1. Ann Chir Plast Esthet. 2009 Oct 27. [Epub ahead of print]
[Mondor's disease and breast plastic surgery.]
[Article in French]
Dudrap E, Milliez PY, Auquit-Auckbur I, Bony-Rerolle S.
Service de chirurgie plastique reconstructrice et esthétique, CHU
Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
AIM: Mondor's disease is a rare complication following breast plastic surgery.
CASE REPORT: We report the case of a 40-year-old woman with breast shape and
volume asymmetry. She was treated by left breast submuscular prothesis
augmentation followed by right breast mastopexy 6months later. Following this
surgery, she presented with subcutaneous painful abdominal cords on the right
side or Mondor's disease. DISCUSSION: We discuss the diagnosis, physiopathology
and treatment of this disease in the light of scientific literature. The
physiopathology is based on fascial origin in a context of local vascularitis.
CONCLUSION: Mondor's disease is a rare but benign pathology following breast
plastic surgery. The treatment is symptomatic and the surgeon must reassure the
patient on the benignity and the lack of consequence on the final cosmetic
result.
PMID: 19875218 [PubMed - as supplied by publisher]
2. Br J Haematol. 2009 Oct 28. [Epub ahead of print]
Increased levels of tissue factor activity and procoagulant phospholipids during
treatment of children with acute lymphoblastic leukaemia.
Schneider P, Dreden PV, Rousseau A, Kassim Y, Legrand E, Vannier JP, Vasse M.
Paediatric Haematology and Oncology &IHU, Rouen University Hospital, rue de
Germont, Rouen, France.
Summary The use of l-asparaginase (l-ASP) in paediatric patients with acute
lymphoblastic leukaemia (ALL) is associated with thrombotic complications. We
evaluated the activities of tissue factor (TFa), thrombomodulin (TMa) and
procoagulant phospholipids (PPL) in 26 consecutive children with ALL (25 B-ALL
and one T-ALL) treated by the French Acute Lymphoblastic Leukemia group
(FRALLE)-2000 protocol. Samples were obtained at diagnosis, after glucocorticoid
(GC) therapy, during the induction phase with l-ASP, vincristine (VCR) and
adriamycin (ADR), during the re-induction and within the week after treatment.
Plasma levels of TFa, TMa and PPL increased gradually and significantly during
the different phases of the treatment, with higher levels observed during the
induction period, and decreased after treatment discontinuation. In vitro studies
showed that the different drugs used for ALL treatment could induce a weak
expression of TF and procoagulant activity (PCA) on normal and leukaemia blood
cells, while a marked effect was observed on endothelial cells. In conclusion,
these data indicate that, in addition to the well-identified increased in
coagulation factors and inhibitor deficiencies, the injury of the endothelium
could lead to the release of TF and PPL and could contribute to the
hypercoagulability of children treated for ALL.
PMID: 19874310 [PubMed - as supplied by publisher]
3. Dysphagia. 2009 Oct 24. [Epub ahead of print]
Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic
Patients.
Gallas S, Marie JP, Leroi AM, Verin E.
Service de physiologie digestive, urinaire, respiratoire et sportive, CHU de
Rouen, 1 rue de Germont, 76031, Rouen Cedex, France.
Oropharyngeal dysphagia is frequent in stroke patients and increases mortality,
mainly because of pulmonary complications. We hypothesized that sensitive
transcutaneous electrical stimulation applied submentally during swallowing could
help rehabilitate post-stroke oropharyngeal dysphagia by improving cortical
sensory motor circuits. Eleven patients were recruited for the study (5 females,
68 +/- 11 years). They all suffered from recent oropharyngeal dysphagia (>eight
weeks) induced by a hemispheric (n = 7) or brainstem (n = 4) stroke, with
pharyngeal residue and/or laryngeal aspiration diagnosed by videofluoroscopy.
