31 results on '"Pavillon G"'
Search Results
2. Disparités de la mortalité par cancer dans l’Union Européenne*
- Author
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Jougla, E., Salem, G., Rican, S., Pavillon, G., and Lefèvre, H.
- Published
- 2004
- Full Text
- View/download PDF
3. Disparités de mortalité « prématurée » selon le sexe et causes de décès « évitables »
- Author
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Lefèvre, H., Jougla, E., Pavillon, G., and Le Toullec, A.
- Published
- 2004
- Full Text
- View/download PDF
4. Qualité des certificats de décès français : comparaison des certificats électroniques aux certificats papiers
- Author
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Lefeuvre, D., Pavillon, G., Aouba, A., Lamarche-Vadel, A., Fouillet, A., Jougla, E., and Rey, G.
- Published
- 2013
- Full Text
- View/download PDF
5. Comparaison du diagnostic principal de la dernière hospitalisation et de la cause initiale du certificat de décès en 2008–2009, France
- Author
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Lamarche-Vadel, A., Pavillon, G., Aouba, A., Meyer, L., Jougla, E., and Rey, G.
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- 2012
- Full Text
- View/download PDF
6. Mise au point d’une méthodologie de suivi annuel des décès en rapport avec l’anesthésie
- Author
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Aouba, A., De Saint Maurice, G., Pavillon, G., Auroy, Y., Benhamou, D., Lienhart, A., and Jougla, E.
- Published
- 2010
- Full Text
- View/download PDF
7. Apports de l’expérimentation de la certification électronique des décès (CEDC) au CHU de Bicêtre pour le déploiement à d’autres établissements de l’Assistance publique–Hôpitaux de Paris (AP–HP), en partenariat avec le CépiDc-Inserm
- Author
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Lamarche-Vadel, A., Frank-Soltysiak, M., Pavillon, G., Gallot, C., Chatellier, G., and Baron, S.
- Published
- 2010
- Full Text
- View/download PDF
8. P10-10 Comparaison de trois systèmes de recueil des cas de décès d’adultes infectés par le virus de l’immunodéficience humaine en France en 2000
- Author
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Lewden, C., Jougla, E., Costagliola, D., Pavillon, G., Morlat, P., Salmon, D., May, T., and Chêne, G.
- Published
- 2004
- Full Text
- View/download PDF
9. C3-6 - L’impact des principales vagues de chaleur sur la mortalité globale et par cause spécifique en France de 1971 à 2003
- Author
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Rey, G., Jougla, E., Fouillet, A., Pavillon, G., and Hémon, D.
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- 2006
- Full Text
- View/download PDF
10. Décès survenant au cours de l’hémophilie acquise en France : analyse en causes multiples pour une amélioration des stratégies de prise en charge
- Author
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Aouba, A., Pavillon, G., Jougla, E., Rothschild, C., Torchet, M.F., Guillevin, L., and Hermine, O.
- Published
- 2011
- Full Text
- View/download PDF
11. Mortalité liée à la drépanocytose en France de 0 à 18 ans
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Kremp, O., Paty, A.-C., Suzan, F., Aouba, A., Pavillon, G., Jougla, E., and Bloch, J.
- Published
- 2008
- Full Text
- View/download PDF
12. [Cancer, reactive oxygen species and chemotherapy-induced peripheral neuropathy].
- Author
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Batteux F, Cerles O, and Nicco C
- Subjects
- Animals, Antineoplastic Agents adverse effects, Edetic Acid analogs & derivatives, Humans, Pyridoxal Phosphate analogs & derivatives, Superoxide Dismutase, Neoplasms drug therapy, Neoplasms metabolism, Peripheral Nervous System Diseases chemically induced, Reactive Oxygen Species metabolism
- Published
- 2014
- Full Text
- View/download PDF
13. [A parotitis as primary infection of Lemierre's syndrome].
