1. Rev Chir Orthop Traumatol. 2009 Dec;95(8):725-732. Epub 2009 Dec 10.
[Mini-invasive nail versus DHS to fix pertrochanteric fractures: A case-control
study.]
[Article in French]
Foulongne E, Gilleron M, Roussignol X, Lenoble E, Dujardin F.
Clinique universitaire de chirurgie orthopédique et traumatologique, hôpital
Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
PMID: 20064331 [PubMed - as supplied by publisher]
2. Rev Mal Respir. 2009 Dec;26(10):1172-3.
[In Process Citation]
[Article in French]
Lubrano-Lavadera M, Michelet I, Couderc L, Marguet C.
Unité de pneumologie et d'allergologie pédiatrique, Département de Pédiatrie
Médicale, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France.
PMID: 20032855 [PubMed - in process]
3. Rev Mal Respir. 2009 Dec;26(10):1161-3.
[In Process Citation]
[Article in French]
Marguet C, Michelet I, Lubrano-Lavadera M, Couderc L.
Unité de Pneumologie et d'allergologie pédiatrique, Département de Pédiatrie
Médicale, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France.
PMID: 20032851 [PubMed - in process]
4. Pediatrics. 2010 Jan;125(1):e29-34. Epub 2009 Dec 21.
Prenatal low-dose aspirin and neurobehavioral outcomes of children born very
preterm.
Marret S, Marchand L, Kaminski M, Larroque B, Arnaud C, Truffert P, Thirez G,
Fresson J, Rozé JC, Ancel PY; EPIPAGE Study Group.
Collaborators: Ancel PY, Blondel B, Bréart G, Dehan M, Garel M, Kaminski M,
Maillard F, du Mazaubrun C, Missy P, Sehili F, Supernant K, Marchand L, Durant
AM, Matis J, Messer J, Treisser A, Burguet A, Abraham-Lerat L, Menget A, Roth P,
Schaal JP, Thiriez G, Lévêque C, Marret S, Marpeau L, Boulot P, Picaud JC,
Donadio AM, Ledésert B, André M, Fresson J, Hascoët JM, Arnaud C, Bourdet-Loubère
S, Grandjean H, Rolland M, Leignel C, Lequien P, Pierrat V, Puech F, Subtil D,
Truffert P, de la Loire P, Boog G, Rouger-Bureau V, Rozé JC, Ancel PY, Bréart G,
Kaminski M, duMazaubrun C, Dehan M, Zupan-Simunek V, Vodovar M, Voyer M.
Department of Neonatal Medicine, Rouen University Hospital, Rouen, France.
stephane.marret@chu-rouen.fr
OBJECTIVE: Low-dose aspirin (LDA) given during pregnancy may alter brain
development in very preterm infants. We report the short- and long-term outcomes
of very preterm infants according to LDA treatment. PATIENTS AND METHODS: Data
were from the Etude Epidemiologique des Petites Ages Gestationnels (EPIPAGE)
cohort study, which included all infants born before 33 weeks of gestation in 9
French regions in 1997. This study was restricted to 656 children who were born
to 584 women with an obstetric history of placental vascular disease or with
chronic hypertension or renal or autoimmune diseases. The main outcome measures
were mortality, cerebral lesions, and outcome at 5 years of age, which were
measured by a diagnosis of cerebral palsy; behavioral difficulties, which were
assessed with the Strength and Difficulties Questionnaire; and cognitive
impairment, which was measured by the mental processing composite scale of the
Kaufman Assessment Battery for Children (an IQ-equivalent measure of cognitive
ability in 2 dimensions: sequential and simultaneous processing scores). RESULTS:
LDA treatment was administered to 125 of 584 (21%) mothers and was not
significantly associated with mortality, cerebral lesions, cerebral palsy, or
global cognitive impairment of the children at 5 years of age. The proportion of
low simultaneous processing scores (<70) was lower in the group with LDA (7% vs
19% without LDA; P = .04). This association was not significant after adjustment
for propensity score, prognostic factors, and social class (adjusted odds ratio
[aOR]: 0.59 [95% confidence interval (CI): 0.17-2.06]). LDA treatment was
associated with a reduction, at the limit of significance, in total behavioral
difficulties (aOR: 0.44 [95% CI: 0.19-1.02]) and hyperactivity (aOR: 0.43 [95%
CI: 0.17-1.05]). CONCLUSIONS: LDA was not associated with adverse neonatal or
long-term outcomes. Moreover, the results suggest that LDA may be associated with
a reduction in neurobehavioral difficulties. More research is needed to assess
the effects of aspirin alone or combined with other neuroprotective agents.