Submental electrical stimulations were performed for 1 h every day for 5 days
(electrical trains: 5 s every minute, 80 Hz, under motor threshold). During the
electrical stimulations, the patients were asked to swallow one teaspoon of paste
or liquid. Swallowing was evaluated before and after the week of stimulations
using a dysphagia handicap index questionnaire, videofluoroscopy, and cortical
mapping of pharyngeal muscles. The results of the questionnaire showed that
oropharyngeal dysphagia symptoms had improved (p < 0.05), while the
videofluoroscopy measurements showed that laryngeal aspiration (p < 0.05) and
pharyngeal residue (p < 0.05) had decreased and that swallowing reaction time (p
< 0.05) had improved. In addition, oropharyngeal transit time, pharyngeal transit
time, laryngeal closure duration, and cortical pharyngeal muscle mapping after
the task had not changed. These results indicated that sensitive submental
electrical stimulations during swallowing tasks could help to rehabilitate
post-stroke swallowing dysphagia by improving swallowing coordination. Plasticity
of the sensory swallowing cortex is suspected.
PMID: 19856025 [PubMed - as supplied by publisher]
4. Arch Pediatr. 2009 Oct 23. [Epub ahead of print]
[Vaccination rate of premature infants at 6 and 24 months of age: A pilot study.]
[Article in French]
Pinquier D, Adde-Michela C, Ploin D, Levêque C, Marret S; le réseau de
Périnatalité en Haute Normandie.
EA4309, service de pédiatrie néonatale et réanimation, université de Rouen, CHU
Charles-Nicolle, institut hospitalo-universitaire de recherche biomédicale, 1,
rue Germont, 76031 Rouen cedex, France.
There are few data examining the vaccine practices for 0- to 24-month-old
premature infants born before 33 GW. The aim of the study was to examine the
vaccine coverage in this population according to the French schedule at 6 and 24
months. RESULTS: Eighty-seven infants were included in this regional prospective
study. The immunization program began late and was initialized principally with
DTPCoqHib (63%), usually after the 4th month. Fewer than one infant out of two
(45%) had received three doses by 6 months of age. At 2 years of age, the
coverage was 99% at 3 doses and decreased to 83% for 4 doses. For the MMR
vaccine, the average age of administration was after 15 months, and 95% of
infants had received one dose of MMR at 2 years of age. BCG coverage at 2 years
of age was 94%, administered on average at 7 months. Forty-seven percent of the
infants had received at least one dose of hepatitis B vaccine before 2 years of
age, but only 31% had received two doses and a booster at 2 years of age. The
adaptation of vaccination practices basically concerns the initial date of
vaccination, but the immunization calendar is not recovered at 2 years of age.
This should be taken into account for pertussis disease prevention in these young
infants during the first 6 months of life, increasing the susceptibility period
for this infectious disease. DISCUSSION AND CONCLUSION: The vaccine practices do
not follow the postnatal chronological age of the premature baby according to the
schedule recommended for full-term infants and vaccination is begun late. Based
on the CSHPF vaccination recommendations, nearly 7 premature infants out of 10
have an incomplete immunization status for DTPCoqHib, hepatitis B, and ROR at 2
years of age. According to the pertussis coverage observed in premature infants,
the new recommendations on vaccination of the newborn's care giver and family
should be completed before the infant's discharge from the hospital using a new
acellular vaccine for adult immunization. The initiation of an immunization
program during hospitalization would be beneficial for premature babies still
hospitalized after 2 months of age.
PMID: 19854629 [PubMed - as supplied by publisher]
5. Encephale. 2009 Oct;35(5):429-35. Epub 2008 Oct 31.
[Renal transplantation, anxiety and depressive disorders and quality of life.]
[Article in French]
Baguelin-Pinaud A, Moinier D, Fouldrin G, Le Roy F, Etienne I, Godin M, Thibaut
F.
Service universitaire de psychiatrie, CHU Charles-Nicolle, 76000 Rouen, France;
Inserm U614, UFR de médecine, centre hospitalier de Rouvray, Rouen, France.
