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Hadhoum S, Ghesquière L, Drumez E, Subtil D, Garabedian C. [Comparison of vaginal prostaglandins with oral misoprostol as a second line of cervical ripening after using a cervical balloon catheter]. Gynecol Obstet Fertil Senol 2024; 52:68-73. [PMID: 37995911 DOI: 10.1016/j.gofs.2023.11.004] [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: 03/08/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To compare vaginal prostaglandins with oral misoprostol as a second line of cervical ripening after using a cervical balloon catheter. MATERIAL AND METHODS This is a retrospective monocentric study (Lille, France), according to a "before"/"after" design. The inclusion criteria were a singleton pregnancy, with a fetus in cephalic presentation, a term >37 WA, with a cervix having a Bishop score lower than 6 after a first line of maturation by cervical balloon catheter. Two groups were formed: "before" corresponding to the continuation of maturation by vaginal prostaglandins, from March 2019 to November 2019, and "after": corresponding to the continuation of maturation by oral misoprostol, from June 2020 to December 2020. The primary outcome was vaginal delivery rate. RESULTS One hundred women were included in each group. The rate of vaginal delivery was similar between the 2 groups (76% vs 81%, p=0.39), as were the times between the start of induction and the birth and between the start of induction and the transition to birth room. There was no difference in the indication for caesarean section, with in particular an identical rate of caesarean sections for induction failure (p=0.52). Subgroup analysis in obese women showed a significantly higher rate of vaginal delivery in the "after" group (OR=4.17;95% CI [1.02;17.07]). CONCLUSION The vaginal delivery rate is similar when using vaginal prostaglandins or oral misoprostol as second line cervical ripening after use of a cervical balloon catheter.
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Affiliation(s)
- S Hadhoum
- Service de gynécologie obstétrique, CHU Lille, avenue Eugène-Avinée, 59000 Lille, France.
| | - L Ghesquière
- Service de gynécologie obstétrique, CHU Lille, avenue Eugène-Avinée, 59000 Lille, France; University Lille, ULR 2694-METRICS, 59000 Lille, France
| | - E Drumez
- University Lille, ULR 2694-METRICS, 59000 Lille, France; Département de biostatistiques, CHU Lille, 59000 Lille, France
| | - D Subtil
- Service de gynécologie obstétrique, CHU Lille, avenue Eugène-Avinée, 59000 Lille, France; University Lille, ULR 2694-METRICS, 59000 Lille, France
| | - C Garabedian
- Service de gynécologie obstétrique, CHU Lille, avenue Eugène-Avinée, 59000 Lille, France; University Lille, ULR 2694-METRICS, 59000 Lille, France
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Lukas S, Martinot P, Putman S, Lons A, Drumez E, Migaud H, Girard J. Metal ion release after hip resurfacing arthroplasty and knee arthroplasty: a retrospective study of one hundred ninety-five cases. Int Orthop 2024; 48:119-126. [PMID: 37650937 DOI: 10.1007/s00264-023-05915-6] [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: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Hip arthroplasty with metal-on-metal bearings like hip resurfacing results in the release of metallic ions. In parallel, like every metallic implant, knee arthroplasty implants undergo passive corrosion. We analyzed blood levels of cobalt and chromium ions in patients who have a hip resurfacing arthroplasty and compared them to patients who have undergone knee arthroplasty at a minimum follow-up of one year. The hypothesis was that there is no difference in the ion release between hip resurfacing and knee arthroplasty. METHODS Sixty-three patients who underwent knee arthroplasty were compared to a cohort of 132 patients who underwent hip resurfacing. The blood levels of cobalt and chromium ions were determined preoperatively and at six and 12 months postoperatively and then compared between groups. We analyzed the relationship between ion release and the change in clinical outcome scores (Harris Hip score, Oxford Hip score, Merle D'Aubigné Postel score, Oxford Knee score, International Knee Society score), the BMI, sex, physical activity, implant size and inclination of the acetabular implant (hip resurfacing patients only). Mixed linear models were used to assess the changes in ion blood levels over time. RESULTS The cobalt blood levels were higher in the first 6 months in the resurfacing group (0.87 ug/L vs 0.67 ug/L; p = 0.011), while it was higher in the knee arthroplasty group at 12 months (1.20 ug/L vs 1.41 ug/L; p = 0.0008). There were no significant differences in chromium levels during the follow-up period. CONCLUSION The increase in metal ion release after knee arthroplasty is as high as after hip resurfacing at the one year follow-up. The monitoring of this parameter probably should not be recommended in case of good clinicals outcomes.
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Affiliation(s)
- S Lukas
- Univ. Lille, CHU Lille, ULR 4490-PMOI, F-59000, Lille, France.
- Service d'Orthopédie, Hôpital Salengro, Place de Verdun, CHU Lille, F-59000, Lille, France.
| | - P Martinot
- Département de Chirurgie Orthopédique, Hôpital Saint Philibert, Université Catholique de Lille, Lomme, France
| | - S Putman
- Univ. Lille, CHU Lille, ULR 4490-PMOI, F-59000, Lille, France
- Service d'Orthopédie, Hôpital Salengro, Place de Verdun, CHU Lille, F-59000, Lille, France
| | - A Lons
- Département de Chirurgie Orthopédique, Hôpital Saint Philibert, Université Catholique de Lille, Lomme, France
| | - E Drumez
- Unité de Biostatistiques, Université Lille, Centre Hospitalier Universitaire Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France
| | - H Migaud
- Univ. Lille, CHU Lille, ULR 4490-PMOI, F-59000, Lille, France
- Service d'Orthopédie, Hôpital Salengro, Place de Verdun, CHU Lille, F-59000, Lille, France
| | - J Girard
- Univ. Lille, CHU Lille, ULR 4490-PMOI, F-59000, Lille, France
- Service d'Orthopédie, Hôpital Salengro, Place de Verdun, CHU Lille, F-59000, Lille, France
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, EA 7369-URePSS-Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59000, Lille, France
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Merlier M, Ghesquière L, Huissoud C, Drumez E, Morel O, Garabedian C. How do French Obstetrician-Gynaecologists perceive their quality of life? A national survey. Eur J Obstet Gynecol Reprod Biol 2023; 286:112-117. [PMID: 37243999 DOI: 10.1016/j.ejogrb.2023.05.010] [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: 02/17/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Obstetrics is a constraining specialty due to heavy workloads and repeated stressful situations. French maternity wards are facing many difficulties to recruit, as a consequence of the conversion of a significant number of Obstetrician-Gynecologists (OB-GYNs) to exclusive daily private practice. The aim of this study was to evaluate the quality of life (QOL) of OB-GYNs in order to identify burnout risk factors, develop prevention strategies and therefore ensure patient safety. STUDY DESIGN A Google forms questionnaire assessing QOL and life/work balance was distributed by e-mail to 1397 members of the National College of French OB-GYNs (CNGOF). This was a declarative multicenter cross-sectional survey. RESULTS Four hundred sixty-one responses were collected (response rate 30%). A burnout episode was reported by 31.3% of respondents. Main burnout risk factors were limited staff on the on-call schedule (p = 0.008) and low salary (p < 0.001). On-call work was considered to have a negative personal life impact by 57.8% of the sample; 34.1% wanted to stop this practice and 81.3% believed that financial compensation would help reinforce its attractiveness. Medico-legal risks influenced the daily practices of 70% of respondents and 86.8% had been personally affected by media coverage of obstetrical violence. CONCLUSIONS This report confirms a high burnout rate within a stressful profession, with major impacts from on-call activity, insufficient salary relative to the arduousness of this practice, high exposure to medico-legal actions and media attention. Revising shift duration to a maximum 12 h, better control over global workload, higher salary and renewed social recognition are urgent priorities.
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Affiliation(s)
- Margaux Merlier
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France.
| | - Louise Ghesquière
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France; University of Lille, ULR 26 94- METRICS, Avenue Eugène Avinée, F-59000 Lille, France
| | - Cyril Huissoud
- Department of Gynaecology, Hôpital universitaire de la Croix-Rousse (Hospices Civils de Lyon), Universities Claude Bernard Lyon 1, Lyon, France
| | - E Drumez
- CHU Lille, Department of Statistics, Avenue Eugène Avinée, 59000 Lille, France
| | - Oliver Morel
- Obstetrics & Gynaecology, CHRU de Nancy, University of Lorraine, 10 rue Heydenreich, 54000 Nancy, France
| | - Charles Garabedian
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France; University of Lille, ULR 26 94- METRICS, Avenue Eugène Avinée, F-59000 Lille, France
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Vasse M, Moyart M, Drumez E, Lejeune S, Deschildre A. Accidents allergiques en vraie vie chez les enfants allergiques à l’arachide et/ou fruits à coque. Revue Française d'Allergologie 2023. [DOI: 10.1016/j.reval.2022.103270] [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: 02/17/2023]
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Farhat MM, Horn M, Vaiva G, Drumez E, Seror R, Gaud-Listrat V, Costedoat-Chalumeau N, Tieulie N, Ait Abdallah N, Devauchelle-Pensec V, Guillaume-Czitrom S, Hamamouche N, Morell-Dubois S, Hachulla E. AB1120 PSYCHOLOGICAL ASSESSMENT IN PATIENTS WITH CHRONIC RHEUMATIC, SYSTEMIC AUTOIMMUNE, OR AUTOINFLAMMATORY DISEASES PRESENTED WITH COVID-19: THE MentCOVRMD STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe COVID-19 pandemic has raised concerns about its psychological effects. Sleep disturbances, anxiety and/or depressive symptoms, post-traumatic stress symptoms have been reported in general population. Patients with chronic rheumatism, systemic autoimmune disease or auto-inflammatory disease, due to immunosuppression, are at risk of severe forms of infection. Currently, there is little information on psychological impact of the pandemic on the mental health of these more vulnerable patients.ObjectivesTo compare psychological assessment between patients with chronic rheumatic, autoimmune and/or autoinflammatory diseases who presented with COVID-19 infection between March and September 2020, first wave of French pandemic, and patients with same diseases who did not presented with infection to date.MethodsThe MentCOVRMD study was a multicenter descriptive study. Cases were patients with chronic rheumatic, autoimmune and/or autoinflammatory diseases from the French RMD cohort who presented COVID-19 infection between March and September 2020. Controls were patients with same diseases who did not develop infection. The study is registered in Clinical Trials under number 2020-A02058-31.For participants, following criteria were collected: demographics (age, gender, smoking status); psychological assessment questionnaires: Insomnia Severity Index (ISI); Post-traumatic stress disorder (PTSD) checklist; Patient Health Questionnaire (PHQ9) Depression; Generalized Anxiety Disorder (GAD7) Anxiety; Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Disorder (SSD)-12.ResultsBetween February and December 2021, 60 cases (46 (76.7%) women), median age 52.0 (39.0; 63.0) were included, of which 15 (25%) had been hospitalized during infection, and 169 controls (148 (87.6%) women), median age of 52.0 (38.0; 63.0). There were more smokers in the group of cases 12 (20%) than controls 14 (9.1%) (p=0.028) as well as more cases on ARA2 treatment (8 (13.3%)) than controls (7 (4.5%)) (p=0.035) with no statistically significant difference in others comorbidities or treatments.There was no statistically difference concerning the ISI scores between cases (11.83 ± 7.31) of which 60% had sleep disorders and controls (11.64 ± 6.82) of which 70.4% had sleep disorders. There was no statistically significant difference in PTSD scores of 15.5 (5.0 to 28.0) for cases and 18.0 (8.0 to 35.0) for controls, of which respectively 12 (20%) had values indicating possible PTSD for cases and 50 (29.6%) for controls. There was no statistically significant difference in PHQ-9 scores (5.5 (1.5 to 11.0)) of which 50% had depressive symptoms and controls (6.0 (2.0 to 11.0)) of which 54.5% had symptoms. There was no statistically significant difference in GAD-7 scores (3.5 (0.0 to 8.0)) of which 40% had anxiety symptoms and controls (4.0 (0.0 to 8.0)) of which 43.2% had symptoms. There was no statistically significant difference in PHQ-15 scores (11.4 ± 6.7), 85% of whom reported presence of symptoms, and controls (10.9 ± 6.2), 82.3% of whom reported symptoms. There was no statistically significant difference in SSD scores between cases (17.7 ± 10.9) and controls (18.4 ± 10.9).There was a statistically significant difference in reported VAS scores of pain related to inflammatory rheumatism in cases with a median of 4.5 (3.0 to 6. 0) compared to controls with a median of 4.0 (1.0 to 6.0) (p=0.011).There was no statistically significant difference in any of the psychological assessment scores between the inpatient and outpatient COVID cases.ConclusionThere was no statistically significant difference between COVID cases and controls in the evaluation of these psychological parameters. Prevalence of all these variables were high in the whole study population, testifying to the need to manage these psychological aspects for patients with chronic rheumatisms, autoimmune and/or autoinflammatory diseases.Disclosure of InterestsNone declared
