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7. European Snakes

Author

de Haro, Luc, Boels, David, Brent, Jeffrey, editor, Burkhart, Keith, editor, Dargan, Paul, editor, Hatten, Benjamin, editor, Megarbane, Bruno, editor, Palmer, Robert, editor, and White, Julian, editor

Published
2017
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8. Scombrotoxisme : expérience des centres antipoison de France de 2012 à 2021

Author

Jarrige, Xavier, primary, Glaizal, Mathieu, additional, Sinno-Tellier, Sandra, additional, Boels, David, additional, Delcourt, Nicolas, additional, Labadie, Magali, additional, Langrand, Jérôme, additional, Le Roux, Gaël, additional, Paret, Nathalie, additional, Tournoud, Christine, additional, Simon, Nicolas, additional, de Haro, Luc, additional, Azzouz, Ramy, additional, Nisse, Patrick, additional, Chevalier, Cécile, additional, Paradis, Camille, additional, Blanc, Ingrid, additional, Nardon, Audrey, additional, Torrents, Romain, additional, Schmitt, Corine, additional, Battefort, Florent, additional, Puskarczyk, Emmanuel, additional, Laborde, Hervé, additional, Caré, Weniko, additional, Vodovar, Dominique, additional, Lecot, Jérémy, additional, Legeay, Marion, additional, and Deguigne, Marie, additional

Published
2023
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12. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

