1: Eur Heart J. 2009 Mar 28. [Epub ahead of print]
Diagnosis and follow-up of Wegener's granulomatosis by cardiac magnetic
resonance.
Caudron J, Fares J, Dominique S, Dacher JN.
Department of Radiology, University Hospital of Rouen, 1 rue de Germont, 76031
Rouen Cedex, France.
PMID: 19329802 [PubMed - as supplied by publisher]
2: Rev Med Interne. 2009 Mar 27. [Epub ahead of print]
[Subcutaneous calcifications and dysmorphic syndrome.]
[Article in French]
Avenel G, Bernet J, Lahaxe L, Levesque H, Marie I.
Département de médecine interne, CHU de Rouen, 147, avenue du Maréchal-Juin,
76031 Rouen cedex, France.
PMID: 19329231 [PubMed - as supplied by publisher]
3: Fertil Steril. 2009 Mar 26. [Epub ahead of print]
Good News for Women with Endometriosis!
Roman H.
Department of Gynaecology and Obstetrics, Rouen University Hospital, Rouen,
France.
Publication Types:
LETTER
PMID: 19328475 [PubMed - as supplied by publisher]
4: Presse Med. 2009 Mar 25. [Epub ahead of print]
[Anti-TNF alpha in the treatment of rheumatoid arthritis and ankylosing
spondylitis.]
[Article in French]
Lanfant-Weybel K, Lequerré T, Vittecoq O.
Service de rhumatologie, CHU de Rouen-Hôpitaux de Rouen, Inserm 905, F-76031
Rouen Cedex, France.
Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are, with psoriatic
arthritis, the most frequent rheumatic diseases. A better understanding of
pathophysiology of these diseases had led to the development of new treatments
refered as to biologic agents and, among them, TNF blocking agents have a major
role. The knowledge of these drugs in terms of mechanisms of action, indications
and potentials side effects has to be known to improve the efficacy/tolerance
balance. Although these 3 anti-TNFalpha agents are currently used, new TNF
blocking agents are under evaluation and should increase the number of drugs
available within the next months.
PMID: 19327945 [PubMed - as supplied by publisher]
5: Crit Care Med. 2009 Mar 25. [Epub ahead of print]
Toll-like receptors 4 contribute to endothelial injury and inflammation in
hemorrhagic shock in mice.
Benhamou Y, Favre J, Musette P, Renet S, Thuillez C, Levesque H, Richard V,
Tamion F.
From the Inserm U644 (YB, JF, SR, CT, VR, FT), Institute for Biomedical Research
and IFRMP 23; Rouen University Medical School, Rouen, France; Rouen University
Hospital (FT), Intensive Care Unit, Rouen, France; Inserm U519 (FT), Institute
for Biomedical Research and IFRMP 23; Rouen University Medical School, Rouen,
France; andDepartment of Internal Medicine (YB, PM, HL); Rouen University
Hospital, France.
OBJECTIVE:: Hemorrhagic shock followed by resuscitation (HS/R) promotes organ
injury by priming cells of the innate immune system for inflammatory response.
Toll-like receptors (TLRs) play an important role in signal transduction in
shock/resuscitation conditions. Because proinflammatory mediators are a critical
event in mesenteric endothelial injury induced by HS/R, we assessed the role of
TLR4 or TLR2 in this setting. DESIGN:: Laboratory investigation. SETTING::
Research laboratory at Rouen University Medical School. SUBJECTS:: Male
wild-type, TLR4 and TLR2 mice with the same C57BL/6 background. INTERVENTIONS::
Mice were submitted to 30 minutes hemorrhagic shock followed by 1 hour
resuscitation, after which mesenteric endothelial dysfunction, microvascular
injury, and TNFalpha production were assessed. MEASUREMENTS AND MAIN RESULTS::
HS/R markedly decreased nitric oxide-mediated mesenteric relaxations induced by
acetylcholine, assessed ex vivo on a myograph. By contrast, in TLR4-deficient
mice, HS/R did not impair the nitric oxide-mediated responses to acetylcholine.
No protection was observed in TLR2-deficient mice. TLR4-deficient mice also
displayed a significant reduction in fluid resuscitation and TNFalpha systemic
production. CONCLUSIONS:: TLR4 contributes to mesenteric endothelial dysfunction
after hemorrhagic shock. This early TLR4-induced vascular injury may be an
important trigger of the systemic inflammatory response occurring in this
disease.
