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7 results on '"Jean Marie Cournac"'

1. Transthoracic Doppler echocardiography during a military mission in a French role II in Mali: is it useful to learn this practice?

Author

Anaïs Chataigneau, Jean-Marie Cournac, Paul-Vincent Martin, Faye Rozwadowski, François-Xavier Arnaud, and Anne-Céline Martin

Subjects
medicine.medical_specialty, Heart disease, Military Health Services, Population, MEDLINE, 030204 cardiovascular system & hematology, Doppler echocardiography, Mali, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Practice Patterns, Physicians', education, Retrospective Studies, education.field_of_study, medicine.diagnostic_test, business.industry, Public Health, Environmental and Occupational Health, Retrospective cohort study, General Medicine, medicine.disease, Echocardiography, Doppler, Military personnel, Military Personnel, Echocardiography, Heart failure, Emergency medicine, Heart murmur, Guideline Adherence, medicine.symptom, business
Abstract

Introduction Ultrasound is now recognized as a key tool in the practice of medicine in isolated situations. This study aims to evaluate the impact of transthoracic echocardiography (TTE) in a military mission when performed by a trained military practitioner (MP). Materials and Methods We conducted a 2-month retrospective observational study on the use of TTE in a French medical complex in Mali with a mission that included providing a medical aid to the population. All patients were included. Every ultrasound performed by the MP was listed, and the epidemiologic data, indication for the exam and results were collected for each TTE. Results A total of 349 patients were included, 16 were war-wounded patients and 333 came for a general medical consultation. In all, 153 ultrasounds were performed, including 48 TTEs. Sixteen TTEs were performed to evaluate injuries in war-wounded patients. During the 333 medical consultations, 32 TTEs were realized. The indications were dyspnoea (10), heart murmur (7), acute chest pain (5) and assessment of heart disease (10). TTE permitted a direct positive diagnosis for 18 patients: 7 with acute heart failure and 11 with morphologic problems. The normality of the exam was a supplementary argument to exclude a cardiac implication for eight patients. Conclusions TTE can provide important information with a direct impact on the management of patients. Faced with cardiac emergencies, an adapted training can be proposed for the MP. Thereby, the transfer of conventional cardiac views could facilitate the advice of a cardiologist.

Published
2020

2. Cholangiopathy in critically ill patients surviving beyond the intensive care period: a multicentre survey in liver units

Author

Jean-Marie Cournac, Lucie Laurent, Matthieu Legrand, Armelle Poujol-Robert, Géraldine Lamblin, Emile-Alexandre Pariente, Caroline Lemaitre, Nassim Mostefa-Kara, Anne Minello, Valérie Vilgrain, Anne Gervais-Hasenknopf, Guillaume Savoye, Dominique-Charles Valla, Odile Goria, Pauline Belenotti, Pierre Bedossa, Aurélie Plessier, Philippe Sogni, Fabienne Tamion, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, CHU Clermont-Ferrand, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Louis Mourier - AP-HP [Colombes], Centre hospitalier de Pau, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Intercommunal Elbeuf - Louviers - Val de Reuil, Dynamiques des Réponses immunes - Dynamics of Immune Responses, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Service de réanimation médicale [CHU Rouen], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (EA 481) (NEURO), Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'Hépato-Gastroentérologie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Service d'Hépato-Gastro-Entérologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service Hépatologie Gastro-Entérologie, Centre Hospitalier Universitaire, Service de Médecine Interne (MARSEILLE - Med Int), Assistance Publique - Hôpitaux de Marseille (APHM), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Hôpital Beaujon-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), CHU Saint-Antoine [APHP], Hopital Louis Mourier - AP-HP [Colombes], Dynamiques des Réponses immunes, Service de biochimie INSERM UMR-S942, Hôpital Lariboisière-APHP, and Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)