PMID: 20026499 [PubMed - in process]
5. Neurosci Lett. 2009 Dec 22. [Epub ahead of print]
Influence of sensory inputs and motor demands on the control of the centre of
mass velocity during gait initiation in humans.
Chastan N, Westby GW, Montcel ST, Do MC, Chong RK, Agid Y, Welter ML.
Centre d'Investigation Clinique, Fédération des Maladies du Système Nerveux,
Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière,
Paris F-75013, France; Service de Neurophysiologie, Centre Hospitalier
Universitaire de Rouen, F-76000, France.
Human gait requires the simultaneous generation of goal-directed continuous
movement (locomotion) and the maintenance of balance (postural control). In
adults, the centre of mass (CoM) oscillates in the vertical plane while walking.
During the single support phase of gait initiation, its vertical (vCoM) velocity
increases as the CoM falls and is actively reversed prior to foot-contact. In
this study we investigated whether this active control, which is thought to
reflect balance control during gait initiation, is controlled by visual and
somatosensory inputs (Experiment 1) and whether it is modified by a change in
motor demands, two steps versus one step (Experiment 2). In all healthy adults,
the vCoM velocity was braked, or controlled, by contraction of the soleus muscle
of the stance leg. The elimination of visual input alone had no effect on
braking, although its amplitude decreased when somatosensory inputs were
disrupted (-47%), and further decreased when both visual and somatosensory inputs
were disrupted (-83%). When subjects performed only one step, with no trailing of
the stance foot, the vCoM velocity braking also decreased (-42%). These results
suggest that active braking of the CoM fall during the transition to double
support, an indicator of balance control, is influenced by both multisensory
integration and the demands of the current motor program. The neural structures
involved in this mechanism remain to be elucidated. Copyright © 2009 Elsevier
Ireland Ltd. All rights reserved.
PMID: 20026383 [PubMed - as supplied by publisher]
6. Schizophr Res. 2009 Dec 16. [Epub ahead of print]
Impaired decision making in schizophrenia and orbitofrontal cortex lesion
patients.
Larquet M, Coricelli G, Opolczynski G, Thibaut F.
Rouen University Hospital, INSERM U 614, Faculty of Medicine, 76031 Rouen,
France.
BACKGROUND: The aim of this study was to examine impaired decision making in
patients with schizophrenia and in patients with orbitofrontal cortex lesions.
METHODS: Schizophrenia patients (N=21), healthy controls (N=20) and an
independent group of orbitofrontal patients (N=10) underwent a computerized
version of the "Regret Gambling Task". Participants chose between two gambles,
each having different probabilities and different expected monetary outcomes, and
rated their emotional states after seeing the obtained outcome. Regret was
induced by providing information about the outcome of the unchosen gamble.
RESULTS: Healthy controls reported emotional responses consistent with
counterfactual reasoning between obtained and unobtained outcomes; they chose
minimizing future regret and were able to learn from their emotional experience.
In contrast, orbitofrontal patients and schizophrenia patients with prominent
positive symptoms did not report any regret and did not anticipate any negative
consequences of their choices. Our results demonstrate first the presence of very
different behavioural deficits within the spectrum of schizophrenia patients
which may have contributed to the discrepancies observed in previous studies.
Second, the results suggest that a subgroup of schizophrenia patients might have
an orbitofrontal dysfunction, in fact, schizophrenia patients with positive
symptoms have a behavioural dysfunction analogous to that of the orbitofrontal
patients. CONCLUSION: Schizophrenia patients with prominent positive symptoms
were unable to integrate cognitive and emotional components of decision making
which may contribute to their inability to generate adaptive behaviours in social
and individual environments. Copyright © 2009 Elsevier B.V. All rights reserved.