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Khobzaoui M, Ghesquiere L, Drumez E, Debarge V, Subtil D, Garabedian C. Cervical maturation in breech presentation: Mechanical versus prostaglandin methods. J Gynecol Obstet Hum Reprod 2022; 51:102404. [DOI: 10.1016/j.jogoh.2022.102404] [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] [Received: 03/01/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022]
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Ghesquière L, Rouilles J, Drumez E, Houfflin-Debarge V, Subtil D, Garabedian C. Is it reasonable to propose vaginal delivery with twin pregnancies, when the first twin is in breech presentation? J Gynecol Obstet Hum Reprod 2022; 51:102377. [DOI: 10.1016/j.jogoh.2022.102377] [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] [Received: 09/23/2021] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
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Bommelaere T, Villers A, Puech P, Ploussard G, Labreuche J, Drumez E, Leroy X, Olivier J. Individualized risk prediction of metastatic recurrence in patients candidate to radical prostatectomy: A new model using clinical, mri and mri-guided biopsy parameters. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00699-6] [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: 11/04/2022]
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Beghin L, Vanhelst J, Drumez E, Kersting M, Molnar D, Kafatos A, De Henauwn S, Widhalm K, Karaglani E, Moreno L, Gottrand F. Le poids de naissance et la durée de l’allaitement maternel programment différemment la condition physique de l’adolescent. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.137] [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: 10/18/2022]
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Morcel J, Béghin L, Mitchels N, Vanhelst J, Labreuche J, Drumez E, Polito A, Ferrari M, De Henauwn S, Miguel Berges M, Moreno L, Gottrand F. Risque cardiovasculaire chez le jeune adulte (étude BELINDA) : design et objectifs. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.143] [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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Plurien A, Berveiller P, Drumez E, Hanssens S, Subtil D, Garabedian C. Ultrasound assessment of fetal head position and station before operative delivery: can it predict difficulty? J Gynecol Obstet Hum Reprod 2022; 51:102336. [DOI: 10.1016/j.jogoh.2022.102336] [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] [Received: 11/15/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
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Lemaitre M, Passet M, Ghesquière L, Martin C, Drumez E, Subtil D, Vambergue A. Is the Development of Gestational Diabetes Associated With the ABO Blood Group/Rhesus Phenotype? Front Endocrinol (Lausanne) 2022; 13:916903. [PMID: 35813660 PMCID: PMC9256971 DOI: 10.3389/fendo.2022.916903] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/19/2022] [Indexed: 12/02/2022] Open
Abstract
AIMS There are few published data on the putative association between the ABO blood group/rhesus (Rh) factor and the risk of developing gestational diabetes mellitus (GDM). Our aim was to explore the link between each one factor and GDM development. METHODS All women having given birth at Lille University Medical Center (Lille, France) between August 1st, 2017, and February 28th, 2018, were tested for GDM, using the method recommended in the French national guidelines. The risk of GDM was assessed for each ABO blood group, each Rh phenotype and combinations thereof, using logistic regression models. RESULTS 1194 women had at least one GDM risk factor. The percentage of GDM varied with the ABO group (p=0.013). Relative to group O women, group AB women were more likely to develop GDM (OR = 2.50, 95% CI [1.43 to 4.36], p=0.001). Compared with the Rh-positive O group, only the Rh-positive AB group had an elevated risk of developing GDM (OR = 3.02, 95% CI [1.69 to 5.39], p < 0.001). CONCLUSIONS Our results showed that Rh-positive group AB women have a greater risk of GDM. With a view to preventing GDM, at-risk individuals could be identified by considering the ABO blood group phenotype either as a single risk factor or in combination with other risk factors.
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Affiliation(s)
- M. Lemaitre
- University of Medicine, Lille, France
- CHU Lille, Department of Diabetology, Endocrinology, Metabolism and Nutrition, Lille University Hospital, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - M. Passet
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - L. Ghesquière
- University of Medicine, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - C. Martin
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Department of Biostatistics, Lille University Hospital, Lille, France
| | - E. Drumez
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Department of Biostatistics, Lille University Hospital, Lille, France
| | - D. Subtil
- University of Medicine, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - A. Vambergue
- University of Medicine, Lille, France
- CHU Lille, Department of Diabetology, Endocrinology, Metabolism and Nutrition, Lille University Hospital, Lille, France
- European Genomic Institute for Diabetes, University School of Medicine, Lille, France
- *Correspondence: A. Vambergue, ; orcid.org/0000-0003-4307-8695
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Mammou Mraghni S, Drumez E, Aeschlimann F, Pajot-Audouin C, Bader-Meunier B, Carbasse A, Clet J, Deslandre C, Duquesne A, Dusser P, Guillaume-Czitrom S, Hentgen V, Koné-Paut I, Melki I, Quartier P, Hachulla E, Belot A. Caractéristiques cliniques de la Covid-19 chez les enfants et adolescents atteints de maladies rhumatismales et inflammatoires : données de la cohorte française RMD COVID-19 de 95 patients. Revue du Rhumatisme 2021. [PMCID: PMC8626124 DOI: 10.1016/j.rhum.2021.10.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Introduction Patients et méthodes Résultats Conclusion
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Gilbert M, Ghesquiere L, Drumez E, Subtil D, Fague V, Berveiller P, Garabedian C. How to reduce fetal scalp blood sampling? A retrospective study evaluating the diagnostic value of scalp stimulation to predict fetal wellbeing assessed by scalp blood sampling. Eur J Obstet Gynecol Reprod Biol 2021; 263:153-158. [PMID: 34216939 DOI: 10.1016/j.ejogrb.2021.05.032] [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: 02/15/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Fetal Blood Sample (FBS) is used as an indicator of fetal acidosis during labor. Its place is discussed through the lack of randomized trials, as well as the limitations related to the technical procedure. An alternative could be the Fetal Scalp Stimulation (FSS). AIM Our objective was to describe the FSS diagnostic value to predict fetal wellbeing defined from FBS. METHODS The FSS consisted in a digital scalp stimulation for 15 s. Test was negative when an acceleration and/or a normal variability were elicited in the 2 min following. FSS was performed before each FBS which was classified as normal when pH was > 7.25. The diagnostic value was assessed by sensibility, specificity, positive and negative predictive values. FINDINGS 148 women were included in our center from February to December 2019. Of the 191 FBS procedures, when accelerations were elicited sensibility was 58,3 (36.8-77.1), specificity was 67,5 (59.3-75), positive predictive value was 20,9 (12.5-32.9) and negative predictive value was 91.7 % (95 %CI, 85-95.5). DISCUSSION FBS is considered as the gold standard in our study which could be discussed as it is abandoned in some countries because of its questioned reliability and the lack of controlled randomized trials. CONCLUSION This study suggests that FSS could be an interesting alternative adjunctive test to perform in the first instance as it seems to be reliable, non-invasive and easy to perform in order to limit FBS only to absence of acceleration after FSS.
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Affiliation(s)
- M Gilbert
- CHU Lille, Department of Obstetrics, F-59000, Lille, France.
| | - L Ghesquiere
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - E Drumez
- Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; CHU Lille, Department of Biostatistics, F-59000, Lille, France
| | - D Subtil
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - V Fague
- CH Valenciennes, Department of Obstetrics, F-59300, Valenciennes, France
| | - P Berveiller
- CH Poissy, Department of Obstetrics, F-78300, Poissy, France
| | - C Garabedian
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
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Avouac J, Drumez E, Hachulla E, Seror R, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Marotte H, Servettaz A, Domont F, Chazerain P, Devaux M, Claudepierre P, Langlois V, Mekinian A, Maria A, Banneville B, Fautrel B, Pouchot J, Thomas T, Flipo RM, Richez C. OP0284 OUTCOME OF COVID-19 IN PATIENTS WITH RHEUMATIC AND INFLAMMATORY DISEASES TREATED WITH RITUXIMAB: DATA FROM DE FRENCH RMD COVID-19 COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Various observations have suggested that the course of the COVID-19 infection may be less favorable in patients with inflammatory rheumatic and musculoskeletal diseases (iRMD) receiving rituximab (RTX).Objectives:To investigate whether treatment with RTX is associated with severe infection and death.Methods:We performed an observational, multicenter, French national cohort study querying the French RMD COVID-19 cohort, including highly suspected/confirmed iRMD-COVID-19 patients. The primary endpoint was to assess the severity rate of COVID-19. Severe disease was defined by hospitalization in intensive care unit or death. The secondary objectives were to analyze death rate and length of hospital stay. Two control groups were considered for comparison with RTX treated patients: a first group including all non-RTX treated iRMD patients and a second consisting on RTX untreated iRMD patients with diseases for which RTX is a recognized therapeutic option. Adjusting on potential confounding factors was performed by using inverse probability of treatment weighting (IPTW) propensity score method.Results:We collected a total of 1090 records. Patients were mainly females (67.3%, 734/1090) with a mean age of 55.2±16.4 years, and 51.1% (557/1090) were over the age of 55. Almost 70% of the population had at least one comorbidity (756/1090). A total of 63 patients were treated with RTX, mainly for rheumatoid arthritis (RA) (31/63, 49.2%). RTX treated patients were more likely to be males, with older age, higher prevalence of comorbidities and corticosteroid use. The control population consisted on 1027 non-RTX treated iRMD patients, and 495 RTX untreated iRMD patients with diseases for which RTX is a recognized therapeutic option.Of the 1,090 patients, 137 developed severe disease (12.6%). After adjusting on potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure and the underlying disease), severe disease was confirmed to be observed more frequently in patients receiving RTX compared to all RTX untreated iRMD patients (effect size, ES 3.26, 95% confidence interval, CI 1.66 to 6.40, p<0.001) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (ES 2.62, 95% CI 1.34 to 5.09, p=0.005). Patients who developed a severe disease had a more recent rituximab infusion compared to patients with mild or moderate disease. Indeed, the time between the last infusion of rituximab and the first symptoms of COVID-19 was significantly shorter in patients who developed a severe form of COVID-19 (Figure 1).Figure 1.Distribution (Tukey’s box plot) of Lag time between last infusion of Rituximab according to disease severity. P-Values for comparison between disease severity with Kruskal Wallis test are reported; P-Value<0.001 for either post-hoc comparison of severe disease group with moderate or mild disease group (calculated using Dunn’s test).Eighty-nine patients in our cohort died, resulting in an overall death rate of 8.2%. Death rate was numerically higher in RTX treated patients (13/63, 20.6%) compared to all RTX untreated iRMDs patients (76/1027, 7.4%) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (49/495, 9.9%). After considering the previously described confounding factors, the risk of death was not significantly increased in patients treated with RTX compared to all RTX untreated iRMDs patients (ES 1.32, 95% CI 0.55 to 3.19, p=0.53) (Table 2) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (ES 1.48, 95% CI 0.68 to 3.20, p=0.32). In line with a more severe COVID-19 disease, the length of hospital stay was markedly longer in patients treated with RTX compared to both untreated RTX patient groups.Conclusion:RTX therapy is associated with a more severe COVID-19 infection. RTX will have to be applied with particular caution in patients with iRMDs.Acknowledgements:Muriel Herasse played a major role in collecting the missing data of the cohort.We thank Julien Labreuche (biostatistician, CHU-Lille) for the help in the statistical analysis.Disclosure of Interests:None declared