PMID: 19325486 [PubMed - as supplied by publisher]
6: Eur J Emerg Med. 2009 Mar 23. [Epub ahead of print]
Waiting time and assessment of patient satisfaction in a large reference
emergency department: a prospective cohort study, France.
Pitrou I, Lecourt AC, Bailly L, Brousse B, Dauchet L, Ladner J.
aEpidemiology and Public Health Department, Rouen University Hospital, Rouen
bEmergency Department, Elbeuf Reference Hospital, Elbeuf, France.
OBJECTIVES: To assess patient satisfaction in a French Emergency Department (ED)
and to determine factors associated with dissatisfaction. METHODS: From July 2003
to February 2004, a prospective cohort study was conducted in an ED (Elbeuf
Reference Hospital, Upper-Normandy region). Baseline data collection was
performed during individual interview at inclusion. Waiting time in the ED was
recorded. Patient satisfaction was assessed by telephone 1 month later. Questions
included assessment of overall satisfaction and three different areas of
satisfaction: quality of reception, patient-doctor communication, and delays.
RESULTS: One hundred sixty-five patients were included, 146 patients (88.5%)
responded to the telephone follow-up. We found high levels of satisfaction in the
ED (89.7%). Highest satisfaction rate (92.5%) was for reception. Lower
satisfaction rates were reported for waiting times (72.6%) and medical
information provided by physicians (71.9%). The mean total time spent was 149.9
min (median=133.5). In multivariate analysis, waiting time was the unique
independent determinant of patient dissatisfaction: second quartile odds ratio
(OR)=0.40; 95% confidence interval (CI)=(0.06-2.66), third quartile OR=1.45; 95%
CI=(0.32-6.47), last quartile OR=2.69; 95% CI=(0.65-11.08); ptrend=0.04.
CONCLUSION: Elevated waiting times appeared as the unique independent risk factor
of patient dissatisfaction. Information on delays and reasons for this delay
could be systematically communicated to patients attending EDs; it could be an
effective strategy to reduce perceived waiting times and improve patient
satisfaction.
PMID: 19318959 [PubMed - as supplied by publisher]
7: Arch Pediatr. 2009 Mar 24. [Epub ahead of print]
[Diagnosis of congenital heart disease in a nonselected population in Upper
Normandy: Retrospective study between 2003 and 2007.]
[Article in French]
Durand I, David N, Blaysat G, Marguet C.
Département de pédiatrie, CHU de Rouen, université de Rouen, 76031 Rouen cedex,
France.
Routine prenatal ultrasound screening for the detection of possible cardiopathy
has existed in Upper Normandy since 1987, including the continuous training of
obstetric ultrasonographers. We evaluated the profitability and the expected
benefit of prenatal detection in a nonselected population in this region.
METHODS: A retrospective study was undertaken from October 2003 to September 2007
in the cardiopediatric units of Upper Normandy. All fetuses and infants with a
diagnosed major cardiac defect were classified into 3 groups: no possibility of
anatomic surgical repair (group 1), risk of early decompensation (group 2), and
anatomic surgical repair possible but without early decompensation (group 3).
Prenatal and postnatal mortality and morbidity were reported. RESULTS: One
hundred and sixty-five major congenital heart defects were detected prenatally
and 68 postnatally. The prenatal detection rate was 71% (93, 53, and 77% for
groups 1, 2, and 3, respectively; p<0.0001). The rate of pregnancy termination
was 92, 17, and 45%, respectively. The mortality rate tended to be higher in the
undiagnosed group of urgent neonatal heart cases (10.6% vs 4.4%). The prenatal
prevalence of abnormal karyotype was 21% and was 11.5% for congenital
malformation syndrome. CONCLUSION: Prenatal detection of major cardiac defects
has continued to attain high success in Upper Normandy. However, 50% of urgent
neonatal heart cases often remain undiagnosed, and therefore the neonatologist
must treat this patient population with particular care. Prenatal diagnosis can
reduce preoperative mortality and morbidity of cardiopathy with a risk of early
decompensation with specific neonatal intensive care.
PMID: 19324538 [PubMed - as supplied by publisher]
8: Rev Med Interne. 2009 Mar 17. [Epub ahead of print]
[Anticoagulation clinics for outpatients: A 5-year experience.]
[Article in French]
Benhamou Y, Le Cam-Duchez V, Schneller JM, Cailleux N, Magne JC, Soubrane JC,
Borg JY, Lévesque H.
Département de médecine interne, CHU Bois-Guillaume, 147, avenue du
Maréchal-Juin, 7620 Bois-Guillaume, 76031 Rouen cedex, France.