PMID: 20022219 [PubMed - as supplied by publisher]
7. Ear Nose Throat J. 2009 Dec;88(12):E1-3.
Vagal paraganglioma of the neck: a case report.
Choussy O, Babin E, De Barros A, Bon-Mardion N, Marie JP, Dehesdin D.
Department of Oto-Rhino-Laryngology-Head and Neck Surgery, University Hospital
Charles Nicolle, Rouen, France.
Vagal paragangliomas are rare in the head and neck. Complementary use of computed
tomography and magnetic resonance imaging can facilitate the diagnosis and help
determine the best management approach. Most paragangliomas should be treated
with surgery. We report a case of vagal paraganglioma of the neck in a
50-year-old man. The patient was treated with superficial parotidectomy via a
transcervical approach. No postoperative morbidity was noted, and at 3 years of
follow-up, he was free of disease.
PMID: 20013662 [PubMed - in process]
8. Ann Surg.. [Epub ahead of print]
Prognostic Value of Circulating Mutant DNA in Unresectable Metastatic Colorectal
Cancer.
Lefebure B, Charbonnier F, Di Fiore F, Tuech JJ, Le Pessot F, Michot F, Michel P,
Frebourg T.
From the *Inserm U614, Institute for Medical Research, Rouen Northwest
Canceropole, France; daggerDepartment of Surgery, Rouen University Hospital,
Rouen, France; double daggerDigestive Oncology Unit, Department of
Hepato-Gastroenterology, Rouen University Hospital, Rouen, France; and section
signDepartment of Pathology, Rouen University Hospital, Rouen, France.
OBJECTIVE:: No validated biologic prognostic marker is presently available in
metastatic colorectal cancer (MCRC). We prospectively evaluated the prognostic
value of circulating mutant DNA in 31 patients presenting an unresectable MCRC
treated by chemotherapy, and we used, as tumor markers, KRAS mutations and
methylation of the RASSF2A promoter. METHODS:: Detection in the serum of KRAS
mutation and RASSF2A methylation were performed using sensitive methods,
respectively, real-time polymerase chain reaction (PCR) performed in the presence
of a peptide nucleic acid specific of the wild-type sequence and methyl-specific
PCR after bisulfite treatment. RESULTS:: Among 29 MCRC patients for whom DNA from
the primary tumor was available, 23 (79%) presented at least one of the markers
in their primary tumor, and 12 of them presented the same alteration in serum.
For the 2 remaining patients, RASSF2A methylation was detected in serum
indicating that this alteration was present in the primary tumor. These 14
patients with a detectable tumor marker in their serum were designed sDNA+
patients. After 6 months of follow-up, 11/14 (79%) sDNA+ and 1/11 (9%) sDNA-
patients presented a progressive disease (P = 0.001). The median progression free
survival was 5 months in sDNA+ patients versus 14 months in sDNA- patients (P =
0.004). After 1 year of follow-up, 2 of 14 (14%) sDNA+ and 8 of 11 (73%) sDNA-
patients presented no signs of disease progression (P = 0.005). CONCLUSIONS::
This study suggests that the presence of circulating mutant DNA in unresectable
MCRC patients, which can be detected using simple methods such as
methylation-specific PCR or real-time PCR, is highly predictive of clinical
outcome.
PMID: 20010083 [PubMed - as supplied by publisher]
9. Encephale. 2009 Dec;35(6):538-43.
[Self-mutilating behaviour: A study on 30inpatients.]
[Article in French]
Baguelin-Pinaud A, Seguy C, Thibaut F.
Inserm U614, UFR de médecine, service universitaire de psychiatrie, centre
hospitalier du Rouvray, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen
cedex, France.