- Author
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Valleix B, Floccard B, Hautin E, Faure F, and Allaouchiche B
- Subjects
- Aged, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Anti-Bacterial Agents therapeutic use, Anti-Inflammatory Agents therapeutic use, Anticoagulants therapeutic use, Cellulitis drug therapy, Cellulitis prevention & control, Humans, Hypnotics and Sedatives therapeutic use, Lemierre Syndrome diagnosis, Lemierre Syndrome microbiology, Male, Methylprednisolone therapeutic use, Otorhinolaryngologic Surgical Procedures, Parotid Gland microbiology, Parotid Gland pathology, Parotid Gland surgery, Parotitis microbiology, Parotitis surgery, Tomography, X-Ray Computed, Lemierre Syndrome complications, Parotitis etiology
- Abstract
Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
14. [Management of bradykinin-mediated angioedema].
- Author
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Floccard B, Crozon J, Rimmelé T, Vulliez A, Coppere B, Chamouard V, Boccon-Gibod I, Bouillet L, and Allaouchiche B
- Subjects
- Algorithms, Angioedema etiology, Emergency Treatment, Humans, Severity of Illness Index, Angioedema diagnosis, Angioedema therapy, Bradykinin physiology
- Abstract
Objectives: Present the clinical signs of bradykinin-mediated angioedema, a disease little known to intensive care anaesthesiologists, and develop their scientific basis with recent data on management in emergency and perioperative care., Data Sources: International recommendations and recent general reviews. Data collection was performed using the Medline database with the keyword: angioedema., Study Selection and Data Extraction: Research studies published during the last 10 years were reviewed. Relevant clinical information was extracted and discussed., Data Synthesis: Angioedema is a clinical syndrome characterized by episodes of transitory recurrent submucosal and subcutaneous oedema, called attacks. During an attack, the oedema may be localized at the level of the skin and/or ENT and digestive tract mucosa. This syndrome is not due to an allergic reaction. It is related to a C1 complement inhibitor deficiency or an increase in factor XII resulting in the excessive release of bradykinin, which leads to capillary permeability. There are hereditary and acquired forms, notably associated with the use of ACE inhibitors and sartans. This rare disease should be recognized by anaesthesiologists and intensive care and emergency physicians because, in the absence of specific treatment, it can be life-threatening due to the appearance of laryngeal oedema. In addition, there is a risk that the patient may have an attack during the perioperatory period, due to surgical trauma. International recommendations exist, and there are new molecules available in France. For moderate attacks, treatment is based on tranexamic acid. For hereditary forms, according to the localization and gravity of the attacks, emergency treatment is based on the use of Icatibant, a bradykinin B2 receptor inhibitor, and C1 inhibitor concentrate. For pregnant women and acquired forms, C1 inhibitor concentrate is the treatment of reference. Antalgic and perfusion treatments should not be neglected, and should be modified as a function of clinical signs. High-risk situations (perioperatory period, birthing, dental care) should be identified and short-term prophylaxis put in place before any procedure that may trigger an attack. Algorithms are proposed for the diagnosis, treatment and prevention of attacks. Recommendations exist for during childbirth, in which case C1 inhibitor concentrate should be used., Conclusion: Bradykinin-mediated angioedema should be evoked in the case of recurrent and transitory oedema. Emergency management has evolved thanks to the commercialization of new molecules. Prevention of attacks during surgery and for during childbirth is important. The availability of C1 inhibitor concentrate in sufficient doses should be verified prior to the procedure. A multi-site reference centre (CREAK) has been created to help clinicians manage this disease. Patients with this disease should be identified in emergency departments. Health establishments, which cannot all have emergency stocks, should set up procedures for rapid provision or the transfer of patients to reference sites., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)
- Published
- 2011
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15. [Knowledge of causes of death in Algeria. Methods and first results].
- Author
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Belamri S, Aouba A, Pavillon G, and Jougla E
- Subjects
- Adolescent, Adult, Age Distribution, Algeria, Child, Child, Preschool, Death Certificates, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Sex Distribution, Young Adult, Cause of Death
- Abstract
Background: This article describes the gradual establishment between 1995 and 2009 of the collection of medical causes of death in Algeria by the National Institute of Public Health (INSP)., Methods: The registration of these causes is based on the WHO certificate's model. The codes and rules of the International Classification of Diseases (ICD10) were used for coding., Results: Initial results for 2007 show that causes of death have been gathered by INSP for 36.5% of the deaths registered by the civil registrar. Among these causes, cardiovascular diseases occupy the first place. Distributions are different by gender and age., Conclusion: This study is a first step towards the knowledge of the causes of death in Algeria., (2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
16. [Low monocytic HLA-DR expression and risk of secondary infection].
