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Baverez C, Grall M, Gerfaud-Valentin M, De Gail S, Belot A, Weber E, Reynaud Q, Sève P, Yvan J. Anakinra pour le traitement de la lymphohistiocytose hémophagocytaire. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bertin E, Louvrier A, Meyer C, Weber E, Barrabé A, Pons M. An epidemiologic retrospective study of maxillofacial traumatology in the elderly. J Stomatol Oral Maxillofac Surg 2022; 123:e878-e882. [PMID: 35659531 DOI: 10.1016/j.jormas.2022.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The elderly population, which is more active than before, is increasingly suffering from trauma (loss of reflexes and systemic pathologic conditions). Surgical management may be more controversial due to the potential consequences of general anesthesia and the sometimes negligible consequences of functional management. The main objective of this study was to analyze the causes and location of facial fractures in subjects older than 65 years. The secondary objective was to evaluate the management of these fractures (surgical or functional) according to comorbidities. MATERIAL & METHODS In this retrospective study (over a five-year period), we analyzed the causes and management of facial fractures in patients aged over 65 years, and the medical history of each patient was investigated. RESULTS One hundred and nineteen patients with 198 facial fractures were included. The main cause of fractures was a fall (50%). The zygomatic region (39.9%) and mandible (27.8%) were the sites of the most frequent fractures. Comorbidities were found in 84.9% of patients, the majority of which were cardiovascular diseases (82.3%). 75.8% of fractures were treated surgically and 4.8% of patients had complications. DISCUSSION This work is a help to understanding the causes and consequences of facial trauma in the elderly population. The management of these facial fractures requires a multidisciplinary assessment, taking into account the patient's medical history and evaluating the risks and benefits of a surgical procedure with general anesthesia.
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Affiliation(s)
- E Bertin
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France.
| | - A Louvrier
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France; UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
| | - C Meyer
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France; Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - E Weber
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
| | - A Barrabé
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
| | - M Pons
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
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Ghilardi G, Chong EA, Svoboda J, Wohlfarth P, Nasta SD, Williamson S, Landsburg JD, Gerson JN, Barta SK, Pajarillo R, Myers J, Chen AI, Schachter L, Yelton R, Ballard HJ, Hodges Dwinal A, Gier S, Victoriano D, Weber E, Napier E, Garfall A, Porter DL, Jäger U, Maziarz RT, Ruella M, Schuster SJ. Bendamustine is safe and effective for lymphodepletion before tisagenlecleucel in patients with refractory or relapsed large B-cell lymphomas. Ann Oncol 2022; 33:916-928. [PMID: 35690221 DOI: 10.1016/j.annonc.2022.05.521] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anti-CD19 chimeric antigen receptor T-cell immunotherapy (CAR-T) is now a standard treatment of relapsed or refractory B-cell non-Hodgkin lymphomas; however, a significant portion of patients do not respond to CAR-T and/or experience toxicities. Lymphodepleting chemotherapy is a critical component of CAR-T that enhances CAR-T-cell engraftment, expansion, cytotoxicity, and persistence. We hypothesized that the lymphodepletion regimen might affect the safety and efficacy of CAR-T. PATIENTS AND METHODS We compared the safety and efficacy of lymphodepletion using either fludarabine/cyclophosphamide (n = 42) or bendamustine (n = 90) before tisagenlecleucel in two cohorts of patients with relapsed or refractory large B-cell lymphomas treated consecutively at three academic institutions in the United States (University of Pennsylvania, n = 90; Oregon Health & Science University, n = 35) and Europe (University of Vienna, n = 7). Response was assessed using the Lugano 2014 criteria and toxicities were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and, when possible, the American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading. RESULTS Fludarabine/cyclophosphamide led to more profound lymphocytopenia after tisagenlecleucel infusion compared with bendamustine, although the efficacy of tisagenlecleucel was similar between the two groups. We observed significant differences, however, in the frequency and severity of adverse events. In particular, patients treated with bendamustine had lower rates of cytokine release syndrome and neurotoxicity. In addition, higher rates of hematological toxicities were observed in patients receiving fludarabine/cyclophosphamide. Bendamustine-treated patients had higher nadir neutrophil counts, hemoglobin levels, and platelet counts, as well as a shorter time to blood count recovery, and received fewer platelet and red cell transfusions. Fewer episodes of infection, neutropenic fever, and post-infusion hospitalization were observed in the bendamustine cohort compared with patients receiving fludarabine/cyclophosphamide. CONCLUSIONS Bendamustine for lymphodepletion before tisagenlecleucel has efficacy similar to fludarabine/cyclophosphamide with reduced toxicities, including cytokine release syndrome, neurotoxicity, infectious and hematological toxicities, as well as reduced hospital utilization.
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Affiliation(s)
- G Ghilardi
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - E A Chong
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - J Svoboda
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - P Wohlfarth
- Medical University of Vienna, Division of Hematology and Hemostaseology, Department of Medicine I Wien, Comprehensive Cancer Center, Vienna, Austria
| | - S D Nasta
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - S Williamson
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - J D Landsburg
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - J N Gerson
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - S K Barta
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - R Pajarillo
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - J Myers
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - A I Chen
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - L Schachter
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - R Yelton
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA
| | - H J Ballard
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - A Hodges Dwinal
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - S Gier
- Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - D Victoriano
- Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - E Weber
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - E Napier
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - A Garfall
- Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - D L Porter
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - U Jäger
- Medical University of Vienna, Division of Hematology and Hemostaseology, Department of Medicine I Wien, Comprehensive Cancer Center, Vienna, Austria
| | - R T Maziarz
- Oregon Health & Science University Knight Cancer Institute, Adult Blood and Marrow Stem Cell Transplant & Cell Therapy Program, Portland, USA
| | - M Ruella
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - S J Schuster
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA; Center for Cellular Immunotherapies and Cellular Therapy and Transplant, University of Pennsylvania, Philadelphia, USA; Division of Hematology-Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
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Giorgiutti S, Gerfaud-Valentin M, Jamilloux Y, Bert A, Weber E, Richard-Colmant G, Krencker D, Ballonzoli L, Kodjikian L, Korganow A, Poindron V, Sève P. Uvéites et grossesse : une étude rétrospective bicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.297] [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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Strober L, Weber E, Lequerica A, Chiaravalloti N. Surviving a global pandemic: The experience of depression, anxiety, and loneliness among individuals with multiple sclerosis. Mult Scler Relat Disord 2022; 58:103497. [PMID: 35066271 PMCID: PMC8742660 DOI: 10.1016/j.msard.2022.103497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/15/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022]
Abstract
Background The world has been experiencing one of the most significant worldwide health pandemics in modern history. The result has been increased depression, anxiety, and loneliness in the general population. However, populations who demonstrated pre-pandemic emotional disturbance and social isolation, such as individuals with multiple sclerosis (MS), are likely uniquely vulnerable to such symptoms. Objective The purpose of the present investigation was to examine the emotional outcomes, including reports of loneliness, in individuals with MS during the COVID-19 pandemic. We additionally sought to examine how individuals’ experiences during the pandemic may contribute to a specific COVID-19-related depression or anxiety. Methods 142 individuals with MS who previously participated in a national, online, survey-based study were asked to complete an online survey assessing their current level of depression, anxiety, loneliness, and perceived impact of the COVID-19 pandemic. Results Increases in the rates of depression and anxiety were noted, with approximately 54% and 33% reporting “new” depression or anxiety, respectively. Given this increase, we examined how individuals with “new” depression or anxiety differed from those without depression and anxiety and those with pre-pandemic depression and/or anxiety. Significant differences in person-specific factors (e.g., personality, self-efficacy) were noted between the groups. Increased loneliness was also found among both those with depression or anxiety regardless of whether “new” or pre-pandemic. Finally, all those depressed or anxious reported greater disruption and distress related to the COVID-19 pandemic with a trend for increased anxiety specifically related to the pandemic (e.g., fear or dying due to COVID-19) among those with new depression or anxiety when compared to those with existing depression or anxiety, suggesting an influence of the pandemic that is specific to reports of new depression or anxiety. Conclusion Findings suggest increased depression, anxiety, and loneliness among individuals with MS following the COVID-19 pandemic, with reports of “new” depression or anxiety, which appears to be related to the pandemic, specifically. Moreover, factors commonly associated with depression or anxiety in MS (e.g., personality, self-efficacy) were more common among those with existing depression or anxiety but not among those experiencing new depression or anxiety. These differences should be considered when attempting to ameliorate the impact of the COVID-19 among those experiencing emotional distress.