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Juge PA, Hachulla E, Richez C, Drumez E, Duhamel A, Borie R, Dieudé P. POS1227 IMPACT OF A PRE-EXISTING INTERSTITIAL LUNG DISEASE ON SEVERITY OF COVID-19 IN PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:COVID19 due to SARS-CoV-2 infection implies an important anti-viral immune response leading to a major inflammatory syndrome with increased pro-inflammatory cytokine levels (i.e. the cytokine storm paradigm). The impact of a preexisting interstitial lung disease (ILD) on the morbi-mortality of COVID-19 is unclear. An increased mortality rate has been identified in studies that included a limited number of patients with ILD from various etiologies. To date, no studies have investigated the severity of COVID-19 in patients with preexisting ILD in a large population of rheumatic and musculoskeletal diseases (RMD-ILD). Since March 18th, 2020, the French RMD COVID19 dataset (NCT04353609) includes patients with an RMD and SARS-Cov-2 infection.Objectives:To assess the impact of a preexisting ILD on COVID-19 morbi-mortality within the French RMD COVID-19 dataset.Methods:Patients from the French RMD COVID-19 dataset were included in the analysis. COVID-19 diagnosis was established by a positive SARS-CoV-2 PCR test and/or typical symptoms or chest CT scans pattern during the period of the pandemic. Baseline phenotypic characteristics of the RMD including pre-existing ILD prior to the SARS-CoV-2 infection were collected. COVID-19 evolution was characterized as benign (ambulatory care), moderate (hospitalization outside intensive care unit [ICU]) and severe (hospitalization in ICU). Association between the ILD status and the severity and mortality rate of COVID-19 was assessed using multivariable logistic regression adjusted on sex, age, body mass index and diabetes.Results:By June 26, 2020, 897 patients were included. Pre-existing ILD was reported in 27 patients (3%): 11 patients with systemic sclerosis, 8 with rheumatoid arthritis, 2 with auto-immune myositis, 2 with mixed connective tissue disease and 4 with other RMD. Among these 27 patients (11 male, mean age 63.1 ± 16.4 y/o, 56.5% having a usual interstitial pneumonia HRCT pattern), 22 had severe infection. Death related to COVID-19, was observed in 58 patients with RMD without ILD (7.1%) and in 10 patients with RMD-ILD (37%). Having a preexisting ILD was found to be independently associated with an increased risk of severe COVID-19 (adjusted OR=7.6 [2.9 – 20.2], P<0.001) and an increased mortality rate (adjusted OR=12.3 [3.8 – 39.2], P<0.001).Conclusion:In RMD patients with SARS-CoV-2 infection, preexisting ILD was associated with an increased risk to severe COVID-19 and related mortality. Our findings suggest that RMD-ILD patients should be prioritized for COVID-19 vaccination according to the high morbi-mortality rate during SARS-CoV-2 infection.Disclosure of Interests:Pierre-Antoine Juge Consultant of: BMS, Eric Hachulla Consultant of: Actelion, Bayer, GSK and Pfizer, Grant/research support from: Actelion, Bayer, GSK and Pfizer, Christophe Richez: None declared, Elodie Drumez: None declared, Alain Duhamel: None declared, Raphael Borie: None declared, Philippe Dieudé: None declared
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El Ahmadi W, Ghesquiere L, Drumez E, Subtil D, Debarge V, Garabedian C. [Impact of a protocol based on the new national recommendations on the use of oxytocin and its maternal-fetal consequences: A single-center before/after study]. ACTA ACUST UNITED AC 2021; 49:744-749. [PMID: 33757924 DOI: 10.1016/j.gofs.2021.03.008] [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: 12/15/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evaluate oxytocin use and impact on maternal and fetal morbidity before and after implementation of a protocol based on national recommendations. MATERIALS AND METHODS A single-center retrospective before-and-after study (Lille, France). A service protocol to harmonize the use of oxytocin was implemented in May 2017 following national recommendations. Data were collected from January to March 2016 for period 1, and from January to March 2019 for period 2. Nulliparous patients in spontaneous labor=37SA delivering a live newborn in cephalic presentation were included. The primary outcome was the use of oxytocin. RESULTS Five hundred eighty-seven patients were included, 302 for period 1 and 285 for period 2. The rate of oxytocin use was 48% (n=144) in 2016 versus 28% (n=79) in 2019 (P<0.001). Total labor time was significantly longer after protocol implementation (425.7min vs. 510.4min ; P<0.001). The cesarean section rate was identical between the 2 periods (7.0% vs. 6.0%; P=0.62). The rate of postpartum hemorrhage greater than 500mL was higher in period 1 (17.7% vs. 10.9%; P=0.019), as was the occurrence of a pH<7.05 (5.4% vs. 1.1%; P=0.004). CONCLUSION The implementation of a protocol contributed to a decrease in the use of oxytocin and thus would allow a decrease in the rate of postpartum hemorrhage and neonatal acidosis, but with an increase in the duration of labor.
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Affiliation(s)
- W El Ahmadi
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France.
| | - L Ghesquiere
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 2694 Metrics, environnement périnatal et santé, université de Lille, 59000 Lille, France
| | - E Drumez
- Département de biostatistiques, CHU de Lille, 59000 Lille, France
| | - D Subtil
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 2694 Metrics, environnement périnatal et santé, université de Lille, 59000 Lille, France
| | - V Debarge
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 2694 Metrics, environnement périnatal et santé, université de Lille, 59000 Lille, France
| | - C Garabedian
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 2694 Metrics, environnement périnatal et santé, université de Lille, 59000 Lille, France
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Hochart A, Nève V, Drumez E, Pigeyre M, Mallart A, Monaca C, Le Rouzic O, Gueorguieva I, Matran R. Dramatic impact of morbid obesity on child lung development. Arch Pediatr 2021; 28:186-190. [PMID: 33714673 DOI: 10.1016/j.arcped.2021.02.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/07/2020] [Accepted: 02/13/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the respiratory function and sleep characteristics of obese adults and children. METHODS All patients with non-syndromic, severe obesity (BMI ≥3 z-scores for children and ≥40.00kg/m2 for adults), referred for pulmonary function tests at Lille University Hospital, were retrospectively included. RESULTS A total of 69 children (mean±SD BMI 36.8±6.7 and mean BMI z-score 4.7±1.0) and 70 adults were included (mean BMI 45.7±6.2). Metabolic syndrome was diagnosed in 13 children (26%) and 40 adults (80%). Reduced lung volumes were observed in 34 children (50.0%) and 16 adults (24.0%) and both the mean functional residual capacity (FRC) and the mean residual volume (RV) were lower in children than in adults (FRC: -1.7±2.1 z-score in children vs. -1.0±1.1 in adults, P=0.026; and RV: -0.8±1.2 z-score in children vs. -0.1±1.1 in adults, P=0.002). The prevalence of severe obstructive sleep apnea syndrome was greater in adults (40.7% vs. 18.8%, P=0.007). Children had a higher average oxygen saturation (median of 96.0% [91.0-98.0] vs. 93.0% [76.0-97.0] in adults, P<0.0001). CONCLUSION Obesity has consequences for lung volumes in children; however, a longitudinal study is needed to determine the impact on pulmonary expansion and growth.
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Affiliation(s)
- A Hochart
- Pediatric department, CHU of Lille, 59000 Lille, France.
| | - V Nève
- University of Lille, CHU of Lille, EA4483, Pulmonary function test unit, 59000 Lille, France
| | - E Drumez
- Department of biostatistics, University of Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, 59000 Lille, France
| | - M Pigeyre
- Department of nutrition, University of Lille, CHU of Lille, Centre intégré d'obésité, 59000 Lille, France
| | - A Mallart
- Pulmonology department, CHU of Lille, 59000 Lille, France
| | - C Monaca
- Neurophysiology department, University of Lille, CHU of Lille, 59000 Lille, France
| | - O Le Rouzic
- Pneumology department, University of Lille, CHU of Lille, 59000 Lille, France
| | - I Gueorguieva
- Pediatric department, CHU of Lille, centre intégré d'obésité, 59000 Lille, France
| | - R Matran
- University of Lille, CHU of Lille, EA4483, Pulmonary function test unit, 59000 Lille, France
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Dujardin K, Duhem S, Guerouaou N, Djelad S, Drumez E, Duhamel A, Bombois S, Nasreddine Z, Bordet R, Deplanque D. Validation in French of the Montreal Cognitive Assessment 5-Minute, a brief cognitive screening test for phone administration. Rev Neurol (Paris) 2021; 177:972-979. [PMID: 33478740 DOI: 10.1016/j.neurol.2020.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/20/2020] [Revised: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The prevalence of cognitive impairment and dementia is high and steadily increasing. Early detection of cognitive decline is crucial since some interventions can reduce the risk of progression to dementia. However, there is a lack of manageable scales for assessing cognitive functions outside specialized consultations. Recently, the MoCA-5min, a short version of the Montreal Cognitive assessment (MoCA), phone-administered, was validated for screening for vascular cognitive impairment. The aim of the present study was to validate the MoCA-5min in French in diverse clinical populations. METHODS The Cantonese version of the MoCA-5min was adapted for French language. Healthy volunteers and patients with possible or established cognitive impairment (Alzheimer's disease or related disorders, Parkinson's disease, Huntington's disease, type-2 diabetes) participated in the study. The original MoCA and the MoCA-5min were administered, by phone, with a 30-day interval. Alternate forms were used to reduce learning effects. RESULTS The scores of the original MoCA and MoCA-5min correlated significantly (Spearman rho=0.751, P<0.0001, 95% confidence interval 0.657 to 0.819). Internal consistency was good (Cronbach alpha=0.795). The area under the ROC curve was 0.870 and the optimal cut-off value for separating patients with and without cognitive impairment with the MoCA-5min was≤27 with 87.32% sensitivity and 76.09% specificity. Interrater and test-retest reliability were adequate. CONCLUSION This study demonstrates that the French version of the MoCA-5min is a valid and reliable scale for detecting cognitive impairment in different clinical populations. It is administrable by phone and thus suitable for remote assessment as well as for large-scale screening and epidemiological studies.