- Author
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Chéron A, Monneret G, Landelle C, Floccard B, and Allaouchiche B
- Subjects
- Humans, Immune System, Multiple Trauma complications, Multiple Trauma immunology, Postoperative Complications immunology, Risk Factors, Cross Infection epidemiology, Cross Infection immunology, HLA-DR Antigens biosynthesis, Monocytes immunology
- Abstract
Objectives: The aim of this bibliographic review is to evaluate the usefulness of the measurement of HLA-DR expression on circulating monocytes (mHLA-DR) in predicting the development of nosocomial infections and unfavourable outcome in critically ill patients., Data Source: References obtained from the medical database PubMed in English and in French were reviewed. The keywords included separately or in combination were: HLA-DR antigens, sepsis, trauma, injuries, wounds, burns, stroke, pancreatitis, postoperative, prognostic, immunity, monocytic., Data Extraction: Data in selected articles were reviewed, clinical and basic science research relevant information were extracted., Data Synthesis: Low mHLA-DR expression appears as a marker for monocytic dysfunctions and immunosuppression, temporarily present in the majority of critically ill patients admitted to the ICU (sepsis, trauma injuries, postoperative, burns, pancreatitis and stroke). The decrease in mHLA-DR expression is a predictor of septic complications in all these clinical conditions. However, no predictive threshold value could be determined regarding unfavourable outcome., Conclusion: The monitoring of mHLA-DR expression could be a biomarker to detect ICU patients at high risk of developing secondary nosocomial infections. Those patients could probably benefit of preemptive strategies to prevent these infections., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
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17. [Acute pancreatitis and bradycardia].
- Author
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Challan Belval A, Chéron A, Floccard B, Lienhart AS, and Allaouchiche B
- Subjects
- Acute Disease, Humans, Male, Middle Aged, Bradycardia etiology, Pancreatitis complications
- Abstract
Acute pancreatitis is frequently associated with electrocardiographic abnormalities, including arrhythmias and repolarization. We briefly describe a male patient with a severe acute pancreatitis who presented several bradycardias during his hospitalization in our intensive care unit. The aim of this case report is to underline the probability of severe arrhythmias during acute pancreatitis, which can increase morbidity of this pathology. Despite many publications or reports, causes of increased EKG abnormalities during severe pancreatitis remained unclear and are probably multifactorial. To prevent accidents or complications, patients with severe acute pancreatitis should have a continuous EKG monitoring., (Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
18. [Recurrent systemic embolism: look for a thrombus in... the thoracic aorta].
- Author
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Prothet J, Floccard B, Levrat A, Guillaume C, Faure A, Marcotte G, and Allaouchiche B
- Subjects
- Humans, Male, Middle Aged, Recurrence, Aorta, Thoracic, Embolism etiology, Thrombosis complications
- Abstract
Thoracic aortic mural thrombus is a rare entity and potential source of serious systemic emboli. The progress of computed tomography (CT) angiography and the current use of transesophageal echocardiography (TEE) after any embolic event have considerably increased the frequency of diagnostic and there is a growing interest about the etiopathogenesis, which is still widely misunderstood. Therapeutic management remains controversial. We present a case of floating thrombus in the thoracic aorta detected by contrast-enhanced CT scan. This thrombus was responsible for two close major embolic events and was therefore managed surgically. Finally, outcome was favorable.
- Published
- 2008
- Full Text
- View/download PDF
19. [Value of double reading of whole body CT in polytrauma patients].
- Author
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Agostini C, Durieux M, Milot L, Kamaoui I, Floccard B, Allaouchiche B, and Pilleul F
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Prospective Studies, Multiple Trauma diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Purpose: To assess the value of standard double reading of whole body CT in the management of polytrauma patients., Materials and Methods: Prospective study between January and July 2005. Two senior radiologists with expertise in trauma imaging, blinded to clinical findings, reviewed 105 initial CT examinations of polytrauma patients. These examinations had initially been interpreted by the on-call radiologist. The second interpretations were performed within 12 hours of admission, and were considered the gold standard., Results: A total of 105 patients were included with 82 males (78%) and 23 females (22%), aged between 2 and 83 years. The level of admission was graded III (n=64), II (n=30) and I (n=11). The second reading identified 3 lesions that were not initially described, each requiring a change in management, including splenic rupture (n=1), thoracic spine fracture (n=1) and epidural hematoma (n=1), with no unfavorable impact on mortality. Additional errors in the initial interpretation were identified: peripheral fractures (n=38), chest (n=36), brain (n=31), abdominal (n=28), spine (n=19) and maxillofacial (17) lesions and contrast extravasation (n=6)., Conclusion: Based on the large number and severity of some lesions missed at initial interpretation of whole body CT of polytrauma patients, we recommend standard double reading of these examinations.