Subjects
Male, Gastroenterology, Distal Common Bile Duct, Liver disease, 0302 clinical medicine, Cholangiography, Liver Function Tests, Surveys and Questionnaires, MESH: Liver Function Tests, Pharmacology (medical), MESH: Cholangiography, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, medicine.diagnostic_test, Liver Diseases, MESH: Aged 80 and over, Middle Aged, Jaundice, 3. Good health, Intensive Care Units, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Critical Illness, Female, 030211 gastroenterology & hepatology, medicine.symptom, Adult, medicine.medical_specialty, MESH: Liver Diseases, Adolescent, Critical Care, Critical Illness, Intrahepatic bile ducts, Bile Duct Diseases, Young Adult, 03 medical and health sciences, Cholestasis, MESH: Critical Care, Internal medicine, Intensive care, medicine, Humans, Secondary Sclerosing Cholangitis, MESH: Surveys and Questionnaires, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, Hepatology, business.industry, MESH: Adult, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, MESH: Male, Bile Ducts, Intrahepatic, MESH: Intensive Care Units, MESH: Bile Duct Diseases, MESH: Bile Ducts, business, Liver function tests, MESH: Female
Abstract

IF 7.286; International audience; BACKGROUND:The outcome of cholangiopathy developing in intensive care unit (ICU) is not known in patients surviving their ICU stay.AIM:To perform a survey in liver units, in order to clarify the course of cholangiopathy after surviving ICU stay.METHODS:The files of the liver units affiliated to the French network for vascular liver disease were screened for cases of ICU cholangiopathy developing in patients with normal liver function tests on ICU admission, and no prior history of liver disease.RESULTS:Between 2005 and 2015, 16 cases were retrieved. Extensive burns were the cause for admission to ICU in 11 patients. Serum alkaline phosphatase levels increased from day 11 (2-46) to a peak of 15 (4-32) × ULN on day 81 (12-511). Magnetic resonance cholangiography showed irregularities or frank stenosis of the intrahepatic ducts, and proximal extrahepatic ducts contrasting with a normal aspect of the distal common bile duct. Follow-up duration was 20.6 (4.7-71.8) months. Three patients were lost to follow-up; 2 patients died from liver failure and no patient was transplanted. One patient had worsening strictures of the intrahepatic bile ducts with jaundice. Nine patients had persistent but minor strictures of the intrahepatic bile ducts on MR cholangiography, and persistent cholestasis without jaundice. One patient had normal liver function tests.CONCLUSIONS:In patients surviving their ICU stay, ICU cholangiopathy is not uniformly fatal in the short term or clinically symptomatic in the medium term. Preservation of the distal common bile duct appears to be a finding differentiating ICU cholangiopathy from other diffuse cholangiopathies.

Published
2017

3. Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea

Author

Benoit Quentin, Hervé Granier, Thierry de Greslan, Philippe Dubrous, Ludovic Karkowski, M. Aletti, Vincent Foissaud, Nancy Maugey, Christophe Rapp, Magali Billhot, Nicolas Gagnon, Thierry Carmoi, Jean Marie Cournac, Christine Mac Nab, Audrey Mérens, Hélène Savini, Emmanuel Sagui, Helene Broto, Claire Rousseau, Pierre-Yves Cordier, Sophie Moroge, S. Duron, Jean Cotte, Gilles Cellarier, Julien Bordes, and Frédéric Janvier

Subjects
Adult, Male, 0301 basic medicine, Microbiology (medical), myalgia, medicine.medical_specialty, 030106 microbiology, Disease, medicine.disease_cause, Rhabdomyolysis, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, Renal Insufficiency, 030212 general & internal medicine, Young adult, Creatine Kinase, Creatinine, Ebola virus, biology, business.industry, Myalgia, Hemorrhagic Fever, Ebola, medicine.disease, Surgery, Infectious Diseases, chemistry, biology.protein, Female, Guinea, Creatine kinase, medicine.symptom, business, Viral load
Abstract

BACKGROUND The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays. METHODS We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors. RESULTS High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load. CONCLUSIONS Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome.

