Search

Your search keyword '"E. Leray"' showing total 17 results
Start Over Author "E. Leray" Topic business
17 results on '"E. Leray"'

1. TRANSCOV, a multidisciplinary project to evaluate long distance COVID patients transfers

Author

O Grimaud, A Girault, L Laude, N Sirven, P Cucharero Atienza, C Fermanian, Y Elgharabawy, J Ramanantsoa, S Bayat, and E Leray

Subjects
business.industry, Public Health, Environmental and Occupational Health, Exceptional circumstances, Retrospective cohort study, medicine.disease, Multidisciplinary approach, Intensive care, Economic evaluation, Health care, medicine, 11.I. Oral presentations: Health care services and systems, AcademicSubjects/MED00860, AcademicSubjects/SOC01210, Medical emergency, Business, Discipline, AcademicSubjects/SOC02610, Parallel Programme, Diversity (business)
Abstract

Background Faced with an abrupt surge of severe COVID patients in March and April 2020, intensive care units (ICU) from four French regions transferred around 660 patients towards six other regions and four neighbouring countries. The intensity and the diversity of the vectors used (plane, helicopter, train, ambulance), during this wave of medical evacuations make it an unprecedented event. The aim of TRANSCOV is to examine the impact of long distance transfers on patient's health and to understand how actors collaborated to overcome clinical and logistical challenges. Methods TRANSCOV is made of three disciplinary components: 1) interviews with clinicians and health authorities staff involved in the organisation and realisation of the transfers as part of the qualitative component; 2) a retrospective cohort collecting clinical parameters and pathway details before during and after transfer; 3) a collection of data regarding human and logistical resources mobilised during transfers as part of an economical evaluation. Results Preliminary results indicate that prior experience in medical evacuations proved useful to collaborate effectively in the exceptional circumstances prevailing in spring 2020. Clinicians had to establish quickly eligibility criteria for transfer. Actors' opinions may vary on the appropriateness of vectors to transfer isolated (e.g. via helicopter) or grouped (train) patients. Early epidemiological data suggest that transferred patients were younger and experienced comparable, if not lower, in-hospital mortality compared to other patients. The economic evaluation is in progress. Conclusions Initial results indicate that effective collaborations led to the selection of clinically eligible patients and the realisation of safe distant transfers. Key messages Healthcare organisations have been able to adapt and create organizational innovations to respond to COVID-19. Multidisciplinary approaches are appropriate to evaluate such complex innovations.

Published
2021

2. Urinary tract infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

C. Donzé, C. Papeix, C. Lebrun-Frenay, C. Lebrun-Frénay, N. Collongues, M. de Seze, A. Dinh, A. Even, C. Scheiber-Nogueira, C. Bensa, B. Bourre, C. Carra-Dallière, J. Ciron, M. Cohen, A.M. Guennoc, C. Louapre, F. Lebreton, L. Michel, E. Maillart, B. Audoin, X. Ayrignac, P. Bernady, B. Brochet, P. Clavelou, R. Colamarino, A. Declemy, J. de Seze, N. Derache, J.-M. Faucheux, O. Heinzlef, P. Labauge, D. Laplaud, E. Lepage, E. Leray, L. Magy, G. Mathey, C. Mekies, V. Mondain, E. Planque, J. Pelletier, S. Pittion, B. Stankhof, P. Tournaire, E. Thouvenot, S. Vukusic, S. Wiertlevski, H. Zephir, H. Alchaar, G. Androdias, M. Benazet, D. Bensmail, D. Biotti, A. Blanchard-Dauphin, M. Bonnan, C. Boutière, P. Branger, S. Bresch, J.-P. Bru, J.-P. Camdessanché, E. Castel Canal, M. Coustans, O. Casez, B. Castan, A. Creange, E. Creisson, T. De Broucker, R. Depaz, X. Douay, C. Dulau, F. Durand-Dubief, O. Fagniez, M. Faucher, A. Floch, M. Fournier, A. Fromont, P. Gallien, X. Gamé, D. Gault, A. Gayou, M. Giroux, O. Gout, J. Grimaud, P. Hautecoeur, A. Kerbrat, L. Kremer, A. Kwiatkowski, C. Labeyrie, S. Lachaud, C. Lanctin-Garcia, L. Lanotte, E. Manchon, A. Maurousset, A.-M. Milor, X. Moisset, A. Mont-Cuquet, T. Moreau, J.-C. Ouallet, I. Patry, D. Peaureaux, M.-C. Pouget, V. Pourcher Martinez, C. Radot, A. Ruet, C. Saint-Val, A. Salmon, F. Taithe, P. Tatevin, M. Vaillant, J.-P. Stahl, F. Vuoto, C. Zaenker, Hôpital Saint Philibert [Lomme], Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Groupe Hospitalier de l'Institut Catholique de Lille (GHICL), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Nice Sophia Antipolis (... - 2019) (UNS), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
medicine.medical_specialty, Urinary system, Population, MESH: Urinary Tract Infections, urologic and male genital diseases, Practice guidelines, Hypogammaglobulinemia, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, MESH: Pregnancy, Health care, medicine, Urinary tracts infections, In patient, 030212 general & internal medicine, Intensive care medicine, education, Asymptomatic bacteriuria, Pregnancy, education.field_of_study, MESH: Humans, Disease modifying therapy, business.industry, MESH: Multiple Sclerosis, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, MESH: Recurrence, Neurology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neurology (clinical), business, MESH: Female, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Objectives Establish recommendations for the management of UTIs in MS patients. Background Urinary tract infections (UTIs) are common during multiple sclerosis (MS) and are one of the most common comorbidities potentially responsible for deaths from urinary sepsis. Methods The recommendations attempt to answer three main questions about UTIs and MS. The French Group for Recommendations in MS (France4MS) did a systematic review of articles from PubMed and universities databases (01/1980–12/2019). The RAND/UCLA appropriateness method, which has been developed to synthesize the scientific literature and expert opinions on health care topics, was used for reaching a formal agreement. 26 MS experts worked on the full-text review and a group of 70 multidisciplinary health care specialists validated the final evaluation of summarized evidences. Results UTIs are not associated with an increased risk of relapse and permanent worsening of disability. Only febrile UTIs worsen transient disability through the Uhthoff phenomenon. Some immunosuppressive treatments increase the risk of UTIs in MS patients and require special attention especially in case of hypogammaglobulinemia. Experts recommend to treat UTIs in patients with MS, according to recommendations of the general population. Prevention of recurrent UTIs requires stabilization of the neurogenic bladder. In some cases, weekly oral cycling antibiotics can be proposed after specialist advice. Asymptomatic bacteriuria should not be screened for or treated systematically except in special cases (pregnancy and invasive urological procedures). Conclusion Physicians and patients should be aware of the updated recommendations for UTis and MS.