Author

Kamilia, Chtara, Regaieg, Kais, Baccouch, Najeh, Chelly, Hedi, Bahloul, Mabrouk, Bouaziz, Mounir, Jendoubi, Ali, Abbes, Ahmed, Belhaouane, Houda, Nasri, Oussama, Jenzri, Layla, Ghedira, Salma, Houissa, Mohamed, Belkadi, Kamal, Harti, Youness, Nsiri, Afak, Khaleq, Khalid, Hamoudi, Driss, Harrar, Rachid, Thieffry, Camille, Wallet, Frédéric, Parmentier-Decrucq, Erika, Favory, Raphaël, Mathieu, Daniel, Poissy, Julien, Lafon, Thomas, Vignon, Philippe, Begot, Emmanuelle, Appert, Alexandra, Hadj, Mathilde, Claverie, Paul, Matt, Morgan, Barraud, Olivier, François, Bruno, Jamoussi, Amira, Jazia, Amira Ben, Marhbène, Takoua, Lakhdhar, Dhouha, Khelil, Jalila Ben, Besbes, Mohamed, Goutay, Julien, Blazejewski, Caroline, Joly-Durand, Isabelle, Pirlet, Isabelle, Weillaert, Marie Pierre, Beague, Sebastien, Aziz, Soufi, Hafiane, Reda, Hattabi, Khalid, Bouhouri, Mohamed Aziz, Hammoudi, Driss, Fadil, Abdelaziz, Harrar, Rachid Al, Zerouali, Khalid, Medhioub, Fatma Kaaniche, Allela, Rania, Algia, Najla Ben, Cherif, Samar, Slaoui, Mohamed Taoufik, Boubia, Souhail, Hafiani, Y., Khaoudi, A., Cherkab, R., Elallam, W., Elkettani, C., Barrou, L., Ridaii, M., Mehdi, Rihi El, Schimpf, Caroline, Mizrahi, Assaf, Pilmis, Benoît, Le Monnier, Alban, Tiercelet, Kelly, Cherin, Mélanie, Bruel, Cédric, Philippart, Francois, Bailly, Sébastien, Lucet, Jc, Lepape, Alain, L’hériteau, François, Aupée, Martine, Bervas, Caroline, Boussat, Sandrine, Berger-Carbonne, Anne, Machut, Anaïs, Savey, Anne, Timsit, Jean-François, Razazi, Keyvan, Rosman, Jérémy, de Prost, Nicolas, Carteaux, Guillaume, Jansen, Chloe, Decousser, Jean Winoc, Brun-Buisson, Christian, Dessap, Armand Mekontso, M’rad, Aymen, Ouali, Zouhour, Barghouth, Manel, Kouatchet, Achille, Mahieu, Rafael, Weiss, Emmanuel, Schnell, David, Zahar, Jean-Ralph, Artiguenave, Margaux, Sophie, Paktoris-Papine, Espinasse, Florence, Sayed, Faten El, Dinh, Aurélien, Charron, Cyril, Geri, Guillaume, Vieillard-Baron, Antoine, Repessé, Xavier, Kallel, Hatem, Mayence, Claire, Houcke, Stéphanie, Guegueniat, Pascal, Hommel, Didier, Dhifaoui, Kaouther, Hajjej, Zied, Fatnassi, Amira, Sellami, Walid, Labbene, Iheb, Ferjani, Mustapha, Dachraoui, Fahmi, Nakkaa, Sabrine, M’ghirbi, Abdelwaheb, Adhieb, Ali, Braiek, Dhouha Ben, Hraiech, Kmar, Ousji, Ali, Ouanes, Islem, Zaineb, Hammouda, Abdallah, Saousen Ben, Ouanes-Besbes, Lamia, Abroug, Fekri, Klein, Simon, Miquet, Mattéo, Thouret, Jean-Marc, Peigne, Vincent, Daban, Jean-Louis, Boutonnet, Mathieu, Lenoir, Bernard, Merhbene, Takoua, Derreumaux, Celine, Seguin, Thierry, Conil, Jean-Marie, Kelway, Charlotte, Blasco, Valery, Nafati, Cyril, Harti, Karim, Reydellet, Laurent, Albanese, Jacques, Aicha, Narjess Ben, Meddeb, Khaoula, Khedher, Ahmed, Ayachi, Jihene, Fraj, Nesrine, Sma, Nesrine, Chouchene, Imed, Boussarsar, Mohamed, Yedder, Soumaya Ben, Samoud, Walid, Radhouene, Bousselmi, Mariem, Bousselmi, Ammar, Asma, Cheikh, Asma Ben, Lakhal, Hend Ben, Khelfa, Messaouda, Hamdaoui, Yamina, Bouafia, Nabiha, Trampont, Timothée, Daix, Thomas, Legarçon, Vincent, Karam, Henri Hani, Pichon, Nicolas, Essafi, Fatma, Foudhaili, Nasreddine, Thabet, Hafedh, Blel, Youssef, Brahmi, Nozha, Ezzouine, Hanane, Kerrous, Mahmoud, Haoui, Saad El, Ahdil, Soufiane, Benslama, Abdellatif, Abidi, Khalid, Dendane, Tarek, Oussama, Ssouni, Belayachi, Jihane, Madani, Naoufal, Abouqal, Redouane, Zeggwagh, Amine Ali, Ghadhoune, Hatem, Chaari, Anis, Jihene, Guissouma, Allouche, Hend, Trabelsi, Insaf, Brahmi, Habib, Samet, Mohamed, Ghord, Hatem El, Habiba, Ben Sik Ali, Hajer, Nouira, Tilouch, Najla, Yaakoubi, Sondes, Jaoued, Oussama, Gharbi, Rim, Hassen, Mohamed Fekih, Elatrous, Souheil, Arcizet, Julien, Leroy, Bertrand, Abdulmalack, Caroline, Renzullo, Catherine, Hamet, Maël, Doise, Jean-Marc, Coutet, Jérôme, Cheikh, Chaigar Mohammed, Quechar, Zakaria, Joris, Magalie, Beauport, Dimitri Titeca, Kontar, Loay, Lebon, Delphine, Gruson, Bérengère, Slama, Michel, Marolleau, Jean-Pierre, Maizel, Julien, Gorham, Julie, Ameye, Lieveke, Berghmans, Thierry, Paesmans, Marianne, Sculier, Jean-Paul, Meert, Anne-Pascale, Guillot, Max, Ledoux, Marie-Pierre, Braun, Thierry, Maestraggi, Quentin, Michard, Baptiste, Castelain, Vincent, Herbrecht, Raoul, Schneider, Francis, Couffin, Severine, Lobo, David, Mongardon, Nicolas, Dhonneur, Gilles, Mounier, Roman, Le Borgne, Pierrick, Couraud, Sophie, Herbrecht, Jean-Etienne, Boivin, Alexandra, Lefebvre, François, Bilbault, Pascal, Zelmat, Setti-Aouicha, Batouche, Djamila-Djahida, Mazour, Fatima, Chaffi, Belkacem, Benatta, Nadia, Sik, Ali Habiba, Talik, I., Perrier, Maxime, Gouteix, Eliane, Koubi, Claude, Escavy, Annabelle, Guilbaut, Victoria, Fosse, Jean-Philippe, Jazia, Rahma Ben, Abdelghani, Ahmed, Cungi, Pierre-Julien, Bordes, Julien, Nguyen, Cédric, Pierrou, Candice, Cruc, Maximilien, Benois, Alain, Duprez, Frédéric, Bonus, Thierry, Cuvelier, Grégory, Ollieuz, Sandra, Machayekhi, Sharam, Paciorkowski, Frédéric, Reychler, Gregory, Coudroy, Remi, Thille, Arnaud W., Drouot, Xavier, Diaz, Véronique, Meurice, Jean-Claude, Robert, René, Turki, Olfa, Ben, Hmida Chokri, Assefi, Mona, Deransy, Romain, Brisson, Hélène, Monsel, Antoine, Conti, Filomena, Scatton, Olivier, Langeron, Olivier, Ghezala, Hassen Ben, Snouda, Salah, Ben, Chiekh Imen, Kaddour, Moez, Armel, Anwar, Youness, Lafrikh, Abdelhak, Bensaid, Youssef, Miloudi, Najib, Al Harrar, Mustapha, Amouzoun, Noufel, Mtioui, Mohamed, Zamd, Salma, El Khayat, Ghizlane, Medkouri, Mohamed, Benghanam, Benyounes, Ramdani, Montini, Florent, Moschietto, Sébastien, Gregoire, Emilien, Claisse, Guillaume, Guiot, Julien, Morimont, Philippe, Krzesinski, Jean-Marie, Mariat, Christophe, Lambermont, Bernard, Cavalier, Etienne, Delanaye, Pierre, Benbernou, Soumia, Ilies, Sofiane, Azza, Abdelkader, Bouyacoub, Khalida, Louail, Meriem, Mokhtari-Djebli, Houria, Arrestier, Romain, Daviaud, Fabrice, Francois, Xavier Laborne, Brocas, Elsa, Choukroun, Gérald, Peñuelas, Oscar, Lorente, José-Angel, Cardinal-Fernandez, Pablo, Rodriguez, José-Maria, Aramburu, José-Antonio, Esteban, Andres, Frutos-Vivar, Fernando, Bitker, Laurent, Costes, Nicolas, Le Bars, Didier, Lavenne, Franck, Devouassoux, Mojgan, Richard, Jean-Christophe, Mechati, Malika, Gainnier, Marc, Papazian, Laurent, Guervilly, Christophe, Garnero, Aude, Arnal, Jean Michel, Roze, Hadrien, Richard, Jean Christophe, Repusseau, Benjamin, Dewitte, Antoine, Joannes-Boyau, Olivier, Ouattara, Alexandre, Harbouze, Nadia, Amine, A. M., Olandzobo, A. G., Herbland, Alexandre, Richard, Marie, Girard, Nicolas, Lambron, Lucile, Lesieur, Olivier, Wainschtein, Sarah, Hubert, Sidonie, Hugues, Albane, Tran, Marc, Bouillard, Philippe, Loteanu, Vlad, Leloup, Maxime, Laurent, Alexandra, Lheureux, Florent, Prestifilippo, Alessia, Cruz, Martin