Until now there are few data in the literature describing psychiatric comorbidity
in patients waiting for renal transplantation. We have conducted a cross
sectional study estimating the prevalence of anxiety and depressive disorders in
three groups of renal transplant patients, before transplantation, six months and
one year after. The MINI was used to estimate the prevalence of anxiety and
depressive disorders. Anxiety and depressive symptoms were assessed using the
HAD. Patients' quality of life was also assessed using the SF-36. This study did
not find any major impact of renal transplantation on the prevalence of
structured psychiatric disorders. Indeed, the prevalence of depressive and
anxiety disorders did not differ significantly between the three groups. The mean
scores of anxiety did not differ significantly between the three groups in
contrast to the mean scores of depression, which differed significantly between
the group "before transplantation" and the group "one year after
transplantation". We did not find any significant difference concerning the
scores of patient's quality of life between the three groups, except for the item
"health perceived by the patients themselves". Health perceived by the patients
was greater in the group "after transplantation". The quality of life of dialysed
or transplant patients was strongly correlated with anxiety and depressive
symptoms scores, emphasizing the major interest of a multidisciplinary approach
for these patients.
PMID: 19853715 [PubMed - in process]
6. Scand J Work Environ Health. 2009 Oct 9:461-465. [Epub ahead of print]
Fate of abstracts presented at an International Commission on Occupational Health
(ICOH) congress - followed by publication in peer-reviewed journals?
Rollin L, Darmoni S, Caillard JF, Gehanno JF.
Service de médicine du travail, CHU de Rouen, 76000 Rouen, France.
-laetitia.rollin@chu-rouen.fr.
OBJECTIVES: Presentations at international meetings offer an excellent way to
disseminate current research findings. One measure of the quality of research is
its subsequent publication. Our study aimed to determine the publication rate of
abstracts presented at a congress of the International Commission of Occupational
Health (ICOH), and to identify predictive factors of publication and differences
between presented abstracts and -subsequently published papers. METHODS: We
identified a random sample of 318 abstracts presented at the 2000 ICOH meeting
from the book of abstracts. Using Medline and Embase, we assessed their
publication rate in the period ranging from 1998 to 2006 and investigated the
factors associated with publication rate. RESULTS: Of 318 abstracts originating
from 51 countries, 105 articles [33%, 95% confidence interval (95% CI) 27-38)]
were subsequently published in 67 journals indexed in Medline or Embase. Mean
time to publication was 17 months (95% CI 13-21). Multivariate analysis revealed
that abstracts with quantitative data and written by authors originating from
developed countries were significantly more published. From the time of abstract
presentation to publication in a peer-reviewed journal, both the study sample
size and the first author frequently changed (respectively 25% and 29%), but the
overall conclusions remained stable, except in one case. CONCLUSIONS: Most of the
abstracts presented at the 2000 ICOH congress were not subsequently published as
full research reports. If this is the case for most abstracts submitted to
conferences, this may limit the ability of a reader to judge the validity,
reliability, and generalizability of the research presented. Caution is advised
when referencing or generalizing from abstracts that have not been subsequently
published in full.
PMID: 19851699 [PubMed - as supplied by publisher]
7. QJM. 2009 Oct 20. [Epub ahead of print]
Palmar fasciitis and polyarthritis syndrome.
Marie I, Cailleux N, Roca F, Benhamou Y, Scotte M, Levesque H.
Département de Médecine Interne, CHU de Rouen, 76031 Rouen Cedex, France.
PMID: 19843603 [PubMed - as supplied by publisher]
8. J Immunol. 2009 Oct 19. [Epub ahead of print]
Critical Role of TLR2 and TLR4 in Autoantibody Production and Glomerulonephritis
in lpr Mutation-Induced Mouse Lupus.
Lartigue A, Colliou N, Calbo S, François A, Jacquot S, Arnoult C, Tron F, Gilbert
D, Musette P.