INTRODUCTION: Anticoagulation clinics and computerized management of chronic oral
anticoagulation increase the time spent in the therapeutic range with both
mortality and morbidity reduction. Usually, anticoagulation clinics are
hospital-based medical care centers. We report the five-year results from a
general medicine center (CSCTA) using a computer-assisted management. METHODS: A
prospective cohort observational study of 530 primary care patients that were
receiving long term oral anticoagulation. RESULTS: Cardiac arrhythmia (55%),
heart valve disease and venous thrombo-embolic disease (30%) represented the most
common indications of oral anticoagulation. Patients received fluindione,
warfarine and acenocoumarol in 80%, 13% and 7%, respectively. The duration of
treatment was at least one year in 54% of the cases, and was at least three years
in 25% of the cases. The rate of patients that were in average within the
therapeutic range (INR 2-3) was 72%, while 12% were under and 16% over the
therapeutic range. Corresponding rates were 82, 17 and 1% respectively for all
anticoagulation targets (INR 1.5-4.5). Twenty-six bleeding events (4.9 per 100
patient-years) and four thrombotic complications (0.75 per 100 patient-years)
occurred. Life-threatening hemorrhage occurred in 1.3 per 100 patient-years.
After the equilibration of the anticoagulation, the average delay of control
between two consecutive INR was 19 days. CONCLUSION: The results obtained with
CSCTA were similar to those reported by other anticoagulation clinics regarding
hemorrhagic complications and time spent in the therapeutic range. In contrast,
thrombotic events were less frequent. Because of the absence of a control group,
a medico-economic analysis could not be performed.
PMID: 19299042 [PubMed - as supplied by publisher]
9: Joint Bone Spine. 2009 Mar 14. [Epub ahead of print]
Atypical forms of syphilis: Two cases.
Avenel G, Goëb V, Abboud P, Ait-Abdesselam T, Vittecoq O.
Service de Rhumatologie, CHU-Hôpitaux de Rouen, & Inserm, U905 (IFRMP23),
Institut de Biologie Clinique, Rouen, France.
Syphilis is a sexually transmitted disease caused by the spirochete Treponema
pallidum. A chancre usually develops initially. Organ involvement and
neurological complications may occur, sometimes several years after the initial
exposure. We managed two patients with syphilis responsible for joint or
neurological manifestations, diagnosed in 2008. One patient presented with
oligoarthritis involving the knees and right elbow, coinciding with a
maculopapular and pustular eruption. In the other patient, meningoradiculitis
involving the T8, T9, and T10 metameres prompted a test for Lyme disease, which
was weakly positive, leading to evaluation for false-positivity due to a
cross-reaction. Neither patient was infected with the HIV.
PMID: 19289298 [PubMed - as supplied by publisher]
10: Ann Endocrinol (Paris). 2009 Mar 13. [Epub ahead of print]
Autocrine/paracrine regulations of steroidogenesis in adrenocortical hyperplasias
and tumors.
Lefebvre H, Duparc C, Cartier D, Contesse V, Perraudin V, Bertherat J, Plouin PF,
Reznik Y, Kuhn JM, Louiset E.
Laboratory, Rouen University Hospital, University of Rouen, Inserm U413/EA4310,
DC2N, IFRMP 23, Rouen, France; IFRMP 23, Department of Endocrinology, Rouen
University Hospital, University of Rouen, Rouen, France.
PMID: 19286160 [PubMed - as supplied by publisher]
11: Int J Colorectal Dis. 2009 Mar 13. [Epub ahead of print]
Constipation in 44 patients implanted with an artificial bowel sphincter.
Gallas S, Leroi AM, Bridoux V, Lefebure B, Tuech JJ, Michot F.
Digestive Tract Research Group EA3234/IFRMP23, Rouen University Hospital, 1 rue
Germont, 76031, Rouen Cedex, France.
PURPOSE: Constipation with or without obstructed defecation (OD) is frequent in
patients with artificial bowel sphincter (ABS). The aims of this study were (1)
to evaluate the functional outcome of ABS based on postoperative constipation and
(2) to assess pre-implantation data to predict post-implantation constipation.
MATERIALS AND METHODS: Thirteen men and 31 women were followed up. Both fecal
incontinence and constipation with and without OD were assessed after
implantation. Pre-implantation characteristics were compared in patients with and
without postoperative constipation. RESULTS: After implantation, nine patients
(20.4%) had constipation without OD, 16 patients (36.4%) had OD, and 19 patients
(43.2%) had neither of these. Incontinence was significantly more frequent in
patients with postoperative constipation with or without OD. In these patients,
an increase in preoperative constipation, anismus, and ultraslow waves was noted.