Published
2020
Full Text
View/download PDF

3. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

C. Lebrun, S. Vukusic, V. Abadie, C. Achour, F. Ader, H. Alchaar, A. Alkhedr, F. Andreux, G. Androdias, R. Arjmand, B. Audoin, D. Audry, D. Aufauvre, C. Autreaux, X. Ayrignac, M. Bailbe, M. Benazet, C. Bensa, D. Bensmail, E. Berger, P. Bernady, Y. Bertagna, D. Biotti, A. Blanchard-Dauphin, J. Bonenfant, M. Bonnan, B. Bonnemain, F. Borgel, E. Botelho-Nevers, S. Boucly, B. Bourre, C. Boutière, P. Branger, D. Brassat, S. Bresch, V. Breuil, B. Brochet, H. Brugeilles, P. Bugnon, P. Cabre, J.-P. Camdessanché, C. Carra-Dalière, O. Casez, J.-M. Chamouard, B. Chassande, P. Chataignier, M. Chbicheb, A. Chenet, J. Ciron, P. Clavelou, M. Cohen, R. Colamarino, N. Collongues, I. Coman, P.-R. Corail, S. Courtois, M. Coustans, A. Creange, E. Creisson, N. Daluzeau, C. Davenas, J. De Seze, M. Debouverie, R. Depaz, N. Derache, L. Divio, X. Douay, C. Dulau, F. Durand-Dubief, G. Edan, Z. Elias, O. Fagniez, M. Faucher, J.-M. Faucheux, M. Fournier, A. Gagneux-Brunon, P. Gaida, P. Galli, P. Gallien, J. Gaudelus, D. Gault, A. Gayou, M. Genevray, A. Gentil, J. Gere, L. Gignoux, M. Giroux, P. Givron, O. Gout, J. Grimaud, A.-M. Guennoc, N. Hadhoum, P. Hautecoeur, O. Heinzlef, M. Jaeger, S. Jeannin, L. Kremer, A. Kwiatkowski, P. Labauge, C. Labeyrie, S. Lachaud, I. Laffont, C. Lanctin-Garcia, J. Lannoy, L. Lanotte, D. Laplaud, D. Latombe, M. Lauxerois, E. Le Page, C. Lebrun-Frenay, P. Lejeune, P. Lejoyeux, B. Lemonnier, E. Leray, C.-M. Loche, C. Louapre, C. Lubetzki, A. Maarouf, B. Mada, L. Magy, E. Maillart, E. Manchon, R. Marignier, P. Marque, G. Mathey, A. Maurousset, C. Mekies, M. Merienne, L. Michel, A.-M. Milor, X. Moisset, A. Montcuquet, T. Moreau, N. Morel, M. Moussa, J.-P. Naudillon, M. Normand, P. Olive, J.-C. Ouallet, O. Outteryck, C. Pacault, C. Papeix, I. Patry, D. Peaureaux, J. Pelletier, B. Pichon, S. Pittion, E. Planque, M.-C. Pouget, V. Pourcher, C. Radot, I. Robert, F. Rocher, A. Ruet, C. Saint-Val, J.-Y. Salle, A. Salmon, E. Sartori, S. Schaeffer, B. Stankhof, F. Taithe, E. Thouvenot, C. Tizon, A. Tourbah, P. Tourniaire, M. Vaillant, P. Vermersch, S. Vidil, A. Wahab, M.-H. Warter, S. Wiertlewski, B. Wiplosz, B. Wittwer, C. Zaenker, H. Zephir, Université Côte d'Azur (UCA), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hosp Civils Lyon, Serv Malad Infect, Lyon, France, Biogéosciences [UMR 6282] [Dijon] (BGS), Centre National de la Recherche Scientifique (CNRS)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Pontchaillou [Rennes], CHU Saint-Etienne, Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - AP-HM] (CEMEREM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Comité de Développement Horticole du Centre Val de Loire (CDHRC), Génétique, physiopathologie et ingénierie du tissu osseux (GéPITOS), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Service d'Etudes du Comportement des Matériaux de Conditionnement (SECM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Galaxies, Etoiles, Physique, Instrumentation (GEPI), Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [Rennes] = Neurology [Rennes], Excitabilité nerveuse et thérapeutique (ENT), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-EA 4391, Service de Physiologie Explorations Fonctionnelles-Hôpital Henri Mondor, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Combustion Research Facility, Sandia National Laboratories - Corporation, Service de Pédiatrie [Jean Verdier], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Kuriwa Observatory, Fondation Ophtalmologique Adolphe de Rothschild [Paris], Laboratoire de Mécanique, Modélisation et Procédés Propres (M2P2), Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Euromov (EuroMov), Université de Montpellier (UM), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Biologie des Interactions Neurones / Glie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire d'automatique et de génie des procédés (LAGEP), Université de Lyon-Université de Lyon-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Haras National Suisse, Centre Hospitalier Universitaire de Reims (CHU Reims), Center for health studies, Service de neurologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Hospices Civils de Lyon, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Biogéosciences [UMR 6282] (BGS), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hôpital Henri Mondor-EA 4391, Service de Physiologie Explorations Fonctionnelles-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Comité de développement horticole de la région Centre-Val-de-Loire (CDHR CENTRE-VAL-DE-LOIRE), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-Université Côte d'Azur (UCA), Service de Neurologie [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Ecole Centrale de Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Neurologie [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-IFR70-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie, CHU Clermont-Ferrand, Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
medicine.medical_specialty, Vaccination schedule, MEDLINE, Scientific literature, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, Health care, Medicine, Humans, 030212 general & internal medicine, Immunization Schedule, Societies, Medical, Vaccines, business.industry, Risk of infection, Prevention, Vaccination, medicine.disease, 3. Good health, Neurology, Immunization, Family medicine, Evidence-Based Practice, Practice Guidelines as Topic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), France, business, Infection, Vaccine, 030217 neurology & neurosurgery
Abstract