- Published
- 2008
- Full Text
- View/download PDF
20. [The abnormal activated partial thromboplastin time biphasic waveform: a red flag in the sepsis? Technique and interest as marker of the sepsis].
- Author
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Vuilliez A, Floccard B, Sobas F, Chopin N, and Allaouchiche B
- Subjects
- Biomarkers blood, C-Reactive Protein analysis, Calcitonin blood, Calcitonin Gene-Related Peptide, Humans, Predictive Value of Tests, Protein Precursors blood, Sensitivity and Specificity, Partial Thromboplastin Time, Sepsis blood, Sepsis diagnosis
- Abstract
The biphasic waveform (BPW) is an abnormality of the optical transmission waveform obtained during measurement of the activated partial thromboplastin time on a specific photometric haemostasis autoanalyzer. This abnormality is related to calcium-dependent formation of complexes between C reactive protein and very low density lipoprotein. Biphasic waveform had a high sensitivity and negative predictive value for the identification of patients with severe sepsis and septic shock. On day 3, the time course of the biphasic waveform is a marker for the prognosis of sepsis-related mortality. The BPW is not a surrogate marker for C-reactive protein or procalcitonin and provides additional information. Further trials should be necessary using BPW for diagnostic and management procedures. Compared with other laboratory markers such as C reactive protein or procalcitonin, activated partial thromboplastin time waveform analysis is a tool that is rapid, inexpensive, effective and available 24 hours a day. When the analyzer is locally available, waveform analysis of this routine coagulation test provides information for the diagnosis of severe sepsis and the prognosis of septic patients.
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- 2007
- Full Text
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21. [Intraductal papillary mucinous tumors of the pancreas].
- Author
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Monneuse OJ, Rochette A, and Pilleul F
- Subjects
- Cholangiopancreatography, Endoscopic Retrograde, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Palliative Care, Pancreas pathology, Pancreatectomy, Pancreatic Ducts pathology, Prognosis, Tomography, X-Ray Computed, Ultrasonography, Carcinoma, Pancreatic Ductal diagnosis, Carcinoma, Pancreatic Ductal pathology, Carcinoma, Pancreatic Ductal surgery, Cystadenocarcinoma, Mucinous diagnosis, Cystadenocarcinoma, Mucinous pathology, Cystadenocarcinoma, Mucinous surgery, Cystadenoma, Mucinous diagnosis, Cystadenoma, Mucinous pathology, Cystadenoma, Mucinous surgery, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms mortality, Pancreatic Neoplasms pathology, Pancreatic Neoplasms surgery
- Abstract
Reports of intraductal papillary mucinous tumors of the pancreas have become substantially more frequent in the literature in the past several years. This increased prevalence is due, among other things, to improved screening techniques, especially high-resolution spatial imaging. These tumors are characterized by proliferation of the intraductal epithelium, mucin production, and ductal dilatation. They grow slowly. Their potential for malignancy is high (although the precise risk remains difficult to assess), but their prognosis, when identified during the first stage of neoplastic transformation (before invasion), is far better than that of 'pancreatic ductal adenocarcinoma. Early diagnosis allows patients to be treated before carcinomatous degeneration. Specific diagnosis makes it possible to define an appropriate treatment strategy - either surgery or monitoring, especially when only the intralobular ducts are affected. In that case, the risk of malignant degeneration is much lower than with lesions in the pancreatic duct or in combined forms.
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- 2006
- Full Text
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22. [Case report: a bacteremic pasteurellosis].