CONCLUSION: Constipation with and without OD is frequent after implantation and
interfere with the functional outcome of ABS.
PMID: 19283389 [PubMed - as supplied by publisher]
12: Gynecol Obstet Fertil. 2009 Mar;37(3):277. Epub 2009 Mar 17.
[Secularism at hospital.]
[Article in French]
Marpeau L.
Clinique gynécologique et obstétricale, hôpital Charles-Nicolle, CHU de Rouen, 1,
rue de Germont, 76031 Rouen cedex, France.
PMID: 19282212 [PubMed - in process]
13: Fetal Diagn Ther. 2009 Mar 12;25(1):136-140. [Epub ahead of print]
Interferon-alpha for Treatment of Essential Thrombocythemia during Pregnancy:
Case Report and Review of the Literature.
Séror J, Sentilhes L, Lefebvre-Lacoeuille C, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen,
France.
Described as a myeloproliferative disorder mainly affecting elderly women, recent
reports now confirm the occurrence of essential thrombocythemia at younger ages,
which questions treatment during pregnancy. We report a further case of
uneventful full term pregnancy with the use of interferon-alpha for maternal
essential thrombocythemia which suggests that interferon-alpha could be
considered as an effective and safe treatment during pregnancy for women with
essential thrombocythemia. Further studies are warranted to determine whether
interferon-alpha is the optimal therapeutic option during pregnancy for this
patient population. Copyright © 2009 S. Karger AG, Basel.
PMID: 19279390 [PubMed - as supplied by publisher]
14: Rev Med Interne. 2009 Mar 6. [Epub ahead of print]
[A double-faced myocarditis: Whipple's disease or sarcoidosis?]
[Article in French]
Benhamou Y, Lachkar S, Cailleux N, Bauer F, Bernet J, Marie I, Lévesque H.
Département de médecine interne, CHU de Rouen-Bois-Guillaume, 76031 Rouen cedex,
France.
INTRODUCTION: Whipple's disease is a systemic infection that may mimic
sarcoidosis in its initial presentation. The heart involvement is not uncommon
and consists generally in an endocarditis. Myocarditis is less common and is
usually accompanied by impairment of heart conduction. CASE REPORT: We report a
56-year-old man with Whipple's disease associated with a myocarditis, initially
diagnosed as having a sarcoidosis with cardiac injury. The contribution of the
histology and molecular biology on intestinal sampling made it possible to
rectify the diagnosis. CONCLUSION: The diagnosis of Whipple's disease should be
considered in the presence of a systemic granulomatosis with or without heart
involvement. Early diagnosis is important because of effectiveness of antibiotic
therapy.
PMID: 19269718 [PubMed - as supplied by publisher]
15: Rheumatology (Oxford). 2009 Mar 3. [Epub ahead of print]
Infection and vasculitis.
Belizna CC, Hamidou MA, Levesque H, Guillevin L, Shoenfeld Y.
Internal Medicine Department, CHU Rouen, Rouen, Internal Medicine A Department,
CHU Hôtel Dieu, Nantes, Internal Medicine Department, Hôpital Cochin, Assistance
Publique-Hôpitaux de Paris, Paris, France, and Department of Medicine 'B' and
Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv University, Tel
Hashomer, Israel.
Vasculitis may be associated with infection, immunization or anti-microbial
drugs. Infections are responsible for a number of different types of vasculitis.
Conversely, patients with vasculitis may develop infections, which sometimes
mimic relapse. The aim of this review is to summarize the various aspects of the
inter-relationship between vasculitis and infection, and the physiopathological
mechanisms involved, in light of our current knowledge from animal models.
Currently, a causal relationship between infection and vasculitis has only been
established in a few instances and many mechanisms remain hypothetical. This
inter-relationship is further assessed from the point of view of clinical
presentation and therapeutic options, based on case reports and prospective
observational data.
PMID: 19258377 [PubMed - as supplied by publisher]
16: Gastroenterol Clin Biol. 2009 Mar;33(3):167-71. Epub 2009 Feb 27.
Validation in French of the SWAL-QOL scale in patients with oropharyngeal
dysphagia.
Khaldoun E, Woisard V, Verin E.
Service de physiologie digestive urinaire respiratoire et sportive, Rouen
University Hospital, 76031 Rouen, France.