Published
2015

4. Ebola Virus–Related Encephalitis: Table 1

Author

Philippe Dubrous, Benoit Quentin, Christine Mac Nab, Fassou Koulibaly, Thierry De Greslan, Julien Bordes, Magali Billhot, Sophie Moroge, S. Duron, Gilles Cellarier, Flavie Bompaire, Nicolas Gagnon, Jean-Luc Renard, Jean-Marie Cournac, Ludovic Karkowski, and Claire Rousseau

Subjects
0301 basic medicine, Microbiology (medical), Ebola virus, business.industry, viruses, virus diseases, Disease, Ideation, medicine.disease, medicine.disease_cause, Virology, Diagnostic spinal puncture, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Infectious Diseases, Cerebrospinal fluid, Medicine, 030212 general & internal medicine, business, Encephalitis
Abstract

Ebola patients frequently exhibit behavioral modifications with ideation slowing and aggressiveness, sometimes contrasting with mild severity of Ebola disease. We performed lumbar punctures in 3 patients with this presentation and found Ebola virus in all cerebrospinal fluid samples. This discovery helps to discuss the concept of a specific Ebola virus encephalitis.

Published
2016

5. Occupational Exposures to Ebola Virus in Ebola Treatment Center, Conakry, Guinea

Author

Nancy Maugey, Marc Aletti, Jean-Marie Cournac, Pierre-Yves Cordier, Sophie Moroge, Christophe Rapp, Hélène Savini, Magali Billhot, Hervé Granier, Christine Mac Nab, Audrey Mérens, Vincent Foissaud, Julien Bordes, Thierry De Greslan, Fassou Koulibaly, Eric Valade, P. Alla, Ludovic Karkowski, Audrey Cambon, Frédéric Janvier, Gilles Cellarier, Claire Rousseau, Philippe Kraemer, Emmanuel Sagui, Jean Cotte, Nicolas Gagnon, and Thierry Carmoi

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Epidemiology, viruses, Health Personnel, 030106 microbiology, lcsh:Medicine, Ebola virus disease, occupational exposures, treatment center, medicine.disease_cause, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Ebola virus, 0302 clinical medicine, Conakry, Occupational Exposure, medicine, Humans, lcsh:RC109-216, 030212 general & internal medicine, Prospective Studies, Ebolavirus, disease, Transmission (medicine), business.industry, healthcare workers, Incidence, lcsh:R, Dispatch, Outbreak, Healthcare worker, virus diseases, Hemorrhagic Fever, Ebola, Virology, Treatment center, Infectious Diseases, Occupational Exposures to Ebola Virus in Ebola Treatment Center, Conakry, Guinea, Emergency medicine, Guinea, Occupational exposure, High incidence, business
Abstract

We report 77 cases of occupational exposures for 57 healthcare workers at the Ebola Treatment Center in Conakry, Guinea, during the Ebola virus disease outbreak in 2014-2015. Despite the high incidence of 3.5 occupational exposures/healthcare worker/year, only 18% of workers were at high risk for transmission, and no infections occurred.

Published
2017

6. Hypercalcemia revealing diffuse granulomatous myositis

Author

Stéphane Lecoules, M. Aletti, Jean-Marie Cournac, Estelle Blanc, Weniko Caré, and Caroline Doutrelon

Subjects
Male, 030203 arthritis & rheumatology, medicine.medical_specialty, Granuloma, Myositis, business.industry, Granulomatous myositis, General Medicine, Middle Aged, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Hypercalcemia, medicine, Humans, Radiology, Nuclear Medicine and imaging, business, 030217 neurology & neurosurgery
Published
2017

7. Exanthème maculopapuleux chez un voyageur de retour de La Martinique lié à une infection au virus Zika

Author

Stéphane Lecoules, Jean Marie Cournac, Charles Soler, Marc Aletti, and Caroline Doutrelon

Subjects
030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030212 general & internal medicine, General Medicine, business, Humanities
Abstract

La Presse Medicale - In Press.Proof corrected by the author Available online since jeudi 28 juillet 2016

Published
2016

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