- Author
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Schoeffler M, Crozon J, Levrat A, Guillaume C, Floccard B, and Allaouchiche B
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- Aged, Anti-Bacterial Agents therapeutic use, Female, Fluoroquinolones therapeutic use, Glasgow Coma Scale, Humans, Immunocompromised Host, Meningoencephalitis complications, Meningoencephalitis microbiology, Pasteurella Infections blood, Pasteurella Infections microbiology, Radiography, Thoracic, Shock, Septic blood, Shock, Septic microbiology, Pasteurella Infections drug therapy, Pasteurella multocida, Shock, Septic drug therapy
- Abstract
Bacteremic pasteurellosis is an uncommon form of Pasteurella multocida infection, usually involved in local infections. This systemic infection often occurs in immuno-compromised patient such as cirrhotic or alcoholic patients, with a high mortality rate (up to 60%). Septic shock may occur and neurological disorders or coma are frequent. We report such a case. Treatment associated local care, antibiotics (beta-lactam antibiotics plus fluoroquinolone) during 14 days and resuscitation of septic shock. Owing these therapies, septic shock was successfully treated without complications.
- Published
- 2006
- Full Text
- View/download PDF
23. [Stabwound of the cervical spinal cord. Two case reports].
- Author
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Dran G, Fontaine D, Litrico S, Grellier P, and Paquis P
- Subjects
- Adult, Humans, Male, Spinal Cord Injuries diagnosis, Wounds, Stab diagnosis, Cervical Vertebrae, Spinal Cord Injuries surgery, Wounds, Stab surgery
- Abstract
Two cases of Brown-Sequard syndrome following a stab wound of the cervical spinal cord are reported. Spinal cord hemisection was confirmed by magnetic resonance imaging and surgical exploration. Both patients presented leakage of the cerebrospinal fluid and underwent surgical repair. In the first case, the pia-mater was sutured to close the wound and decrease the risk of post-traumatic syringomyelia. Outcome at ten and two years follow up was good in both patients who were able to walk. One of them returned to work. The contribution of surgical repair of spinal cord stab wounds and mechanisms of recovery are discussed.
- Published
- 2005
- Full Text
- View/download PDF
24. [Gender differences in premature mortality and avoidable deaths].
- Author
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Lefèvre H, Jougla E, Pavillon G, and Le Toullec A
- Subjects
- Adolescent, Adult, Age Distribution, Age Factors, Cause of Death, Child, Child, Preschool, Europe epidemiology, Female, France epidemiology, Humans, Infant, Male, Middle Aged, Sex Factors, Mortality trends
- Abstract
Objective: This paper aims to describe and to analyse disparities between men and women for "premature" mortality rates (deaths before 65 year-old). The study is particularly focused on "avoidable" causes of death. These types of deaths are greatly related to risk behaviours such as alcohol abuse, tobacco abuse or dangerous driving. Taking account of these indicators ("premature" and "avoidable" mortality) enables to study health status discrepancies by gender and to characterize specific public health issues in France including high rates of "premature" mortality and risk behaviours., Methods: The analysis is based on exhaustive mortality data from 1980 to 1999 supplied by the Centre for epidemiology of medical causes of death (CepiDc-INSERM). Specific causes of death closely related to risk behaviours are classified as "avoidable": lung and upper airways cancers, cirrhosis, alcoholic psychosis, traffic accidents, aids and suicide. The contribution of these categories in the global male overmortality was assessed according to different demographic and geographic characteristics., Results: Within "premature" mortality, males experience greater burden of "avoidable" mortality (sex-ratio: 4 versus 2). The gender differences are mainly due to injuries and suicides in the younger age groups and to tobacco and alcohol-related cancers (lung and upper airways) in the 45-64 years age group. The recent decline in "premature" mortality sex-ratio is explained by an increase of these two cancers for females. Among european countries, the French male overmortality is especially marked and mainly attributable to "avoidable" causes of death., Conclusion: "Avoidable" and "premature" mortality provide useful tools for the follow-up of health status in France particularly because of high risk behaviours and prevention inadequacy. Reducing gender discrepancies will depend mainly on public health policies in terms of primary prevention.
- Published
- 2004
- Full Text
- View/download PDF
25. [Abdominal wound injuries: diagnosis and treatment. Report of 79 cases].