INTRODUCTION: Deliberate self-injury is defined as the intentional, direct
injuring of body tissue without suicidal intent. There are different types of
deliberate self-mutilating behaviour: self cutting, phlebotomy, bites, burns, or
ulcerations. Sometimes, especially among psychotic inpatients, eye, tongue, ear
or genital self-mutilations have been reported. In fact, self-mutilation
behaviour raises nosological and psychopathological questions. A consensus on a
precise definition is still pending. Many authors consider self-mutilating
behaviour as a distinct clinical syndrome, whereas others hold it to be a
specific symptom of borderline personality disorder. Self-mutilating behaviour
has been observed in 10 to 15% of healthy children, especially between the age of
9 and 18months. These self mutilations are considered as pathological after the
age of 3. Such behaviour is common among adolescents, with a higher proportion of
females, and among psychiatric inpatients. Patients use different locations and
methods for self-mutilation. Deliberate self harm syndrome is often associated
with addictive behaviour, suicide attempt, and personality disorder. CLINICAL
MATERIAL: We report on an observational study including 30inpatients and we
compared the data with the existing literature. As a matter of fact, until now,
most of the papers deal with case reports or with very specific patterns of
self-mutilation (eye, tongue or genital self-mutilations). Otherwise, papers
report the relationships between self-mutilation and somatic or personality
disorders (Lesh Nyhan syndrome, borderline personality disorder, dermatitis
artefacta, self-mutilation in children following brachial plexus related to birth
injury, mental retardation...). Our study included all self harmed patients who
had been admitted to our psychiatric hospital (whatever the location and type of
self-mutilation). Patients suffering from brain injury or mental retardation were
excluded. RESULTS: In our sample, there was a higher percentage of women (29women
and 1man) and the mean age was 18 (12 to 37). More than half of the patients were
aged under 18. Single parent families were reported in 30% of cases. Thirty
percent of patients had been physically or sexually abused during childhood.
Sixty percent had a comorbid psychiatric disorder, 63% had been hospitalised
previously (half of them twice or more). Seventy-three percent of patients had
previously attempted suicide (notably deliberate self-poisoning and cutting) that
was not considered as self-mutilating behaviour by the patients themselves. Each
patient had self harmed themselves at least twice and most often different
methods and locations were used (deliberate self harm of forearms 90%, thighs
26.7%, legs 16.7%, chest 10%, belly 10%, hands 6.9%, face 6.9%, arms 6.7%, and
feet 3.3%). Addictive disorders, such as substance abuse (tobacco 46.7%; alcohol
23.3%; illicit drugs 16.7% mostly cannabis or cocaine) and eating disorders
(33.3% and among them 50% of cases were restrictive anorexia nervosa) were often
associated with a deliberate self harm syndrome. Three psychiatric diagnoses were
often observed in our cohort: depressive disorder 36.7%; personality disorder
20%; psychosis 10% and depressive disorder associated with personality disorder
33.3%. In our sample, psychotic patients differed on several clinical aspects:
the atypical location (abdomen, nails) and method (needles) of self-mutilating
behaviour. None of them had been abused during childhood and none was suffering
from addictive disorders.
PMID: 20004284 [PubMed - in process]
10. Am J Gastroenterol. 2009 Dec 8. [Epub ahead of print]
Increased Proteasome-Mediated Degradation of Occludin in Irritable Bowel
Syndrome.
Coëffier M, Gloro R, Boukhettala N, Aziz M, Lecleire S, Vandaele N, Antonietti M,
Savoye G, Bôle-Feysot C, Déchelotte P, Reimund JM, Ducrotté P.
[1] Nutrition Unit, Rouen University Hospital, Rouen, France [2] Appareil
Digestif, Environnement Nutrition (ADEN EA4311), Institute for Biomedical
Research, European Institute for Peptide Research (IFRMP 23), Rouen University,
Rouen, France.
OBJECTIVES:Proteasome-mediated protein degradation may contribute to the
regulation of intestinal inflammation. At the same time, low-grade inflammation
and increased intestinal permeability seem to be involved in the pathophysiology
of irritable bowel syndrome (IBS). Thus, we aimed to evaluate proteasome
composition and activities in colonic mucosa of IBS patients and its putative
pathogenic role.METHODS:Proteasome activities and proteasome subunit expression
were measured in colonic mucosa of IBS, Crohn's disease (CD), and control
patients by fluorometric assays and western blot, respectively. Expression of
inhibitor of kappa B factor (IkappaBalpha) and occludin, a tight junction
protein, was also evaluated in colonic biopsies. The degradation of recombinant
occludin incubated with protein extracts from colonic mucosa was evaluated in the
presence or absence of proteasome inhibitor, MG132.RESULTS:Proteasome
trypsin-like activity was increased in IBS patients compared with CD and
controls, whereas chymotrypsin-like activity was upregulated in CD patients only.