A quality-of-life (QOL) questionnaire specifically designed for patients with
oropharyngeal dysphagia (SWAL-QOL) has been elaborated and validated by Colleen
McHorney. The aim of the present study was to validate the French translation of
the SWAL-QOL in 73 patients with either post-stroke or post-surgical
oropharyngeal dysphagia. The French version was considered understandable and
acceptable by the study patients, who completed the questionnaire in
approximately 20 minutes. However, 32 patients needed help in filling out the
questionnaire-mostly in reading the questions and writing the answers. Completion
was excellent, although seven patients missed one item. Analysis of convergent
validity of the French version showed good correlation between items and the
corresponding scale. Validity convergence was excellent for all the different
items, with a correlation between each item and its own scale that was always
greater than 0.40. Internal coherence was also excellent, with Cronbach's alpha
coefficient greater than 0.7. Patients with oropharyngeal dysphagia have a poor
QOL, as reflected by their very low scores. The lowest scores were related to the
impact of swallowing disorders on the QOL (47+/-30) and on mental health
(51+/-31). This study also demonstrated the linguistic and psychometric validity
of the French version of the SWAL-QOL questionnaire.
PMID: 19250781 [PubMed - in process]
17: Acta Anaesthesiol Scand. 2009 Mar;53(3):339-45.
Major complications after 400 continuous popliteal sciatic nerve blocks for
post-operative analgesia.
Compère V, Rey N, Baert O, Ouennich A, Fourdrinier V, Roussignol X, Beccari R,
Dureuil B.
Department of Anaesthetics and Intensive Care, Rouen University Hospital, Rouen,
France. Vincent.Compere@chu-rouen.fr
BACKGROUND: A continuous popliteal sciatic nerve block (CPSNB) has been performed
with increasing frequency for post-operative analgesia after foot surgery. Major
complications associated with the placement of a perineural catheter remain
rarely studied. The aim of this study was to prospectively determine the
incidence of major complications (neurological and infectious) in post-operative
adult patients with a continuous popliteal catheter inserted by the anatomical
posterior approach for analgesia after foot surgery. METHODS: All popliteal
catheters were placed pre-operatively under sterile conditions with the aid of a
nerve stimulator technique. The primary outcome measure was the incidence of
major complications including infection and neuropathy. As a secondary outcome,
adverse effects as well as other complications were also evaluated. Data were
expressed as median [25th-75th percentiles]. RESULTS: A total of 400 patients
were included in the study during a 2-year period. The median time the catheter
remained indwelling was 47 h [23, 54]. Major complications included three events
(0.75%) with one infection (0.25%) and two neuropathies (0.50%). Three blocks
were unsuccessful and the catheter insertion was difficult in 12 patients (3%).
During the CPSNB procedure, one patient reported slight paraesthesia during
stimulation. Patient satisfaction was scored at 4 for 89%, 3 for 6% and 2 for 5%
on the analogue scale. CONCLUSIONS: Major complications after the use of CPSN are
not in fact rare. The incidence of severe neuropathy or infection complications
is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be
considered effective and is associated with only a few minor complications.
PMID: 19243320 [PubMed - in process]
18: Presse Med. 2009 Mar;38(3):471-84. Epub 2009 Feb 12.
[Ventilatory support at home: indications of oxygen therapy and non invasive
ventilation]
[Article in French]
Muir JF, Lamia B, Molano C, Cuvelier A.
Service de Pneumologie et Unité de Soins Intensifs Respiratoires, CHU de Rouen,
Rouen Cedex, France. Jean-Francois.Muir@chu-rouen.fr
The main indication of LTO is COPD with chronic respiratory failure, where it
improves life expectancy. By extension, LTO may be proposed to other etiologies
of CRF with chronic documented hypoxemia. Daily duration is at least 15H per day.
Non invasive ventilation (NIV) represents facial or nasal ventilation. Consensus
indications of NIV are restrictive pulmonary diseases (chest wall and /or
parenchmal sequelae, neuromuscular diseases, or obesity hypoventilation syndrome)
Real role of NIV in log-term management of COPD remains controversial.
Publication Types:
English Abstract
PMID: 19217250 [PubMed - in process]
19: Arch Pediatr. 2009 Mar;16(3):283-4. Epub 2009 Jan 30.
[Acute RSV bronchiolitis: Should we be looking for pertussis?]
[Article in French]
Legru E, Lubrano M, Lemée L, Marguet C.