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Affiliation(s)
- L Strober
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936, USA; Department of Physical Medicine & Rehabilitation, New Jersey Medical School, Rutgers, State University of New Jersey, USA.
| | - E Weber
- Department of Physical Medicine & Rehabilitation, New Jersey Medical School, Rutgers, State University of New Jersey, USA; Center for Traumatic Brain Injury Research, Kessler Foundation, USA
| | - A Lequerica
- Department of Physical Medicine & Rehabilitation, New Jersey Medical School, Rutgers, State University of New Jersey, USA; Center for Traumatic Brain Injury Research, Kessler Foundation, USA
| | - N Chiaravalloti
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936, USA; Department of Physical Medicine & Rehabilitation, New Jersey Medical School, Rutgers, State University of New Jersey, USA; Center for Traumatic Brain Injury Research, Kessler Foundation, USA
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Heymonet S, Thibaud E, Weber E. Rupture de rate spontanée en contexte de mononucléose infectieuse. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0332] [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: 11/20/2022]
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Peter E, Jean-Baptiste F, Harbaoui B, Kone-Paut I, Dauphin C, Gomard-Mennesson E, Hervier B, De Boysson H, Varron L, Pugnet G, Gobert D, Bachmeyer C, Humbert S, Roblot P, Cathébras P, Gerfaud-Valentin M, Weber E, Jamilloux Y, Fain O, Sève P. Devenir cardiovasculaire à long terme dans la maladie de Kawasaki de l’adulte. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.278] [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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Millar NL, Mcinnes I, Mindeholm L, Seroutou A, Praestgaard J, Schramm U, Levitch R, Weber E, Laurent D, Rosen J, Schett G, Roubenoff R, Schieker M. POS0020 EFFICACY AND SAFETY OF SECUKINUMAB IN PATIENTS WITH ROTATOR CUFF TENDINOPATHY: A 24-WEEK, RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE II PROOF-OF-CONCEPT TRIAL. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rotator cuff tendinopathy (RC TP) is a multifactorial condition and one of the most common causes of musculoskeletal burden. Current standard of care (SoC) is limited to pain relief with NSAIDs and physiotherapy. Recent evidence indicates that IL-17A-expressing tendon-resident immune cells are present in human overuse tendinopathy, and IL-17A levels are increased in early human tendinopathic tissue samples [1, 2]. Secukinumab (SEC) is a fully human, monoclonal antibody that binds to and neutralises IL-17A.Objectives:To evaluate the efficacy and safety of SEC in patients with active overuse RC TP refractory to oral NSAIDs/acetaminophen, physiotherapy or corticosteroid injections.Methods:96 patients with symptomatic RC TP with no or <50% rupture were randomly assigned to receive seven subcutaneous injections of SEC 300 mg or placebo (PBO) at baseline and Weeks 1, 2 and 3, followed by every 4 weeks starting at Week 4. The primary endpoint was change from baseline in the Western Ontario Rotator Cuff (WORC) index score at Week 14 for SEC vs PBO (two-sided p<0.1). Secondary endpoints included, visual analogue scale (VAS) pain score, Disability of Arm, Shoulder and Hand Questionnaire (QuickDASH) score, American Shoulder and Elbow Surgeons Shoulder Evaluation Form (ASES), EQ-5D-5L score and patient global assessment (PGA) score. All endpoints were assessed through 24 weeks.Results:Clinically relevant improvement in both SEC and PBO groups on top of SoC treatment was observed, with no statistically significant difference demonstrated in the full study population on physical symptoms and function (Table 1). Similar results were observed in the secondary endpoints with marked improvement in both groups over time. Exploratory post-hoc analyses in a subpopulation of 39% of the study subjects with non-acute, moderate to severe disease, SEC provided significant and clinically relevant improvements vs PBO through Week 24 in total WORC score (overall treatment difference: 19.2, p <0.01) and pain (VAS, overall treatment difference: 15, p = 0.02) with early effect observed after two weeks (Figure 1). A favourable treatment effect in the more severe subgroup was demonstrated in other patient-reported outcomes. No serious adverse events were reported.Conclusion:Although SEC did not demonstrate a significant benefit vs PBO in the overall patient population with active overuse RC TP, SEC did provide benefit in the subpopulation with non-acute, moderate to severe disease. Larger clinical trials of SEC in this area are warranted.References:[1]Millar NL, et al. Sci Rep. 2016;6:27149.[2]Millar NL, et al. Nat Rev Rheumatol.2017;13:110-122.Table 1.Change from baseline in the SEC versus PBO groups in WORC index and pain (VAS)VisitSEC 300 mgPBOp-valueTotal treated population N=96WORC Index percentage score (0 worst -100 best)aDay 2922.3519.490.45Day 9937.0037.770.87Day 16943.4140.970.64Pain (VAS, 0 best - 100 worst)bDay 29−26.04−23.130.57Day 99−46.11−40.560.28Day 169−52.23−50.740.78Post-hoc population* N=37WORC Index percentage score (0 worst - 100 best)cDay 2930.0910.840.002Day 9948.2631.830.048Day 16955.9835.240.028Pain (VAS, 0 best - 100 worst)dDay 29−29.20−14.850.125Day 99−51.48−35.370.045Day 169−57.01−46.640.217aDay 1: SEC 42.47, PBO 40.47; bSEC 67.04, PBO 64.85; cSEC 35.93, PBO 32.90, dSEC 71.72, PBO 67.58. Day 1 values are given as absolute values to describe baseline WORC/Pain status*Post-hoc subpopulation: Baseline: (Disease duration 2-6 months) AND (WORC ≤40 OR Tear Thickness (Bauer) ≥1 OR Sein ≥2)PBO, placebo; SEC, secukinumab; SoC, standard of care; WORC, Western Ontario Rotator Cuff Index; VAS, visual analogue scaleFigure 1.Post-hoc analysis of function (WORC) in the treatment groups in non-acute, moderate to severe subpopulationSECSE, standard error; SEC, secukinumab; WORC, Western Ontario Rotator Cuff IndexDisclosure of Interests:Neal L Millar Grant/research support from: Honoraria or research funding from Novartis and Stryker, Iain McInnes Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Lilly, Novartis, Pfizer, and UCB, Linda Mindeholm Employee of: Employee of Novartis, Abdelkader Seroutou Employee of: Employee of Novartis, Jens Praestgaard Employee of: Employee of Novartis, Ursula Schramm Employee of: Employee of Novartis, Rafael Levitch Employee of: Employee of Novartis, Eckhard Weber Employee of: Employee of Novartis, Didier Laurent Employee of: Employee of Novartis, Jeffrey Rosen Consultant of: Research advisor for Novartis, Georg Schett Speakers bureau: Received speakers honoraria from Abbvie, Amgen, BMS, Eli Lilly, Gilead, Janssen, Novartis, UCB, Ronenn Roubenoff Employee of: Employee of Novartis, Matthias Schieker Employee of: Employee of Novartis.
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Affiliation(s)
- E Weber
- Ludwig-Maximilians-University, Munich, Germany
| | - E Richter
- Ludwig-Maximilians-University, Munich, Germany
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Recker F, Weber E, Haverkamp N, Gembruch U, Mustea A, Strizek B. Nutzung des Nationalen Kompetenzbasierten Lernzielkatalogs Medizin (NKLM) im Fach der Frauenheilkunde – Eine Single Center-Analyse. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- F. Recker
- Universitätsklinikum Bonn, Zentrum für Frauenheilkunde und Geburtshilfe
- Medizinisches Studiendekanat
| | - E. Weber
- Universitätsklinikum Bonn, Zentrum für Frauenheilkunde und Geburtshilfe
| | | | - U. Gembruch
- Universitätsklinikum Bonn, Zentrum für Frauenheilkunde und Geburtshilfe
| | - A. Mustea
- Universitätsklinikum Bonn, Klinik für Gynäkologie und gynäkologische Onkologie
| | - B. Strizek
- Universitätsklinikum Bonn, Zentrum für Frauenheilkunde und Geburtshilfe
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Otten L, Stephan S, Weber E, Hircin E, Strizek B, Gembruch U, Mustea A, Recker F. Der Digital-Turn in der gynäkologisch-geburtshilflichen Lehre – Etablierung eines AMBOSS-orientierten, digital-interaktiven Peer-Teaching-Kurses. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- L.A. Otten
- Universitätsklinikum, Zentrum für Frauenheilkunde und Geburtshilfe
| | - S. Stephan
- Universitätsklinikum, Zentrum für Frauenheilkunde und Geburtshilfe
| | - E. Weber
- Universitätsklinikum, Zentrum für Geburtshilfe und Pränatale Medizin
| | | | - B. Strizek
- Universitätsklinikum, Zentrum für Geburtshilfe und Pränatale Medizin
| | - U. Gembruch
- Universitätsklinikum, Zentrum für Geburtshilfe und Pränatale Medizin
| | - A. Mustea
- Universitätsklinikum, Zentrum für Frauenheilkunde und Geburtshilfe
| | - F. Recker
- Universitätsklinikum, Zentrum für Frauenheilkunde und Geburtshilfe
- Universitätsklinikum, Medizinisches Studiendekanat
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Tascon-Padron L, Weber E, Keil V, Gembruch U, Merz WM. Schwangerschaft nach Hemisphärotomie bei Rasmussen Enzephalitis - ein Fallbericht. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- L Tascon-Padron
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatale Medizin
| | - E Weber
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatale Medizin
| | - V Keil
- Universitätsklinium Bonn, Radiologische Klinik
| | - U Gembruch
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatale Medizin
| | - WM Merz
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatale Medizin
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Dohmen S, Weber E, Stope M, Mustea A, Recker F. Praktische Prüfungsformate in der gynäkologisch-geburtshilflichen Lehre: Ein Überblick verschiedener Assessmentformen im Rahmen des NKLM und der ÄApprO 2020. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- S. Dohmen
- Zentrum für Frauenheilkunde und Geburtshilfe
| | - E. Weber
- Zentrum für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe und pränatale Medizin
| | - M. Stope
- Zentrum für Frauenheilkunde und Geburtshilfe, Abteilung für Gynäkologie und gynäkologische Onkologie
| | - A. Mustea
- Zentrum für Frauenheilkunde und Geburtshilfe, Abteilung für Gynäkologie und gynäkologische Onkologie
| | - F. Recker
- Zentrum für Frauenheilkunde und Geburtshilfe
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Condic M, Siebers P, Weber E, Strizek B, Gembruch U, Recker F. Strukturierte praktische Untersuchungsfertigkeiten im Fach der Frauenheilkunde. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- M. Condic
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
| | - P. Siebers
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
| | - E. Weber
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
| | - B. Strizek
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
| | - U. Gembruch
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
| | - F. Recker
- Universitätsfrauenklinik Bonn, Zentrum für Geburtshilfe und Frauenheilkunde