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Affiliation(s)
- K Dujardin
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France; Neurology and Movement Disorders, Lille University Medical Center, Lille, France.
| | - S Duhem
- Clinical Investigation Center, Lille University Medical Center, Lille, France
| | - N Guerouaou
- Clinical Investigation Center, Lille University Medical Center, Lille, France
| | - S Djelad
- Neurology and Movement Disorders, Lille University Medical Center, Lille, France
| | - E Drumez
- EA 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, Lille, France
| | - A Duhamel
- EA 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, Lille, France
| | - S Bombois
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
| | | | - R Bordet
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
| | - D Deplanque
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
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Mille B, Dezoteux F, Fievet C, Moreau A, Poissy J, Mathieu D, Kipnis E, Duhamel A, Drumez E, Buche S, Staumont-Salle D. Fréquence des acrosyndromes chez les patients avec infection sévère à SARS-CoV-2 en réanimation. Ann Dermatol Venereol 2020. [PMCID: PMC7688275 DOI: 10.1016/j.annder.2020.09.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction De nombreuses manifestations cliniques dermatologiques ont été rapportées durant la pandémie mondiale de la COVID-19. Parmi elles, des phénomènes d’acrosyndromes ont été décrits, principalement chez des patients suspects d’infection par SARS-Cov-2 mais asymptomatiques ou pauci-symptomatiques. Peu d’études se sont intéressées à ces manifestations chez les patients admis en réanimation. Notre objectif était donc d’évaluer la fréquence instantanée des manifestations acrales cutanées chez les patients sévères atteints de la COVID19 admis en réanimation. Matériel et méthodes Nous avons réalisé une étude observationnelle et prospective, réalisée du 5 au 6 mai 2020. Tout patient adulte hospitalisé en réanimation au CHU de Lille dans le cadre de la COVID19 était inclus et bénéficiait d’un examen systématique du tégument par un dermatologue sénior. Résultats Au total, 39 patients ont été examinés (34 hommes, 5 femmes) avec un âge moyen de 60,6 ans. Aucun patient n’avait présenté de symptôme dermatologique au début de la maladie. La durée médiane d’hospitalisation en réanimation était de 35 jours [21-41] ; 35 patients (90 %) avaient reçu un support ventilatoire par intubation oro-trachéale et 21 (54 %) un support circulatoire par amines vasopressives. Nous avons observé des manifestations cutanées acrales chez 11 patients (28 %) : lésions nécrotiques (5/11, 45 %), bulles hémorragiques (3/11, 27 %), livedo (1/11, 9 %), érosions (1/11, 9 %), hémorragies sous unguéales (2/11, 18 %). Un patient présentant à la fois des lésions nécrotiques et des érosions cutanées. Aucun patient ne présentait de manifestations à type d’engelure ou pseudo-engelure. Il n’y avait pas de différence significative entre les patients avec et sans manifestation acrale concernant la durée d’hospitalisation et les complications thromboemboliques, les symptômes initiaux, et les caractéristiques de base des patients excepté l’IMC moyen plus bas chez les patients avec manifestations acrales. La durée moyenne de la maladie était significativement plus longue et davantage de médicaments vasoactifs ont été administrés aux patients présentant des manifestations cutanées acrales, suggérant une gravité plus élevée de la maladie dans ce groupe et pouvant être en lien avec les manifestations observées. Discussion Nous rapportons une série de manifestations cutanées acrales chez seulement 28 % des patients pris en charge en réanimation au moment de l’étude. Ces manifestations sont variées et peu spécifiques. Aucune manifestation à type d’engelure n’était observée contrairement aux patients suspects de formes pauci ou asymptomatiques et inconstamment confirmées sur le plan sérologique ou moléculaire. Sur le plan physiopathologique, plusieurs hypothèses sont avancées comme une réponse immune antivirale de type interféron. Des études sont nécessaires afin de mieux comprendre les mécanismes à l’origine de ces manifestations.
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Buisset J, Olivier J, Villers A, Norris J, Puech P, Drumez E. Évaluation rétrospective de l’incidence du cancer de prostate cliniquement significatif a 10 ans et intérêt de l’utilisation de la densité du PSA dans le choix des premières biopsies en cas d’IRM négative. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.006] [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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Ghesquière L, Garabedian C, Drumez E, Lemaître M, Cazaubiel M, Bengler C, Vambergue A. Effects of COVID-19 pandemic lockdown on gestational diabetes mellitus: A retrospective study. Diabetes Metab 2020; 47:101201. [PMID: 33069845 PMCID: PMC7557293 DOI: 10.1016/j.diabet.2020.09.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 11/19/2022]
Abstract
Objective The objective of our study was to evaluate the impact of the lockdown period on the glycemic balance in patients with GDM. Methods A retrospective study in one center (Lille, France) compared two periods: the COVID-19 lockdown of 18 March 2020 to 7 May 2020 versus the same period during 2019. Glucose targets were defined by a capillary fasting glucose target < 5.1mmol/L and/or a 2-hour postprandial capillary glucose < 6.6 mmol/L. GDM control was defined as: good (< 20% of the glycemic values were not within the target range), acceptable (20 to 40% of the glycemic values were not within the target range) or poor (> 40% of the glycemic values were not within the target range). Results Two hundred twenty-nine patients were included in 2019 and 222 in 2020. The same mean number of capillary blood sugar tests was performed by the two groups. Postprandial blood sugar was significantly less well controlled in 2020, with a lower rate of good control (61.6% vs 69.4%) and higher rates of acceptable (24.7% vs 21.8%) and poor control (13.7% and 8.7%) (p < 0.05). Use of insulin therapy was significantly higher in 2020 compared with 2019 (47.7% and 36.2%, respectively; p < 0.05). Conclusion Diabetes control was lower during the COVID-19 pandemic lockdown, even if follow-up was not impacted. This may be explained by reduced physical activity, modified dietary habits and anxiety during this period.
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Affiliation(s)
- L Ghesquière
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; University of Lille, CHU Lille, ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, F-59000 Lille, France.
| | - C Garabedian
- CHU Lille, Department of Obstetrics, F-59000 Lille, France; University of Lille, CHU Lille, ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, F-59000 Lille, France
| | - E Drumez
- University of Lille, CHU Lille, ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, F-59000 Lille, France; CHU Lille, Department of Biostatistics, F-59000 Lille, France
| | - M Lemaître
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, F-59000 Lille, France
| | - M Cazaubiel
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, F-59000 Lille, France
| | - C Bengler
- CHU Lille, Department of Obstetrics, F-59000 Lille, France
| | - A Vambergue
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, F-59000 Lille, France; University of Lille, European Genomics Institute for Diabetes (EGID), F-59000 Lille, France
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Envain F, Drumez E, Cappe M, Subtil D, Garabedian C. Impact of a change of a pH analyzer machine on the determination of umbilical cord pH at birth. J Gynecol Obstet Hum Reprod 2020; 49:101819. [PMID: 32450306 DOI: 10.1016/j.jogoh.2020.101819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022]
Affiliation(s)
- F Envain
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France.
| | - E Drumez
- University of. Lille, CHU Lille, EA 2694- Public Health: Epidemiology and Quality of Care, Department of Biostatistics, F-59000 Lille, France
| | - M Cappe
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France
| | - D Subtil
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France
| | - C Garabedian
- CHU Lille, Department of Obstetrics, Avenue Eugène Avinée, F-59000 Lille, France; University of Lille, EA 4489- Perinatal Environment and Health, F-59000 Lille, France
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Benzekri C, Ghesquière L, Drumez E, Houfflin-Debarge V, Subtil D, Garabedian C. [Comparison of antepartum management of breech versus cephalic presentation]. ACTA ACUST UNITED AC 2020; 48:722-728. [PMID: 32335341 DOI: 10.1016/j.gofs.2020.04.010] [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: 08/02/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Delivery mode of term breech presentation is still being discussed. The aim of this study was to compare the labor management of a breech presentation to a vertex presentation during a vaginal delivery attempt. METHODS It was a single-center, comparative, descriptive retrospective study from 2014 to 2017. We studied fetal heart rate (FHR) during labor and expulsion, duration of the different stage of labor, mode of delivery and neonatal outcomes for breech and vertex presentations. RESULTS Two hundred and thirty-nine patients were included whom 106 (44%) breech presentation. The use of oxytocin was more common in breech group (63,2% versus 48,1%, P=0.020). Average dilatation rate was slower for breech presentation than for vertex presentation (1.9cm/h vs. 2.8cm/h; P=0.005). There was more FHR with high risk of acidosis in the breech presentations (37.2% vs 19.1%, P=0.001) and Melchior's FHR classification were comparable in both groups. CONCLUSIONS The per-partum management of a fetus in breech presentation differs from a fetus in cephalic presentation. It must be known and anticipated for an optimal management in the delivery room.
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Affiliation(s)
- C Benzekri
- EA 4489, University Lille, 59000 Lille, France.
| | - L Ghesquière
- EA 4489, University Lille, 59000 Lille, France; Department of obstetrics, CHU de Lille, 59000 Lille, France
| | - E Drumez
- EA 2694 - Public health: epidemiology and quality of care, Department of biostatistics, University of Lille, CHU de Lille, 59000 Lille, France
| | - V Houfflin-Debarge
- EA 4489, University Lille, 59000 Lille, France; Department of obstetrics, CHU de Lille, 59000 Lille, France
| | - D Subtil
- EA 4489, University Lille, 59000 Lille, France
| | - C Garabedian
- EA 4489, University Lille, 59000 Lille, France; Department of obstetrics, CHU de Lille, 59000 Lille, France
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Peru J, Garabedian C, Drumez E, Ghesquière L. [Does rupture of membranes have an impact on the fetal heart rate during spontaneous labor?]. ACTA ACUST UNITED AC 2020; 48:715-721. [PMID: 32092489 DOI: 10.1016/j.gofs.2020.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Evaluate the influence of rupture of membranes (spontaneous or artificial) on fetal heart rate. Secondary objectives were to compare spontaneous and artificial ruptures and to investigate the risk factors associated with the occurrence of abnormalities of fetal heart rate (FHR). METHODS This is a monocentric retrospective study (Lille, France) from January to March 2018. All low-risk pregnancies with cephalic presentation, spontaneous labor, gestational age more than 37 weeks of amenorrhea, singleton pregnancy, absence of maternal or fetal pathology were included. The elements sought were the occurrence of bradycardia, tachycardia, decelerations (early, late, typical variable, atypical variable, prolonged) and abnormal variability. FHR was analyzed one hour before and one hour after rupture. The groups with and without abnormalities of FHR were compared according to the type of rupture. RESULTS Two hundred and thirty-three patients were included. A total of 44.54% (n=129, P<0.001) showed abnormalities of FHR after rupture of membranes. In the fetal heart rate time study after the rupture event, prolonged decelerations were more frequent in the first quarter hour compared to the second quarter hour. There was significantly more risk of abnormalities of fetal heart rate if the fetal heart rate before the rupture of membranes was already pathological, as well as if the time between rupture and delivery was short. The type of rupture, artificial or spontaneous, was not a risk factor. CONCLUSION The rupture of membranes increased the occurrence of abnormalities of FHR. However, there is no more deleterious impact of one type of rupture than the other.
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Affiliation(s)
- J Peru
- École de sages-femme, CHU de Lille, 59000 Lille, France
| | - C Garabedian
- Département d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, 59000 Lille, France; Université de Lille, EA4489-environnement périnatal et croissance, 59000 Lille, France
| | - E Drumez
- Université de Lille, CHU de Lille, EA 2694 - santé publique : épidémiologie et qualité des soins, 59000 Lille, France
| | - L Ghesquière
- Département d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, 59000 Lille, France; Université de Lille, EA4489-environnement périnatal et croissance, 59000 Lille, France.
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Pagniez MA, Kasivisvanathan V, Puech P, Drumez E, Villers A, Olivier J. Predictive Factors of Missed Clinically Significant Prostate Cancers in Men with Negative Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis. J Urol 2020; 204:24-32. [PMID: 31967522 DOI: 10.1097/ju.0000000000000757] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We systematically reviewed the literature on predictive factors for clinically significant prostate cancer diagnosis after prebiopsy negative magnetic resonance imaging in prostate cancer naïve patients. MATERIALS AND METHODS The MEDLINE® and Scopus® databases were searched up to March 2019. The review protocol was published in the PROSPERO database (CRD42019125549). The clinical factors and markers studied were age, prostate specific antigen, prostate specific antigen isoforms, prostate specific antigen density, PCA3, prostate volume, family history, ethnicity and risk calculators. The primary objective was to determine their predictive ability for clinically significant prostate cancer diagnosis. Secondary objectives included meta-analysis of the negative predictive value of prebiopsy negative magnetic resonance imaging when combined with these predictive factors. RESULTS A total of 16 studies were eligible for inclusion. Few studies reported negative predictive value of magnetic resonance imaging combined with a marker. Prostate specific antigen density was the best studied and the strongest predictor of clinically significant prostate cancer in men with prebiopsy negative magnetic resonance imaging. There were 8 studies (1,015 patients) eligible for meta-analysis of the added value of prostate specific antigen density less than 0.15 ng/ml/ml to magnetic resonance imaging in reducing the risk of missing clinically significant prostate cancer. When combined with prostate specific antigen density, overall magnetic resonance imaging negative predictive value increased from 84.4% to 90.4% in cancer naïve patients. The increase was from 82.7% to 88.7% in biopsy naïve and from 88.2% to 94.1% in previous negative biopsy subgroups. CONCLUSIONS The use of prostate specific antigen density less than 0.15 ng/ml/ml in the presence of prebiopsy negative magnetic resonance imaging was the most useful factor to identify men without clinically significant prostate cancer who could avoid biopsy.