Delgado Maria, Romain, Rigal, Antonelli, Massimo, Blanch, Torra Lluis, Bonnetain, Franck, Grazzia-Bocci, Maria, Mancebo, Jordi, Samain, Emmanuel, Paul, Hebert, Capellier, Gilles, Zavgorodniaia, Taissa, Soichot, Marion, Malissin, Isabelle, Voicu, Sebastian, Garçon, Pierre, Goury, Antoine, Kerdjana, Lamia, Deye, Nicolas, Bourgogne, Emmanuel, Megarbane, Bruno, Mejri, Olfa, Hmida, Marwa Ben, Tannous, Salma, Chevillard, Lucie, Labat, Laurence, Risede, Patricia, Fredj, Hana, Léger, Maxime, Brunet, Marion, Le Roux, Gaël, Boels, David, Lerolle, Nicolas, Farah, Souaad, Amiel-Niemann, Hélène, Kubis, Nathalie, Declèves, Xavier, Peyraux, Nicoals, Baud, Frederic, Serafini, Micaela, Alvarez, Jean-Claude, Heinzelman, Annette, Jozwiak, Mathieu, Millasseau, Sandrine, Teboul, Jean-Louis, Alphonsine, Jean-Emmanuel, Depret, François, Richard, Nathalie, Attal, Pierre, Richard, Christian, Monnet, Xavier, Chemla, Denis, Jerbi, Salma, Khedhiri, Wafa, Necib, Hatem, Scarfo, Paolo, Chevalier, Charles, Piagnerelli, Michael, Lafont, Alexandre, Galy, Antoine, Mancia, Claire, Zerhouni, Amel, Tabeliouna, Kheira, Gaja, Ali, Hamrouni, Bassem, Malouch, Abir, Fourati, Sami, Messaoud, Rihab, Zarrouki, Youssef, Ziadi, Amra, Rhezali, Manal, Zouizra, Zahira, Boumzebra, Drissi, Samkaoui, Mohamed Abdennasser, Brunet, Jennifer, Canoville, Bertrand, Verrier, Pierre, Ivascau, Calin, Seguin, Amélie, Valette, Xavier, Du Cheyron, Damien, Daubin, Cedric, Bougouin, Wulfran, Aissaoui, Nadia, Lamhaut, Lionel, Jost, Daniel, Maupain, Carole, Beganton, Frankie, Bouglé, Adrien, Dumas, Florence, Marijon, Eloi, Jouven, Xavier, Cariou, Alain, Poirson, Florent, Chaput, Ulriikka, Beeken, Thomas, Maxime, Leclerc, Haikel, Oueslati, Vodovar, Dominique, Chelly, Jonathan, Marteau, Philippe, Chocron, Richard, Juvin, Philippe, Loeb, Thomas, Adnet, Frederic, Lecarpentier, Eric, Riviere, Antoine, De Cagny, Bertand, Soupison, Thierry, Privat, Elodie, Escutnaire, Joséphine, Dumont, Cyrielle, Baert, Valentine, Vilhelm, Christian, Hubert, Hervé, Leteurtre, Stéphane, Fresco, Marion, Bubenheim, Michael, Beduneau, Gaetan, Carpentier, Dorothée, Grange, Steven, Artaud-Macari, Elise, Misset, Benoit, Tamion, Fabienne, Girault, Christophe, Dumas, Guillaume, Chevret, Sylvie, Lemiale, Virginie, Mokart, Djamel, Mayaux, Julien, Pène, Frédéric, Nyunga, Martine, Perez, Pierre, Moreau, Anne-Sophie, Bruneel, Fabrice, Vincent, François, Klouche, Kada, Reignier, Jean, Rabbat, Antoine, Azoulay, Elie, Frat, Jean-Pierre, Ragot, Stéphanie, Constantin, Jean-Michel, Prat, Gwenael, Mercat, Alain, Boulain, Thierry, Demoule, Alexandre, Devaquet, Jérôme, Nseir, Saad, Charpentier, Julien, Argaud, Laurent, Beuret, Pascal, Ricard, Jean-Damien, Teiten, Christelle, Marjanovic, Nicolas, Palamin, Nicola, L’Her, Erwan, Bailly, Arthur, Boisramé-Helms, Julie, Champigneulle, Benoit, Kamel, Toufik, Mercier, Emmanuelle, Le Thuaut, Aurélie, Lascarrou, Jean-Baptiste, Rolle, Amélie, De Jong, Audrey, Chanques, Gérald, Jaber, Samir, Hariri, Geoffroy, Baudel, Jean-Luc, Dubée, Vincent, Preda, Gabriel, Bourcier, Simon, Joffre, Jeremie, Bigé, Naïke, Ait-Oufella, Hafid, Maury, Eric, Mater, Houda, Merdji, Hamid, Grimaldi, David, Rousseau, Christophe, Mira, Jean-Paul, Chiche, Jean-Daniel, Sedghiani, Ines, Benabderrahim, A., Hamdi, Dhekra, Jendoubi, Asma, Cherif, Mohamed Ali, Hechmi, Youssef Zied El, Zouheir, Jerbi, Bagate, François, Bousselmi, Radhwen, Schortgen, Frédérique, Asfar, Pierre, Guérot, Emmanuel, Fabien, Grelon, Anguel, Nadia, Sigismond, Lasocki, Matthieu, Henry-Lagarrigue, Gonzalez, Frédéric, François, Legay, Guitton, Christophe, Schenck, Maleka, Jean-Marc, Doise, Dreyfuss, Didier, Radermacher, Peter, Frère, Antoine, Martin-Lefèvre, Laurent, Colin, Gwenhaël, Fiancette, Maud, Henry-Laguarrigue, Matthieu, Lacherade, Jean-Claude, Lebert, Christine, Vinatier, Isabelle, Yehia, Aihem, Joret, Aurélie, Menunier-Beillard, Nicolas, Benzekri-Lefevre, Dalila, Desachy, Arnaud, Bellec, Fréderic, Plantefève, Gaëtan, Quenot, Jean-Pierre, Meziani, Ferhat, Tavernier, Elsa, Ehrmann, Stephan, Chudeau, Nicolas, Raveau, Tommy, Moal, Valérie, Houillier, Pascal, Rouve, Emmanuelle, Lakhal, Karim, Gandonnière, Charlotte Salmon, Jouan, Youenn, Bodet-Contentin, Laetitia, Balmier, Adrien, Messika, Jonathan, De Montmollin, Etienne, Pouyet, Victorine, Sztrymf, Benjamin, Thiagarajah, Abirami, Roux, Damien, De Chambrun, Marc Pineton, Luyt, Charles-Edouard, Beloncle, François, Zapella, Nathalie, Ledochowsky, Stanislas, Terzi, Nicolas, Mazou, Jean-Marc, Sonneville, Romain, Paulus, Sylvie, Fedun, Yannick, Landais, Mickael, Raphalen, Jean-Herlé, Combes, Alain, Amoura, Zahir, Jacquemin, Aemilia, Guerrero, Felipe, Marcheix, Bertrand, Hernandez, Nicolas, Fourcade, Olivier, Georges, Bernard, Delmas, Clément, Makoudi, Sarah, Genton, Audrey, Bernard, Rémy, Lebreton, Guillaume, Amour, Julien, Mazet, Charlotte, Bounes, Fanny, Murat, Gurbuz, Cronier, Laure, Robin, Guillaume, Biendel, Caroline, Silva, Stein, Boubeche, Samia, Abriou, Caroline, Wurtz, Véronique, Scherrer, Vincent, Rey, Nathalie, Gastaldi, Gioia, Veber, Benoit, Doguet, Fabien, Gay, Arnaud, Dureuil, Bertrand, Besnier, Emmanuel, Rouget, Antoine, Gantois, Guillaume, Magalhaes, Eric, Wanono, Ruben, Smonig, Roland, Lermuzeaux, Mathilde, Lebut, Jordane, Olivier, Andremont, Dupuis, Claire, Radjou, Aguila, Mourvillier, Bruno, Neuville, Mathilde, D’ortho, Marie Pia, Bouadma, Lila, Rouvel-Tallec, Anny, Rudler, Marika, Weiss, Nicolas, Perlbarg, Vincent, Galanaud, Damien, Thabut, Dominique, Rachdi, Emna, Mhamdi, Ghada, Trifi, Ahlem, Abdelmalek, Rim, Abdellatif, Sami, Daly, Foued, Nasri, Rochdi, Tiouiri, Hanene, Lakhal, Salah Ben, Rousseau, Geoffroy, Asmolov, Romain, Grammatico-Guillon, Leslie, Auvet, Adrien, Laribi, Said, Garot, Denis, Dequin, Pierre François, Guillon, Antoine, Fergé, Jean-Louis, Abgrall, Gwénolé, Hinault, Ronan, Vally, Shazima, Roze, Benoit, Chaplain, Agathe, Chabartier, Cyrille, Savidan, Anne-Charlotte, Marie, Sabia, Cabie, Andre, Resiere, Dabor, Valentino, Ruddy, Mehdaoui, Hossein, Benarous, Lucas, Soda-Diop, Marième, Bouzana, Fouad, Perrin, Gilles, Bourenne, Jeremy, Eon, Béatrice, Lambert, Dominique, Trebuchon, Agnes, Poncelet, Géraldine, Le Bourgeois, Fleur, Michael, Levy, Camille, Guillot, Naudin, Jérôme, Deho, Anna, Dauger, Stéphane, Sauthier, Michaël, Bergeron-Gallant, Krystale, Emeriaud, Guillaume, Jouvet, Philippe, Tiebergien, Nicolas, Jacquet-Lagrèze, Matthias, Fellahi, Jean-Luc, Baudin, Florent, Essouri, Sandrine, Javouhey, Etienne, Guérin, Claude, Lampin, Marie, Mamouri, Ouardia, Devos, Patrick, Karaca-Altintas, Yasemin, Vinchon, Matthieu, Brossier, David, Eltaani, Redha, Teyssedre, Sonia, Sabine, Meyet, Bouchut, Jean-Christophe, Peguet, Olivier, Petitdemange, Lucie, Guilbert, Anne