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7 results on '"Christophe Duez"'

1. Bacterial findings in patients referred to hospital for the treatment of acute tonsillitis with or without peritonsillar phlegmon

Author

Camilla Andersen, Thomas Greve, Kasper Basse Reinholdt, Ann Marlene Gram Kjaerulff, Nichlas Udholm, Vesal Khalid, Adnan Madzak, Christophe Duez, Henrik Münch, Søren Pauli, Christian Sander Danstrup, Niels Krintel Petersen, and Tejs Ehlers Klug

Subjects
Streptococcus pyogenes, Fusobacterium necrophorum, Streptococcus dysgalactiae, Dysbacteriosis, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background The vast majority of patients with acute tonsillitis (AT) are managed in general practice. However, occasionally patients are referred to hospital for specialized management because of aggravated symptoms and/or findings suggestive of peritonsillar involvement. No prospective studies have been conducted aiming to investigate the prevalent and significant microorganisms in this highly selected group of patients. We aimed to describe the microbiological findings of acute tonsillitis with or without peritonsillar phlegmon (PP) in patients referred for hospital treatment and to point out potential pathogens using the following principles to suggest pathogenic significance: (1) higher prevalence in patients compared to healthy controls, (2) higher abundance in patients compared to controls, and (3) higher prevalence at time of infection compared to time of follow up. Methods Meticulous and comprehensive cultures were performed on tonsillar swabs from 64 patients with AT with (n = 25) or without (n = 39) PP and 55 healthy controls, who were prospectively enrolled at two Danish Ear-Nose-Throat Departments between June 2016 and December 2019. Results Streptococcus pyogenes was significantly more prevalent in patients (27%) compared to controls (4%) (p

Published
2023
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2. Platelet aggregation during targeted temperature management after out-of-hospital cardiac arrest: A randomised clinical trial

Author

Anni Nørgaard Jeppesen, Anne-Mette Hvas, Anders Morten Grejs, Christophe Duez, Susanne Ilkjær, and Hans Kirkegaard

Subjects
aggregation, haemostasis, heart arrest, multiplate, platelets, targeted temperature management, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Some studies conclude that mild hypothermia causes platelet dysfunction leading to an increased bleeding risk, whereas others state that platelet aggregation is enhanced during mild hypothermia. Therefore, the aim of this study was to clarify whether standard or prolonged duration of targeted temperature management affected platelet aggregation. We randomised 82 comatose patients resuscitated after out-of-hospital cardiac arrest to either 24 hours (standard group) or 48 hours (prolonged group) of targeted temperature management at 33±1°C. Blood samples were collected 22 hours, 46 hours and 70 hours after reaching target temperature. Platelet aggregation was assessed by impedance aggregometry employing a Multiplate®Analyser, using the COLtest®, TRAPtest®, ADPtest® and ASPItest® as agonists, and with the results reported as area under the curve (AUC, AU*min). The platelet aggregation was below the normal range in all blood samples. No differences were observed between the standard group and the prolonged group in either of the blood samples (all p ≥ 0.11), except for a 24% decreased aggregation (95% confidence interval (CI) (10%;37%), p = 0.002) when using the COLtest® in the 46-hour sample. Comparing the 22-hour sample with the 46-hour sample in the prolonged group separately, we found no differences when employing the COLtest®, the ASPItest® or the ADPtest® in patients without the use of adenosine diphosphate receptor inhibitors (all p values ≥0.21), but aggregation induced by the TRAPtest® decreased by 14% (95% CI −8%;−20%), p < 0.001). We concluded that the platelet aggregation post cardiac arrest was below the normal range independent of the core temperature. Moreover, no substantial difference was found in platelet aggregation between standard and prolonged targeted temperature management.

Published
2018
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3. Fibrinolysis in Cardiac Arrest Patients Treated with Hypothermia

Author

Anni Nørgaard Jeppesen, Christophe Duez, Hans Kirkegaard, Anders Morten Grejs, and Anne-Mette Hvas

Subjects
Anesthesiology and Pain Medicine, Critical Care and Intensive Care Medicine
Abstract

Hypothermia affects coagulation, but the effect of hypothermia on fibrinolysis is not clarified. Imbalance in the fibrinolytic system may lead to increased risk of bleeding or thrombosis. Our aim was to investigate if resuscitated cardiac arrest patients treated with hypothermia had an unbalanced fibrinolysis. A prospective cohort study, including 82 patients were treated with hypothermia at 33°C ± 1°C after out-of-hospital cardiac arrest. Blood samples were collected at 24 hours (hypothermia) and at 72 hours (normothermia). Samples were analyzed for fibrin D-dimer, tissue plasminogen activator (tPA), plasminogen, plasminogen activator Inhibitor-1 (PAI-1), thrombin-activatable fibrinolysis inhibitor (TAFI), and an in-house dynamic fibrin clot formation and lysis assay.Compared with normothermia, hypothermia significantly increased plasminogen activity (mean difference = 10.4%, 95% confidence interval [CI] 7.9-12.9), p

Published
2022

4. Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

Author

Hans Kirkegaard, Anders M. Grejs, Simon Gudbjerg, Christophe Duez, Anni Jeppesen, Christian Hassager, Timo Laitio, Christian Storm, Fabio Silvio Taccone, Markus B. Skrifvars, Eldar Søreide, Department of Diagnostics and Therapeutics, and HUS Emergency Medicine and Services

Subjects
THERAPEUTIC HYPOTHERMIA, HYPOKALEMIA, RESUSCITATION, Sodium, Hypothermia, Induced/methods, Hypothermia, General Medicine, 3126 Surgery, anesthesiology, intensive care, radiology, Out-of-Hospital Cardiac Arrest/therapy, Phosphates, Electrolytes, Anesthesiology and Pain Medicine, TARGETED TEMPERATURE MANAGEMENT, Hypothermia/therapy, Hypothermia, Induced, Potassium, Humans, Calcium, Magnesium, HYPOPHOSPHATEMIA, Out-of-Hospital Cardiac Arrest
Abstract

BACKGROUND: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM.METHODS: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements.RESULTS: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p < .05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1-1.2) mmol/l during the first 24 h (p < .05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8-1.2) mmol/l (p < .05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p < .05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval.CONCLUSIONS: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM's different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.

Published
2022

7. In-person versus video instruction of patients with sleep apnoea in the use of continuous positive airway pressure (CPAP)

Author

Milos Fuglsang, Christophe Duez, Line Borreskov Dahl, Marianne Bach Nielsen, and Jesper Bille

Subjects
Sleep Apnea, Obstructive, Sleep Apnea Syndromes, Continuous Positive Airway Pressure, Sleep Apnea, Obstructive/therapy, Humans, Sleep Apnea Syndromes/therapy, Ambulatory Care Facilities
Abstract

INTRODUCTION: Instructing newly diagnosed sleep apnoea patients in the use of continuous positive airway pressure (CPAP) machines is time consuming for healthcare workers and patients alike. Our aim was to test the feasibility of video instruction as an alternative to physical attendance in the clinic.METHODS: In this randomised controlled trial, we enrolled 120 patients who were randomised to either classic instruction by a nurse or video instruction at home. Both patients and doctors answered questionnaires at the time of inclusion. Follow-up was 1-3 months.RESULTS: No significant difference was recorded between the two groups on any measured parameter.CONCLUSIONS: Video instruction is feasible and should be considered as an alternative to physical attendance for the CPAP start-up.FUNDING: none.TRIAL REGISTRATION: clinicaltrials.gov (NCT number 15022020).

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