporting of ethical requirements in phase III cancer trials. J Med Ethics 2005; 31:251-255. [PMID: 15863678 PMCID: PMC1734140 DOI: 10.1136/jme.2003.007435] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND The approval of a research ethics committee (REC) and obtaining informed consent from patients (ICP) could be considered the main issues in the ethics of research with human beings. The aim of this study was to assess both methodological quality and ethical quality, and also to assess the relationship between these two qualities in randomised phase III cancer trials. METHOD Methodological quality (Jadad score) and ethical quality (Berdeu score) were assessed for all randomised controlled trials (RCTs) published in 10 international journals between 1999 and 2001 (n = 231). RESULTS The mean Jadad score was 9.86 +/- 1.117. The methodological quality was poor in 75 RCTs (Jadad score <9). The mean Berdeu score was 0.42 +/- 0.133. The mean ethical quality score for poor methodological quality RCTs (n = 75) was 0.39 +/- 0.133; it was 0.43 +/- 0.133 for good (n = 156) methodological quality RCTs (p = 0.07). There was improvement in ethical quality according to the year of commencement of the trials (p < 0.001). There was no correlation between methodological quality and the number of participating patients (R2 = 0.003, p = 0.78), between ethical quality and the number of participating patients (R2 = 0.003, p = 0.76 ), or between ethical quality and methodological quality (R2 = 0.012, p = 0.1). ICP and REC approval were not obtained for 21 and 77 trials respectively. CONCLUSION The association between methodological quality and the reporting of ethical requirements probably reflects the respect shown for patients during the whole research process. These results suggest that closer attention to the conduct of clinical research, as well as the reporting of its ethical aspects, is needed.
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Affiliation(s)
- J J Tuech
- Laboratoire d'Ethique Médicale et de Santé Publique, Faculté de Médecine Necker, Université Paris René Descartes, France.
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Tuech JJ, Chaudron V, Thoma V, Ollier JC, Tassetti V, Duval D, Rodier JF. Prevention of radiation enteritis by intrapelvic breast prosthesis. Eur J Surg Oncol 2005; 30:900-4. [PMID: 15336738 DOI: 10.1016/j.ejso.2004.06.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2004] [Indexed: 12/12/2022] Open
Abstract
Pelvic malignancies frequently require post-operative radiation therapy that may induce small bowel damage at an incidence of 5-25%. Various surgical techniques have been reported to prevent acute and chronic radiation enteritis. This article describes the technical aspects of pelvic exclusion by an intrapelvic silicone breast prosthesis.
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Affiliation(s)
- J J Tuech
- Department of Digestive Surgery, Hôpital E. Muller, 20 r Docteur René Laennec, 68070 Mulhouse Cedex 1, France.
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