Caspase-like activity was reduced both in IBS and CD patients. IkappaBalpha
expression was similar between IBS and controls. In contrast, occludin expression
was lower in IBS than in controls, but occludin mRNA level was similar. Protein
extracts from IBS patients but not from controls degraded recombinant occludin
(20% over 160 min), which was blocked by MG132. Although mast cell number was
increased in IBS patients, no correlation was found between this number and
proteasome alterations.CONCLUSIONS:Our study shows that proteasome alterations
are present in the colonic mucosa of IBS patients and may contribute to the
pathophysiology of IBS by increasing occludin degradation.Am J Gastroenterol
advance online publication, 8 December 2009; doi:10.1038/ajg.2009.700.
PMID: 19997094 [PubMed - as supplied by publisher]
11. Rev Neurol (Paris). 2009 Dec 4. [Epub ahead of print]
[Argyrophilic grain disease: Synergistic component of dementia?]
[Article in French]
Wallon D, Sommervogel C, Laquerrière A, Martinaud O, Lecourtois M, Hannequin D.
Service de neurologie, université de Rouen, CHU Charles-Nicolle, 1, rue de
Germont, 76031 Rouen cedex, France.
INTRODUCTION: Argyrophilic grain disease (AGD) is one cause of neurodegenerative
dementia with a variable clinical spectrum. A neuropathology study is required
for diagnosis. CASE REPORT: We report the case of a 68-year-old patient
presenting with cognitive decline associating with frontal dysfunction and
parkinsonism. Death occurred two years after onset. The neuropathology study
revealed a status criblosus in the basal ganglia, neurofibrillary tangles and
AGD. DISCUSSION: We suggest that AGD could explain the atypical course of this
dementia considering the fast cognitive decline, the clinical expression and the
topography of the lesions. CONCLUSION: This case illustrates the possible
synergistic deleterious effect of this pathology on other causes of dementia.
PMID: 19963233 [PubMed - as supplied by publisher]
12. Prog Urol. 2009 Dec;19(12):897-901. Epub 2009 Oct 23.
[Male stress urinary incontinence: The place of alternatives to an artificial
urinary sphincter.]
[Article in French]
Grise P, Caremel R.
Service d'urologie, University Hospital, CHU Charles-Nicolle, rue de Germont,
76031 Rouen cedex, France.
Male stress urinary incontinence is most often the consequence of surgery for
localised cancer of the prostate. The mechanism is a deficit of the sphincter and
a problem of support. Clinical analysis is based on a questionnaire together with
mictional results, a standard questionnaire and the pad-test. The value of the
pressure of the urethral sphincter and a verification of the absence of urethral
stenosis are checked. This allows for the gravity of the incontinence to be
evaluated: severe, moderate or minor. First line treatment for severe forms is an
artificial sphincter. For more moderate forms or disabling minor forms,
mini-invasive surgery can be proposed if physiotherapy does not work. Suburethral
tape is inserted via the perineal and transurethral routes, the periurethral
balloons are inserted by perineal route and inflated progressively. Total
continence is reestablished for half the patients treated with the tape and a
third of those with the balloons. There are many complications with the balloons
but the long-term effectiveness of both methods needs to be assessed.
PMID: 19963188 [PubMed - in process]
13. Prog Urol. 2009 Dec;19(12):863.
[Nurse specialized in urology, the way is on.]
[Article in French]
Grise P.
Service d'urologie, hôpital Charles-Nicolle, CHU de Rouen, rue de Germont, 76031
Rouen, France.
PMID: 19963179 [PubMed - in process]
14. Rev Chir Orthop Traumatol. 2009 Dec;95(8):592-8.
Mini-invasive nail versus DHS to fix pertrochanteric fractures: a case-control
study.