Unité de pneumo-allergologie pédiatrique, service de pédiatrie, CHU
Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
Publication Types:
Letter
PMID: 19186038 [PubMed - in process]
20: J Hosp Infect. 2009 Mar;71(3):256-62. Epub 2009 Jan 21.
Aerial dispersal of meticillin-resistant Staphylococcus aureus in hospital rooms
by infected or colonised patients.
Gehanno JF, Louvel A, Nouvellon M, Caillard JF, Pestel-Caron M.
Department of Occupational Medicine, Rouen University Hospital, Rouen, France.
jean-francois.gehanno@chu-rouen.fr
The aim of this study was to assess to what extent patients with
meticillin-resistant Staphylococcus aureus (MRSA) at respiratory sites shed
viable MRSA into the air of hospital rooms. We also evaluated whether the
distance from the patient could influence the level of contamination. Air
sampling was performed directly onto MRSA-selective agar in 24 hospital rooms
containing patients with MRSA colonization or infection of the respiratory tract.
Samplings were performed in duplicate at 0.5, 1 and 2-3 m from the patients'
heads. Clinical and environmental isolates were compared using antimicrobial
resistance patterns and pulsed-field gel electrophoresis. MRSA strains were
isolated from 21 out of 24 rooms, in quantities varying from between 1 and 78
cfu/m3. In each of the 21 rooms, at least one of the environmental isolates was
identical to a clinical isolate from the patient in that room. There was no
significant difference in MRSA counts between the distance from the patient's
head and the sampler. This study demonstrates that most patients with MRSA
infection or colonisation of the respiratory tract shed viable MRSA into the air
of their room. The results emphasise the need to study MRSA in air in more detail
in order to improve infection control recommendations.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 19162372 [PubMed - in process]
21: J Hosp Infect. 2009 Mar;71(3):263-8. Epub 2009 Jan 14.
Influence of infection control report cards on patients' choice of hospital:
pilot survey.
Merle V, Germain JM, Tavolacci MP, Brocard C, Chefson C, Cyvoct C, Edouard S,
Guet L, Martin E, Czernichow P.
Department of Epidemiology and Public Health, Rouen University Hospital, Rouen,
France. veronique.merle@chu-rouen.fr
The impact on patients' attitudes of quality report cards on infection control in
hospitals has never previously been studied. In 2006, the French government
implemented a mandatory report card on infection control activity (ICALIN) in all
hospitals. This approach was aimed at encouraging professionals to change their
routine practices in case they should lose patients due to a low ICALIN score.
Our objective was to assess what impact ICALIN could have on patients' attitude
as regards hospital choice. We performed a survey of patients and visitors in 14
randomly selected hospitals of various ICALIN scores. A convenience sample of 381
patients and visitors completed an anonymous questionnaire on ICALIN, their
reasons for choosing a hospital and attitude in the event of a low ICALIN score.
Factors associated with interest in ICALIN and impact of ICALIN on hospital
choice were assessed by logistic regression. Our results showed that 77% of
participants were interested in ICALIN. ICALIN was ranked sixth as a reason for
choosing a hospital. In the case of a low ICALIN, 24.1% of participants would
refuse admission and 54.9% would seek advice from their general practitioner.
Sociodemographic factors had no influence on patients' attitude. In conclusion,
our survey suggests that patients take note of poor performance on infection
control report cards. As most patients rely on their general practitioner to
interpret these report cards, there is a definite need for further communication
with general practitioners on this issue.
PMID: 19147258 [PubMed - in process]
22: Rev Neurol (Paris). 2009 Mar;165(3):223-31. Epub 2008 Dec 10.
[Alzheimer disease: Autosomal dominant forms.]
[Article in French]
Guyant-Maréchal L, Campion D, Hannequin D.
Service de neurologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex,
France; Inserm U614, faculté de médecine-pharmacie, Rouen, France.
We propose a review devoted to the autosomal dominant forms of Alzheimer disease
(AD). These forms are the consequences of either PSEN1 mutations (69%), APP
mutations (1%), or APP duplication (7.5%), and exceptionally of PSEN2 mutations
(2%). The main characteristic of these AD forms is the early age of onset usually
before the age of 60 years. The first part of the review focuses on the
identification of unusual clinical and neuropathological phenotypes enlarging the
AD spectrum: intracrebral hemorrhages caused by severe amyloid angiopathy,
spastic paraparesis, Lewy body dementia and exceptional cerebellar ataxia. The
second part concerns the consequences of these mutations on Abeta processing,
thus demonstrating the key role of the causal "amyloid cascade".