Sophie, Aoul, Nabil Tabet, Addou, Zakaria, Aouffen, Nabil, Anas, Benqqa, Kalouch, Samira, Yaqini, Khalid, Chlilek, Aziz, Abdou, Rchi, Gravellier, Perrine, Chantreuil, Julie, Travers, Nadine, Listrat, Antoine, Le Reun, Claire, Favrais, Geraldine, Coppere, Zoe, Blanot, Stéphane, Montmayeur, Juliette, Bronchard, Régis, Rolando, Stephane, Orliaguet, Gilles, Leger, Pierre-Louis, Rambaud, Jérôme, Thueux, Emilie, De Larrard, Alexandra, Berthelot, Véronique, Denot, Julien, Reymond, Marie, Amblard, Alain, Morin-Zorman, Sarah, Lengliné, Etienne, Pichereau, Claire, Mariotte, Eric, Emmanuel, Canet, Poujade, Julien, Trumpff, Guillaume, Janssen-Langenstein, Ralf, Harlay, Marie-Line, Zaid, Noorah, Ait-Ammar, Nawel, Bonnal, Christine, Merle, Jean-Claude, Botterel, Francoise, Levesque, Eric, Riad, Zakaria, Mezidi, Mehdi, Yonis, Hodane, Aublanc, Mylène, Perinel-Ragey, Sophie, Lissonde, Floriane, Louf-Durier, Aurore, Tapponnier, Romain, Louis, Bruno, Forel, Jean-Marie, Bisbal, Magali, Lehingue, Samuel, Rambaud, Romain, Adda, Mélanie, Hraiech, Sami, Marchi, Elisa, Roch, Antoine, Guerin, Vincent, Rozencwajg, Sacha, Schmidt, Matthieu, Hekimian, Guillaume, Bréchot, Nicolas, Trouillet, Jean Louis, Besset, Sébastien, Franchineau, Guillaume, Nieszkowska, Ania, Pascal, Leprince, Loiselle, Maud, Sarah, Chemam, Laurence, Dangers, Guillemette, Thomas, Jacquens, Alice, Kerever, Sebastien, Guidet, Bertrand, Aegerter, Philippe, Das, Vincent, Fartoukh, Muriel, Hayon, Jan, Desmard, Mathieu, Fulgencio, Jean-Pierre, Zuber, Benjamin, Soufi, A., Khaleq, K., Hamoudi, D., Garret, Charlotte, Peron, Matthieu, Coron, Emmanuel, Bretonnière, Cédric, Audureau, Etienne, Audrey, Winters, Christophe, Duvoux, Christian, Jacquelinet, Daniel, Azoulay, Cyrille, Feray, Aissaoui, Wissal, Rghioui, Kawtar, Haddad, Wafae, Barrou, Houcine, Carteaux-Taeib, Anna, Lupinacci, Renato, Manceau, Gilles, Jeune, Florence, Tresallet, Christophe, Habacha, Sahar, Fathallah, Ines, Zoubli, Aymen, Aloui, Rafaa, Kouraichi, Nadia, Jouet, Emilie, Badin, Julie, Fermier, Brice, Feller, Marc, Serie, Mathieu, Pillot, Jérôme, Marie, William, Gisbert-Mora, Chloé, Vinclair, Camille, Lesbordes, Pierre, Mathieu, Pascal, De Brabant, Fabienne, Muller, Emmanuel, Robaux, Marie-Aline, Giabicani, Mikhael, Marchalot, Antoine, Gelinotte, Stéphanie, Declercq, Pierre Louis, Eraldi, Jean-Pierre, Bougerol, François, Meunier-Beillard, Nicolas, Devilliers, Hervé, Rigaud, Jean-Philippe, Verrière, Camille, Ardisson, Fanny, Kentish-Barnes, Nancy, Jacq, Gwenaëlle, Chermak, Akli, Lautrette, Alexandre, Legrand, Matthieu, Soummer, Alexis, Thiery, Guillaume, Cottereau, Alice, Canet, Emmanuel, Caujolle, Marie, Allyn, Jérôme, Valance, Dorothée, Brulliard, Caroline, Martinet, Olivier, Jabot, Julien, Gallas, Thomas, Vandroux, David, Allou, Nicolas, Durand, Arthur, Nevière, Rémi, Delguste, Florian, Boulanger, Eric, Preau, Sebastien, Martin, Ruste, Cochet, Hélène, Ponthus, Jean Pierre, Amilien, Virginie, Tchir, Martial, Barsam, Elise, Ayoub, Mohsen, Georger, Jean Francois, Guillame, Izaute, Assaraf, Julie, Tripon, Simona, Mallet, Maxime, Barbara, Guilaume, Louis, Guillaume, Gaudry, Stéphane, Barbarot, Nicolas, Jamet, Angéline, Outin, Hervé, Gibot, Sébastien, Bollaert, Pierre-Edouard, Holleville, Mathilde, Legriel, Stéphane, Chateauneuf, Anne Laure, Cavelot, Sébastien, Moyer, Jean-Denis, Bedos, Jean Pierre, Merle, Philippe, Laine, Aurelie, Natalie, De Sa, Cornuault, Mathieu, Libot, Jérome, Asehnoune, Karim, Rozec, Bertrand, Dantal, Jacques, Videcoq, Michel, Degroote, Thècle, Jaillette, Emmanuelle, Zerimech, Farid, Malika, Balduyck, Llitjos, Jean-François, Amara, Marlène, Lacave, Guillaume, Pangon, Béatrice, Mavinga, José, Makunza, Joseph Nsiala, Mafuta, M. E., Yanga, Yves, Eric, Amisi, Ilunga, Jp, Kilembe, Ma, Alby-Laurent, Fanny, Toubiana, Julie, Mokline, Amel, Laajili, Achraf, Amri, Helmi, Rahmani, Imene, Mensi, Nidhal, Gharsallah, Lazheri, Tlaili, Sofiene, Gasri, Bahija, Hammouda, Rym, Messadi, Amen Allah, Allain, Pierre-Antoine, Gault, Nathallie, Paugam-Burtz, Catherine, Foucrier, Arnaud, Chatbri, Bassem, Bourbiaa, Yousra, Thabet, Lamia, Neuschwander, Arthur, Vincent, Looten, Beck, Jennifer, Vibol, Chhor, Amelie, Yavchitz, Resche-Rigon, Matthieu, Pirracchio, Jean MantzRomain, Bureau, Côme, Decavèle, Maxens, Campion, Sébastien, Ainsouya, Roukia, Niérat, Marie-Cécile, Prodanovic, Hélène, Raux, Mathieu, Similowski, Thomas, Dubé, Bruno-Pierre, Demiri, Suela, Dres, Martin, May, Faten, Quintard, Hervé, Kounis, Ilias, Saliba, Faouzi, André, Stephane, Boudon, Marc, Ichai, Philippe, Younes, Aline, Nakad, Lionel, Coilly, Audrey, Antonini, Teresa, Sobesky, Rodolphe, De Martin, Eleonora, Samuel, Didier, Hubert, Noemie, Nay, Mai-Anh, Auchabie, Johann, Giraudeau, Bruno, Jean, Reignier, Darmon, Michaël, Ruckly, Stephane, Garrouste-Orgeas, Maïté, Gratia, Elisabeth, Goldgran-Toledano, Dany, Jamali, Samir, Dumenil, Anne Sylvie, Schwebel, Carole, Brisard, Laurent, Bizouarn, Philippe, Lepoivre, Thierry, Nicolet, Johanna, Rigal, Jean Christophe, Roussel, Jean Christian, Cheurfa, Cherifa, Abily, Julien, Lescot, Thomas, Page, Isaline, Warnier, Stéphanie, Nys, Monique, Rousseau, Anne-Françoise, Damas, Pierre, Uhel, Fabrice, Lesouhaitier, Mathieu, Grégoire, Murielle, Gaudriot, Baptiste, Gacouin, Arnaud, Le Tulzo, Yves, Flecher, Erwan, Tarte, Karin, Tadié, Jean-Marc, Georges, Quentin, Soares, M., Jeon, Kyeongman, Oeyen, Sandra, Rhee, Chin Kook, Gruber, Pascale, Ostermann, Marlies, Hill, Quentin, Depuydt, Peter, Ferra, Christelle, Muller, Alice, Aurelie, Bourmaud, Niles, Christopher, Herbert, Fabien, Pied, Sylviane, Loridant, Séverine, François, Nadine, Bignon, Anne, Sendid, Boualem, Lemaitre, Caroline, Dupre, Celine, Zayene, Aymen, Portier, Lucie, De Freitas Caires, Nathalie, Lassalle, Philippe, Le Neindre, Aymeric, Selot, Pascal, Ferreiro, Daniel, Bonarek, Maria, Henriot, Stépahen, Rodriguez, Julie, Taddei, Mara, Di Bari, Mauro, Hickmann, Cheryl, Castanares-Zapatero, Diego, Deldicque, Louise, Van Den Bergh, Peter, Caty, Gilles, Roeseler, Jean, Francaux, Marc, Laterre, Pierre-François, Dupuis, Bastien, Machayeckhi, Sharam, Sarfati, Celine, Moore, Alex, Mendialdua, Paula, Rodet, Emilie, Pilorge, Catherine, Stephan, Francois, Rezaiguia-Delclaux, Saida, Dugernier, Jonathan, Hesse, Michel, Jumetz, Thibaud, Bialais, Emilie, Depoortere, Virginie, Michotte, Jean Bernard, Wittebole, Xavier, Jamar, François, REA‑RAISIN Studygroup, OUTCOMEREA study group, Sudden Death Expertise Center, for the HYPER2S Investigators and REVA research network, Clinical Research in Intensive Care and Sepsis (CRICS network), Cubrea network, and Brain Liver Pitié-Salpêtrière Study Group (BLIPS)