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Lacagne AS, Brumpt E, Barrabé A, Pomero E, Chatelain B, Grillet F, Weber E, Malakhia A, Pons M, Aubry S, Meyer C, Sigaux N, Louvrier A. Diagnostic performance of mobile cone beam computed tomography versus conventional multi-detector computed tomography in orbital floor fractures: a study on human specimens. Int J Oral Maxillofac Surg 2020; 50:205-211. [PMID: 32921556 DOI: 10.1016/j.ijom.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the diagnostic accuracy of mobile cone beam computed tomography (MCBCT) versus multi-detector computed tomography (MDCT) in orbital floor fractures. Twenty-four fresh cadaver heads were used, and one orbital floor was fractured for each head by transconjunctival approach. MDCT and MCBCT were performed on each of the heads. The images obtained were then analysed independently by eight evaluators. The radiological characteristics of the orbital floor fractures were visualized with good interpretation agreement between the two images. The location of the fracture and enophthalmos were identified in a comparable manner with strong agreement (κ=0.93 and κ=0.85, respectively). Measurements of fatty hernias and bone defects showed a strong correlation between the two imaging modalities (Pearson coefficient between 0.64 and 0.71 and between 0.67 and 0.71, respectively). The fracture limits and the presence of bone fragments, an intrasinus fatty hernia, and a fracture of the associated medial orbital wall were visualized in both examinations with good agreement (κ=0.68, κ=0.51, κ=0.57, and κ=0.46, respectively). The soft tissue study showed superiority for MDCT, with a κ<0.0009. MCBCT showed good diagnostic performance in the study of orbital floor fracture characteristics.
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Affiliation(s)
- A S Lacagne
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France.
| | - E Brumpt
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Pomero
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - F Grillet
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Malakhia
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - M Pons
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
| | - S Aubry
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - N Sigaux
- Hospices Civils de Lyon, University Claude Bernard Lyon 1, Maxillofacial and Stomatology, Lyon-Sud Hospital Centre, Pierre-Benite, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
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Assouline SL, Meyer C, Weber E, Chatelain B, Barrabe A, Sigaux N, Louvrier A. How useful is intraoperative cone beam computed tomography in maxillofacial surgery? An overview of the current literature. Int J Oral Maxillofac Surg 2020; 50:198-204. [PMID: 32605822 DOI: 10.1016/j.ijom.2020.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Intraoperative imaging is increasingly used by surgeons and has become an integral part of many surgical procedures. This study was performed to provide an overview of the current literature on the intraoperative use of cone beam computed tomography (CBCT) imaging in maxillofacial surgery. A bibliographic search of PubMed was conducted in March 2020, without time limitation, using "intraoperative imaging" AND "maxillofacial surgery" AND "cone beam computed tomography" as key words. Ninety-one articles were found; after complete reading, 16 articles met the eligibility criteria and were analysed. The results showed that the majority of the indications were related to maxillofacial trauma, particularly zygomaticomaxillary complex fractures. Final verification with intraoperative CBCT before wound closure was the most common use of this device. However, innovative uses of intraoperative CBCT are expanding, such as CBCT coupling with mirror computational planning, and even the combined use of initial intraoperative CBCT acquisition with navigation. Immediate, fast, and easy evaluation of bone repositioning to avoid the need for further surgical revision is the main advantage of this technique. Imaging quality is comparable to that of multi-slice computed tomography, but with lower radiation exposure. Nevertheless, CBCT is still not widely available in maxillofacial centres, probably because of its cost, and perhaps because not everyone is aware of its advantages and versatility, which are reported in this review.
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Affiliation(s)
- S L Assouline
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Department of Oral and Maxillofacial Surgery, University Hospital of Strasbourg, Strasbourg, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; NanomedicineLab, Imagery and Therapeutics, EA 4662, Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Barrabe
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre-Bénite, France; 3d.FAB platform, ICBMS, CNRS 5246 Claude-Bernard Lyon 1 University, Villeurbanne, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; University of Bourgogne Franche- Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon- Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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Weber E, Lega JC. Response to: Paradoxical embolism as a cause of renal and/or splenic infarction. QJM 2020; 113:444. [PMID: 31681947 DOI: 10.1093/qjmed/hcz286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Weber
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Médecine Interne et Médecine Vasculaire, F-69310 Pierre-Bénite, France
| | - J C Lega
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Médecine Interne et Médecine Vasculaire, F-69310 Pierre-Bénite, France
- Univ Lyon, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, CNRS, Claude Bernard University Lyon, F-69100 Lyon, France
- Groupe d'Etude Multidisciplinaire des Maladies Thrombotiques (GEMMAT), Hospices Civils de Lyon, F-69003 Lyon, France
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Strizek B, Gottschalk I, Recker F, Weber E, Flöck A, Gembruch U, Geipel A, Berg C. Vesicoamniotic shunting for fetal megacystis in the first trimester with a Somatex ® intrauterine shunt. Arch Gynecol Obstet 2020; 302:133-140. [PMID: 32449061 PMCID: PMC7266802 DOI: 10.1007/s00404-020-05598-z] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/08/2020] [Indexed: 11/30/2022]
Abstract
Purpose The objective was to evaluate the feasibility of vesicoamniotic shunting (VAS) in the first trimester with the Somatex® intrauterine shunt and report on complications and neonatal outcome. Methods Retrospective cohort study of all VAS before 14 weeks at two tertiary fetal medicine centres from 2015 to 2018 using a Somatex® intrauterine shunt. All patients with a first trimester diagnosis of megacystis in male fetuses with a longitudinal bladder diameter of at least 15 mm were offered VAS. All patients that opted for VAS after counselling by prenatal medicine specialists, neonatologists and pediatric nephrologists were included in the study. Charts were reviewed for complications, obstetric and neonatal outcomes. Results Ten VAS were performed during the study period in male fetuses at a median GA of 13.3 (12.6–13.9) weeks. There were two terminations of pregnancy (TOP) due to additional malformations and one IUFD. Overall there were four shunt dislocations (40%); three of those between 25–30 weeks GA. Seven neonates were born alive at a median GA of 35.1 weeks (31.0–38.9). There was one neonatal death due to pulmonary hypoplasia. Neonatal kidney function was normal in the six neonates surviving the neonatal period. After exclusion of TOP, perinatal survival was 75%, and 85.7% if only live-born children were considered. Conclusion VAS in the first trimester is feasible with the Somatex® Intrauterine shunt with low fetal and maternal complication rates. Neonatal survival rates are high due to a reduction in pulmonary hypoplasia and the rate of renal failure at birth is very low. VAS can be safely offered from the late first trimester using the Somatex® intrauterine shunt.
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Affiliation(s)
- B Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - I Gottschalk
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Cologne, Cologne, Germany
| | - F Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - E Weber
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Flöck
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - C Berg
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Cologne, Cologne, Germany
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Louvrier A, Barrabé A, Weber E, Chatelain B, Sigaux N, Meyer C. The high sub-mandibular approach: Our experience about 496 procedures. J Stomatol Oral Maxillofac Surg 2020; 121:626-633. [PMID: 32205300 DOI: 10.1016/j.jormas.2020.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The potential drawbacks of surgical approaches to neck and base fractures of the mandibular condyle (visible scare, facial nerve injury) are still considered by many surgeons as a brake for open reduction and internal fixation. The aim of our study was to analyze the results in terms of access, scare quality and complications that could be noticed in a 12 years period of time with the use of the high sub-mandibular approach (HSMA) we first described in 2006 for the surgical treatment of neck and base fractures. MATERIAL AND METHOD All the files of patients operated on for condylar neck and base fractures approached by mean of a HSMA between January 2006 and December 2018 in our department and containing information concerning age, sex, type of fracture, kind of osteosynthesis material, operating time, name of the surgeon, postoperative complication linked to the approach, scare quality at 6 months follow-up at least were included. The skin incision and the dissection planes followed the original publication of Meyer et al. in 2006. RESULTS 434 patients (sex ratio: 2.06, mean age: 32, 496 approaches) met the inclusion criteria. Following the AO classification, 21.2% of the fractures were classified as neck fractures and 78.8% as base fractures. 97.6% of all fractures were stabilized by mean of a 3D plate (TCP® plate, Medartis, Basel-CH), the remaining ones by mean of a combination of 1.2, 1.5 and 2.0 straight plates. Mean operating time was 40minutes per side. Patients were operated on by senior surgeons in 71.7% of the cases and by trainees under supervision for the others. Concerning the complications linked to the approach, we noticed 11 (2.2%) temporary (0 definitive) paresis of the facial nerve, 1 (0.2%) hematoma and 1 (0.2%) abscess that both needed revision. Scare was hypertrophic or considered as unaesthetic by the patient in 5 cases (1%). DISCUSSION The HSMA, if performed as initially described, is a safe and quick procedure compared to other cutaneous approaches. It gives access to all base fractures and to most of neck fractures. The very low rate of facial nerve complications is mainly explained by the plane by plane dissection making it very easy to avoid the facial nerve branches or to check them when encountered. The HSMA is particularly suited to the use of TCP plates as the upper holes of these plates, placed horizontally, are easy to reach from below. The HSMA is therefore still our preferred cutaneous approach to the condylar process.