*INSERM, Unité 905, Rouen, France.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by
pathogenic autoantibodies directed against nuclear Ags and immune complex
deposits in damaged organs. Environmental factors have been thought to play a
role in the onset of the disease. The recognition of these factors is mediated by
TLRs, in particular TLR2 and TLR4 which bind pathogen-associated molecular
patterns of Gram(+) and Gram(-) bacteria, respectively. We attempted to determine
the role of these TLRs in SLE by creating TLR2- or TLR4-deficient
C57BL/6(lpr/lpr) mice. These mice developed a less severe disease and fewer
immunological alterations. Indeed, in C57BL/6(lpr/lpr)-TLR2 or -TLR4-deficient
mice, glomerular IgG deposits and mesangial cell proliferation were dramatically
decreased and antinuclear, anti-dsDNA, and anti-cardiolipin autoantibody titers
were significantly reduced. However, the response against nucleosome remained
unaffected, indicating a role of TLR2 and TLR4 in the production of Abs directed
against only certain categories of SLE-related autoantigens. Analysis of B cell
phenotype showed a significant reduction of marginal zone B cells, particularly
in C57BL/6(lpr/lpr)-TLR4-deficient mice, suggesting an important role of TLR4 in
the sustained activation of these cells likely involved in autoantibody
production. Interestingly, the lack of TLR4 also affected the production of
cytokines involved in the development of lupus disease.
PMID: 19841185 [PubMed - as supplied by publisher]
9. Am J Ophthalmol. 2009 Oct 16. [Epub ahead of print]
Vision-Related Function After Scleral Lens Fitting in Ocular Complications of
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.
Tougeron-Brousseau B, Delcampe A, Gueudry J, Vera L, Doan S, Hoang-Xuan T,
Muraine M.
Ophthalmology Department, Charles Nicolle Hospital, CHU de Rouen, Rouen, France.
PURPOSE: To describe the therapeutic benefits of scleral lenses in the management
of severe ocular surface disease attributable to toxic epidermal necrolysis (TEN)
and Stevens-Johnson syndrome (SJS). DESIGN: Retrospective study. METHODS:
Clinical records of 39 patients (67 eyes) fitted with scleral lenses for
refractory ocular surface disease attributable to SJS or TEN were reviewed. To
assess vision-specific quality of life, each patient completed the Ocular Surface
Disease Index (OSDI) questionnaire and the National Eye Institute Visual Function
Questionnaire (NEI VFQ-25). Slit-lamp examination was performed at regular
intervals to detect side effects. Main outcome measures were best-corrected
visual acuity (VA) and OSDI and NEI VFQ-25 composite score before and 6 months
after scleral lens fitting. RESULTS: The mean age was 35.8 +/- 13.9 years.
Scleral lens fitting failed in 3 patients. The mean follow-up was 33.3 +/- 17.6
months. Among fitted patients, VA in the better eye (36 patients, 36 eyes)
progressed from 0.73 to 0.50 logarithm of the minimum angle of resolution (P =
.0001) 6 months after scleral lens placement. The mean OSDI improved from 76.9
+/- 22.8 to 37.1 +/- 26.7 (P = .0001). Thirty-two NEI VFQ-25 composite scores
were available. The mean NEI VFQ-25 composite score improved from 25.1 +/- 16.8
to 67.4 +/- 22.1 (P = .0001). No serious adverse events attributable to the
scleral lenses occurred. CONCLUSIONS: Scleral lens use appears to be efficient
and safe for visual rehabilitation of refractory ocular surface disease
attributable to TEN and SJS.
PMID: 19837383 [PubMed - as supplied by publisher]
10. Rev Med Interne. 2009 Oct 13. [Epub ahead of print]
[Aspirin for primary prevention of cardiovascular events in diabetes: Is there a
place?]
[Article in French]
Benhamou Y, Lévesque H.
Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France.
PMID: 19833416 [PubMed - as supplied by publisher]
11. BJOG. 2009 Oct 13. [Epub ahead of print]
Fertility and pregnancy following pelvic arterial embolisation for postpartum
haemorrhage.
Sentilhes L, Gromez A, Clavier E, Resch B, Verspyck E, Marpeau L.
Department of Obstetrics and Gynaecology, Rouen University Hospital, Charles
Nicolle, Rouen, France.