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Affiliation(s)
- M A Pagniez
- Department of Urology, CHU Lille, Lille, France
| | - V Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London, United Kingdom.,Department of Urology, University College London Hospital, London, United Kingdom
| | - P Puech
- Department of Radiology, CHU Lille, Lille, France
| | - E Drumez
- Santé Publique, Épidémiologie et Qualité des Soins, Department of Biostatistics, Universite Lille, CHU Lille, Lille, France
| | - A Villers
- Department of Urology, CHU Lille, Lille, France.,UMR8161/CNRS-Institut de Biologie de Lille, Lille, France
| | - J Olivier
- Department of Urology, CHU Lille, Lille, France.,UMR8161/CNRS-Institut de Biologie de Lille, Lille, France
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Guckert M, Clouqueur E, Drumez E, Petit C, Houfflin-Debarge V, Subtil D, Garabedian C. Is homecare management associated with longer latency in preterm premature rupture of membranes? Arch Gynecol Obstet 2019; 301:61-67. [PMID: 31760462 DOI: 10.1007/s00404-019-05363-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/25/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE According to national guidelines, conventional management of preterm premature rupture of membranes (PPROM) is hospitalization until induction. Outpatient management could be another option. Our objective was to compare latency period between patients managed in hospital versus outpatients. METHODS A retrospective before/after monocentric study that occured from 2002 to 2015. Were included all patients with PPROM prior to 35 weeks with homecare inclusion criteria. The primary outcome measure was to study length of latency period (delay between PPROM and delivery). Second outcome measures were maternal and perinatal morbidities and mortalities. RESULTS Among the 395 women included after PPROM, 191 were managed as outpatients and 204 in hospital. In the outpatient group, the length of latency period was longer than in the inpatient group [39 (IQR 20 to 66) versus 21 (IQR 13 to 42) days; p < 0.001]. Clinical chorioamnionitis was observed in 30 (15.7%) in outpatient group versus 49 (24.0%) in inpatient group (p = 0.039). Concerning neonatal outcome, there were less neonatal transfer (49.2% versus 77.2%, p < 0.001), less respiratory distress syndrome (29.4% versus 47.5%; p < 0.001), less neonatal sepsis (13.9% versus 22.1%; p = 0.037), less bronchodysplasia (2.7% versus 9.8%; p = 0.004), and less pulmonary arterial hypertension (4.8% versus 10.3%; p = 0.040) in the outpatient group than in the inpatient group. CONCLUSION Home management seems to be a safe option to hospitalization in selected patients with PPROM. However, a randomized study would be required to approve those results.
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Affiliation(s)
- M Guckert
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France.
| | - E Clouqueur
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France
| | - E Drumez
- Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694-Public Health Epidemiology and Healthcare Quality, 59000, Lille, France
| | - C Petit
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France
| | - V Houfflin-Debarge
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France
- University of Lille, EA 4489-Perinatal Environment and Health, 59000, Lille, France
| | - D Subtil
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France
| | - C Garabedian
- Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France
- University of Lille, EA 4489-Perinatal Environment and Health, 59000, Lille, France
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Servant D, Drumez E, Raynal S, Demarty AL, Salembier A, Deschepper MH, Bizet MA, Pisanu-Zimny A, Culem JB, Labreuche J, Duhamel A, Vaiva G. [Elaboration and psychometric properties of a well-being scale at work. The Serenat study among employees in occupational medicine unit]. Rev Epidemiol Sante Publique 2019; 67:303-309. [PMID: 31262608 DOI: 10.1016/j.respe.2019.05.011] [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: 07/16/2018] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Well-being at work is nowadays a major public health challenge. It includes, among others, absence of psychological (anxio-depressive) symptoms, perceived positive work conditions (environment and organization), happiness and good quality of life at work. Many studies have shown that social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for anxiety and depression. There is currently no global indicator to measure both the state of mental health and social working conditions. The main objective of this work is to construct and explore the psychometric properties of scale of well-being at work called "Serenat" in order to validate it. METHODS The Serenat Scale is a self-report questionnaire composed of 20 items. All items are scored on a four-point Likert scale ranging from 0 (strongly disagree) to 3 (strongly agree) resulting in a range of 0 to 60. It was constructed from data collected from the literature and from consultations in an Occupational Health Unit. From January 2014 to May 2017 193 subjects who have consulted an occupational doctor are included in this cross sectional survey. Validation included item quality and data structure diagnosis, internal consistency, intraobserver reliability evaluation and external consistency. RESULTS The Serenat scale showed very good item quality, with a maximal non-response rate of 0.01 % per item, and no floor effect. Factor analysis concluded that the scale can be considered unidimensional. Cronbach's alpha of internal consistency was 0.89. The intraclass correlation coefficient for intraobserver reliability was 0.89. Serenat scale was correlated with HADS (r=-0.54; P<0.001), STAI-Y (r=-0.78; P<0.001) and BDI-13 (r=-0.57; P<0.001). CONCLUSION Serenat's well-being at work scale shows good psychometric properties for final validation. It could be useful to occupational physicians for individual and collective screening. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02905071.
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Affiliation(s)
- D Servant
- Consultation spécialisée sur le stress et l'anxiété, service universitaire de psychiatrie adulte, hôpital Fontan, CHU, rue Verhaeghe, 59037 Lille cedex, France; CNRS, UMR 9193, clinique de psychiatrie, CURE, université de Lille, SCALab-sciences cognitives et sciences affectives & CHU de Lille, 59000 Lille, France.
| | - E Drumez
- EA 2694 - Santé publique : épidémiologie et qualité des soins, département de biostatistiques, université de Lille, CHU de Lille, 59000 Lille, France
| | - S Raynal
- Service de psychiatrie, centre hospitalier d'Arras, boulevard Besnier, 62000 Arras, France
| | - A L Demarty
- Département de la recherche et de l'innovation (DRI), maison régionale de la recherche clinique, CHRU, rue du Pr Laguesse, 59037 Lille cedex, France
| | - A Salembier
- Service de médecine du travail, CHU, 2, avenue Oscar-Lambret, 59000 Lille, France
| | - M H Deschepper
- Pôle Santé travail, 118, rue Solferino, 59800 Lille, France
| | - M A Bizet
- Service de santé au travail Transpole, 276, avenue de la Marne, 59701 Marcq-en-Baroeul, France
| | - A Pisanu-Zimny
- Service de psychiatrie, centre hospitalier de Cholet, 1, rue Marengo, 49300 Cholet, France
| | - J B Culem
- Service de psychiatrie, centre hospitalier de Cholet, 1, rue Marengo, 49300 Cholet, France
| | - J Labreuche
- EA 2694 - Santé publique : épidémiologie et qualité des soins, département de biostatistiques, université de Lille, CHU de Lille, 59000 Lille, France
| | - A Duhamel
- EA 2694 - Santé publique : épidémiologie et qualité des soins, département de biostatistiques, université de Lille, CHU de Lille, 59000 Lille, France
| | - G Vaiva
- Consultation spécialisée sur le stress et l'anxiété, service universitaire de psychiatrie adulte, hôpital Fontan, CHU, rue Verhaeghe, 59037 Lille cedex, France; CNRS, UMR 9193, clinique de psychiatrie, CURE, université de Lille, SCALab-sciences cognitives et sciences affectives & CHU de Lille, 59000 Lille, France
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Béghin L, Vanhelst J, Drumez E, Migueles JH, Androutsos O, Widhalm K, Julian C, Moreno LA, De Henauw S, Gottrand F. Gender influences physical activity changes during adolescence: The HELENA study. Clin Nutr 2019; 38:2900-2905. [PMID: 30718097 DOI: 10.1016/j.clnu.2018.12.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND We compared differences in physical activity (PA) between pre/mid-pubertal and post-pubertal participants according to gender. METHODS The study included a total of 1842 healthy participants aged 12.5-17.4 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Participants wore a uniaxial accelerometer (ActiGraph© GT1M, Pensacola, FL, USA) attached to their lower back for seven consecutive days to measure PA. Pubertal status was assessed by physical examination and the population was classified as pre/mid-pubertal (Tanner stages 1-3) or post-pubertal (Tanner stages 4-5). PA was compared between these groups according to gender during the whole week, on school-free days and on school days, before and after school, and during lessons and recesses. RESULTS When comparing the pre/mid-pubertal group with the post-pubertal group, girls' total PA did not differ between groups. However, a slight difference was observed in boys, among whom PA on school-free days showed a difference of 17.6% between the pre/mid-pubertal group and the post-pubertal group (679 kcounts vs 564 kcounts, respectively; P = 0.0007) and 20% (162 kcount vs 135 kcounts; P = 0.006) for school recess. There was no difference among girls. CONCLUSIONS A reduced level of PA in the post-pubertal groups was only observed in boys during non-organized times such as on school-free days and during school recesses, with a moderate impact on total PA.
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Affiliation(s)
- L Béghin
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France.
| | - J Vanhelst
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France
| | - E Drumez
- Univ. Lille, CHU Lille, Department of Biostatistics, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - J H Migueles
- PROFITH ''PROmoting FITness and Health through physical Activity'' Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Ctra. Alfacar s/n, 18011 Granada, Spain
| | - O Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - K Widhalm
- Department of Pediatrics, School of Medicine, Vienna University, Vienna, Austria
| | - C Julian
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Zaragoza University, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Zaragoza University, Zaragoza, Spain
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - F Gottrand
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France
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Vannerum M, Subtil D, Drumez E, Brochot C, Houfflin-Debarge V, Garabedian C. [Per-partum risk factors of neonatal acidemia in planned vaginal delivery for fetuses in breech presentation]. ACTA ACUST UNITED AC 2018; 47:11-17. [PMID: 30563786 DOI: 10.1016/j.gofs.2018.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Delivery mode of term breech presentation is debated because of higher rate of neonatal acidosis (pH<7.15) in planned vaginal delivery than in planned caesarean section. The objective was to evaluate per-partum risk factors of neonatal acidosis in vaginal delivery for podalic fetuses. METHODS It was a single-centre, case-control retrospective study that included planned vaginal delivery in singleton term breech presentation between 2012 and 2016. The "case" group defined by neonatal pH≤7.10 and the "control" group defined by neonatal pH≥7.20 were matched. The maternal, labor, and neonatal characteristics were noted. RESULTS One hundred and thirty-two patients were included: each of 44 patients in "case" group, has been matched according to breech type (legs position) to 2 patients in the "control" group, so 88. In multivariate analysis, significant risk factors identified were oxytocin use [ORa=5.663 (95% CI=1.844-17.397)], "high risk" fetal heart rate (FHR) abnormalities according to FIGO classification [ORa=10.997 (95% CI=1.864-64.866)] and FHR abnormalities during expulsion, Melchior 2 [ORa=8.088 (95% CI=1.192-54.875)] and Melchior 4 [ORa=12.705 (95% CI=1.157-139.541)]. CONCLUSIONS These risk factors of neonatal acidemia have to be known to improve the labor management in case of breech planned vaginal delivery.