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Affiliation(s)
- A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Host-Graft Interactions Lab-Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France.
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - N Sigaux
- Department of Maxillofacial Surgery and Plastic Facial Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 69310 Pierre-Bénite, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France.
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Weber E, Grangeon F, Reynaud Q, Hot A, Sève P, Jardel S, Tazarourte K, Fouque D, Juillard L, Salles G, Grange C, Durieu I, Rousset P, Lega JC. Acute renal and splenic infarctions: a review. QJM 2020; 113:186-193. [PMID: 31593227 DOI: 10.1093/qjmed/hcz252] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Renal and splenic infarctions are close entities, with few data concerning their clinical, biological and radiological features. AIM The aim of this study was to compare the clinical presentations, etiologies and outcomes of acute renal infarctions (RI) and splenic infarctions (SI). DESIGN A retrospective multicentric cohort study included patients of the 6 university hospitals in Lyon with RI, SI, or associated RI-SI infarctions was conducted. METHODS All consecutive cases diagnosed by CT imaging, between January 2013 and October 2016, were included. The exclusion criteria were causes of infarction that did not require additional investigations. RESULTS A total of 161 patients were selected for analysis: 34 patients with RI, 104 patients with SI and 23 patients with both RI-SI. Mean ± SD age of patients was 63.2 ± 16.6 years; 59.6% were male. Only 5/161 (3.1%) were healthy prior to the event. The main symptoms were diffuse abdominal pain (26.4%), followed by nausea/vomiting (18.3%) and fever (16.4%).The causes of RI or SI varied significantly within the three groups. Hypercoagulable state was associated with SI, and embolic disease and arterial injury were associated with RI. Extensive (i.e.>2/3 of organ volume) (OR 6.22, 95%CI 2.0119.22) and bilateral infarctions (OR 15.05, 95%CI 1.79-126.78) were significantly associated with hemodynamic shocks. The survival at 1 month follow-up did not significantly differ between the three groups. CONCLUSION Acute RI and SI are heterogenous entities in regards to their clinical presentation, etiology, associated venous or arterial thrombosis, but prognoses were not different at short term follow-up.
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Affiliation(s)
- E Weber
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - F Grangeon
- Service de radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - Q Reynaud
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, Health Services and Performance Research EA7425, Claude Bernard University Lyon, F-69003 Lyon
| | - A Hot
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69003 Lyon
| | - P Sève
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Service de médecine interne, Hospices Civils de Lyon, Hôpital de la Croix Rousse, F-69004 Lyon
| | - S Jardel
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - K Tazarourte
- Service d'accueil des Urgences, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69003 Lyon
| | - D Fouque
- Service de Néphrologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - L Juillard
- Service de Néphrologie, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69310 Lyon
| | - G Salles
- Service d'Hématologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - C Grange
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Groupe d'Etude Multidisciplinaire des Maladies Thrombotiques (GEMMAT), Hospices Civils de Lyon, Lyon
| | - I Durieu
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Univ Lyon, Health Services and Performance Research EA7425, Claude Bernard University Lyon, F-69003 Lyon
| | - P Rousset
- Service de radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - J C Lega
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Groupe d'Etude Multidisciplinaire des Maladies Thrombotiques (GEMMAT), Hospices Civils de Lyon, Lyon
- Univ Lyon, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, CNRS, Claude Bernard University, F-69003 Lyon, France
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LaRiviere M, Wright C, Arscott W, Miller D, Weber E, Landsburg D, Svoboda J, Nasta S, Gerson J, Chong E, Schuster S, Maity A, Plastaras J. Induction Radiation Prior to Commercial Chimeric Antigen Receptor T-Cell Therapy for Relapsed/Refractory Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cotte P, Jamilloux Y, Gerfaud-Valentin M, Weber E, Francois M, Grumet P, Planchette J, Denis P, Mathis T, Kodjikian L, Sève P. Intérêt de l’association ECA élevée–lymphopénie pour le diagnostic des uvéites sarcoïdosiques. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ryn-McKenna JV, Gray E, Weber E, Ofosu FA, Buchanan MR. Effects of Sulfated Polysaccharides on Inhibition of Thrombus Formation initiated by Different Stimuli. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1646517] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryTo test the possibility that different doses of heparin or other sulfated polysaccharides are required to inhibit thrombosis initiated by different stimuli, we compared the effects of heparin (HEP), pentosan polysulfate (SP54) and dermatan sulfate (DS) on the inhibition of thrombus formation induced by either I) tissue thromboplastin; II) thrombin; or III) factor Xa. Inhibition of thrombus formation induced by the stimuli was measured in a rabbit jugular vein hypercoagulation/stasis model. First, we determined the minimum dose of each sulfated polysaccharide which inhibited tissue thromboplastin-induced thrombus formation by ∼75%, and then compared the relative effectiveness of this dose to prevent thrombus formation initiated with the other two stimuli. HEP and SP54 were less effective when thrombin was the thrombogenic stimulus, while DS was more effective. HEP was the most effective agent when factor Xa was the stimulus. We conclude that the antithrombotic effectiveness of a given dose of a sulfated polysaccharide may vary depending on the stimulus which initiates thrombus formation.
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Affiliation(s)
- J Van Ryn-McKenna
- The Department of Pathology, McMaster University Medical Centre and the Canadian Red Cross Blood Transfusion Service, Hamilton, Ontario, Canada
| | - E Gray
- The Department of Pathology, McMaster University Medical Centre and the Canadian Red Cross Blood Transfusion Service, Hamilton, Ontario, Canada
| | - E Weber
- The Department of Pathology, McMaster University Medical Centre and the Canadian Red Cross Blood Transfusion Service, Hamilton, Ontario, Canada
| | - F A Ofosu
- The Department of Pathology, McMaster University Medical Centre and the Canadian Red Cross Blood Transfusion Service, Hamilton, Ontario, Canada
| | - M R Buchanan
- The Department of Pathology, McMaster University Medical Centre and the Canadian Red Cross Blood Transfusion Service, Hamilton, Ontario, Canada
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Brischoux-Boucher E, Trimouille A, Baujat G, Goldenberg A, Schaefer E, Guichard B, Hannequin P, Paternoster G, Baer S, Cabrol C, Weber E, Godfrin G, Lenoir M, Lacombe D, Collet C, Van Maldergem L. IL11RA-related Crouzon-like autosomal recessive craniosynostosis in 10 new patients: Resemblances and differences. Clin Genet 2018; 94:373-380. [DOI: 10.1111/cge.13409] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 02/02/2023]
Affiliation(s)
| | - A. Trimouille
- CHU Bordeaux, Service de Génétique Médicale, INSERM U1211; Université de Bordeaux; Bordeaux France
| | - G. Baujat
- Centre de Référence Maladies Osseuses Constitutionnelles, Institut Imagine; Université Paris Descartes-Sorbonne Paris Cité; Paris France