Objectives To establish recommendations on immunization for patients with multiple sclerosis (MS). Background Vaccines have been suspected in the past to trigger MS and relapses. With the extension of the immunoactive treatment arsenal, other concerns have been raised more recently about an increased risk of infection or a decreased effectiveness of immunization in immunosuppressed patients. Methods The French Group for Recommendations into Multiple Sclerosis (France4MS) performed a systematic search of papers in Medline and other university databases (January 1975–June 2018). The RAND/UCLA appropriateness method was chosen to review the scientific literature and to formalize the degree of agreement among experts on 5 clinical questions related to immunization and MS. Readers from the steering committee conducted a systematic analysis, wrote a critical synthesis and prepared a list of proposals that were evaluated by a rating group of 28 MS experts. The final version of the recommendations was finally reviewed by a reading group of 110 health care professionals and classified as appropriate, inappropriate or uncertain. Results Neurologists should verify the vaccination status as soon as MS is diagnosed and before disease-modifying treatments (DMTs) are introduced. The French vaccination schedule applies to MS patients and seasonal influenza vaccination is recommended. In the case of treatment-induced immunosuppression, MS patients should be informed about the risk of infection and the vaccination standards of the French High Council of Health should be applied. Live attenuated vaccines are contra-indicated in patients recently treated with immunosuppressive drugs, including corticosteroids; other vaccines can be proposed whatever the treatment, but their effectiveness may be partly reduced with some drugs. Conclusion Physicians and patients should be aware of the updated recommendations for immunizations of patients with MS.

Published
2019
Full Text
View/download PDF

4. Peut-on expliquer la mort inattendue du nourrisson ? Réflexions à partir d’une série de 80 cas autopsiés au CHU de Rennes entre 1994 et 2007

Author

E. Leray, A. Venisse, H. Jouan, P. Loget, C. Saint-Stéban, and Michel Roussey

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Incidence (epidemiology), Public health, Autopsy, Context (language use), Sudden infant death syndrome, Sudden death, Pediatrics, Perinatology and Child Health, Epidemiology, Medicine, business, Cause of death
Abstract

Sudden infant death syndrome (SIDS) is a huge hardship for parents, but also for health professionals. In 2007, 210 cases occurred in France, corresponding to a crude rate of 31.8 for 100,000 births. Between 1994 and 2007, 140 children of less than 2 years old were examined in the reference centre for SIDS in Rennes, France. We included in our study the children who were aged more than 28 days at death date, did not have a known lethal disease and were autopsied. A total of 80 children fulfilled those criteria. Post-mortem investigation included an autopsy, clinical and paraclinical exams (blood test, radiography, CT-scan...), and investigation of the circumstances of the death. Most of the cases were boys and were 2- to 5-month old. Ventral decubitus and gastrointestinal symptoms were often present. Autopsy gave elements about the causes of death in 23 cases and the other exams performed frequently showed an infectious viral context. Thanks to prevention and information campaigns about childcare done in the 1990s, SIDS incidence has largely decreased in France, but it is still too frequent. In our opinion, advice needs to be given again and again, especially concerning safe sleep practices, in order to increase adherence to these recommendations. Moreover, research should be continued to better understand this unexplained syndrome.