Published
2017
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13. Scombrotoxisme : expérience des centres antipoison de France de 2012 à 2021

Author

Azzouz, Ramy, Nisse, Patrick, Chevalier, Cécile, Paradis, Camille, Blanc, Ingrid, Nardon, Audrey, Torrents, Romain, Schmitt, Corine, Battefort, Florent, Puskarczyk, Emmanuel, Laborde, Hervé, Caré, Weniko, Vodovar, Dominique, Lecot, Jérémy, Legeay, Marion, Deguigne, Marie, Jarrige, Xavier, Glaizal, Mathieu, Sinno-Tellier, Sandra, Boels, David, Delcourt, Nicolas, Labadie, Magali, Langrand, Jérôme, Le Roux, Gaël, Paret, Nathalie, Tournoud, Christine, Simon, Nicolas, and de Haro, Luc

Published
2023
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17. Human poisonings by neurotoxic phycotoxins related to the consumption of shellfish: study of cases registered by the French Poison Control Centres from 2012 to 2019

Author

Sinno-tellier, Sandra, Abadie, Eric, De Haro, Luc, Paret, Nathalie, Langrand, Jérôme, Le Roux, Gaël, Labadie, Magali, Boels, David, Bloch, Juliette, Delcourt, Nicolas, Sinno-tellier, Sandra, Abadie, Eric, De Haro, Luc, Paret, Nathalie, Langrand, Jérôme, Le Roux, Gaël, Labadie, Magali, Boels, David, Bloch, Juliette, and Delcourt, Nicolas

Abstract

Context In June 2019, a paralytic shellfish poisoning (PSP) case related to the consumption of mussels contaminated by saxitoxins at a concentration below the regulatory threshold came to the attention of the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). This pointed to probable undetected human cases of poisoning by neurotoxic phycotoxins. Methods We conducted a retrospective study of poisoning cases by bivalve shellfish (oysters, mussels and scallops) recorded by the French Poison Control Centres (PCC) from 2012 to 2019. All medical records were reviewed by a toxicologist. Cases that could be related to neurotoxic phycotoxins were selected and described. Diagnosis was based on symptoms compatible with ingestion of contaminated shellfish and on contamination data for the shellfish production area (analysed by the French Research Institute for Exploitation of the Sea, Ifremer), or notifications to the European Rapid Alert System for Food and Feed when the origin of the shellfish was known. Results Among the 619 shellfish poisoning cases recorded by the PCCs from 2012 to 2019, 22% (n = 134) had reported at least one neurological symptom (headache, dizziness or paraesthesia). Review of medical records for the 134 patients led to suspicion of 14 cases of PSP and one case of amnesic shellfish poisoning. Five patients experienced persistent neurological symptoms. Marine toxins were not tested for in the blood or urine of these patients. Conclusion This retrospective identification of cases strongly suspected of being related to neurotoxic phycotoxins led ANSES, PCCs and Ifremer to develop a specific questionnaire and to recommend actions to take when neurological symptoms related to shellfish consumption are reported to a PCC. Daily monitoring of shellfish poisoning cases registered in the national PCCs database was also implemented in order to rapidly detect any suspicious cases, alert the competent authorities, and warn the general p

Published
2022
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26. Case report on two-cathinones abuse: MPHP and N-ethyl-4′methylnorpentedrone, with a fatal outcome

Author

Iwanikow Deborah, Coulon Audrey, Allorge Delphine, Deguigne Marie, Ferec Severine, Drevin Guillaume, Brofferio Morgan, Gaulier Jean-Michel, Richeval Camille, Jousset Nathalie, Boels David, and Lelievre Benedicte

Subjects
Fatal outcome, Chromatography, Chemistry, 010401 analytical chemistry, Biochemistry (medical), Blood ethanol, Context (language use), Urine, Toxicology, Mass spectrometry, 01 natural sciences, Diode array, 0104 chemical sciences, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, medicine, 030216 legal & forensic medicine, Gas chromatography, Tetrahydrocannabinol, medicine.drug
Abstract

The correlation between the rising consumption of new psychoactive drugs (NPS), including that of cathinones, and the occurrence of death has not been sufficiently backed up with published analytic data. In fact, the identification of cathinones in human biological samples remains difficult mainly due to the diversity of these substances and their high turnover. In this context, this manuscript aims at documenting a fatal case of a 39-year-old man: autopsy findings consisted in unspecific asphyxic syndrome. Blood ethanol concentration determination and toxicological screenings were performed using gas chromatography with flame ionization detection, liquid chromatography with diode array detection and gas chromatography with mass spectrometry detection, respectively. Liquid chromatography with high-resolution mass spectrometry detection allowed the confirmation of the presence of NPS and the subsequent metabolic study. The analyses have shown the presence of ethanol, tetrahydrocannabinol and two cathinones, 4′-methyl-α-pyrrolidinohexanophenone (MPHP) and N-ethyl-4′-methylnorpentedrone (4-MEAP). MPHP/4-MEAP concentrations were 47/1.6, 97/3.5 and 2380/49,700 µg/L in femoral blood, cardiac blood and urine, respectively. The in vitro metabolic study has highlighted the presence of five metabolites derived from MPHP and three from 4-MEAP but only two metabolites of these products have been detected in biological samples. The 4′-carboxy-PHP, one of the metabolites of MPHP, was detected in every biological sample with higher chromatographic signals than MPHP itself. The number of fatalities related to cathinones use is expected to increase in the coming years. This manuscript reports useful analytical data about MPHP, one of its metabolites (4′-carboxy-PHP) and 4-MEAP.