| | - A. Goldenberg
- Service de Génétique, Centre Normand de Génomique Médicale et Médecine Personnalisée; Centre Hospitalier et Universitaire, Université de Rouen; Rouen France
| | - E. Schaefer
- Service de Génétique Médicale; Centre Hospitalier et Universitaire, Hôpital de Hautepierre, Université de Strasbourg; Strasbourg France
| | - B. Guichard
- Service de Chirurgie Maxillo-Faciale; Centre Hospitalier et Universitaire, Université de Rouen; Rouen France
| | - P. Hannequin
- Service de Neurochirurgie; Centre Hospitalier et Universitaire, Université de Rouen; Rouen France
| | - G. Paternoster
- Service de Neurochirurgie Pédiatrique; Hôpital Necker-Enfants Malades; Paris France
| | - S. Baer
- Service de Génétique Médicale; Centre Hospitalier et Universitaire, Hôpital de Hautepierre, Université de Strasbourg; Strasbourg France
| | - C. Cabrol
- Centre de Génétique Humaine; Université de Franche-Comté; Besançon France
| | - E. Weber
- Service de Chirurgie Maxillo-Faciale; Centre Hospitalier et Universitaire, Université de Franche-Comté; Besançon France
| | - G. Godfrin
- Service de Neurochirurgie; Centre Hospitalier et Universitaire, Université de Franche-Comté; Besançon France
| | - M. Lenoir
- Service de Radiologie; Centre Hospitalier et Universitaire, Université de Franche-Comté; Besançon France
| | - D. Lacombe
- CHU Bordeaux, Service de Génétique Médicale, INSERM U1211; Université de Bordeaux; Bordeaux France
| | - C. Collet
- Service de Biochimie et Biologie Moléculaire; Groupement Hospitalier et Universitaire Lariboisière, Assistance Publique - Hôpitaux de Paris, Université Paris-Descartes; Paris France
| | - L. Van Maldergem
- Centre de Génétique Humaine; Université de Franche-Comté; Besançon France
- Integrative and Cognitive Neurosciences Research Unit EA481; University of Franche-Comté; Besançon France
- Clinical Investigation Center 1431; National Institute of Health and Medical Research (INSERM), University of Franche-Comté; Besançon France
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Abstract
ZusammenfassungEnantiomere sind Moleküle, die sich wie Bild zu Spiegelbild verhalten; sie weisen fast identische chemische oder physikalische Eigenschaften auf, unterscheiden sich aber in ihren physiologischen Wirkungen. Es wird über das unterschiedliche pharmakokinetische Verhalten und die differierenden pharmakodynamischen Eigenschaften der Enantiomeren der oralen Antikoagulanzien Phenoprocoumon (PH), Warfarin (WA) und Acenocoumarol (AC) beim Menschen und über die daraus resultierenden therapeutischen Konsequenzen berichtet.Für eigene Untersuchungen zur enantioselektiven Elimination von PH bei einer großen Zahl von Patienten unter Langzeit-Antikoagulation wurden die Enantiomere aus Plasmaund Urinproben mit HPLC an chiralen Säulen getrennt und quantifiziert. Die Ergebnisse zeigten folgendes: 1. Bei 50% der Patienten wird das S-Enantiomer langsamer aus dem Plasma eliminiert als das R-Enantiomer, bei 25% mit gleicher Geschwindigkeit und bei weiteren 25% schneller. Dies weist auf eine große interindividuelle Variabilität hin. 2. Das S/R-Verhältnis im Plasma war über die Zeit konstant (intraindividuell konstantes S/R-Verhältnis). 3. Im Durchschnitt wird das S-Enantiomer jedoch nach Abbruch der PHTherapie schneller eliminiert als das R-Enantiomer. Die Eliminationshalbwertszeiten aus dem Plasma betragen 123,7 ± 43,6 h für das Sund 156,5 ± 72,4 h für das R-Enantiomer. 4. Die Plasmaproteinbindung für das Sund R-Enantiomer ist unterschiedlich (fu%: 0,198 für S; 0,322 für R). 5. Der enantioselektive Effekt der Elimination ist bei PH nicht so ausgeprägt wie bei WA und könnte das beobachtete unterschiedliche Spektrum an Interaktionen mit anderen Arzneimitteln erklären.
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Liney GP, Dong B, Weber E, Rai R, Destruel A, Garcia-Alvarez R, Manton DJ, Jelen U, Zhang K, Barton M, Keall P, Crozier S. Imaging performance of a dedicated radiation transparent RF coil on a 1.0 Tesla inline MRI-linac. ACTA ACUST UNITED AC 2018; 63:135005. [DOI: 10.1088/1361-6560/aac813] [Citation(s) in RCA: 17] [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] [Indexed: 11/12/2022]
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Abstract
ZusammenfassungBeim Sanarelli-Shwartzman-Phänomen des Kaninchens findet man neben anderen Gerinnungsstörungen auch eine verminderte Retraktionsfähigkeit des Blutes. Ursache hierfür ist ein Verlust von energiereichem Phosphat (ATP) in den Thrombozyten, welches offenbar mit anderen Nukleotiden die geschädigten Plättchen verläßt. Es kann dabei eine quantitative Beziehung zwischen dem ATP-Gehalt der Plättchen und dem m-Wert des TEG nachgewiesen werden. Für die Thrombozytenschädigung wird intravasal auftretendes Thrombin verantwortlich gemacht, welches die viskose Metamorphose startet, die Permeabilität verändert und so die Blutplättchen zum Untergang vorbereitet. Quantitative und qualitative Plättchenveränderungen sind die Folge. Freiwerdende Plättchen- lipide gehen im Rahmen der Thrombokinasefunktion des Blutes in den ubiquitären intravasalen Gerinnungsprozeß ein. Die konsekutive Thrombozytopathie bzw. experimentelle “Thrombasthenie” bietet gewissermaßen im Modell weitere Ansatzpunkte für Thrombozytenstudien.
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Abstract
ZusammenfassungIn vorliegenden Untersuchungen konnte gezeigt werden, daß zahlreiche Lipid-Wasser-Emulsionen zu einer ausgeprägten und rasch einsetzenden Steigerung der Thrombozytenaggregation führen. Bei Abwesenheit von Kalziumionen in EDTA-Plasma ließ sich ein Lipideffekt an Thrombozyten nicht mehr nachweisen. Mehrfach gewaschene Plättchen zeigten jedoch auch ohne Kalziumionen eine deutliche Steigerung der Aggregation. Bei 4° C war der Ablauf der Aggregation deutlich verlangsamt. Die Zugabe von Albumin oder EPL verhinderte die aggregationssteigernde Wirkung einer Lipidemulsion. Adenosin führte lediglich zu einer teilweisen Hemmung der lipid -induzierten Klebrigkeitssteigerung. Aufgrund der Ergebnisse wird vermutet, daß der erste Schritt der Wirkung einer Lipidemulsion auf Thrombozyten mit der Oberflächenaktivität der Emulsionsteilchen in ursächlichem Zusammenhang steht. Im weiteren Verlauf kommt es zu einer Phagozytose von Lipidemulsionsteilchen durch Thrombozyten, was mit einer Zunahme einer Aggregationsneigung und erheblichen morphologischen und biochemischen Veränderungen verknüpft ist.
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Abstract
ZusammenfassungDer Einfluß emulgierter Lipide (Fettsäuren, Triglyzeride, Lipidgemische) und fettähnlicher Substanzen (Paraffin- und Silikonöl) auf die Struktur der Blutplättchen von Mensch und Schwein wurde licht- und elektronenmikroskopisch untersucht. Es zeigte sich, daß die Emulsionsteilchen aller geprüften Substanzen von den Plättchen durch Membraninvagination, wie das bei phagozytierenden Zellen bekannt ist, aufgenommen werden. Daneben beobachteten wir eine vermutlich ADP-induzierte Neigung der Plättchen zu aggregieren, die durch Adenosin gehemmt wurde. Emulsionen mit hohem Anteil unveresterter Fettsäuren oder reine Fettsäureemulsionen führten darüber hinaus zu starken Destruktionen der Plättchen, während nach Behandlung mit Triglyzeriden oder Lipidgemischen ohne freie Fettsäuren diese Erscheinungen erst nach langen Inkubationszeiten auftraten und sich vermindern ließen, wenn die intraplasmatische Lipolyse durch Protaminsulfat gehemmt wurde. Der Zusatz von Emulgatoren (Albumin, Phospholipide) setzte die Fettsäurewirkung und die Aggregationsneigung der Plättchen herab, EDTA verhinderte die Aggregatbildung völlig. Aus den Beobachtungen schließen wir, daß für die Aufnahme von Lipiden die Eigenschaften der Emulsionsteilchen bestimmend sind, während freie Fettsäuren aufgrund ihrer Moleküleigenschaften die Plättchenmembranen passieren und in hohen Konzentrationen zur Zellzerstörung führen.