Published
2010
Full Text
View/download PDF

5. Dislocation and bicruciate lesions of the knee: Epidemiology and acute stage assessment in a prospective series

Author

Ph Neyret, Philippe Boisrenoult, P. Laffargue, Christophe Trojani, Sébastien Lustig, E. Leray, Dominique Saragaglia, Philippe Rosset, Centre Albert Trillat [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hôpital Pontchaillou, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier de Versailles André Mignot (CHV), Hopital L'Archet-II, Hôpital Claude Huriez [Lille], CHU Lille, Hopital Sud, hôpital Sud, Centre Hospitalier Régional Universitaire de Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
Male, Bicruciate lesions, medicine.medical_treatment, Arthroscopy, Injury Severity Score, 0302 clinical medicine, Orthopedic Procedures, Orthopedics and Sports Medicine, Prospective Studies, Anterior Cruciate Ligament, 10. No inequality, Pain Measurement, Arthrotomy, 030222 orthopedics, medicine.diagnostic_test, Knee Dislocation, Middle Aged, Combined Modality Therapy, 3. Good health, Treatment Outcome, medicine.anatomical_structure, Ligament, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Adult, medicine.medical_specialty, Anterior cruciate ligament, Knee dislocation, Risk Assessment, Young Adult, 03 medical and health sciences, BIOMECANIQUE, medicine.artery, Preoperative Care, medicine, Humans, Aged, business.industry, Anterior Cruciate Ligament Injuries, Recovery of Function, 030229 sport sciences, Plastic Surgery Procedures, Popliteal artery, Surgery, Radiography, Posterior cruciate ligament, Orthopedic surgery, Posterior Cruciate Ligament, business, Follow-Up Studies
Abstract

Summary Introduction Knee dislocation and bicruciate lesions are rare. Assessments of results from retrospective series carry an insufficient level of evidence. A prospective multicenter study was therefore set up, under the auspices of the French Society of Orthopedic Surgery. Material and methods The inclusion period covered the whole of 2007. Clinical, imaging (dynamic X-ray and MRI) and vascular (angioscan and arteriography) assessment was performed systematically. In patients over the age of 60 years, ligament lesions were always managed non-surgically; in those under the age of 60 years, surgery was considered in the absence of associated vascular lesion or open dislocation and if there was frontal laxity exceeding 15° or a posterior drawer test greater than 10 mm. The posterior cruciate ligament (PCL) and peripheral ligament tears were repaired or reinforced under arthroscopy or by arthrotomy. The anterior cruciate ligament was never operated on. In all other cases, management was conservative. Results Sixty-seven knees were included (55 male, 11 female; mean age: 37 years). Fifteen patients (25.4%) had bicruciate lesion, and 44 (74.6%) knee dislocation. Mean trauma-to-reduction interval was 3 hrs 50 min. Only one of the nine cases of popliteal artery lesion exhibited discernible distal pulse wave. Only three of these patients underwent vascular surgical repair. Twelve knees (five bicruciate lesions, seven dislocations) had isolated common peroneal nerve damage. Discussion This prospective study detailed the epidemiology and treatment of the lesions encountered, with the option of PCL and peripheral ligament reconstruction. The results, however, still require long-term analysis. Level of evidence Level IV prospective epidemiologic study.

Published
2009
Full Text
View/download PDF

6. Vascular lesions associated with bicruciate and knee dislocation ligamentous injury

Author

Dominique Saragaglia, Sébastien Lustig, Gilbert Versier, Philippe Rosset, Philippe Boisrenoult, P. Bonneviale, E. Leray, Philippe Neyret, Chirurgie orthopédique et traumatologie, Hôpital de Versaille, Hôpital de Versaille, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Chirurgie Orthopédique et Traumatologique, Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Chirurgie orthopédique et traumatologie, Hôpital d'instruction des armées Bégin, Hôpital d'Instruction des Armées Bégin, Chirurgie orthopédique et traumatologie, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Chirurgie orthopédique et traumaologique, hôpital Sud, Grenoble, Hôpital Sud de Grenoble, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Département Chirurgie Orthopédique et traumatologique [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Rennes (UR)