Publication Types:
English Abstract
PMID: 19081588 [PubMed - in process]
23: Fertil Steril. 2009 Mar;91(3):934.e5-9. Epub 2008 Nov 8.
Fertility after B-Lynch suture and stepwise uterine devascularization.
Sentilhes L, Gromez A, Trichot C, Ricbourg-Schneider A, Descamps P, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital, Charles
Nicolle, Rouen, France. loicsentilhes@hotmail.com
OBJECTIVE: To report the obstetric outcome in a patient who had previously
undergone a stepwise uterine devascularization followed by a B-Lynch suture for
severe postpartum hemorrhage (PPH). DESIGN: Case report. SETTING: University
hospital. PATIENT(S): A 29-year-old woman whose first pregnancy was complicated
by severe PPH due to uterine atony. INTERVENTION(S): Stepwise uterine
devascularization followed by a B-Lynch suture because of persistent PPH. MAIN
OUTCOME MEASURE(S): Preservation of reproductive capacity. RESULT(S): Two years
later, the patient conceived spontaneously and delivered a healthy infant by
caesarean section after an uneventful pregnancy. During the operation, the uterus
showed no marks of the former B-Lynch suture. CONCLUSION(S): This is the first
reported case of obstetric outcome after stepwise uterine devascularization and
B-Lynch suture. Further case series with mid- and long-term follow-up are
required to determine whether the B-Lynch suture has an impact on the patient's
subsequent fertility and pregnancies and to establish its place in the PPH
surgical management algorithm.
PMID: 18996514 [PubMed - indexed for MEDLINE]
24: Endocr Relat Cancer. 2009 Mar;16(1):281-90. Epub 2008 Oct 23.
Metoclopramide stimulates catecholamine- and granin-derived peptide secretion
from pheochromocytoma cells through activation of serotonin type 4 (5-HT4)
receptors.
Guillemot J, Compagnon P, Cartier D, Thouennon E, Bastard C, Lihrmann I, Pichon
P, Thuillez C, Plouin PF, Bertherat J, Anouar Y, Kuhn JM, Yon L, Lefebvre H.
INSERM U413, University of Rouen, Mont Saint Aignan, France.
The gastroprokinetic agent metoclopramide is known to stimulate catecholamine
secretion from pheochromocytomas. The aim of the study was to investigate the
mechanism of action of metoclopramide and expression of serotonin type 4
(5-HT(4)) receptors in pheochromocytoma tissues. Tissue explants, obtained from
18 pheochromocytomas including the tumor removed from a 46-year-old female
patient who experienced life-threatening hypertension crisis after metoclopramide
administration and 17 additional pheochromocytomas (9 benign and 8 malignant)
were studied. Cultured pheochromocytoma cells derived from the patient who
previously received metoclopramide were incubated with metoclopramide and various
5-HT(4) receptor ligands. In addition, total mRNAs were extracted from all the 18
tumors. Catecholamine- and granin-derived peptide concentrations were measured in
pheochromocytoma cell incubation medium by HPLC and radioimmunological assays. In
addition, expression of 5-HT(4) receptor mRNAs in the 18 pheochromocytomas was
investigated by the use of reverse transcriptase-PCR. Results: Metoclopramide and
the 5-HT(4) receptor agonist cisapride were found to activate catecholamine- and
granin-derived peptide secretions by cultured tumor cells. Metoclopramide- and
cisapride-evoked catecholamine- and granin-derived peptide productions were
inhibited by the 5-HT(4) receptor antagonist GR 113808. 5-HT(4) receptor mRNAs
were detected in the patient's tumor and the series of 17 additional
pheochromocytomas. This study shows that pheochromocytomas express functional
5-HT(4) receptors that are responsible for the stimulatory action of
metoclopramide on catecholamine- and granin-derived peptide secretion. All
5-HT(4) receptor agonists must therefore be contraindicated in patients with
proven or suspected pheochromocytoma.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 18948374 [PubMed - in process]
25: Intensive Care Med. 2009 Mar;35(3):519-26. Epub 2008 Oct 15.
Cephalic versus oronasal mask for noninvasive ventilation in acute hypercapnic
respiratory failure.
Cuvelier A, Pujol W, Pramil S, Molano LC, Viacroze C, Muir JF.