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Affiliation(s)
- M Vannerum
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France.
| | - D Subtil
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
| | - E Drumez
- EA 2694 - santé publique : épidémiologie et qualité des soins, département de biostatistiques, université de Lille, CHU de Lille, 6, rue du Professeur-Laguesse, 59037 Lille, France
| | - C Brochot
- Maternité, centre hospitalier d'Arras, 3, boulevard Georges-Besnier, 62000 Arras, France
| | - V Houfflin-Debarge
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
| | - C Garabedian
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
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El Amrani M, Fulbert M, Lenne X, Clément G, Drumez E, Pruvot FR, Truant S. Do complications following pancreatic resections impact hospital costs in France: Medico-economic study on 127 patients. J Visc Surg 2018; 155:465-470. [DOI: 10.1016/j.jviscsurg.2018.04.003] [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] [Indexed: 12/19/2022]
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Vanhelst J, Vidal F, Ley D, Drumez E, Djeddi D, Devouge E, Spyckerelle C, Zandzou SG, Legrand C, Béghin L, Gottrand F, Coopman S, Turck D. L’activité physique est associée à une meilleure santé osseuse chez l’enfant et l’adolescent présentant une maladie inflammatoire chronique de l’intestin. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.066] [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]
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Yelnik CM, Lambert M, Drumez E, Le Guern V, Bacri JL, Guerra MM, Laskin CA, Branch DW, Sammaritano LR, Morel N, Guettrot-Imbert G, Launay D, Hachulla E, Hatron PY, Salmon JE, Costedoat-Chalumeau N. Bleeding complications and antithrombotic treatment in 264 pregnancies in antiphospholipid syndrome. Lupus 2018; 27:1679-1686. [PMID: 30016929 DOI: 10.1177/0961203318787032] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study was to evaluate the safety of antithrombotic treatments prescribed during pregnancy in patients with antiphospholipid syndrome (APS). Methods This international, multicenter study included two cohorts of patients: a retrospective French cohort and a prospective US cohort (PROMISSE study). Inclusion criteria were (1) APS (Sydney criteria), (2) live pregnancy at 12 weeks of gestation (WG) with (3) follow-up data until six weeks post-partum. According to APS standard of care, patients were treated with aspirin and/or low-molecular weight heparin (LMWH) at prophylactic (pure obstetric APS) or therapeutic doses (history of thrombosis). Major bleeding was defined as abnormal blood loss during the pregnancy and/or post-partum period requiring intervention for hemostasis or transfusion, or during the peripartum period greater than 500 mL and/or requiring surgery or transfusion. Other bleeding events were classified as minor. Results Two hundred and sixty-four pregnancies (87 prospectively collected) in 204 patients were included (46% with history of thrombosis, 23% with associated systemic lupus). During pregnancy, treatment included LMWH ( n = 253; 96%) or low-dose aspirin ( n = 223; 84%), and 215 (81%) patients received both therapies. The live birth rate was 89% and 82% in the retrospective and prospective cohorts, respectively. Adverse pregnancy outcomes occurred in 28% of the retrospective cohort and in 40% of the prospective cohort. No maternal death was observed in either cohort. A combined total of 45 hemorrhagic events (25%) occurred in the retrospective cohort, but major bleeding was reported in only six pregnancies (3%). Neither heparin nor aspirin alone nor combined therapy increased the risk of hemorrhage. We also did not observe an increased rate of bleeding in the case of a short interval between last LMWH (less than 24 hours) or aspirin (less than five days) doses and delivery. Only emergency Caesarean section was significantly associated with an increased risk of bleeding (odds ratio (OR) 5.03 (1.41-17.96); p=.016). In the prospective cohort, only one minor bleeding event was reported (vaginal bleeding). Conclusion Our findings support the safety of antithrombotic therapy with aspirin and/or LMWH during pregnancy in high-risk women with APS, and highlight the need for better treatments to improve pregnancy outcomes in APS. PROMISSE Study ClinicalTrials.gov identifier: NCT00198068.
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Affiliation(s)
- C M Yelnik
- 1 INSERM U995 LIRIC-Inflammation Research International Centre, CHU Lille, Département de Médecine Interne et d'Immunologie clinique, Centre National de Référence Maladies Systémiques et Auto-Immunes Rares, European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases (ReCONNECT), University of Lille, France
| | - M Lambert
- 1 INSERM U995 LIRIC-Inflammation Research International Centre, CHU Lille, Département de Médecine Interne et d'Immunologie clinique, Centre National de Référence Maladies Systémiques et Auto-Immunes Rares, European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases (ReCONNECT), University of Lille, France
| | - E Drumez
- 2 CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Département de Biostatistique, University of Lille, France
| | - V Le Guern
- 3 Service de Médecine Interne, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares, Hôpital Cochin, Paris, France
| | - J-L Bacri
- 4 Service de Médecine Interne, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - M M Guerra
- 5 Rheumatology, Hospital for Special Surgery, New York, USA
| | - C A Laskin
- 6 University of Toronto and Trio Fertility, Toronto, Canada
| | - D W Branch
- 7 University of Utah and Intermountain Healthcare, Salt Lake City, USA
| | | | - N Morel
- 3 Service de Médecine Interne, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares, Hôpital Cochin, Paris, France
| | - G Guettrot-Imbert
- 3 Service de Médecine Interne, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares, Hôpital Cochin, Paris, France
| | - D Launay
- 1 INSERM U995 LIRIC-Inflammation Research International Centre, CHU Lille, Département de Médecine Interne et d'Immunologie clinique, Centre National de Référence Maladies Systémiques et Auto-Immunes Rares, European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases (ReCONNECT), University of Lille, France
| | - E Hachulla
- 1 INSERM U995 LIRIC-Inflammation Research International Centre, CHU Lille, Département de Médecine Interne et d'Immunologie clinique, Centre National de Référence Maladies Systémiques et Auto-Immunes Rares, European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases (ReCONNECT), University of Lille, France
| | - P-Y Hatron
- 1 INSERM U995 LIRIC-Inflammation Research International Centre, CHU Lille, Département de Médecine Interne et d'Immunologie clinique, Centre National de Référence Maladies Systémiques et Auto-Immunes Rares, European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases (ReCONNECT), University of Lille, France
| | - J E Salmon
- 5 Rheumatology, Hospital for Special Surgery, New York, USA
| | - N Costedoat-Chalumeau
- 3 Service de Médecine Interne, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares, Hôpital Cochin, Paris, France.,8 Université Paris Descartes-Sorbonne Paris Cité, Paris, France.,9 INSERM U 1153, Center for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), Paris, France
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Garabedian C, Bonnard A, Rousseau V, Sfeir R, Drumez E, Michaud L, Gottrand F, Houfflin-Debarge V. Management and outcome of neonates with a prenatal diagnosis of esophageal atresia type A: A population-based study. Prenat Diagn 2018; 38:517-522. [DOI: 10.1002/pd.5273] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 02/05/2023]
Affiliation(s)
- C. Garabedian
- Department of Obstetrics; CHU Lille; Lille France
- EA 4489-Perinatal Environment and Health; Univ. Lille; Lille France
- CHU Lille, CRACMO Reference Center for Rare Esophageal Diseases, Univ. Lille, LIRIC UMR 995; Lille France
| | - A. Bonnard
- Department of Paediatric Surgery; University Hospital Robert Debré; Paris France
| | - V. Rousseau
- Department of Paediatric Surgery; University Hospital Necker-Enfants Malades; Paris France
| | - R. Sfeir
- Department of Paediatric Surgery; CHU Lille; Lille France
| | - E. Drumez
- Department of Biostatistics, EA 2694-Santé Publique : épidémiologie et qualité des soins; Univ. Lille, CHU Lille; Lille France
| | - L. Michaud
- CHU Lille, CRACMO Reference Center for Rare Esophageal Diseases, Univ. Lille, LIRIC UMR 995; Lille France
| | - F. Gottrand
- CHU Lille, CRACMO Reference Center for Rare Esophageal Diseases, Univ. Lille, LIRIC UMR 995; Lille France
| | - V. Houfflin-Debarge
- Department of Obstetrics; CHU Lille; Lille France
- EA 4489-Perinatal Environment and Health; Univ. Lille; Lille France
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Leroy HA, Delmaire C, Le Rhun E, Drumez E, Lejeune JP, Reyns N. High-field intraoperative MRI in glioma surgery: A prospective study with volumetric analysis of extent of resection and functional outcome. Neurochirurgie 2018; 64:155-160. [PMID: 29754739 DOI: 10.1016/j.neuchi.2018.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 08/21/2017] [Revised: 01/14/2018] [Accepted: 02/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND High-field intraoperative MRI (IoMRI) is a useful tool to improve the extent of glioma resection (EOR). OBJECTIVE To compare the interest of 1.5T IoMRI in glioma surgery between enhancing and non-enhancing tumors, based on volumetric analysis. METHODS A prospective single-center study included consecutive adult patients undergoing glioma surgery with IoMRI. Volumetric evaluation was based on FLAIR hypersignal after gadolinium injection in non-enhancing tumors and T1 hypersignal after gadolinium injection in enhancing tumors. Endpoints comprised: residual tumor volume (RTV), EOR, workflow and clinical outcome on Karnofsky performance score (KPS). RESULTS Fifty-three surgeries were performed from July 2014 to January 2016. Thirty-four patients underwent one IoMRI, and 19 two IoMRIs. In non-enhancing tumors, intraoperative RTV on 1st IoMRI T2/FLAIR was higher than in enhancing tumors on T1 sequences (7.25cm3 vs. 0.74cm3, respectively; P=0.008), whereas the RTV on 2nd IoMRIs and final RTV were no longer significantly different. After IoMRI, 72% of patients underwent additional resection. In non-enhancing tumors, EOR increased from 77.3% on 1st IoMRI to 97.4% on last MRI (P<0.001). Taking all tumors together, final RTV values were: median=0cm3, mean=3.9cm3. Mean final EOR was 94%. In 25% of patients, KPS was reduced during early postoperative course; at 3 and 6 months postoperatively, median KPS was 90. CONCLUSION Intraoperative MRI guidance significantly enhanced the extent of glioma resection, especially for non- or minimally enhancing tumors, while preserving patient autonomy.
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Affiliation(s)
- H-A Leroy
- Department of Neurosurgery and Neuro-Oncology, CHU de Lille, 59000 Lille, France; Inserm, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, University Lille, CHU de Lille, 59000 Lille, France.
| | - C Delmaire
- Department of Radiology, CHU de Lille, 59000 Lille, France
| | - E Le Rhun
- Department of Neurosurgery and Neuro-Oncology, CHU de Lille, 59000 Lille, France
| | - E Drumez
- EA 2694-santé publique : epidémiologie et qualité des soins, Department of Biostatistics, CHU de Lille, University Lille, 59000 Lille, France
| | - J-P Lejeune
- Department of Neurosurgery and Neuro-Oncology, CHU de Lille, 59000 Lille, France
| | - N Reyns
- Department of Neurosurgery and Neuro-Oncology, CHU de Lille, 59000 Lille, France; Inserm, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, University Lille, CHU de Lille, 59000 Lille, France
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Paccou J, Viget N, Drumez E, Cortet B, Robineau O. Prevalence and risk factors for low bone mineral density in antiretroviral therapy-naive HIV-infected young men. Med Mal Infect 2018; 48:442-448. [PMID: 29699830 DOI: 10.1016/j.medmal.2018.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/01/2017] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We aimed to investigate the prevalence of low bone mineral density (BMD) and associated factors in antiretroviral therapy (ART)-naive HIV-infected young men. METHODS In this cross-sectional study, dual-energy X-ray absorptiometry (DXA) was used to measure BMD. BMD at the lumbar spine, total hip and femoral neck sites was expressed as a Z-score (number of standard deviations away from the mean in an age, race and sex-matched reference population). Low BMD was defined as Z-scores≤-2 at any of the three sites. The prevalence of low BMD was evaluated at the lumbar spine, total hip and femoral neck sites, as were risk factors associated with Z-scores. RESULTS The study cohort comprised 49 men, of whom 87.8% were white. Mean age was 31.6 (±7.7) years and mean BMI was 22.7 (±4.0)kg/m2. Half of patients (51.0%) were current smokers. The prevalence of low BMD was 24.5% [95% CI, 13.3-38.9]. Low estradiol levels and low BMI were associated with low Z-scores at each skeletal site, whereas current smoking and high IGF1 levels were associated with low Z-scores at the lumbar spine site. Among the HIV-related factors, low CD4+ cell count was associated with low Z-scores at the lumbar spine site. CONCLUSIONS We observed a high prevalence of low BMD in our ART-naive cohort of young men. Risk factors associated with low Z-scores were those usually observed in HIV-infected individuals (low BMI, current smoking and CD4+ cell count) or linked to endocrine hormone levels (estradiol, IGF-1).