Subjects
Male, Knee Joint, medicine.medical_treatment, Magnetic resonance angiography, 0302 clinical medicine, Injury Severity Score, Ischemia, Popliteal Artery, Orthopedics and Sports Medicine, Prospective Studies, Anterior Cruciate Ligament, 030222 orthopedics, medicine.diagnostic_test, Middle Aged, Combined Modality Therapy, 3. Good health, Treatment Outcome, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Radiology, medicine.symptom, Vascular Surgical Procedures, Adult, medicine.medical_specialty, Knee Dislocation, Physical examination, Multiligament knee injury, Revascularization, Asymptomatic, Risk Assessment, Lesion, BIOMECANIQUE, 03 medical and health sciences, medicine.artery, medicine, Dislocation, Humans, Knee, Emergency Treatment, Aged, business.industry, Multiple Trauma, Anterior Cruciate Ligament Injuries, 030208 emergency & critical care medicine, Recovery of Function, Plastic Surgery Procedures, medicine.disease, Popliteal artery, Surgery, Amputation, Vascular lesions, Posterior Cruciate Ligament, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Magnetic Resonance Angiography, Follow-Up Studies
Abstract

Summary Introduction The incidence of associated vascular lesions in biligamentous cruciate injuries of the knee ranges from 16 to 64%, with a mean rate of 30%. Treatment of ischemic vascular lesions associated with ligaments injury is well established, comprising emergency arterial vascular repair, most of the times combined to external fixation. In the absence of clinical symptoms of vascular lesion, some authors recommend systematically performing arteriography, while others advocate selectively prescribing this examination in doubtful clinical situations. The present study analyzed data extracted from the prospective series of the 2008 SOFCOT Symposium (dedicated to management of bicruciate knee lesions) and from an analysis of the literature, with emphasis on developing a diagnostic strategy for vascular lesions associated with bicruciate lesions. Material and methods This multicenter prospective study included all patients treated in the reference centers for dislocation or bicruciate lesion of the knee between January 2007 and January 2008. All patients underwent early objective vascular imaging. Results Sixty-seven patients were included. Mean dislocation reduction time was 2 hrs 45 min (max, 21 hrs). There were nine vascular lesions (12%). Absence of vascular lesion could be confirmed in 58 of the 59 patients exhibiting presence of peripheral pulses at initial examination. In one case, a vascular lesion was found on early imaging, but with no clinical consequence. In all eight cases with associated clinical pulse abnormality, complementary vascular check-up confirmed the presence of a vascular lesion. Angioscan induced no error of vascular assessment in this series, with no false positives or false negatives. One patient underwent amputation for critical ischemia. Three patients had vascular surgical treatment, two not undergoing secondary ligament surgery. Four of the five patients whose vascular lesion was conservatively managed by simple observation were able to undergo the scheduled treatment for their ligament lesions. Discussion At initial examination, it is essential to look for the peripheral pulse. In case of ischemic syndrome, the priority is a revascularization procedure associated to intraoperative arteriography. In case of abnormal pulse without obvious ischemia, emergency imaging (usually arteriogram or angioscan) is essential. Where there is no initial clinical vascular abnormality, good practice is less clearly cut. Initially, present pulses are found in a mean 30% (17–55%) of cases of popliteal artery lesion, according to the series. Different authors draw diverging conclusions from this fact. For some, the absence of frank abnormality on clinical examination is sufficient to exclude not any possible anatomic vascular lesion but any vascular lesion requiring surgery. However, even without pulse abnormality, we consider systematic imaging to be justified, partly by the difficulty of ensuring strict monitoring, and partly by the decompensation risk of clinically asymptomatic intimal lesions during the ligament surgery under consideration in most cases. Although many authors cling to the dogma of late emergency arteriography, recent reports argue against this attitude. Angio-MRI has good diagnostic value, but in practice is difficult to obtain in emergency. We would rather advocate angioscanning, which is easily available in emergency and does not incur the risk of local complication associated with arteriography. Type of study Prospective continuous. Level IV.

Published
2009
Full Text
View/download PDF

7. Les luxations du genou, les lésions ligamentaires graves, quelle prise en charge ?

Author

Paul Bonnevialle, Stéphane Boisgard, Philippe Boisrenoult, Christophe Trojani, Olivier Barbier, Stéphane Descamps, Frédéric Dubrana, Dominique Saragaglia, Philippe Rosset, E. Leray, J.-L. Paillot, Gilbert Versier, Philippe Neyret, P. Laffargue, C. Lapra, Sébastien Lustig, and B. Galaud

Subjects
business.industry, Medicine, Orthopedics and Sports Medicine, Surgery, business
Published
2009
Full Text
View/download PDF

8. Results of spinal meningioma surgery in patients with severe preoperative neurological deficits

Author

Gilles Brassier, Seyed F A Amlashi, Xavier Morandi, E. Leray, Laurent Riffaud, and C. Haegelen

Subjects
medicine.medical_specialty, business.industry, Spinal Cord Neoplasm, Spinal Meningiomas, medicine.disease, Surgery, Meningioma, Severity of illness, medicine, Original Article, Orthopedics and Sports Medicine, In patient, Meningeal Neoplasm, Neurosurgery, business, Paraplegia
Abstract

Spinal meningiomas are usually benign, slow-growing tumours and are commonly associated with good patient outcome following surgery. However, the existence of a severe preoperative neurological deficit has been considered to be a possible predictor of poor functional outcome after surgery. We retrospectively reviewed data from 33 patients with 35 spinal meningiomas treated in our institution over the past 17 years and exhibiting severe preoperative deficits before surgery. Among them, 20 suffered from paraparesis and 13 were paraplegic. The mean follow-up duration was 70.7 months (range 12–183 months). By the 1-year follow-up, all patients had improved in comparison with their preoperative neurological status, and 60% of them had totally recovered. It can be concluded from this study, that, in the vast majority of cases, patients harbouring spinal meningioma with severe preoperative deficits can expect a good outcome.