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Barrabé A, Meyer C, Bonomi H, Weber E, Sigaux N, Louvrier A. Surgically assisted rapid palatal expansion in class III malocclusion: Our experience. J Stomatol Oral Maxillofac Surg 2018; 119:384-388. [PMID: 29753777 DOI: 10.1016/j.jormas.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 05/06/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Maxillary transverse deficiency (MTD) is a common facial disharmony that may need surgical assisted rapid palatal expansion (SARPE). The aim of this study was to present our SARPE technique and to report about our experience. MATERIEL AND METHOD Medical records of all class III patients who underwent SARPE in our department from 2010 to 2015 and for whom a follow-up of at least 1year was available, were included in a retrospective study. The technique consisted, after short orthodontic preparation allowing for divergence of the upper central incisors, in a complete Le Fort I osteotomy without down fracture, and medial sagittal submucosal separation of the hard palate under general anesthesia in an inpatient procedure. Teeth-supported distracters were sealed preoperatively while bone-supported devices were inserted peroperatively. Activation of the distracter was allowed from day 2 at the rate of 2×0.25 per day during 4days and 2×0.5mm per day the following days. Distracters were left in place for about 4months. Orthodontic treatment resumption was allowed from the second month. The initial malocclusion, the amount and type (parallel or angular) of distraction that was needed, the type of distracter used, the amount of distraction obtained, the per- and postoperative complications and the clinical stability of the end result were analyzed. RESULTS The records of 23 patients (18 women, 5 men - average age: 25.4years, extremes: 16-55years) could be included. MTD was isolated in 6 cases, associated with a maxillary retrognathism in 5 cases, with a mandibular prognathism in 6 cases, and with both in 6 cases. The average amount of distraction needed was 7.2mm (range: 4-12), parallel in 20 cases and angular in 3 cases. The distracters were bone-supported (Rapid Palatal Expander®, KLS Martin Group, Tuttlingen, Germany) in 3 patients and custom-made tooth-supported in 20 patients. The average amount of distraction obtained at the level of the distracter cylinder was 7.7mm (range: 5-13). We noted 2 cases of palatal fibromucosa perforations, 1 case of posterior excess of distraction, 1 case of nasal septum deviation, 1 case of iatrogenic necrosis of tooth No.°11, 1 case of naso-genial sulcus hematoma, 1 case of intraoperative mobility of tooth No.°21, 5 cases of asymmetric distraction. Seventeen patients needed a second orthognathic procedure and 22 had stable Class I occlusion after removal of appliances at 18 months follow-up on average. DISCUSSION SARPE is a quite safe procedure that allows for transverse coordination without dental extraction. Transverse discrepancies greater than 4mm are for us clear indications for SARPE. When a sagittal discrepancy is associated, we prefer performing SARPE first and correcting the sagittal plane in a second operation. The recent development of Le Fort I sliding osteosynthesis plates opens the way to one time correction and the development of double-action distracters fitted out with 2 cylinders will be helpful for performing angular distractions.
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Affiliation(s)
- A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics, EA 4662, UFR Sciences et Techniques, University of Franche-Comté Route de Gray, 25030 Besançon cedex, France
| | - H Bonomi
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; Department of orthodontics, Dental School, Univeristy Hospital of Strasbourg, 67091 Strasbourg, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - N Sigaux
- Department of Maxillofacial, Plastic, Reconstructive and Esthetic Surgery, Lyon-Sud University Hospital, 69495 Lyon, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
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Weber E, Sozio F, Borghini A, Sestini P, Renzoni E. Pulmonary lymphatic vessel morphology: a review. Ann Anat 2018; 218:110-117. [PMID: 29679722 DOI: 10.1016/j.aanat.2018.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/07/2018] [Accepted: 02/28/2018] [Indexed: 01/02/2023]
Abstract
Our understanding of lymphatic vessels has been advanced by the recent identification of relatively specific lymphatic endothelium markers, including Prox-1, VEGFR3, podoplanin and LYVE-1. The use of lymphatic markers has led to the observation that, contrary to previous assumptions, human lymphatic vessels extend deep inside the pulmonary lobule, either in association with bronchioles, intralobular arterioles or small pulmonary veins. Pulmonary lymphatic vessels may thus be classified into pleural, interlobular (in interlobular septa) and intralobular. Intralobular lymphatic vessels may be further subdivided in: bronchovascular (associated with a bronchovascular bundle), perivascular (associated with a blood vessel), peribronchiolar (associated with a bronchiole), and interalveolar (in interalveolar septa). Most of the intralobular lymphatic vessels are in close contact with a blood vessel, either alone or within a bronchovascular bundle. A minority is associated with a bronchiole, and small lymphatics are occasionally present even in interalveolar septa, seemingly independent of blood vessels or bronchioles. The lymphatics of the interlobular septa often contain valves, are usually associated with the pulmonary veins, and connect with the pleural lymphatics. The large lymphatics associated with bronchovascular bundles have similar characteristics to pleural and interlobular lymphatics and may be considered conducting vessels. The numerous small perivascular lymphatics and the few peribronchiolar ones that are found inside the lobule are probably the absorbing compartment of the lung responsible for maintaining the alveolar interstitium relatively dry in order to provide a minimal thickness of the air-blood barrier and thus optimize gas diffusion. These lymphatic populations could be differentially involved in the pathogenesis of diseases preferentially involving distinct lung compartments.
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Affiliation(s)
- E Weber
- Dept. of Molecular and Developmental Medicine, University of Siena, via A.Moro 2, 53100 Siena, Italy
| | - F Sozio
- Dept. of Molecular and Developmental Medicine, University of Siena, via A.Moro 2, 53100 Siena, Italy
| | - A Borghini
- Dept. of Molecular and Developmental Medicine, University of Siena, via A.Moro 2, 53100 Siena, Italy
| | - P Sestini
- Dept. of Medicine, Surgery and Neuroscience, University of Siena, viale Bracci 16, 53100 Siena, Italy
| | - E Renzoni
- ILD Unit Royal Brompton Hpospital,Sydney Street SW3 6LR, London, UK.
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Baral HO, Weber E, Marson G, Quijada L. A new connection between wood saprobism and beetle endosymbiosis: the rarely reported saprobic discomycete Tromeropsis is congeneric with the symbiotic yeast Symbiotaphrina (Symbiotaphrinales, Xylonomycetes) and two asexual morphs misplaced in Hyphozyma. Mycol Prog 2017. [DOI: 10.1007/s11557-017-1340-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Louvrier A, Marty P, Barrabé A, Euvrard E, Chatelain B, Weber E, Meyer C. How useful is 3D printing in maxillofacial surgery? Journal of Stomatology, Oral and Maxillofacial Surgery 2017; 118:206-212. [DOI: 10.1016/j.jormas.2017.07.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 12/20/2022]
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Groth K, Berezhanskyy T, Aneja MK, Geiger J, Schweizer M, Maucksch L, Pasewald T, Brill T, Tigani B, Weber E, Rudolph C, Hasenpusch G. Tendon healing induced by chemically modified mRNAs. Eur Cell Mater 2017; 33:294-307. [PMID: 28537650 DOI: 10.22203/ecm.v033a22] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tendon disorders are frequent both in human and veterinary medicine with high re-injury rates and unsatisfactory therapeutic treatments. Application of naked, chemically-modified mRNA (cmRNA), encoding for therapeutic proteins, is an innovative approach to address tendon healing. In the current study, we demonstrated that injection of naked cmRNA, diluted in a glucose-containing solution, into tendons resulted in high protein expression in healthy and experimentally-injured tendons. Injection of bone morphogenetic protein 7 (BMP-7)-encoding cmRNA resulted in a significantly higher expression of BMP-7 protein and reduced formation of collagen type III, compared to vehicle control. Moreover, in a large animal model, reporter protein expression was detectable not only in healthy, but also in experimentally-injured, severely inflamed tendons. Summarising, these results demonstrated the potential of cmRNAs encoding for therapeutic proteins as a new class of drugs for the treatment of tendon disorders.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - C Rudolph
- Ethris GmbH, Semmelweisstr. 3, 82152 Planegg,
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Martin R, Louvrier A, Weber E, Chatelain B, Meyer C. [Consequences of impacted wisdom teeth extraction on the periodontal environment of second molars. A pilot study]. J Stomatol Oral Maxillofac Surg 2017; 118:78-83. [PMID: 28343833 DOI: 10.1016/j.jormas.2016.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/17/2016] [Accepted: 10/26/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Wisdom teeth extraction is a common procedure, generally considered as safe by patients. However, complications are possible, especially periodontal ones. The aim of this study was to evaluate the frequency and the consequences of periodontal complications at the level the 2nd molars after extraction of the wisdom teeth. MATERIAL AND METHODS A single-center retrospective observational multi-operator study was conducted at the university hospital of Besançon - France. The files of all the adult patients who underwent extraction of four impacted wisdom teeth by mean of a standardized surgical technique between November 2012 and November 2014 and who could be followed 1 year postoperatively at least and that precisely mentioned the periodontal status of the surgical sites were included. Postoperative complications, gingival and plaque indexes according to Loë and Silness, periodontal attachment level and periodontal second molar probing were recorded. The main judgment criterion was the occurrence of a periodontal complication in the second molar areas. RESULTS The files of 20 patients (15 women - 5 men), operated on by five different surgeons, met the inclusion criteria. Two patients suffered from dry socket at one of the avulsion sites. No patient had a gingival or plaque index greater than 2. No gingival recession or periodontal pocket over 4mm was found. DISCUSSION Extraction of impacted third molars in young healthy adults didn't have any impact on the second molars periodontal environment in our study. Literature suggests that surgical technique greatly influences the occurrence and the extent of periodontal sequelae.