Please cite this paper as: Sentilhes L, Gromez A, Clavier E, Resch B, Verspyck E,
Marpeau L. Fertility and pregnancy following pelvic arterial embolisation for
postpartum haemorrhage. BJOG 2009; DOI:
10.1111/j.1471-0528.2009.02381.x.Objectives To determine and compare the
fertility and pregnancy outcomes following embolisation with or without
uterine-sparing surgery for postpartum haemorrhage, and to attempt to identify
specific risk factors associated with an increased likelihood of intrauterine
synechia. Design Retrospective study. Setting University-affiliated tertiary
referral centre. Population All consecutive women who had an embolisation with or
without uterine-sparing surgery (vessel ligation and/or uterine compression) for
postpartum haemorrhage between 1994 and 2007 were included. Methods Data were
retrieved from medical files and telephone interviews. Main outcome measure(s)
Fertility and pregnancy outcomes, synechia. Results Data were available for 68 of
the 85 women (80%) included in the study. Among the 15 women who complained of
amenorrhoea or decreased flow of menstruation, synechia was found in all those
who decided to undergo an ambulatory hysteroscopy (n = 8). Seventeen women had 26
pregnancies with 19 term deliveries, one ectopic pregnancy, two abortions and
four miscarriages. The clinical courses of the 19 complete gestations were
uneventful, but postpartum haemorrhage recurred in six women (31.6%) (caused by
placenta accreta in two women). Fertility and pregnancy outcomes did not differ
between women who had undergone embolisation versus both embolisation and a
uterine-sparing surgical procedure. The occurrence of synechia was significantly
associated with a higher rate of placenta accreta/percreta (P < 0.001) and
postpartum fever above 38.5 degrees C (P = 0.04). Conclusions Embolisation,
whether or not associated with a uterine-sparing surgical procedure, for
postpartum haemorrhage does not appear to compromise a woman's subsequent
fertility and obstetric outcome. Nevertheless, these women should be considered
at high risk for postpartum haemorrhage during future deliveries.
PMID: 19832826 [PubMed - as supplied by publisher]
12. Rev Med Interne. 2009 Oct 12. [Epub ahead of print]
[Stiff-person syndrome and other neurological disorders associated with anti-GAD
antibodies.]
[Article in French]
Hijazi J, Bedat-Millet AL, Hannequin D.
Service de neurologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
Autoantibodies to glutamic acid decarboxylase (GAD), originally identified in the
stiff-person syndrome, are also associated with rare cases of therapy-resistant
epilepsy and sporadic cerebellar ataxia. The association of GAD antibodies with
these three syndromes and other auto-immune diseases, particularly type 1
diabetes mellitus, argues for their auto-immune origin. Anti-GAD antibodies
inhibit GABAergic circuits inducing a neuronal hyper-excitability that seems to
be responsible for these three syndromes. However, an additional mechanism seems
to be involved in the degenerative component of the cerebellar ataxia associated
with anti-GAD antibodies. A more accurate diagnosis and the study of
neuropathological cases are necessary to document the different mechanisms
implicated in these neurological disorders.
PMID: 19828214 [PubMed - as supplied by publisher]
13. J Gastrointest Surg. 2009 Oct 14. [Epub ahead of print]
Reporting on Quality of Life in Randomised Controlled Trials in Gastrointestinal
Surgery.
Bridoux V, Moutel G, Lefebure B, Scotte M, Michot F, Herve C, Tuech JJ.
Department of Digestive Surgery, Rouen University Hospital, 1 rue Germont, 76031,
Rouen Cedex, France.
BACKGROUND: Although health-related quality of life (HRQOL) has become an
important outcome measure in surgical trials, questions still remain about the
quality of its reporting. The aim of this study was to evaluate HRQOL assessment
methodology of randomised clinical trials concerning gastrointestinal surgery.
METHODS: All articles published in the calendar years 2006 and 2007 that
purported to assess quality of life as end points or make some conclusion about
quality of life were chosen for review from eight general surgical journals and
four medical journals. Identified eligible studies were selected and then
evaluated on a broad set of predetermined criteria. RESULTS: Twenty-four
published randomised controlled clinical trials (RCTs)s with an HRQOL component
were identified. Although most trials exhibited good-quality research, some
methodological limitations were identified: Only 21% of the studies gave a
rationale for selecting a specific HRQOL measure, 46% of the studies failed to
report information about the administration of the HRQOL measure, and 37% did not
give details on missing data. CONCLUSIONS: Although it is clear that HRQOL is an
important end point in surgical RCTs because the information helps to influence
treatment recommendations, a number of methodological shortcomings have to be
further addressed in future studies.