Published
2004
Full Text
View/download PDF

9. Pertinence et reproductibilité de l’interprétation de l’IRM dans les luxations et les lésions ligamentaires bicroisées du genou

Author

Philippe Rosset, Paul Bonnevialle, Dominique Saragaglia, E. Leray, Olivier Barbier, Stéphane Descamps, Ph Neyret, Philippe Boisrenoult, C. Lapra, P. Laffargue, Sébastien Lustig, B. Galaud, J.-L. Paillot, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), Service de Chirurgie Orthopédique [Centre Albert Trillat], Centre Albert Trillat [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Ecosystèmes littoraux et côtiers (ELICO), Université de Lille, Sciences et Technologies-Université du Littoral Côte d'Opale (ULCO)-Centre National de la Recherche Scientifique (CNRS), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire [Grenoble] (CHU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
Adult, Male, medicine.medical_specialty, Soft Tissue Injuries, Adolescent, Knee Dislocation, Interobserver reproducibility, Clinical exam, 030218 nuclear medicine & medical imaging, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Multiple-ligament injuries, medicine, Humans, Dislocation, Orthopedics and Sports Medicine, Knee, Prospective Studies, Prospective cohort study, 030222 orthopedics, Reproducibility, medicine.diagnostic_test, Knee dislocations, business.industry, Soft tissue, Magnetic resonance imaging, Level iv, Middle Aged, Vascular System Injuries, Magnetic Resonance Imaging, Surgery, medicine.anatomical_structure, Ligaments, Articular, Ligament, Wounds and Injuries, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Radiology, business, MRI
Abstract

International audience; IntroductionAprès luxations et lésions ligamentaires bicroisées du genou, l’évaluation clinique des lésions des parties molles est difficile et une IRM est généralement réalisée.HypothèseL’IRM est un examen fiable permettant un bilan précis et reproductible des lésions des parties molles après luxation ou lésion ligamentaire bicroisée du genou.Patients et méthodeQuarante patients présentant des lésions ligamentaires bicroisées du genou ont été inclus dans cette étude prospective multicentrique. Tous ont eu une IRM du genou dans les 48 heures suivant l’accident. Trente-quatre patients ont été traités chirurgicalement. Une fiche d’interprétation standardisée de l’IRM a été créée. Cette fiche comprenait 17 items. La reproductibilité intra-observateur a été évaluée en comparant les résultats des interprétations de cinq chirurgiens réalisées à deux reprises à trois semaines d’intervalle. La reproductibilité inter-observateurss a été évaluée en comparant les résultats des interprétations de 40 IRM réalisées par trois binômes de chirurgiens. La pertinence des interprétations IRM était réalisée en comparant les résultats des chirurgiens à ceux d’un radiologue et avec les données des comptes rendus opératoires.RésultatsLa concordance globale intra-observateur et inter-observateurss était faible. En comparant les résultats du chirurgien à ceux du radiologue et des données opératoires, la concordance était faible.DiscussionAprès luxation ou lésion ligamentaire bicroisée du genou, un diagnostic précis est nécessaire. Notre étude met en évidence le manque de précision et de reproductibilité des interprétations par IRM de façon isolée pour le diagnostic lésionnel topographique. L’IRM doit être intégrée dans une évaluation complète avec un examen clinique précis et des radiographies de stress.

Published
2013
Full Text
View/download PDF

10. Diagnostic accuracy of esophageal capsule endoscopy versus conventional upper digestive endoscopy for suspected esophageal squamous cell carcinoma

Author

E Ben Soussan, B Filoche, Jean-Louis Gaudin, M. G. Lapalus, Marianne Gaudric, Vincent Quentin, PN d'Halluin, D. Heresbach, E Leray, Stanislas Chaussade, Kouroche Vahedi, Jean-Christophe Saurin, Franck Cholet, and T. Ponchon

Subjects
Adult, Male, medicine.medical_specialty, Esophageal Neoplasms, Gastroenterology, Capsule Endoscopy, Sensitivity and Specificity, Endoscopy, Gastrointestinal, law.invention, Diagnosis, Differential, Capsule endoscopy, law, Internal medicine, Biopsy, medicine, Carcinoma, Humans, Esophagus, Aged, medicine.diagnostic_test, business.industry, Esophageal disease, Esophagogastroduodenoscopy, Reproducibility of Results, Middle Aged, medicine.disease, Endoscopy, medicine.anatomical_structure, Dysplasia, Carcinoma, Squamous Cell, Female, business, Follow-Up Studies
Abstract