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Affiliation(s)
- R Martin
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
| | - A Louvrier
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Nanomedicine Lab, EA 4662, université de Franche-Comté, Besançon, France
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Berquet A, Louvrier A, Denis F, Bornert F, Weber E, Meyer C. [Evaluation of healing time of osteochemonecrosis of the jaw after surgery: Single-center retrospective study and review of the literature]. J Stomatol Oral Maxillofac Surg 2017; 118:11-19. [PMID: 28330568 DOI: 10.1016/j.jormas.2016.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/17/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Osteochemonecrosis of the jaw (ONJ) is a chronic ischemic bone exposure. It has an increasing incidence. ONJ is mainly related to bisphosphonate and denosumab therapies in oncologic settings. Healing is considered uncertain ad as occurring slowly. International recommendations suggest to treat ONJ symptomatically in a first attempt. A surgical procedure, potentially aggressive, should be carefully weight up in patients in poor condition and whose life expectancy is often limited. However, surgical treatment seems to allow for a high rate of clinical remission. Postoperative remission periods, when mentioned in the studies, are disparate. The aim of our study was to clarify the remission period of ONJ after surgical management. METHOD A retrospective study was conducted on all patients operated for an ONJ at stage 2 and 3 in the Department for Oral and Maxillofacial Surgery - University Hospital of Besançon (France) from January 2006 to September 2015. Healing was defined as complete mucosal closure and asymptomatic site. Stage of the disease, the number and the type of surgery and the time between the last operation and the healing was noticed. These data were compared to an exhaustive review of the literature on PubMed with the following key-words: "osteonecrosis" AND "jaw" AND "surgery" AND "management". Only the articles giving the healing period were included. RESULTS Regarding the single-center retrospective study, the files of 23 patients could be included. Fifteen percent of the patients benefited from several procedures under general anesthesia. Twenty percent had a stage 3 ONJ and 80 % had a stage 2 ONJ. Twenty-five interventions were performed on 23 sites in 20 patients. Immediate healing after surgery occurred in 35 % of the patients. At 6 months after surgery, 57 % of the treated areas were healed. Twenty percent of the patients had died. The healing rate did not improve further after 6 months postoperatively. Regarding the review of the literature, 7 articles could be included. The mean postoperative healing period was 60.7 % at 6 months, 71.1 % at 12 months and 69.5 % at 18 months. DISCUSSION Our study shows that the postoperative healing rate of ONJ lies between 57 and 66.7 % at 6 months and that this rate was optimized in the order of 10 % to 12months and stable at 18months postoperatively. The ONJ of our series were partially or fully linked to other drugs than bisphosphonates in 70 % of the cases: 50 % were related to denosumab, alone or in combination and 35 % were related to an association with antiangiogenics, bevacizumab mainly.
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Affiliation(s)
- A Berquet
- Département d'odontologie et de chirurgie orale, CHU François Mitterrand, Dijon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France.
| | - A Louvrier
- Faculté de médecine, université de Franche-Comté, Besançon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France
| | - F Denis
- Département de chirurgie orale, service d'odontologie, hôpital de la Maison-Blanche, université Champagne-Ardennes, Reims, France; EA 481 neurosciences intégratives et cliniques, Besançon, France; Centre hospitalier La Chartreuse, 21033 Dijon, France
| | - F Bornert
- Inserm (French National Institute of Health and Medical Research), "Osteoarticular and Dental Regenerative Nanomedicine" laboratory, UMR 1109, faculté de médecine, FMTS, 67085 Strasbourg cedex, France; Université de Strasbourg, faculté de chirurgie dentaire, Strasbourg, France; Pôle de médecine et de chirurgie bucco-dentaires, unité de pathologie-chirurgie buccale, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - E Weber
- Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; EA 4662 Nanomedicine Lab, université de Franche-Comté, 25000 Besançon, France
| | - C Meyer
- Département d'odontologie et de chirurgie orale, CHU François Mitterrand, Dijon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; EA 4662 Nanomedicine Lab, université de Franche-Comté, 25000 Besançon, France
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Weber E, Moulis G, Mahévas M, Guy C, Lioger B, Durieu I, Hunault M, Ramanantsoa M, Royer B, Default A, Pérault-Pochat MC, Moachon L, Bernard N, Bardy G, Jonville-Bera AP, Geniaux H, Godeau B, Cathébras P. Thromboses sous agonistes du récepteur de la thrombopoïétine au cours du purpura thrombopénique immunologique. Étude rétrospective multicentrique en France. Rev Med Interne 2017; 38:167-175. [DOI: 10.1016/j.revmed.2016.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/01/2016] [Accepted: 09/22/2016] [Indexed: 12/11/2022]
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Morelon JB, Meyer C, Parmentier J, Prost G, Weber E, Louvrier A. [Treatment of a unilateral Brodie's syndrome by surgical contraction of the maxillae]. J Stomatol Oral Maxillofac Surg 2017; 118:57-62. [PMID: 29595476 DOI: 10.1016/j.jormas.2016.11.002] [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] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 08/25/2016] [Accepted: 11/17/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Brodie's syndrome consists in a transverse occlusal discrepancy in relation with an excessive width of the maxilla, a narrow mandible or a combination of both, leading to lateral scissors bite. This kind of infrequent malocclusion is usually treated by orthodontics alone in children. In adults, additional orthognathic surgery id often required. We present a case of unilateral Brodie's syndrome treated by surgical contraction of the maxillae. OBSERVATION A 22-year-old patient presented with a left scissors bite and severe unilateral molar overbite. After failure of an attempt to ingress the left molars by help of a sub-apical corticotomy and anchorage mini-screws, the patient was referred for surgery. The mandible being considered as normal, a segmented Le Fort I osteotomy was planned, combining a contraction (4mm) and an impaction (4mm) of the left maxilla. This allowed for an immediate correction of the skeletal discrepancy and for the achievement of orthodontics in less than 6 months. DISCUSSION Le Fort I osteotomy provides a good access to the sagittal suture. Maxillary contraction is an uncommon procedure that enables a quick management of scissors bite and doesn't need any patient cooperation. Treatment time is reduced and the need for intraoral devices is limited.
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Affiliation(s)
- J B Morelon
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - C Meyer
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; EA 4662, UFR sciences et techniques, Nanomedicine Lab, Imagery and Therapeutics, université de Franche-Comté, 16, route de Gray, 25030 Besançon cedex, France
| | - J Parmentier
- Cabinet de chirurgie maxillo-faciale et stomatologie, 2, rue de Mirande, 21000 Dijon, France
| | - G Prost
- Cabinet d'orthopédie dento-faciale, 14, bis rue de Mulhouse, 21000 Dijon, France
| | - E Weber
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - A Louvrier
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
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Gennaro P, Borghini A, Chisci G, Mazzei FG, Weber E, Tedone Clemente E, Guerrini S, Gentili F, Gabriele G, Ungari C, Mazzei MA. Could MRI visualize the invisible? An Italian single center study comparing magnetic resonance lymphography (MRL), super microsurgery and histology in the identification of lymphatic vessels. Eur Rev Med Pharmacol Sci 2017; 21:687-694. [PMID: 28272715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Aim of this study is to evaluate the possibility of limb magnetic resonance lymphography (MRL) to differentiate lymphatic vessels from pathological veins, collect a specimen of the identified lymphatic vessel during operations of super microsurgical lymphatic-venular anastomosis (s-LVA) and perform immunohistochemical stainings to confirm the nature of the collected vessels. PATIENTS AND METHODS Twenty patients presenting lymphedema were enrolled in this study. Five patients reported lower limb lymphedema and 15 patients reported upper limb lymphedema. All patients had the indication for s-LVA and underwent preoperative MRL imaging of the affected limb. A total of 57 lymphatic vessels were identified by MRL and used to guide s-LVA: all these vessels have also been used to perform an intraoperative biopsy for immunohistochemical evaluation. RESULTS A total of 53/57 vascular structures resulted compatible with lymphatic vessels at the immunohistochemical study performed with D2-40 antibody; 3/57 specimen showed the absence of the D2-40 antibody. A significant association was found between preoperative MRL and immunohistochemical marker D2-40 on collected specimen. CONCLUSIONS Most of the articles in the international literature report the concomitant presence of both lymphatic and venous vessels at MRL. However, no one in literature describes the possibility to differentiate venous vessels from lymphatic vessels, and this is a crucial issue for the correct evaluation of the lymphatic system in patients with limb lymphedema undergoing a future surgical correction. In the present study, MRL allowed to identify active lymphatic vessels. MRL was predictive to determine preoperatory lymphatic vessels and to perform successful s-LVA in lymphedema patients. This is the first study to prove the nature of the vessels identified at the preoperative MRL with immunohistochemical stainings.