- Author
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Monneuse OJ, Barth X, Gruner L, Pilleul F, Valette PJ, Oulie O, and Tissot E
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Decision Trees, Female, Humans, Male, Middle Aged, Retrospective Studies, Abdominal Injuries diagnosis, Abdominal Injuries surgery, Wounds, Penetrating diagnosis, Wounds, Penetrating surgery
- Abstract
Introduction: - Traditionally, penetrating abdominal wounds justify routine laparotomy. However, this policy can be adapted to mechanism of injury (stab or firearm) and accuracy of imaging procedures if they eliminate visceral injury thus allowing close follow up., Patients and Methods: Retrospective study of 79 patients (May 1995-May 2002) with a penetrating abdominal wound: (47 (59%) stab wounds and 32 (41 %) firearm wounds). Correlation between imaging and surgical findings, treatment, post-operative course were studied., Results: Sixty-eight patients were operated on from the outset, and 11 underwent close follow-up. Of the 11 patients who had follow-up, (9 after stab wound and 2 after firearm wound), two had to be operated (1 in each group). Correlation between imaging and surgical findings was good in 34 (72%) patients after stab wound and in 21 (80%) after firearm wound; the mean number of visceral injuries was 1 and 3 respectively. Six patients (8%) died (mortality: 2% and 16% respectively), 12 (15%) had postoperative complications., Conclusion: Penetrating abdominal stab wounds can be treated by close follow-up if imaging excludes visceral injury. Firearm wounds still justify routine laparotomy due to both multiplicity of visceral injuries and bad prognosis.
- Published
- 2004
- Full Text
- View/download PDF
26. [Quality of suicide mortality data].
- Author
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Jougla E, Pequignot F, Chappert J, Rossollin F, Le Toullec A, and Pavillon G
- Subjects
- Adolescent, Adult, Aged, Cause of Death, Confidentiality, Death Certificates, Female, France, Humans, Male, Middle Aged, Suicide psychology, World Health Organization, Public Health, Suicide statistics & numerical data
- Abstract
Prevention of suicide is a public health priority in France. Indicators of suicide mortality have been widely used to describe epidemiological situations or to evaluate public health actions. It is therefore essential to examine the quality of suicide mortality data. The purpose of this work was to identify potential biases affecting the quality of such data and their comparability between different countries as well as to determine how they can affect conclusions. Potential biases were identified by studying the characteristics of the death certificate system and analyzing the international literature on data quality. The impact of biases was assessed by analyzing the causes of "concurrent" death with suicide in the official statistics (trauma and poisoning caused in an undetermined way concerning intention and unknown causes). The proportion of suicides listed as "concurrent" causes of death, estimated from specific surveys was extrapolated to official data. This method was also used to correct the international data. Practices concerning death certificates for violent deaths vary considerably from one country to another: type of certifying physician, frequency of medicolegal investigations, frequency of autopsies, suicide definition criteria, confidentiality regulations, religious and culture context. These practical differences lead to variability in undetermined and unknown causes. The corrections made on the mortality data after taking into account for these potential biases showed that the rate of suicide determined from official data is considerably underestimated, but that sociodemographic and geographic factors of suicide change little after correction. Likewise, the order by country was similar after taking into consideration concurrent causes. A reliable evaluation of the rate of suicide for a given country is of course important. However, it is possible to characterize populations at risk and analyze the determinants of suicidal behavior without necessarily recording all suicides, as long as the declaration bias is stable. Statistical analysis of death by suicide in France shows that, despite under-reporting, the principal sociodemographic and geographic features and trends over time can be considered as valid. A series of recommendations is proposed however to improve data quality and homogeneity for death certificate reporting. Designing operational criteria for deciding when to declare suicide as the cause of death would be helpful to guide physicians who report deaths. Classical autopsies could be completed by "psychological autopsies" with friends and family of the deceased. The death certificate form could be improved to include items for complementary information favoring or not suicide.
- Published
- 2002
27. [Thigh cellulitis: atypical presentation of intra-abdominal infection].