Published
2019

27. Réseau bayésien en toxicologie clinique Gradation de l'envenimation vipérine

Author

Mazzobel, Giovanni, Boels, David, Leray, Philippe, Laboratoire des Sciences du Numérique de Nantes (LS2N), Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Service de Pharmacologie Clinique [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), PILGRIM, IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), and Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[INFO.INFO-LG]Computer Science [cs]/Machine Learning [cs.LG], Réseau bayésien, toxicologie clinique, envenimation vipérine
Abstract

National audience; En toxicologie clinique, la gradation des cas d'envenimations vipérine nécessite une expertise accrue. Pour répondreà ces besoins, un système clinique d'aideà la décision aété initié reposant sur un moteur d'inférence par les règles. L'utilisation de celui-ci nécessite une réponse exhaustivè a toutes les entrées du système, ne prend pas en compte l'incertitude et possède un questionnement fixe et non adapté aux réponses de l'utilisateur. Nous avons initié le développement d'un réseau bayésien, capable de reproduire la logique clinique et offrant des résultats similaires au système actuel. Nous nous sommes appuyées sur une méthode de construction mixte. Nous avons testé le système en condition d'entrées exhaustives pour mesurer la performance du modèle et observé une technique d'ordonnancement des questions basé sur la maximisation de l'information mutuelle entre les variables d'entrées et la sortie du réseau. En comparant l'entropie du noeud de sortie entre l'ordre actuel et l'ordre modulé par les réponses. Le système offre des performances similaires en condition exhaustive. Sur les 12 questions poséesà l'utilisateur, l'entropie est réduite significativement (p-value

Published
2021

28. Ciguatera - Bilan des cas enregistrés par les Centres antipoison en 2020

Author

de Haro, Luc, Le Roux, Gaël, Abadie, Eric, Boels, David, Delcourt, Nicolas, Maillot, Adrien, Oliva-Labadie, Magali, Langrand, Jérôme, Guitton, Jérôme, Michel, Sylvie, Paret, Nathalie, Sinno-Tellier, Sandra, and Druesne, Christine

Subjects
Ciguatoxins, Ciguatoxines, [SDV] Life Sciences [q-bio], Poison control center, Ciguatera, Toxicovigilance, Ciguatera fish poisoning, Centre anti-poison, Outre-Mer, French overseas territories
Abstract

La ciguatera est une intoxication alimentaire due à la consommation de poissons contaminés par la présence de toxines marines, les ciguatoxines, produites par des algues microscopiques présentes dans les récifs coralliens. Les toxines sont ingérées par des petits poissons herbivores, eux-mêmes ingérés par de plus gros poissons carnivores, que l'Homme peut consommer. L'intoxication sévit dans eaux les chaudes des régions tropicales et intertropicales du Pacifique, des Caraïbes et des Antilles, d’Océanie et de l’Océan-Indien (Auvigne 2021). Depuis quelques années, des cas de ciguatera ont été rapportés avec une fréquence croissante en Europe, en particulier dans les îles espagnoles et portugaises de l'Atlantique (Macaronésie).En France, les intoxications par des ciguatoxines doivent être déclarées dans le cadre de la déclaration obligatoire de Toxi-intoxication alimentaire collective (TIAC) aux Agences régionales de santé (ARS) et/ou aux Directions départementales de la protection des populations (DDPP). Santé Publique France (SPF) analyse chaque année les caractéristiques épidémiologiques des TIAC et des facteurs ayant pu contribuer à leur survenue (Fournet et al. 2021). La gestion et l’amélioration du contrôle du risque de contamination par des ciguatoxines dans les produits de la pêche nécessite l'acquisition régulière de nouvelles données sur les espèces de poissons impliquées, les zones de pêche et la symptomatologie des cas humains. Ces éléments sont indispensables pour évaluer et faire évoluer, sous la responsabilité de la Direction générale de l’alimentation (DGAL), les mesures de gestion mises en place, notamment par des arrêtés préfectoraux interdisant la pêche/vente d'espèces à risque et/ou issues de zones à risque, tel qu'il en existe aujourd'hui en Guadeloupe, à La Réunion et à Mayotte.Dans ce contexte, la DGAL a sollicité en juillet 2020 les différents réseaux de recueil de données sanitaires sur les cas de ciguatera observés en France.Le Centre antipoison (CAP) de Marseille a publié en 2020 un bilan de 25 ans d’expérience de son service concernant la ciguatera (de Haro et al. 2020). Le CAP de Marseille a ensuite mené, avec l’ensemble du réseau des CAP français, destinataire des appels issus de métropole comme d’Outre-mer , une étude rétrospective nationale incluant tous les cas de ciguatera enregistrés par les CAP de 2012 à 2019 (de Haro et al. 2021). Cette étude, qui a porté sur 52 « dossiers » ou « repas » impliquant au total 130 personnes (un même repas pouvant concerner de 1 à 15 convives), a montré que les CAP français étaient appelés chaque année pour 2 à 12 repas à l’origine de cas de ciguatera.Suite à ce bilan, l’Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), en charge de la coordination de la toxicovigilance, a mis en place un suivi des cas de ciguatera enregistrés par les CAP afin de transmettre un bilan annuel de ce suivi aux tutelles concernées, la DGAL et la Direction générale de la santé (DGS).Le dernier bilan portant sur la période 2012-2019, le présent rapport décrit le bilan des cas de ciguatera observés par les CAP en 2020, ainsi que la mise en place d’une fiche de recueil prospectif permettant de faciliter la documentation des nouveaux cas.

Published
2021

29. Intoxication par des champignons shiitake. Quoi de neuf depuis la levée de l’obligation d’information en 2017 ?

Author

Boels, David, Bloch, Juliette, Centre hospitalier universitaire de Nantes (CHU Nantes), Direction des alertes et des vigilances sanitaires (DAVS), and Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)

Subjects
Shiitake, Poison Control Centers, Intoxication, MESH: Poison Control Centers, Champignon, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.TOX.TCA]Life Sciences [q-bio]/Toxicology/Toxicology and food chain, MESH: Shiitake Mushrooms
Abstract

International audience; Un nouveau bilan des cas d’intoxication par des champignons shiitake (Lentinula edodes), rapportés aux Centres antipoison entre le 1er janvier 2014 et le 31 décembre 2019, montre que le nombre d’intoxications a fortement augmenté en 2018 et 2019. Les atteintes cutanées caractéristiques liées à une cuisson insuffisante de ces champignons, restent, elles stables. L’information des producteurs, des restaurateurs et des consommateurs doit être renforcée.

Published
2021

32. Potential drug–drug interactions when managing status epilepticus patients in intensive care: A cohort study.

Author

Le Roux, Clémentine, Destère, Alexandre, Hervy, Sarah, Lloret‐Linares, Célia, Reignier, Jean, Caillet, Pascal, Jolliet, Pascale, Mégarbane, Bruno, and Boels, David

Subjects
INTENSIVE care patients, DRUG interactions, STATUS epilepticus, OLDER patients, COHORT analysis
Abstract

Aims: The risk for drug–drug interactions (DDIs) associated with antiseizure drugs (ASDs) used to manage status epilepticus (SE) patients in the intensive care unit (ICU) has been poorly investigated. We aimed to quantify and describe those potential DDIs and determine SE patient risk profiles. Methods: We conducted an observational bi‐centric cohort study including all SE patients admitted to the ICU in the period 2016–2020. Results: Overall, 431 SE patients were included and 5504 potential DDIs were identified including 1772 DDIs (33%) between ASDs, 2610 DDIs (47%) between ASDs and previous usual treatments (PUTs), and 1067 DDIs (20%) between ASDs and ICU treatments (ICUTs). DDIs were moderate (n = 4871), major (n = 562) or severe (n = 16). All patients exhibited potential DDIs, which were major‐to‐severe DDIs in 47% of the cases. DDIs were pharmacokinetic (n = 1972, 36%), mostly involving cytochrome P450 modulators, and pharmacodynamic (n = 3477, 64%), mainly leading to increased sedation. ASD/PUT DDIs were the most frequent and severe. Age, PUT and ASD drug numbers and length of ICU stay were significantly associated with increased DDI number. We identified four SE patient profiles with different DDI risks and outcomes including (1) epileptic or brain trauma patients, (2) withdrawal syndrome patients, (3) older patients with comorbidities and (4) self‐poisoned patients with psychiatric disorders and/or past epilepsy. Conclusion: SE patients are subject to potential DDIs between ASDs, ASD/PUT and ASD/ICUT. Major‐to‐severe DDIs mostly occur between ASDs and PUTs. Physicians should pay attention to SE patient characteristics and history to limit DDI numbers and prevent their consequences. [ABSTRACT FROM AUTHOR]

Published
2022
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33. First step in assessment of VipGrade®, a computerized clinical decision system to assess Vipera envenomation grading: a single-center interrater reliability study.