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Affiliation(s)
- P Gennaro
- Department of Biotechnology, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
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Arnold C, Beezhold B, Bailey M, Isler H, Kong Y, Niedzinski V, Richardson R, Weber E. Predictors of Fish Intake in the College Population. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.094] [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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Marty P, Louvrier A, Weber E, Dubreuil PA, Chatelain B, Meyer C. [Arthrocentesis of the temporomandibular joint and intra-articular injections : An update]. ACTA ACUST UNITED AC 2016; 117:266-72. [PMID: 27554488 DOI: 10.1016/j.revsto.2016.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Arthocentesis of the temporomandibular joint combined with intra-articular washout and, more recently, intra-articular injection of pharmacological agents has been developed from the 1990s and is nowadays extensively in use for the treatment of temporomandibular dysfunctions (TMDs). The goal of our work was to answer 3 questions: 1. Is intra-articular washout effective for the treatment of TMDs ? 2. What kind of pharmacological agents may nowadays be injected in addition to washout and are these injections useful ? 3. What is the place of these treatments in the treatment strategies of TMDs ? MATERIAL AND METHODS A bibliographic research has been carried out in the PubMed database using following keywords arthrocentesis, temporomandibular joint. The 27 articles published between 1991 and 2016, indicating patient's inclusion criterions and objectively evaluating the clinical results (mouth opening, intra-articular noises, pain) were selected. Pharmacological agents were noticed when used. RESULTS 1. All authors concluded to the efficacy of intra-articular washout. No prognostic factor for arthrocentesis efficacy could be identified. 2. Main pharmacological agents used were steroids, hyaluronic acid, morphine-based drugs and platelet rich plasma. Superiority of ith-injection protocols failed to win unanimous support. All authors who compared with- and without-injection protocols concluded to the superiority of with-injection protocols, whatever the agent. DISCUSSION Numerous studies have proven the efficacy of intra-articular washout for the treatment of TMDs resistant to noninvasive treatments. The advantage of any kind of pharmacological agent is not clear. Mechanisms of action are not all elucidated. No pharmacological agent showed any superiority over another. Study methodologies are often defective: imprecise inclusion criterions, short follow-up, confounding variables not taken into account, few comparison between pharmacological agents.
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Affiliation(s)
- P Marty
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - A Louvrier
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - P-A Dubreuil
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab, Imagery and Therapeutics-UFR SMP, 19, rue Ambroise-Paré, 25030 Besançon cedex, France
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Delgrange E, Weber E, Michel L, Coster PD, Buysschaert M, Donckier J. Bilan De Trois Annees De Traitement D’Hyperthyroidies Par Iode-131. Acta Clin Belg 2016. [DOI: 10.1080/17843286.1994.11718390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- E. Delgrange
- Servicc de Medecinie Interne Generale et Endocrinologie
| | - E. Weber
- Servicc de Medecinie Interne Generale et Endocrinologie
| | | | - P. De Coster
- Service de Medicine Nucleaire. Cliniques Universitaires UCL de Mont-Godinne. 5530 Yvoir, Belgique
| | | | - J. Donckier
- Servicc de Medecinie Interne Generale et Endocrinologie
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Weber E, Moulis G, Guy C, Mahevas M, Cathébras P. Thromboses sous agonistes du récepteur de la thrombopoïétine. Étude multicentrique observationnelle : à propos de 36 cas. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weber E, Reynaud Q, Barba T, Durupt S, Cathébras P, Durieu I, Lega J. Évaluation des immunosuppresseurs dans le PTI réfractaire par revue systématique et méta-analyse de 37 études. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weber E, Reynaud Q, Fort R, Durupt S, Cathébras P, Durieu I, Lega J. Évaluation de l’effet traitement des immunomodulateurs dans le PTI réfractaire par revue systématique et méta-analyse de 28 études. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weber E, Meyer C, Czorny A, Chatelain B, Benassarou M. [Study of the normality of the orbito-naso-frontal bandeau]. ACTA ACUST UNITED AC 2015; 116:336-42. [PMID: 26603752 DOI: 10.1016/j.revsto.2015.05.002] [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: 03/23/2015] [Accepted: 05/13/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Craniosynostoses are cranio-facial malformations affecting about 1/2100 newborns in France. The involvement of anterior sutures (coronal and metopic) leads to orbito-frontal deformities. The treatment calls upon surgery the goal being, on an esthetic point of view, to restore a normal anatomy. The purpose of our work was to establish if some facial and/or frontal measures easy to perform on a CT are correlated to the global shape of the normal orbito-naso-frontal bandeau (ONFB). MATERIAL AND METHOD Cranial CTs of 123 consecutive non-malformed children aged between 4 and 12 months were selected in the database of Department of Radiology of the University Hospital of Besançon - France. The CTs were all relocated by rigid transformation in an orthonormal coordinate system. On each of the 123 CTs, 21 reproducible measures representative of the global shape of the ONFB were made. Statistical analyses of these measures were achieved, considering age and gender, in order to determine the correlation between each measure and the ONFB shape. RESULTS The only measure statistically correlated to the ONFB shape was the distance between the fronto-zygomatic sutures (FZD). The FZD was independent from age (in an interval of 4 months) and from gender. The 20 other measures did not show any correlation with age or gender. DISCUSSION The FZD allows in itself to determine the ONFB global shape. This measure, easily available on a CT, can help the surgeon to perform a customized reshaping of the ONFB. The development of a surgical template using this measure is ongoing.
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Affiliation(s)
- E Weber
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - C Meyer
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (Li4S), EA 4268, IFR 133, université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France
| | - A Czorny
- Service de neurochirurgie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - M Benassarou
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (Li4S), EA 4268, IFR 133, université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France
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Montmartin M, Meyer C, Euvrard E, Pazart L, Weber E, Benassarou M. [3D printing in health care facilities: What legislation in France?]. ACTA ACUST UNITED AC 2015; 116:302-7. [PMID: 26071022 DOI: 10.1016/j.revsto.2015.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 04/30/2015] [Indexed: 11/16/2022]
Abstract
Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.
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Affiliation(s)
- M Montmartin
- Génie biomédical, institut supérieur d'ingénieurs de Franche-Comté (ISIFC), université de Franche-Comté, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France.
| | - E Euvrard
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France; Centre d'investigation clinique en innovation technologique (CIC-IT - Inserm CIT808), CHU de Besançon, 25030 Besançon cedex, France
| | - L Pazart
- Centre d'investigation clinique en innovation technologique (CIC-IT - Inserm CIT808), CHU de Besançon, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - M Benassarou
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France
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Heinze J, Werner T, Weber E, Rillig MC, Joshi J. Soil biota effects on local abundances of three grass species along a land-use gradient. Oecologia 2015; 179:249-59. [PMID: 25964063 DOI: 10.1007/s00442-015-3336-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
Biotic plant-soil interactions and land-use intensity are known to affect plant individual fitness as well as competitiveness and therefore plant-species abundances in communities. Therefore, a link between soil biota and land-use intensity on local abundance of plant species in grasslands can be expected. In two greenhouse experiments, we investigated the effects of soil biota from grassland sites differing in land-use intensity on three grass species that vary in local abundances along this land-use gradient. We were interested in those soil-biota effects that are associated with land-use intensity, and whether these effects act directly or indirectly. Therefore, we grew the three plant species in two separate experiments as single individuals and in mixtures and compared their performance. As single plants, all three grasses showed a similar performance with and without soil biota. In contrast, in mixtures growth of the species in response to the presence or absence of soil biota differed. This resulted in different soil-biota effects that tend to correspond with patterns of species-specific abundances in the field for two of the three species tested. Our results highlight the importance of indirect interactions between plants and soil microorganisms and suggest that combined effects of soil biota and plant-plant interactions are involved in structuring plant communities. In conclusion, our experiments suggest that soil biota may have the potential to alter effects of plant-plant interactions and therefore influence plant-species abundances and diversity in grasslands.
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Affiliation(s)
- J Heinze
- Biodiversity Research/Botany, Institute for Biochemistry and Biology, University of Potsdam, Maulbeerallee 1, 14469, Potsdam, Germany,
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Weber E, Meyer C, Ernoult C, Chatelain B, Benassarou M. [3D mandibular distraction planification in a case of severe temporomandibular ankylosis]. ACTA ACUST UNITED AC 2015; 116:153-60. [PMID: 25910933 DOI: 10.1016/j.revsto.2015.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/24/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION When occurring in childhood, temporomandibular ankylosis joint is responsible for complex maxillofacial deformities, including mandibular growth deficiency. We present a case of temporomandibular joint ankylosis associated with severe mandibular asymmetry treated by mandibular bone distraction performed under computer assistance. OBSERVATION A 27-year-old patient presented with a severe facial asymmetry consisting in hypoplasia of the left hemi-mandible and maxilla. Mouth opening was non-existent. The CT-scan showed a left temporomandibular ankylosis. A left mandibular distraction was decided. The distraction characteristics (choice and positioning of the distractor, axis and amount of distraction) were determined preoperatively on the 3D CT-scan. The planning has been transferred to a navigation console (Kolibri®, Brainlab®). A combined intraoral and cutaneous was performed. Navigation allowed for an appropriate placement of the osteotomy line and fixation of the distractor. Distraction was started at the 5th postoperative day at the rate of 1mm per day and lasted 25 days without complication. DISCUSSION 3D planning allows for better indication setting, better preparation of the procedure, reducing complications and operative time. It may help as an educational tool for young surgeons and for a better understanding from the patient. Navigation is an accurate method for the transfer of the planning in the operation room.
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Affiliation(s)
- E Weber
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - C Meyer
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (EA 4268, IFR 133), université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France
| | - C Ernoult
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - M Benassarou
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (EA 4268, IFR 133), université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France
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Bubeck B, Brandau W, Weber E, Pomer S, Georgi P, zum Winkel K. Renal function studies using 99mTc-MAG3: pharmacokinetics and slope clearance determination. Contrib Nephrol 2015; 79:72-3. [PMID: 2146089 DOI: 10.1159/000418153] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- B Bubeck
- Department of Nuclear Medicine, University of Heidelberg, FRG
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