- Author
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Tramoni G, Mohammedi I, Peguet O, and Petit P
- Subjects
- Aged, Humans, Male, Middle Aged, Bacterial Infections, Cellulitis microbiology, Colonic Diseases complications, Colonic Diseases microbiology, Rectal Diseases complications, Rectal Diseases microbiology, Thigh
- Abstract
The initial clinical presentation of intraabdominal disease can be an extraabdominal location. We report three cases of patients admitted to our intensive care unit because of a severe soft tissue infection of the lower extremity. Systematic research of the primitive source by using computed tomography (CT) scan allows us to find perforation of the gastrointestinal tract. Despite an unusual presentation, a high index of suspicion for lower intestine perforation must always be considered in face of a patient presenting with a spontaneous thigh cellulitis. Immediate radical debridement, appropriate antibiotics, and intensive care support are critical to control these life-threatening infections.
- Published
- 2001
- Full Text
- View/download PDF
28. [Functioning of a bone tissue bank in 1998].
- Author
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Vastel L, Lemercier V, Kerboull L, and Kerboull M
- Subjects
- Ethics, Medical, France, Humans, Infection Control methods, Models, Organizational, Physician's Role, Practice Guidelines as Topic, Quality Assurance, Health Care organization & administration, Bone Banks organization & administration, Facility Regulation and Control organization & administration, Tissue and Organ Procurement organization & administration
- Abstract
Last few years, the french legislation and reglementation concerning donated human tissues, safety precautions, and human tissues' uses have been deeply modified. Therefore, tissue banks' organisation, processing of allograft tissue, and the way surgeons use frozen bone graft have changed. Accordingly, authors describe different obligations these activities implicate and practical consequences for tissue banks and surgeons. First, they recall 94' laws and the doctrinal and ethical principles essential to understand current laws and official standards. Then, they specify sanitary rules all tissue banks have to conform to. They detail the different approaches to recovery, processing, preservation and distribution of transplantable bone tissue and expose modalities of the financing by social organisms. It follows practical consequences in bank functioning: supplying, importation, internal organization. In conclusion, authors synthesize surgeon's responsibilities in that specific activity.
- Published
- 1999
29. [Nosocomial pneumonia in intensive care. Value of different diagnostic tools].
- Author
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Godard J and Allaouchiche B
- Subjects
- Bronchoalveolar Lavage Fluid, Bronchography, Bronchopneumonia epidemiology, Cross Infection epidemiology, Humans, Pneumonia, Bacterial epidemiology, Respiration, Artificial adverse effects, Bronchopneumonia diagnosis, Critical Care, Cross Infection diagnosis, Pneumonia, Bacterial diagnosis
- Abstract
The authors analyzed in published studies providing histologic data the value of diagnostic means of nosocomial bronchopneumonia (NBP) in critically ill patients. At least 10% of patients whose trachea is intubated and the lungs mechanically ventilated suffer an histologically-confirmed NBP. Histology of NBP consists of non systematized foci of infection, localised in 90% of cases in the posterior segments of the lower pulmonary lobes. In fact, small foci are disseminated in both lungs, usually within large areas of non infectious pulmonary lesions and are often multimicrobial. This may explain why the clinical and radiological diagnosis is inaccurate in more than 40% of cases. On chest X-ray, aeric bronchogram and alveolar infiltrates are suggestive but non-specific for NBP, as are also fever, leukocytosis and purulent sputum. Therefore, to confirm the diagnosis of infection and to isolate the microorganisms responsible for NBP, additional investigations are required whose interpretation is uneasy. In a simplified manner, bacteriological inoculum takes a course parallel to the histological bronchopulmonary lesions: no bacteria in the absence of infection, high bacterial inoculum in case of confluent NBP, intermediary in case of bronchitis, however with exceptions when antibiotherapy has recently been modified. In fact, neither bronchial protected brushing nor broncho-alveolar lavage techniques have a perfect sensitivity and specificity. As an example, a diagnostic procedure in assessed in calculating the probability of an accurate diagnosis of NBP. It is concluded that diagnosis of ventilator-associated pneumonia remains still unreliable with the means available today.
- Published
- 1994
- Full Text
- View/download PDF
30. [The 10th revision of the International Classification of Diseases].
- Author
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Pavillon G and Maguin P
- Subjects
- Humans, Disease classification
- Published
- 1993
31. [Diffusion of information on medical causes of death: interview procedures and costs].
- Author
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Michel E, Pavillon G, and Hatton F
- Subjects
- Costs and Cost Analysis, Data Collection economics, France epidemiology, Humans, Cause of Death, Data Collection methods
- Published
- 1991
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