Foulongne E, Gilleron M, Roussignol X, Lenoble E, Dujardin F.
Department of Orthopaedic and Trauma Surgery, Charles Nicolle Hospital, Rouen
University Hospital Center, 76031 Rouen cedex, France.
BACKGROUND: Fixation devices to treat trochanteric fractures belong to two
general categories: dynamic hip screw (DHS) type and intramedullary type
implants. In spite of possible pitfalls, both are considered valid options.
Comparing a sliding screw-plate system (DHS) along a mini-invasive nailing device
(BCM nail) with primary insertion of the cephalic screw, sheds light on the
debated management of trochanteric fractures. HYPOTHESIS: Due to its design, the
BCM nailing system allows a stable internal fixation and promotes enhanced
postoperative functional recovery. OBJECTIVES: To test this hypothesis in a
comparative prospective case-control study using the DHS screw-plate as a
reference. MATERIALS AND METHODS: Two groups of 30 patients, older than 60 years
old, with trochanteric fractures were included in this study. The screw-plates
were placed according to the standard method. Regarding the nailing system, the
cephalic screw was positioned first, then the nail was inserted through the screw
via a mini-invasive approach and locked distally using a bicortical screw.
Comparison between the two groups was based on (1) operative data: operating
time, intra- and postoperative blood loss; (2) immediate postoperative course:
complications, length of hospital stay, delay to sitting in a wheelchair; (3) the
postdischarge evolution: weightbearing, readmission to hospital; (4) functional
outcomes: recovery and mobility; (5) anatomical outcomes: restitution and bone
healing. RESULTS: The operating time (54+/-8.8 min vs 59+/-13.8 min) and
intraoperative (1.37+/-0.98 vs 1.90+/-1.43) and at Day 3 (1.25+/-1.05 vs
1.82+/-1.5) blood loss (haemoglobin loss), were favourable to the screw-plate
subgroup (p<0.05). The delay to sitting in a wheelchair (4.76+/-1.53 d vs
4+/-1.44 d) was favourable to the nail subgroup (p<0.05). There was a higher
incidence of secondary displacements in the screw-plate subgroup (3/26 [11.5%] vs
0/25 [0%]) (p<0.05). The screw-plate subgroup demonstrated a poorer healing rate
at 3 months (88% vs 100%) (p<0.05). Regarding functional recovery, a lesser
decrease in the Parker score was observed in the nail subgroup at 3 postoperative
months (2.42+/-2.3 vs 1.52+/-1.44) (p<0.05). CONCLUSION: This study has shown the
benefits of the BCM nail in terms of stability. But the potential advantages of
this mini-invasive technique were limited by ancillary-related difficulties which
need to be rectified. These preliminary results are in favour of a further
development of this innovating device.
PMID: 19945367 [PubMed - in process]
15. Arch Pediatr. 2009 Dec;16(12):1533-9. Epub 2009 Oct 24.
[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. didier.pinquier@chu-rouen.fr
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 - in process]
16. Am J Ophthalmol. 2009 Dec;148(6):852-9.e2. Epub 2009 Oct 17.
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 - indexed for MEDLINE]
17. J Neuroradiol. 2009 Dec;36(5):278-84. Epub 2009 Sep 25.
Usefulness of multislice computerized tomography angiography in preoperative
diagnosis of ruptured cerebral aneurysms.
Gerardin E, Daumas-Duport B, Tollard E, Langlois O, Dacher JN, Clavier E, Proust
F.
Department of Neuradiology, Hôpital Charles Nicolle, University of Rouen, France;
LITIS, EA 1108, University of Rouen, France. emmanuel.gerardin@chu-rouen.fr
OBJECTIVE: Non-invasive imaging methods have become primordial in subarachnoid
hemorrhage. The aim of our study was to evaluate the sensitivity and specificity
of multislice computed tomographic angiography (MSCTA) for the diagnosis of
cerebral aneurysm. METHODS: The 28 included consecutive patients with SAH
underwent both MSCTA and digital subtraction angiography (DSA). The MSCTA studies
were interpreted by two independent readers (A and B) for the presence, the
location and size of the aneurysm comparatively to the DSA as reference
examination. RESULTS: In 20 patients, 38 aneurysms were diagnosed and in eight no
aneurysm was found. Per patient basis, the diagnostic sensitivity and specificity
were excellent. Per aneurysm basis, the diagnostic sensitivity and specificity of
MSCTA were, respectively, 97.4 and 100% for reader A, 100 and 100% for reader B.