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Affiliation(s)
- J Paccou
- Service de rhumatologie, CHU Lille, 59000 Lille, France; Université de Lille, université Littoral Côte d'Opale, PMOI EA 4490 faculté de chirurgie dentaire, place de Verdun, 59000 Lille, France.
| | - N Viget
- Service des maladies infectieuses, centre hospitalier Tourcoing, CHU Lille, 59000 Lille, France.
| | - E Drumez
- Département de biostatistiques - Santé publique, épidémiologie et qualité des soins, université de Lille, EA 2694, CHU Lille, 59000 Lille, France.
| | - B Cortet
- Service de rhumatologie, CHU Lille, 59000 Lille, France; Université de Lille, université Littoral Côte d'Opale, PMOI EA 4490 faculté de chirurgie dentaire, place de Verdun, 59000 Lille, France.
| | - O Robineau
- Service des maladies infectieuses, centre hospitalier Tourcoing, CHU Lille, 59000 Lille, France.
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Perrin A, Saab M, Putman S, Benad K, Drumez E, Chantelot C. The benefit of the systematic revision of the acetabular implant in favor of a dual mobility articulation during the treatment of periprosthetic fractures of the femur: a 49 cases prospective comparative study. Eur J Orthop Surg Traumatol 2017; 28:239-246. [PMID: 28900737 DOI: 10.1007/s00590-017-2037-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 05/12/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The SOFCOT symposium (2005) on periprosthetic fractures of the femur (PFFs) highlighted a high rate of dislocation (15.6% at 6 months) after change of prosthesis. So far, no study has ever proved the benefit of dual-mobility articulation during PFFs revisions. We conducted a comparative study on two prospective cohorts in order to (1) assess the influence of systematic acetabular revision in favor of a double mobility on dislocation rate (2) and in order to evaluate the rate of morbidity associated with this extra surgical procedure. HYPOTHESIS A systematic replacement of the cup in favor of a dual-mobility articulation enables to reduce the dislocation rate in PFFs revisions without increasing morbidity. METHODOLOGY We compared two prospective multicenter cohorts over a year (2005 and 2015) using the same methodology. Any fracture around hip prosthesis which occurred 3 months at least after surgery was included. Data collection was clinical and radiological on preoperative, intraoperative and 6 months after surgery. The 2015 "bipolar" group (n = 24) included patients who had a bipolar revision (both femoral and dual-mobility articulation). The 2005 "unipolar" group (n = 25) included patients who had only a femoral implant revision. Patients were comparable by age (p = 0.36), sex (p = 0.91), ASA score (p = 0.36), history of prosthetic revision (p = 1.00), Katz score (p = 0.50) and the type of fracture according to the Vancouver classification (p = 0.55). RESULTS There was a 4% rate of dislocation in the "bipolar group" while there was 21% rate of dislocation in the "unipolar group" (8% of recurrent dislocation) (p = 0.19). The rate of all-cause complications 6 months after surgery was not significantly different (p = 0.07): 12.5% in the 2015 "bipolar" cohort (one dislocation, one non-symptomatic cup migration and one pseudarthrosis of the major trochanter) versus 35% in the "unipolar" cohort (5 dislocations, 1 major trochanter fracture and 1 femur pseudarthrosis, 1 secondary displacement associated with a superficial infection). The surgical revision after 6 months was not significantly different (1/23 or 4% vs. 4/25 or 16%, p = 0.35). CONCLUSION We confirm the low rate of dislocations after fitting a dual-mobility cup in case of revision of the femoral side in case of periprosthetic femoral fracture, as well as the need for additional cases to be carried out upon further studies to significantly confirm the interest of preventing instability after femoral revision.
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Affiliation(s)
- A Perrin
- Department of Orthopedic Surgery and Traumatology, CHRU de Lille, Place de Verdun, 59037, Lille Cedex, France.
- Lille Nord University, 59000, Lille, France.
- Department of Orthopedic Surgery and Traumatology, Hospital Group of the Catholic Institute of Lille, Saint-Philibert Hospital, Rue du Grand But, 59160, Lomme, France.
| | - M Saab
- Department of Orthopedic Surgery and Traumatology, CHRU de Lille, Place de Verdun, 59037, Lille Cedex, France
- Lille Nord University, 59000, Lille, France
| | - S Putman
- Department of Orthopedic Surgery and Traumatology, CHRU de Lille, Place de Verdun, 59037, Lille Cedex, France
- Lille Nord University, 59000, Lille, France
| | - K Benad
- Department of Orthopedic Surgery and Traumatology, CHRU de Lille, Place de Verdun, 59037, Lille Cedex, France
- Lille Nord University, 59000, Lille, France
| | - E Drumez
- Public Health Department: Epidemiology and Quality of Care, Biostatistics Unit, EA 2694, F-59000, Lille, France
| | - C Chantelot
- Department of Orthopedic Surgery and Traumatology, CHRU de Lille, Place de Verdun, 59037, Lille Cedex, France
- Lille Nord University, 59000, Lille, France
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Outteryck F, Boule S, Pontana F, Longere B, Coisne A, Ninni S, Drumez E, Brigadeau F, Marquie C, Klug D, Remy Jardin M, Lacroix D. P1482Additional value of contrast-enhanced cardiac magnetic resonance imaging for patients with coronary artery disease and ejection fraction over 35% presenting with unexplained syncope. Europace 2017. [DOI: 10.1093/ehjci/eux158.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cap M, Drumez E, Lejeune S, Thumerelle C, Mordacq C, Nève V, Deschildre A. L’allergie alimentaire a-t-elle un impact sur la morbidité de l’asthme ? Arch Pediatr 2017. [DOI: 10.1016/j.arcped.2017.02.006] [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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Boulé S, Sémichon M, Guédon-Moreau L, Drumez E, Kouakam C, Marquié C, Brigadeau F, Potelle C, Escande W, Souissi Z, Lacroix D, Klug D. Electrical storms in patients with implantable cardioverter-defibrillators implanted for secondary prophylaxis indications: incidence, features, predictors and impact on mortality. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30249-5] [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: 11/30/2022]
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Boulé S, Sémichon M, Guédon-Moreau L, Drumez E, Kouakam C, Marquié C, Brigadeau F, Potelle C, Escande W, Souissi Z, Lacroix D, Klug D. Long-term outcome of implantable cardioverter-defibrillator implantation in secondary prevention of sudden cardiac death. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30237-9] [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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Alidjinou EK, Robineau O, Chéret A, Ajana F, Drumez E, Kyheng M, Choisy P, Hober D, Bocket L. The history of plasma viral load and CD4 count impacts the size of HIV-1 reservoir. J Infect 2016; 74:420-422. [PMID: 27998749 DOI: 10.1016/j.jinf.2016.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
Affiliation(s)
- E K Alidjinou
- Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, F-59000 Lille, France.
| | - O Robineau
- Service Universitaire de Maladies Infectieuses, CH de Tourcoing, France
| | - A Chéret
- Service Universitaire de Maladies Infectieuses, CH de Tourcoing, France; Service de Médecine Interne, Hôpital du Kremlin Bicêtre, AP-HP, Le Kremlin-Bicêtre, France; EA 7327 Paris Descartes Sorbonne-Paris-Cité University, France
| | - F Ajana
- Service Universitaire de Maladies Infectieuses, CH de Tourcoing, France
| | - E Drumez
- Univ Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de Biostatistiques, F-59000 Lille, France
| | - M Kyheng
- Univ Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de Biostatistiques, F-59000 Lille, France
| | - P Choisy
- Service Universitaire de Maladies Infectieuses, CH de Tourcoing, France
| | - D Hober
- Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, F-59000 Lille, France
| | - L Bocket
- Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, F-59000 Lille, France
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Godier A, Bacus M, Kipnis E, Tavernier B, Guidat A, Rauch A, Drumez E, Susen S, Garrigue-Huet D. Compliance with evidence-based clinical management guidelines in bleeding trauma patients. Br J Anaesth 2016; 117:592-600. [DOI: 10.1093/bja/aew317] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 01/13/2023] Open
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Drumez E, Putman S, Sorin G, Pasquier G, Arnould A, Migaud H, Duhamel A. Reply to the Letter by Siamak Sabour, Fariba Ghassemi. Orthop Traumatol Surg Res 2016; 102:829. [PMID: 27499116 DOI: 10.1016/j.otsr.2016.07.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/11/2016] [Indexed: 02/02/2023]
Affiliation(s)
- E Drumez
- Unité de biostatistiques, university Lille, CHU de Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, 59000 Lille, France; Université Lille, 59000 Lille, France
| | - S Putman
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - G Sorin
- Département d'orthopédie, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France
| | - G Pasquier
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - A Arnould
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - H Migaud
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France.
| | - A Duhamel
- Unité de biostatistiques, university Lille, CHU de Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, 59000 Lille, France; Université Lille, 59000 Lille, France
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Delay C, Putman S, Dereudre G, Girard J, Lancelier-Bariatinsky V, Drumez E, Migaud H. Is there any range-of-motion advantage to using bearings larger than 36mm in primary hip arthroplasty: A case-control study comparing 36-mm and large-diameter heads. Orthop Traumatol Surg Res 2016; 102:735-40. [PMID: 27184931 DOI: 10.1016/j.otsr.2016.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Large-diameter (>36mm) total hip arthroplasty (THA) has developed rapidly since the advent of ceramic-on-ceramic (CoC) bearings and highly cross-linked polyethylene. Theoretically, the increase in diameter reduces the risk of instability, although the advantage of calibers beyond 36mm has not been demonstrated in terms of range-of-motion recovery. We conducted a comparative study with a single prosthesis model to determine whether increasing the caliber beyond 36mm provides: (1) better recovery of range-of-motion, (2) a higher functional score, and (3) reduction of the dislocation rate. HYPOTHESIS Increasing the range-of-motion by increasing the caliber beyond 36mm provides better range-of-motion. MATERIAL AND METHODS We analyzed two consecutive, single-operator cementless THA series performed via the mini posterior approach, which differed only in the bearing system (51 metal-on-metal [MoM] with a mean caliber of 45mm±3.3 [range, 40-54] and 61 CoC with a 36-mm caliber). Both series were comparable preoperatively in terms of age, diagnosis, functional scores, preoperative range-of-motion, body mass index, UCLA activity level, and Charnley score. We compared the joint range of movement at follow-up and the gains in range of movement, onset of dislocation, and functional scores (Oxford, Postel-Merle d'Aubigné [PMA]). RESULTS The mean overall joint range-of-motion was 254°±39° (range, 150-310°) for an 81°±44° (range, -50 to 180°) gain in the MoM group and 256°±23° (range, 200-280°) for an 84°±40° (range, 0-160°) gain in the CoC group (NS). The MoM group presented the following results: Oxford=13.71±3.66 (range, 12-33) for a gain of 24.82 points±7.9 (range, -1 to 40), PMA=17.75±1.06 (range, 11-18) for a gain of 7.78 points±4.01 (range, 2-15). The CoC group had: Oxford=14.98±4.42 (range, 12-36) for a gain of 24.75 points±6.55 (range, 12-40), PMA 17.66±0.7 (range, 14-18) for a gain of 8 points±3.77 (range, 1-15). None of the gains and scores at follow-up differed significantly between the two groups. No episode of dislocation was identified. DISCUSSION The current trend of increasing femoral head diameters beyond 36mm to improve the gains in joint range-of-motion and function is not warranted. The potential side effects of increasing the caliber call for even greater caution in the use of large-diameter heads because our hypothesis has not been confirmed. LEVEL OF EVIDENCE Case-control study, level III.