BACKGROUND AND STUDY AIM: A video capsule similar to that used in small-bowel capsule endoscopy is now available for esophageal exploration. The aim of our study was to compare the accuracy of upper endoscopy (esophageal gastroduodenoscopy [EGE]) with esophageal capsule endoscopy (ECE) in patients at risk of esophageal squamous cell cancer (SCC). PATIENTS AND METHODS: 68 patients at risk of SCC secondary to a history of head and neck neoplasia were included in this comparison of techniques for detecting SCC and dysplasia. ECE was done using the first generation Pillcam ESO and EGE was performed in accordance with the usual practice of each center, followed by examination with 2 % Lugol staining and biopsy of unstained areas (39 neoplasia comprising 5 low grade dysplasia, 8 high grade dysplasia and 26 SCC). RESULTS: Compared with EGE with and without Lugol staining, the sensitivities of ECE for neoplasia diagnosis were 46 % and 54 %, respectively. On a per-patient basis, the sensitivity, specificity, and positive and negative predictive value of ECE were 63 %, 86 %, 77 % and 76 %, respectively, compared with EGE without staining, and 61 %, 86 %, 77 % and 73 % compared with EGE with iodine staining. Neither the ECE transit time nor the distance between the esopharyngeal line and the neoplastic lesion differed between the 21 false-negative and 18 true-positive cases diagnosed by ECE; the only difference was a smaller median diameter among false negatives ( P < 0.001). CONCLUSION: In a cohort at high risk for esophageal SCC, ECE is not sensitive enough to diagnose neoplastic lesions.

Published
2010

11. Longitudinal study of bone mineral density in children after a diagnosis of Crohn's disease

Author

F. Samson, B. Cagnard, Pascal Guggenbuhl, E. Leray, L. Bridoux-Henno, and Alain Dabadie

Subjects
musculoskeletal diseases, Male, medicine.medical_specialty, Longitudinal study, Adolescent, Standard score, Gastroenterology, Absorptiometry, Photon, Crohn Disease, Bone Density, Reference Values, Internal medicine, Active disease, Medicine, Humans, Prospective Studies, Child, Bone mineral, Crohn's disease, business.industry, Bone age, General Medicine, musculoskeletal system, medicine.disease, Endocrinology, El Niño, Bone maturation, Osteoporosis, Female, business, Follow-Up Studies
Abstract

The purpose of this study was to measure the bone mineral density (BMD) of children with Crohn's disease (CD) and to prospectively assess its evolution.A total of 27 children (20 boys, seven girls), aged 12.1±2.5 years, were recruited at the time of CD diagnosis. Dual-energy X-ray absorptiometry (DEXA) was used to measure BMD, expressed as Z scores for chronological age (BMD/CA) and bone age (BMD/BA). One year later, BMD was measured again to identify any correlations with disease activity [group A (active disease) vs group R (remission)].BMD/CA and BMD/BA were negatively correlated with delay in diagnosis (P0.0001 and P0.05, respectively). BMD/CA was less than -2 standard deviation (SD) in nine patients and BMD/BA was less -2 SD in four patients. At the follow-up, the increase in BMD was smaller in group A (n=14), whether expressed as absolute values (-0.002 vs 0.040 g/cm(2) per year; P0.024) or as percentages (-0.2 vs 6.6%; P0.041); changes in BMD/CA (-0.5 vs -0.1 SD/year) and BMD/BA (-0.3 vs 0 SD/year) did not differ.Diagnostic delay greatly affects BMD in children with CD even prior to corticosteroid therapy. The risk of low BMD increases with persistent CD activity, although the risk is reduced in association with bone maturation delay.

Published
2009

13. Federated Accounting Management System Architecture for Multimedia Service Usage Management

Author

E. de Leastar, E. Leray, Bharat Bhushan, Thomas Gringel, Conor Ryan, and James Cloney

Subjects
Service (systems architecture), Service quality, Process management, Quality management, Standardization, business.industry, Computer science, Accounting management, Service provider, Walton Institute for Information and Communications Systems Science, computer.software_genre, Shared resource, World Wide Web, Systems management, Systems architecture, Revenue, The Internet, Telecommunications Software and Systems Group, business, Requirements analysis, computer
Abstract

Service consumers are increasingly becoming aware of QoS and service subscriptions. Service providers (SPs) are also recognizing the opportunity to generate revenue by bundling services in packages and providing them to customers. Standardization bodies have begun to address requirements of charging and usage accounting management as SPs are increasingly relying on them. Federated accounting management concept stems from these developments. It specifically supports the requirement of SPs to co-operate in a federated manner and share the revenue. It also supports the requirements of charging and billing being subcontracted to a third-party. This paper proposes that standard-based interfaces and shared information model, and a well-accepted development methodology are keys to enabling co-operation between SPs. It presents a requirement analysis and a federated accounting management system architecture, which are based on the recommendations laid down by TMForum, IPDR, OMG and IETF organisations. The architecture supports mediation, rating, charges aggregation, settlement, and online billing.