Author

Boels, David, Courtois, Arnaud, Paradis, Camille, Caillet, Pascal, and Labadie, Magali

Subjects
*INTER-observer reliability, *TOXICOLOGISTS, *RELIABILITY in engineering, *SNAKE venom, *VIPERIDAE, *RETROSPECTIVE studies
Abstract

We conducted a retrospective review of Vipera spp. snakebite cases registered by the PCC of Bordeaux, France, between January 1, 2018, and December 31, 2020, evaluating the agreement between VipGrade® assessments, toxicologists' assessments, and current guidelines. 133 patients with Vipera aspis snakebites were included. There was 100% agreement in severity grading by PCC guidelines and VipGrade®. However, grading by toxicologists and VipGrade® diverged in 19 cases (85% agreement; κ = 0.80; 95% CI: 0.71 to 0.87). The VipGrade® tool's grading reflects current PCC guidelines, which are authoritative in France, and may allow for a more rapid and standardized determination of management and follow-up of viper-bitten patients. It should be noted, however, that the more complex and dynamic aspects of management are not included in VipGrade®. Its purpose is to supplement, not replace, the advice of the PCC's clinical toxicologists, and this advice should be sought whenever a viper bite is encountered in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2022
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35. Reply to Comment on Failure of a Mexican antivenom on recovery from snakebite-related coagulopathy in French Guiana

Author

Heckmann, Xavier, primary, Lambert, Véronique, additional, Mion, Georges, additional, Ehrhardt, Adrien, additional, Marty, Christian, additional, Perotti, Frédérique, additional, Carod, Jean-François, additional, Jolivet, Anne, additional, Boels, David, additional, Andi, Ibrahim Lehida, additional, and Larréché, Sébastien, additional

Published
2020
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38. Snake bites by European vipers in Mainland France in 2017–2018: comparison of two antivenoms Viperfav® and Viperatab®

Author

Boels, David, primary, Hamel, Jean François, additional, Le Roux, Gaël, additional, Labadie, Magali, additional, Paret, Nathalie, additional, Delcourt, Nicolas, additional, Langrand, Jérôme, additional, Puskarczyk, Emmanuel, additional, Nisse, Patrick, additional, Sinno-Tellier, Sandra, additional, and de Haro, Luc, additional

Published
2020
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40. Severe poisoning with naproxen causing coagulopathy

Author

Lelièvre, Bénédicte, primary, Drouillard, Isabelle, additional, Thill, Chloé, additional, Le Roux, Gaël, additional, Bruneau, Chloé, additional, Mahé, Julien, additional, Deguigne, Marie, additional, and Boels, David, additional

Published
2019
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43. Failure of a Mexican antivenom on recovery from snakebite-related coagulopathy in French Guiana.

Author

Heckmann, Xavier, Lambert, Véronique, Mion, Georges, Ehrhardt, Adrien, Marty, Christian, Perotti, Frédérique, Carod, Jean-François, Jolivet, Anne, Boels, David, Lehida Andi, Ibrahim, and Larréché, Sébastien

Subjects
VENOM, ANTIVENINS, BLOOD coagulation disorders, PARTIAL thromboplastin time, AMNIOTIC fluid embolism, LENGTH of stay in hospitals
Abstract

In French Guiana, most snakebites are caused by crotalids, with the main signs being tissue damage and bleeding due to venom-induced coagulopathy. Since December 2014 the Western Guiana Hospital (WGH) has used Antivipmyn TriTM, a Mexican polyvalent antivenom. The aim of the study was to assess its benefit on the correction of snakebite-related coagulopathy. This retrospective study included patients hospitalized at the WGH with snakebite and a coagulopathy defined by: a prothrombin rate (PR) lower than 45%, an activated partial thromboplastin time ratio (aPTTr) greater than 2 or a fibrinogen lower than 100 mg.dL−1. The antivenom group included patients receiving Antivipmyn TriTM from December 2014 to September 2017. The control group included patients admitted between January 2013 and November 2014 (when antivenom was unavailable) or admitted between December 2014 and September 2017 during times of antivenom shortage. We graphically compared the time courses of PR, aPTTr and fibrinogen between groups. Other endpoints were the length of hospital stay and the need for surgery or dialysis. 84 patients were included: 42 in the antivenom group, 42 in the control group. Both groups were similar for age, sex-ratio, proportion of bleedings, necrosis, and severity. Most patients in the antivenom group received 3 vials. There were no significant differences in recovery of PR, aPTTr and fibrinogen through the first 24 h. Fibrinogen declined again in the control group at 30 h and showed a slower rise to normal concentration. There were no significant differences in any secondary endpoint. Antivipmyn TriTM as currently used did not show any benefit in recovery from coagulopathy. [ABSTRACT FROM AUTHOR]

Published
2021
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44. Ciguatera fish poisoning in France: experience of the French Poison Control Centre Network from 2012 to 2019.

Author

de Haro, Luc, Schmitt, Corinne, Sinno-Tellier, Sandra, Paret, Nathalie, Boels, David, Le Roux, Gaël, Langrand, Jérôme, Delcourt, Nicolas, Labadie, Magali, and Simon, Nicolas

Subjects
SEAFOOD poisoning, ALCOHOL drinking, POISONS, SELF-poisoning, NON-self-governing territories, SYMPTOMS
Abstract

Ciguatera fish poisoning (CFP) is a common Poisoning in the tropical countries. France is directly concerned with French tourists in endemic area and with French citizens living in the French overseas territories. Retrospective, descriptive study of CFP cases handled by the French Poison Control Centre Network from 2012 through 2019. Fifty-two events were studied concerning 130 patients. The fish species was identified for 41 events, mainly belonging to five fish families: 14 groupers, 11 snappers, 5 jacks, 4 parrotfishes, 4 barracudas. The origin of the fish was the Atlantic Ocean (23 events), the Indian Ocean (17 events) and the Pacific Ocean (12 events). 91% of the poisonings occurring in the Atlantic Ocean began with gastrointestinal effects while in 44% of events occurring in the Pacific Ocean, the patients had no gastrointestinal effects (onset with neurological symptoms: paraesthesia and dysesthesia). The evolution of the 130 patients has been classic for CFP with persistent symptoms during 1 to 45 weeks. Numerous patients reported exacerbation of neurological signs several months after poisoning following consumption of alcoholic beverages (23 patients) or seafood (19 patients). Medical practitioners in Europe must be trained to manage CFP as cases are reported with tourists returning from endemic areas but also with poisoned patients far from tropical areas after consumption of imported fish. [ABSTRACT FROM AUTHOR]

Published
2021
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45. Snake bites by European vipers in Mainland France in 2017–2018: comparison of two antivenoms Viperfav® and Viperatab®.