PMID: 19826884 [PubMed - as supplied by publisher]
14. Blood Coagul Fibrinolysis. 2009 Oct 3. [Epub ahead of print]
Plasma thrombomodulin activity, tissue factor activity and high levels of
circulating procoagulant phospholipid as prognostic factors for acute myocardial
infarction.
Van Dreden P, Rousseau A, Savoure A, Lenormand B, Fontaine S, Vasse M.
aResearch and Development, Diagnostica Stago, Gennevilliers, France bLaboratoire
d'Hématologie & IHURBM, France cDépartement de Cardiologie, CHU Charles Nicolle,
Rouen, France.
Several studies have indicated an association between haemostatic markers and
acute myocardial infarction, but few or no studies refer to their activity. We
studied plasma levels of 10 coagulation factors (fibrinogen, protein C, protein
S, von Willebrand factor, D-dimers, factor VIIa, free tissue factor pathway
inhibitor, tissue-type plasminogen activator, plasminogen activator inhibitor-1,
thrombomodulin) and using new specific assays analysed the activity of plasma
tissue factor (TFa), thrombomodulin (TMa), and procoagulant phospholipid in 46
consecutive patients with acute myocardial infarction at the time of hospital
admission, and compared them with 34 healthy normal volunteers. Plasma levels of
TFa, TMa, and procoagulant phospholipid were significantly higher in cases than
in control patients (P < 0.001). In addition the ratio of TFa/free tissue factor
pathway inhibitor was higher in patients than in controls, whereas the
tissue-type plasminogen activator (t-PA)/plasminogen activator inhibitor-1 ratio
was lower in patients. Interestingly, patients with an unfavourable outcome
during a 2-month follow-up had higher levels of TFa, TMa, procoagulant
phospholipid, a higher ratio of TFa/free tissue factor pathway inhibitor and a
lower ratio of t-PA/plasminogen activator inhibitor-1 than patients who
recovered. The combination of these different parameters reveals an increase in
procoagulant activity as well as impaired fibrinolytic activity during the acute
phase of an acute myocardial infarction. The association of the level of the
activity of these three factors may provide a new tool to assess the prognosis of
acute myocardial infarction. Further studies are needed to support our findings
and to elucidate the clinical interest of measuring these factors.
PMID: 19809306 [PubMed - as supplied by publisher]
15. J Immunol. 2009 Oct 1;183(7):4182-6.
Cutting edge: CD4-independent development of functional FoxP3+ regulatory t
cells.
Blache C, Adriouch S, Calbo S, Drouot L, Dulauroy S, Arnoult C, Le Corre S, Six
A, Seman M, Boyer O.
INSERM, Unité 905, Rouen, France; University of Rouen, Institut Fédératif de
Recherches Multidisciplinaires sur les Peptides, Institute for Biomedical
Research, F-76000 Rouen, France.
The CD4 coreceptor is mandatory for the differentiation and function of
conventional MHC class II-restricted T cells, but little is known about its
contribution in regulatory T cells (Tregs). We thus investigated the Treg
compartment in mice lacking CD4. CD3+CD8-FoxP3+ cells were readily detected in
the periphery of CD4(-/-) mice, where their percentages were even increased as
compared with wild-type animals. These cells had a classical CD25+CD152+GITR+
Treg phenotype, were enriched in memory-type Tregs, and displayed a diversified
TCR repertoire. Functionally, CD4(-/-) Tregs were equally as suppressive as
CD4(+/+) Tregs in vitro as well as in vivo. Hence, the CD4 coreceptor is
dispensable for the generation and function of FoxP3+ Tregs. Furthermore,
CD3+CD8-FoxP3+ Tregs were also found to develop in the absence of both CD4 and
MHC-II molecules, demonstrating that the generation of Tregs can occur
independently of MHC-II recognition.