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Affiliation(s)
- C Delay
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France; Laboratoire d'anatomie et d'organogenèse, faculté de médecine, place de Verdun, 59045 Lille, France.
| | - S Putman
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - G Dereudre
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France; Laboratoire d'anatomie et d'organogenèse, faculté de médecine, place de Verdun, 59045 Lille, France
| | - J Girard
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - V Lancelier-Bariatinsky
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - E Drumez
- Unité de biostatistiques, université Lille, CHU de Lille, EA 2694 - santé publique : épidémiologie et qualité des soins, 59000 Lille, France
| | - H Migaud
- Université Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
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Vanhelst J, Béghin L, Drumez E, Baudelet JB, Labreuche J, Chapelot D, Mikulovic J, Ulmer Z. [Physical fitness levels in French adolescents: The BOUGE program]. Rev Epidemiol Sante Publique 2016; 64:219-28. [PMID: 27592032 DOI: 10.1016/j.respe.2016.05.002] [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: 11/27/2015] [Revised: 04/28/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND A high level of physical fitness is associated with cardiovascular health in adolescents. The aims of this study were to assess the levels of physical fitness of French adolescents and to determine the prevalence of these adolescents below the minimum level of cardiorespiratory fitness needed to guarantee future favorable cardiovascular profile. METHODS Participants were 12,082 French children and adolescents (5975 boys, 6107 girls) aged to 9 from 16 years. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. The associations of physical fitness measures with adolescent's characteristics were analyzed using Student t test, one-way ANOVA, or Pearson correlations as appropriate. RESULTS Boys were physically fitter than girls, expected for flexibility (P<0.0001). Subjects of normal weight adolescents had significantly better results than overweight or obese adolescents (P<0.05 for all comparisons), but also in comparison with underweight adolescents for muscular endurance, flexibility, cardiorespiratory fitness test (P<0.05). Our findings indicate that, on the basis of cardiorespiratory fitness, 16% of French boys and 7.7% of French girls have a risk of future cardiovascular disease (P<0.0001). This subgroup also performed poorly in all other tests of physical fitness used (P<0.0001). Aerobic fitness decreased significantly with the age (r=-0.168 for boys; r=-0.261 for girls). CONCLUSIONS Our results indicate that the physical fitness of French adolescents must be improved to help protect against cardiovascular disease in adulthood, especially in boys. The study showed also a dramatically decrease of the cardiorespiratory fitness during the adolescence period. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness.
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Affiliation(s)
- J Vanhelst
- U995, Lille Inflammation Research International Center (LIRIC), Inserm, CHU de Lille, université de Lille, 59000 Lille, France; Centre d'investigation clinique, CIC 1403, université de Lille, Inserm, CHU de Lille, 59000 Lille, France.
| | - L Béghin
- U995, Lille Inflammation Research International Center (LIRIC), Inserm, CHU de Lille, université de Lille, 59000 Lille, France; Centre d'investigation clinique, CIC 1403, université de Lille, Inserm, CHU de Lille, 59000 Lille, France
| | - E Drumez
- EA 2694, santé publique : épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - J-B Baudelet
- Centre d'investigation clinique, CIC 1403, université de Lille, Inserm, CHU de Lille, 59000 Lille, France
| | - J Labreuche
- EA 2694, santé publique : épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - D Chapelot
- Nutritional Epidemiology Research Unit, Paris 13 University, Sorbonne Paris cité, 93000 Bobigny, France
| | - J Mikulovic
- Laboratoire LACES, université de Bordeaux, 33000 Bordeaux, France
| | - Z Ulmer
- Fédération nationale mutualité française, 75015 Paris, France
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Yelnik CM, Urbanski G, Drumez E, Sobanski V, Maillard H, Lanteri A, Morell-Dubois S, Caron C, Dubucquoi S, Launay D, Duhamel A, Hachulla E, Hatron PY, Lambert M. Persistent triple antiphospholipid antibody positivity as a strong risk factor of first thrombosis, in a long-term follow-up study of patients without history of thrombosis or obstetrical morbidity. Lupus 2016; 26:163-169. [PMID: 27432808 DOI: 10.1177/0961203316657433] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction The long-term risk of first thrombosis and benefit of prophylaxis in antiphospholipid antibody (aPL) carriers without history of thrombosis or obstetrical morbidity is poorly known. This study aimed to evaluate the long-term rate and risk factors associated with a first thrombosis in those patients. Patients and methods After a prior study ended in December 2005 and was already published, we extended the follow-up period of our cohort of aPL carriers. Results Ninety-eight of the 103 patients of the previous study were included. The annual first thrombosis rate was 2.3% per patient-year during a median of 13 years (6-17). None of the baseline characteristics was predictive of risk of first thrombosis, but persistent aPL over time were associated with an increased risk. The stronger association was found in triple aPL-positive carriers: OR 3.38 (95% CI: 1.24-9.22). Of note, conversely to our previous findings, no benefit of aspirin prophylaxis was observed. Conclusion The risk of first thrombosis in aPL carriers without history of thrombosis or obstetrical morbidity was significant, persisted linearly over time and was associated with persistent aPL. This risk was especially increased in triple aPL-positive carriers, in whom a close follow-up seems to be necessary. Nevertheless, the benefit of aspirin prophylaxis remained unclear.
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Affiliation(s)
- C M Yelnik
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - G Urbanski
- 2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - E Drumez
- 3 Département de biostatistiques, EA2694, Université Lille 2, CHRU Lille, France
| | - V Sobanski
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - H Maillard
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - A Lanteri
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - S Morell-Dubois
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - C Caron
- 4 Laboratoire d'Hémostase, Centre de Biologie-Pathologie-Génétique, CHRU Lille, France
| | - S Dubucquoi
- 1 Université Lille 2, UFR Médecine, Lille, France.,5 Institut d'Immunologie, Centre de Biologie-Pathologie-Génétique, CHRU Lille, France
| | - D Launay
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - A Duhamel
- 3 Département de biostatistiques, EA2694, Université Lille 2, CHRU Lille, France
| | - E Hachulla
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - P Y Hatron
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
| | - M Lambert
- 1 Université Lille 2, UFR Médecine, Lille, France.,2 Service de Médecine Interne, Centre National de Référence des Maladies Systémiques Rares, Hôpital Claude Huriez, CHRU Lille, France
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Sorin G, Pasquier G, Drumez E, Arnould A, Migaud H, Putman S. Reproducibility of digital measurements of lower-limb deformity on plain radiographs and agreement with CT measurements. Orthop Traumatol Surg Res 2016; 102:423-8. [PMID: 27052940 DOI: 10.1016/j.otsr.2016.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 11/23/2015] [Revised: 01/26/2016] [Accepted: 02/01/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Five angles (HKA, HKS, alpha, beta, tibial slope) are used for goniometry in total knee arthroplasty. The reproducibility of the measurement of these angles has been assessed on plain and digitized x-rays, but to our knowledge, this has not been confirmed on x-rays taken on the PACS system and they have not been compared to computed tomography (CT) measurements, the reference for angle measurement. This prospective study aimed to: (1) evaluate the inter- and intrarater reliability of the measurement of these angles on digital x-rays taken on a PACS; (2) determine the agreement of these measurements with those obtained using a CT protocol. HYPOTHESIS The measurements of these five angles on digitized radiographs are reproducible and in agreement with CT values. MATERIAL AND METHODS Forty-two patients suffering from knee osteoarthritis and scheduled for total knee arthroplasty were included in the study. Each patient had a PACS digitized x-ray and a CT intended to produce patient-specific instrumentation (Symbios, Yverdon, Switzerland) including measurements of the angles evaluated. Four senior orthopaedic surgeon-raters measured all the angles twice. Inter- and intrarater reliability was then calculated as well as the agreement between the second measurement of each rater and the CT measurement using interclass correlation and kappa coefficients (data provided as means and 95% confidence intervals). RESULTS The inter- and intrarater reliability values were excellent for the HKA, alpha, and beta angles (with, respectively, a coefficient of 0.99 [0.97-0.99], 0.84 [0.76-0.9], and 0.94 [0.86-0.96] interrater reliability and 0.98 [0.96-0.99], 0.86 [0.75-0.92], and 0.65 [0.44-0.8] intrarater reliability). Interrater reliability was low for HKS and tibial slope angles (coefficients all<0.4 for interrater reliability and <0.7 for intrarater reliability). The x-ray/CT agreement was very good for the HKA, alpha, and beta angles (0.81 [0.67-0.99], 0.74 [0.56-0.91], and 0.74 [0.45-0.92], respectively) and low for the HKS and tibial slope angles (all<0.45). DISCUSSION/CONCLUSION The HKA, alpha, and beta angles were reproducible for digital radiographs and showed good agreement with CT measurements. HKS and tibial slope angles should be used with greater caution, and other navigation methods or patient-specific instrumentation should be explored. LEVEL OF EVIDENCE Level III, prospective, comparative diagnostic case-control study.
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Affiliation(s)
- G Sorin
- Département d'orthopédie, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France.
| | - G Pasquier
- Département de chirurgie orthoépdique et de traumatologie, CHRU de Lille, université de Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - E Drumez
- Département de chirurgie orthoépdique et de traumatologie, CHRU de Lille, université de Lille, 59000 Lille, France; Unité de biostatistiques et d'é́pidémiologie, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - A Arnould
- Département de chirurgie orthoépdique et de traumatologie, CHRU de Lille, université de Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - H Migaud
- Département de chirurgie orthoépdique et de traumatologie, CHRU de Lille, université de Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
| | - S Putman
- Département de chirurgie orthoépdique et de traumatologie, CHRU de Lille, université de Lille, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille cedex, France
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Pouessel G, Beaudouin E, Renaudin JM, Drumez E, Moneret-Vautrin DA, Deschildre A. Pratiques et adhésion aux recommandations pour la prescription des dispositifs auto-injectables d’adrénaline : enquête auprès des allergologues du réseau allergo-vigilance. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2015.10.006] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Faure C, Cottencin O, Drumez E, De Pourtales MA, Molenda S, Warembourg F, Brelinski-Biencourt L, Pages V, Consoli S, Bougerol T, Chantelot C, Grégory T, Théry D, Cordonnier D, Berger A, Demarty AL, Duhem S, Vaiva G. Intérêt d’un outil de dépistage infirmier d’un état de stress post-traumatique (ESPT) après un accident de la voie publique (AVP) : étude DEPITAC. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Les AVP sont le principal pourvoyeur d’ESPT (Kupchik et al., 2007), dont la prévalence fluctue de 6 à 45 % entre les études (Heron-Delaney et al., 2013). En l’absence de repérage clinique, l’ESPT peut se chroniciser (Kessler et al., 1995). Les outils actuels permettent son diagnostic (Jackson et al., 2011), mais pas de dépister précocement les sujets à risque de développer un ESPT post-AVP en aigu (8 semaines) comme en chronique (6 mois) ou en tardif (1 an). Nous présentons une étude longitudinale réalisée sur 274 patients répartis sur 6 centres de traumatologie ayant pour objectif principal de valider un outil infirmier de dépistage précoce d’ESPT après un AVP (DEPITAC). Dix questions ont été soumises à tout patient hospitalisé dans les 15 jours après un AVP, ainsi qu’une PDI et un MINI DSM-IV. La PCL-S (cut-off à 44) a permis le diagnostic à 8 semaines, 6 mois et 1 an. L’analyse statistique a été réalisée avec le logiciel SAS Institute 9.4. Le score total DEPITAC était significativement associé au diagnostic d’ESPT à 1 an (OR : 1,43 ; IC95 % : 1,14–1,79) avec un pouvoir discriminant de 0,64 (IC95 % : 0,56–0,72). DEPITAC était corrélé à l’échelle PDI (p < 0,0001) avec un faible coefficient de corrélation (r = 0,32) montrant une faible redondance. Seules 3 questions après analyses bivariées s’avèrent significatives : « présence d’autres blessés ou décédés lors de l’AVP », « présence d’une dissociation post-AVP » et « s’être vu mourir lors de l’AVP » avec un pouvoir discriminant de 0,65 (IC95 % : 0,57–0,73). Aucun effet centre n’a été mis en évidence (p = 0,90). Nos résultats semblent montrer qu’à l’aide de seulement 3 questions de dépistage, les équipes infirmières pourraient repérer les patients à risque de développer un ESPT aigu ou tardif, leur permettant ainsi d’alerter précocement les équipes psychiatriques de liaison ou de pschotraumatologie.
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