Published
2002

14. Federated Accounting: Service Charging and Billing in a Business-to-Business Environment

Author

William Donnelly, Bharat Bhushan, E. Leray, and M. Tschichholz

Subjects
Service (business), Service assurance, Computer science, business.industry, Service delivery framework, Service design, Service level objective, Service level requirement, Accounting, Service provider, Walton Institute for Information and Communications Systems Science, Customer Service Assurance, business, Telecommunications Software and Systems Group
Abstract

The liberalisation of the telecommunications industry has resulted in a proliferation of new services and services providers. This is particularly the case in the rapidly expanding IP-based services market. Providers include Internet Service Providers (ISPs), Virtual Private Network (VPN), communication (backbone operators), and application service providers. The final service set delivered to the customer enduser will result from the combination of these service offerings. From a service usage accounting perspective, this new environment creates a number of important challenges, which did not apply in the traditional monopolistic telecommunications environment. The first issue is that of multiple administrative domains from the customer and service provider side and the second issue concerns applying customer Service Level Agreements (SLA) and Quality of Service (QoS). This paper addresses the issue of settlement of service usage charging across several service providers when they collectively provide application, information, or communication service to a customer. The issue at the stake is to develop standardised mechanisms that allow various business and operation support systems operating in various domains to exchange service usage information. The work presented in this paper focuses on the development of a business-tobusiness (B2B) service provisioning and management architecture to provide guidance to international organisations on the development of a federated accounting management solution. This architecture aims to be both open and adaptable and draws requirements from standardisation work going on in TMForum (TeleManagement Forum), IPDR (IP Detail Record), IETF (Internet Engineering Task Force) and ETSI (European Telecommunication Standardisation Institute).

Published
2001

16. CO.130 Variations interendoscopistes observées dans le cadre du dépistage organisé du cancer colorectal après test Hémoccult® positif

Author

Jean-François Bretagne, G. Durand, F. Riou, E. Leray, Christine Piette, S. Hamonic, and Sylvain Manfredi

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Medicine, General Medicine, business
Abstract

Objectif Il existe des variations de performance de la coloscopie entre endoscopistes, mais elles n’ont ete que peu evaluees en pratique courante en France, et jamais dans le cadre du depistage generalise du cancer colorectal par test Hemoccult ® . Il apparaissait d’autant plus important de le faire que la valeur predictive d’un test Hemoccult ® positif est elevee pour la detection des cancers et des adenomes. Patients et Methodes Nous avons analyse les resultats des coloscopies realisees dans notre departement a l’occasion des 1 ere et 2 eme campagnes de depistage (C1 et C2). Ont ete inclus pour l’analyse les gastroenterologues (GE) ayant effectue au moins 30 coloscopies par campagne (le depistage organise represente environ 10 % du total des coloscopies). Nous avons calcule pour chaque lesion, cancer ou adenome, les taux de detection par GE, bruts et ajustes sur le sexe et l’âge des patients. Les donnees ont ete analysees separement pour C1 (21 GE) et C2 (18 GE), puis comparees entre C1 et C2 pour les 18 GE communs aux 2 campagnes, puis analysees globalement (resultats pooles de C1 + C2). L’analyse statistique a recouru pour les comparaisons entre groupes aux tests de Student, Wilcoxon, Kruskal-Wallis, Khi2 et au test de correlation de Spearman (r S ). Un modele de regression logistique a ete utilise pour l’analyse multivariee avec calcul du coefficient de determination R 2 par variable identifiee. Resultats Pour C1 et C2, les 21 et 18 GE avaient realise 2 079 et 1 526 examens, soit 90,6 % et 82,9 % du total des coloscopies de la campagne. Pour C1, les taux ajustes de detection de ≥ 1 adenome (Ad) variaient entre GE de 15,6 % a 48,4 %, ≥ 2 Ad de 2,6 % a 24,5 %, ≥ 3 Ad de 0 % a 13,1 %, ≥ 1 Ad ≥ 10 mm de 8,2 % a 30,4 %, ≥ 1 cancer de 7,0 % a 16,8 %. Il existait une correlation entre le taux de detection de ≥ 1 Ad et de ≥ 1 Ad ≥ 10 mm (r S = 0,46, p = 0,02), mais pas de correlation significative avec l’âge du GE, ni le nombre de coloscopies realisees par GE dans la campagne. Les resultats etaient similaires pour C2. L’analyse multivariee pour C1 et C2 poolees montrait que le GE etait une variable independante liee au taux de detection des Ad (p odds ratios des 17 autres GE variaient de 1,11 a 2,83 (mediane : 1,48) pour la detection de ≥ 1 Ad et de 1,87 a 5,22 (mediane : 2,67) pour ≥ 1 Ad ≥ 10 mm. L’analyse de R 2 montrait que le poids de la variable « GE » etait intermediaire entre « sexe » et « âge » des patients. Conclusion Cette etude montre pour la premiere fois que, dans le cadre d’un programme national de depistage base sur l’Hemoccult ® , il existe des variations significatives entre GE pour le taux de detection des adenomes, quelque soit le nombre et la taille des lesions considerees, mais pas de variation significative pour le diagnostic des cancers. Les causes de ces variations devront etre identifiees. Ces resultats doivent inciter les GE a enregistrer leur score de detection et si besoin a l’ameliorer.

Published
2009
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results