Pulmonary and Intensive Care Department, Rouen University Hospital & UPRES EA
3830, IFR MP23, Institute for Biomedical Research, University of Rouen, Rouen,
France. antoine.cuvelier@chu-rouen.fr
OBJECTIVE: Compared to oronasal interfaces, a cephalic mask has a larger inner
volume, covers the entire anterior surface of the face and limits the risk of
deleterious cutaneous side effects during noninvasive ventilation (NIV). The
present clinical study aimed to compare the clinical efficacy of a cephalic mask
versus an oronasal mask in patients with acute hypercapnic respiratory failure
(AHRF). DESIGN AND SETTING: Randomized controlled study in a Respiratory
Intermediate Care Unit. PATIENTS: All consecutive patients admitted for AHRF were
randomly assigned to receive bilevel NIV either with a cephalic mask (n = 17) or
an oronasal mask (n = 17) during the first 48 h. MEASUREMENTS: The main outcome
criterion was the improvement of arterial pH, 24 h after NIV initiation.
Secondary criteria included PaCO(2) and physiological parameters. RESULTS:
Compared to values at inclusion, pH, PaCO(2), encephalopathy score, respiratory
distress score and respiratory frequency improved significantly and similarly
with both masks. None of these parameters showed statistically significant
differences between the masks at each time point throughout the study period.
Mean delivered inspiratory and expiratory pressures were similar in both patient
groups. Tolerance of the oronasal mask was improved at 24 h and further. One
patient with the cephalic mask suffered from claustrophobia that did not lead to
premature study interruption. CONCLUSIONS: In spite of its larger inner volume,
the cephalic mask has the same clinical efficacy and requires the same
ventilatory settings as the oronasal mask during AHRF.
PMID: 18854973 [PubMed - in process]
26: Leuk Res. 2009 Mar;33(3):407-17. Epub 2008 Oct 1.
Secretion of MMP-2 and MMP-9 induced by VEGF autocrine loop correlates with
clinical features in childhood acute lymphoblastic leukemia.
Poyer F, Coquerel B, Pegahi R, Cazin L, Norris V, Vannier JP, Lamacz M.
Groupe de Recherche sur le Micro-Environnement et le Renouvellement Cellulaire
Intégré M.E.R.C.I., Faculté de Médecine-Pharmacie, Université de Rouen; 22 bd
Gambetta, 76183 Rouen, France.
In children with acute lymphoblastic leukemia (ALL), leukemic cells express
several members of the VEGF family and the three VEGF receptors which, via an
autocrine loop are responsible for secretion of MMP-2/-9. MMP activity and the
presence of elements of the autocrine loop are correlated with clinical and
prognostic parameters as follows: i) high basal MMP-9 activity with tumoral
syndrome, ii) MMP-2 activity with treatment failure, iii) VEGFR-1/-3
co-expression with high hemoglobin level and iv) expression of the VEGF-A 121
isoform and favorable response to treatment. These data implicate autocrine
VEGF-induced secretion of MMP-2/-9 in the physiopathology of childhood ALL.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 18829111 [PubMed - indexed for MEDLINE]
27: J Biomed Mater Res A. 2009 Mar 15;88(4):1069-78.
Proteomic analysis of Staphylococcus aureus biofilms grown in vitro on mechanical
heart valve leaflets.
Bénard L, Litzler PY, Cosette P, Lemeland JF, Jouenne T, Junter GA.
Research Group on Antimicrobials and Microorganisms, EA 2656, Charles Nicolle
University Hospital, Rouen, France.
The in vitro colonization of three commercial heart valve leaflets by
Staphylococcus aureus was investigated. The leaflets, made of pyrolytic carbon
alloyed with or without silicon, displayed similar surface properties
(wettability, roughness) and were readily colonized by S. aureus that formed
patchy biofilms on the three supports. A proteomic approach was used to assess
the physiological status of biofilm populations by comparing their protein maps
to those of bacteria cultured as free cells in the presence or absence of biofilm
substratum. Principal component analysis (PCA) revealed, for each tested leaflet,
statistical relationships between the protein maps of the biofilm and
free-floating microbial populations. A spot-by-spot comparison of protein levels
on two-dimensional electropherograms showed that many proteins were accumulated
or underproduced by microbial populations grown in the presence of a leaflet
compared with protein levels in control free populations. The number of
accumulated proteins was noticeably higher than that of underproduced
polypeptides. This protein overproduction was emphasized in biofilm populations.
Several proteins, some of which were identified, were differentially produced by
both surface-associated planktonic and biofilm-grown cell populations compared
with control free-cell ones cultured in the absence of leaflet, whatever the
leaflet tested. The potential of this proteomic approach for fighting against
microbial adhesion and biofilm formation is discussed.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 18404712 [PubMed - in process]