PMID: 19767568 [PubMed - in process]
16. Gynecol Obstet Fertil. 2009 Oct;37(10):771-2. Epub 2009 Sep 17.
[Postoperative long-term amenorrhea avoids endometriosis recurrences: That is
ultimately proven!]
[Article in French]
Roman H.
Clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont,
76031 Rouen cedex, France.
PMID: 19766041 [PubMed - in process]
17. Presse Med. 2009 Oct;38(10):1443-50. Epub 2009 Sep 16.
[Searching French institutional health information sources: catalogue and index
of French-language medical sites (CISMeF)]
[Article in French]
Sakji S, Thirion B, Dahamna B, Darmoni SJ.
CISMeF, Centre hospitalier universitaire de Rouen, GCSIS, LITIS EA 4108, Institut
de recherche biomédicale, Université de Rouen, F-76031 Rouen, France.
The Catalogue and index of French-language medical sites (CISMeF) is a medical
portal that provides users with results as pertinent as possible according to
their requirements, expectations, and context of use. Indexing and single-term
research are based on theMedical subject headings(MeSH) thesaurus. The
integration of new medical terminology for indexing the catalogue's resources is
intended to minimize false-negatives during searches and to contextualize the
users' needs. The creation of a drug information portal makes more targeted
research possible, with numerous entries according to user (physicians,
pharmacists, chemists, and pharmacologists). For simplicity's sake, the
catalogue's index of resources by different nomenclatures is not entirely
displayed. The choice of display is left to the user, with MeSH only as the
default. These multi-nomenclature tools should be applicable as well to
electronic patient records. In this case, the objective is to improve patient
care by better searches and identification of the information required during
consultations and hospitalization.
PMID: 19762200 [PubMed - indexed for MEDLINE]
18. Rheumatology (Oxford). 2009 Oct;48(10):1314-9. Epub 2009 Aug 20.
Small intestinal bacterial overgrowth in systemic sclerosis.
Marie I, Ducrotté P, Denis P, Menard JF, Levesque H.
Department of Internal Medicine, Rouen University Hospital, 76301 Rouen Cedex,
France. isabelle.marie@chu-rouen.fr
OBJECTIVES: The aims of this study were to: (i) determine the prevalence of small
intestinal bacterial overgrowth (SIBO) in unselected patients with SSc; (ii)
assess both clinical presentation and outcome of SIBO; and (iii) make predictions
about which SSc patients are at risk for SIBO. METHODS: Fifty-one consecutive
patients with SSc underwent glucose hydrogen and methane (H(2)/CH(4)) breath
test. All SSc patients also completed a questionnaire for intestinal symptoms,
and a global symptomatic score (GSS) was calculated. SSc patients with SIBO were
given rotating courses of antibiotics (norfloxacin/metronidazole) for 3 months;
glucose H(2)/CH(4) breath test was performed at 3-month follow-up. RESULTS: The
prevalence of SIBO was 43.1% in our SSc patients. After logistic regression, we
identified the following risk factors for SIBO: presence of diarrhoea and
constipation. Interestingly, we observed a marked correlation between values of
GSS of digestive symptoms (> or =5) and the presence of SIBO (P = 10(-6));
indeed, both sensitivity and specificity of GSS > or =5 to predict SIBO were as
high as 0.909 and 0.862, respectively. Finally, eradication of SIBO was obtained
in 52.4% of the SSc patients with a significant improvement of intestinal
symptoms. CONCLUSION: Our study underscores that SIBO often occurs in SSc
patients. We further suggest that GSS may be systematically performed in SSc
patients; since we found a correlation between GSS of digestive symptoms > or =5
and SIBO, we suggest that glucose H(2)/CH(4) breath test may be performed in the
subgroup of SSc patients exhibiting GSS > or =5.
PMID: 19696066 [PubMed - in process]
19. Int J Qual Health Care. 2009 Oct;21(5):321-9. Epub 2009 Aug 19.
Does comparison of performance lead to better care? A pilot observational study
in patients admitted for hip fracture in three French public hospitals.