Author

Boels, David, Hamel, Jean François, Le Roux, Gaël, Labadie, Magali, Paret, Nathalie, Delcourt, Nicolas, Langrand, Jérôme, Puskarczyk, Emmanuel, Nisse, Patrick, Sinno-Tellier, Sandra, and de Haro, Luc

Subjects
*SNAKEBITES, *VIPERIDAE, *ANTIVENINS, *MULTIVARIATE analysis, *DATA analysis, *SYMPTOMS, *PIT vipers
Abstract

Context: Today, immunotherapy with Fab or F(ab′)2 fragments is considered as a gold standard treatment for patients bitten by vipers. We compared the efficiency of two antivenoms, Viperfav® and Viperatab®, in mainland France in 2017–2018 with data provided by the French poison control centre (PCC). Methods: Patients with a moderate (2a and 2b) or severe (3) envenomation after a European viper bite and treated with immunotherapy were included and the markers chosen were the risk of post-antivenom treatment worsening, duration of hospital stay and persistent functional discomfort on day 15. Statistical studies were based on multivariate data analysis. Results: Two hundred and ninety-seven cases were recorded. One hundred and eighty-two (61.3%) patients received Viperfav® and 115 (38.7%) received Viperatab®. Compared to Viperfav®, use of Viperatab® significantly increased the risk of post-antivenom treatment worsening (OR* 12.05; 95%CI [3.11; 46.70]; p <.001). No significant difference between these antivenoms was recorded with respect to the duration of hospital stay and persistent functional discomfort on day 15. Viperfav® and Viperatab® have a similar tolerance (p >.21). Otherwise, duration of hospitalisation was significantly increased by a delay of immunotherapy infusion of more than 12 h (OR 2.70; 95%CI [1.45–5.06]; p =.002) or a preventive administration of LMWH (OR 6.55; 95%CI [1.58–27.13]; p=.02). Discussion: While Viperfav® and Viperatab® have a similar tolerance, our data show that Viperatab® was associated with a higher risk of post-antivenom treatment worsening compared to Viperfav®. Furthermore, this study confirms that the antivenom should be used as soon as possible. Indeed, patients receiving the immunotherapy infusion from the grade 2b presented significantly more frequent exacerbated symptoms (OR 3.99; 95%CI [1.16–13.73]; p=.028) after the antivenom infusion compared to grade 2a group. Conclusions: Whereas no significant difference between these antivenoms was recorded with respect to the duration of hospital stay and persistent functional discomfort on day 15, use of Viperatab®, compared to Viperfav®, significantly increased the risk of post-antivenom treatment worsening (OR* 12.05; 95%CI [3.11; 46.70]; p <.001). Taken together, these data show that Viperfav® is the treatment of choice for the management of snake bites in France. [ABSTRACT FROM AUTHOR]

Published
2020
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46. Snake bites by European vipers in Mainland France in 2017–2018: comparison of two antivenoms Viperfav® and Viperatab®.

Author

Boels, David, Hamel, Jean François, Le Roux, Gaël, Labadie, Magali, Paret, Nathalie, Delcourt, Nicolas, Langrand, Jérôme, Puskarczyk, Emmanuel, Nisse, Patrick, Sinno-Tellier, Sandra, and de Haro, Luc

Subjects
SNAKEBITES, VIPERIDAE, ANTIVENINS, MULTIVARIATE analysis, DATA analysis, SYMPTOMS, PIT vipers
Abstract

Context: Today, immunotherapy with Fab or F(ab′)2 fragments is considered as a gold standard treatment for patients bitten by vipers. We compared the efficiency of two antivenoms, Viperfav® and Viperatab®, in mainland France in 2017–2018 with data provided by the French poison control centre (PCC). Methods: Patients with a moderate (2a and 2b) or severe (3) envenomation after a European viper bite and treated with immunotherapy were included and the markers chosen were the risk of post-antivenom treatment worsening, duration of hospital stay and persistent functional discomfort on day 15. Statistical studies were based on multivariate data analysis. Results: Two hundred and ninety-seven cases were recorded. One hundred and eighty-two (61.3%) patients received Viperfav® and 115 (38.7%) received Viperatab®. Compared to Viperfav®, use of Viperatab® significantly increased the risk of post-antivenom treatment worsening (OR* 12.05; 95%CI [3.11; 46.70]; p <.001). No significant difference between these antivenoms was recorded with respect to the duration of hospital stay and persistent functional discomfort on day 15. Viperfav® and Viperatab® have a similar tolerance (p >.21). Otherwise, duration of hospitalisation was significantly increased by a delay of immunotherapy infusion of more than 12 h (OR 2.70; 95%CI [1.45–5.06]; p =.002) or a preventive administration of LMWH (OR 6.55; 95%CI [1.58–27.13]; p=.02). Discussion: While Viperfav® and Viperatab® have a similar tolerance, our data show that Viperatab® was associated with a higher risk of post-antivenom treatment worsening compared to Viperfav®. Furthermore, this study confirms that the antivenom should be used as soon as possible. Indeed, patients receiving the immunotherapy infusion from the grade 2b presented significantly more frequent exacerbated symptoms (OR 3.99; 95%CI [1.16–13.73]; p=.028) after the antivenom infusion compared to grade 2a group. Conclusions: Whereas no significant difference between these antivenoms was recorded with respect to the duration of hospital stay and persistent functional discomfort on day 15, use of Viperatab®, compared to Viperfav®, significantly increased the risk of post-antivenom treatment worsening (OR* 12.05; 95%CI [3.11; 46.70]; p <.001). Taken together, these data show that Viperfav® is the treatment of choice for the management of snake bites in France. [ABSTRACT FROM AUTHOR]

Published
2020
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47. Severe poisoning with naproxen causing coagulopathy.

Author

Lelièvre, Bénédicte, Drouillard, Isabelle, Thill, Chloé, Le Roux, Gaël, Bruneau, Chloé, Mahé, Julien, Deguigne, Marie, and Boels, David

Subjects
POISONING, ANTI-inflammatory agents, DRUG side effects, NAPROXEN, NONSTEROIDAL anti-inflammatory agents, METABOLIC disorders
Abstract

Non‐steroidal anti‐inflammatory drugs (NSAIDs) are well known for their most frequent side effects (digestive, renal and metabolic disorders) but are lesser known for other effects, such as coagulation disturbances. In this issue, we report the case of a 58‐year‐old woman who ingested 26 g of naproxen in a suicidal attempt and developed cardiovascular shock, hypocoagulability and thrombopenia. Her outcome was positive (extubation 3 days after admission [D3], correction of haemostatic disruptions on D5 and of thrombopenia on D6). Naproxen plasma concentration was at a toxic concentration of 1320 mg/L at 6 hours after drug ingestion. Only few cases of hypocoagulopathy are reported with the NSAIDs, and this is the first case that can be attributed to naproxen. A possible explanation of this phenomenon following naproxen ingestion is an inhibition of thromboxane A2, usually attributed to NSAIDs, combined with an inhibition of activation of downstream the cascade. [ABSTRACT FROM AUTHOR]

Published
2020
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50. High mortality due to snakebites in French Guiana: Time has come to re-evaluate medical management protocols

Author

Mutricy, Rémi, primary, Heckmann, Xavier, additional, Douine, Maylis, additional, Marty, Christian, additional, Jolivet, Anne, additional, Lambert, Véronique, additional, Perotti, Frédérique, additional, Boels, David, additional, Larréché, Sébastien, additional, Chippaux, Jean-Philippe, additional, Nacher, Mathieu, additional, and Epelboin, Loïc, additional

Published
2018
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