Merle V, Moret L, Pidhorz L, Dujardin F, Gouin F, Josset V, Graveleau S, Petit J,
Riou F, Lombrail P, Czernichow P.
Department of Epidemiology and Public Health, Rouen University Hospital, France.
veronique.merle@chu-rouen.fr
OBJECTIVE: To assess whether comparison of quality of hip fracture care among
three teams located in different hospitals is associated with improvement in
process and outcomes. DESIGN: A baseline assessment was performed using quality
indicators selected by professionals. RESULTS: were discussed among the three
teams followed by a post-comparison assessment of the same indicators. SETTING:
Three hospitals in North Western France. PARTICIPANTS: Professionals caring for
patients operated on for a low-impact hip fracture. INTERVENTION: Review and
discussion of comparative performance results by three teams followed by
implementation of quality improvement as deemed necessary by each team. MAIN
OUTCOME MEASURES: Fifteen quality indicators of health care during orthopedic and
rehabilitation stay, mobility, dependence and place of residence before hip
fracture and 3 months after discharge, 3 month post-surgery mortality and
readmission rates. RESULTS: Major differences were observed among hospitals
throughout the care process during baseline period. Comparison of performance and
discussion among the three teams were followed by corrective action in 11 areas.
After comparison, a significant improvement was observed in 10 areas, seven of
which corresponded to quality improvement areas chosen for improvement action by
professionals. A significant decrease in readmission rate (6.7% vs. 15.7%, P <
0.001) was observed but there was no change in mortality, functional outcome or
length of stay. CONCLUSIONS: Comparison of performance among voluntary teams, on
fields selected by health-care professionals, was associated with improvement in
the care process and with improvement of some related outcomes.
PMID: 19692425 [PubMed - in process]
20. Urology. 2009 Oct;74(4):765-70. Epub 2009 Jul 30.
Ineffectiveness of associating a suburethral tape to a transobturator mesh for
cystocele correction on concomitant stress urinary incontinence.
Sergent F, Gay-Crosier G, Bisson V, Resch B, Verspyck E, Marpeau L.
Department of Gynaecology and Obstetrics, Rouen University Hospital, University
of Rouen, Rouen, France. Fabrice.Sergent@chu-rouen.fr
OBJECTIVES: To evaluate the effect of a transobturator subvesical mesh for
cystocele on concomitant stress urinary incontinence (SUI). Genital and urinary
prolapse surgery presents difficulties, particularly regarding cure of SUI.
Advances in vaginal prosthetic surgery could correct these difficulties. METHODS:
Between July 2003 and October 2007, a total of 74 patients with a minimum stage 2
anterior prolapse with concomitant SUI were operated on, using a porcine
collagen-coated large-pore-size monofilament polypropylene mesh with 2
transobturator expansions, but without an additional procedure for SUI. All
patients had a physical examination and a subjective symptoms assessment using a
questionnaire in the preoperative period and again 6 weeks, 6 months, and then
each year after surgery. The pelvic organ prolapse quantification system was used
for anatomic results. For SUI, Ingelman-Sundberg classification and cough test
were used. Loss of urine was measured by a 1-hour pad test. Functional results
were evaluated by visual analog scale, pelvic floor distress inventory, and
pelvic floor impact questionnaire. RESULTS: Median follow-up was 36 months (range
12-51). Seventy-two women (97%) were cured of their prolapse. A total of 53 women
(72%) were cured of their SUI and 11 (15%) were improved. Pad test, visual analog
scale, pelvic floor distress inventory, and pelvic floor impact questionnaire all
showed improvement (P <.05). Prolonged bladder catheterization was not required.
Complications consisted of 1 hematoma requiring blood transfusion and 5 vaginal
extrusions (6%). CONCLUSIONS: Transvaginal mono prosthesis for the simultaneous
correction of prolapse and SUI represents an effective treatment without the risk
of prolonged urinary retention.
PMID: 19643459 [PubMed - indexed for MEDLINE]