For aneurysms less than 3mm, sensitivity was 100% for both readers. Interobserver
agreement was excellent for the detection of aneurysm (kappa=0.98, 95% CI
[0.96-1]). Intertechnique and interobserver agreements were excellent for the
measurement of aneurysms (slope=0.86, r=0.91 p=3.1x10(-7) and slope=1.04, r=0.99,
p<10(-6), respectively). CONCLUSION: MSCTA was an accurate and reproducible
non-invasive imaging technique for preoperative diagnosis of ruptured cerebral
aneurysm. The MSCTA may be proposed in first intention after the diagnosis of SAH
was established, with special care regarding injection procedure and a strict
reading method using native images and thin MPR.
PMID: 19782402 [PubMed - in process]
18. Neurochirurgie. 2009 Dec;55(6):589-94. Epub 2009 Jul 9.
[Severe orthostatic hypotension and intramedullary tumor: a case report and
review of the literature]
[Article in French]
Derrey S, Maltête D, Ahtoy P, Fregey P, Proust F.
Service de neurochirurgie, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen
cedex 1, France. stephane.derrey@chu-rouen.fr
A 55-year-old woman presented with bilateral neuropathic pain of the upper limbs,
motor palsy of the right arm, urinary dysfunction, and postural dizziness. MRI
showed an intramedullary cervical tumor with a solid portion extended from C1 to
C3 surrounded by a cystic portion. A macroscopic complete resection was performed
and histological examination confirmed the diagnosis of ependymoma.
Postoperatively, the patient's neuropathic pain and postural dizziness worsened,
with syncopal attack while upright because of severe orthostatic hypotension
(OH). On physical examination, her supine systolic blood pressure was 130 mmHg
and fell to 80 mmHg while sitting with no change in heart rate. We found motor
palsy of the left arm, bilateral ataxia, and urinary retention. Three months
later, the patient was still bedridden, notably because of the OH. After 6
months, with the association of preventative measures of OH and high doses of a
direct alpha1-adrenoreceptor agonist, a vasoconstricting agent, the patient
recovered an independent gait permitting her to walk unassisted. The main causes
of OH include medication, nonneurogenic causes such as cardiac insufficiency, and
central or peripheral neurogenic causes such as diabetic insufficiency. Brainstem
tumors are known to provide severe OH but this symptom has been seldom described
in a purely spinal cord lesion. We report an interesting case of severe OH that
had complicated the surgical treatment of a high cervical spinal cord ependymoma
and we review the literature.
PMID: 19592056 [PubMed - in process]
19. Neurochirurgie. 2009 Dec;55(6):595-9. Epub 2009 Jul 4.
[Polyostotic fibrous dysplasia of the thoracic spine. A case study and review of
the literature]
[Article in French]
Ould Slimane M, Foulongne E, Derrey S, Fréger P, Proust F.
Service de neurochirurgie, CHU de Rouen, 1, avenue de Germont, 76031 Rouen cedex,
France.
Polyostotic fibrous dysplasia of the thoracic spine is extremely rare and
considered a benign disease. We report the case of a 46-year-old woman admitted
to the emergency department for subacute paraplegia. The spinal X-ray showed a
spontaneous fracture at the T4-T5 level. The CT scan revealed a tumor
infiltration of the vertebral body responsible for lysis. Spinal MRI confirmed
the neoplasia also located in the epidural space with spinal cord compression.
The patient underwent an emergency laminectomy associated with transpedicular
screw fixation between the T2 and T6 levels. At 2 months, she had evolved to a
normal gait. In the second session, a transthoracic approach was used for a
bone-graft-assisted fusion procedure to achieve long-term stabilization. At 4
years, the bone fusion was excellent and the patient was able to resume
socioprofessional activities. The diagnosis of fibrous dysplasia is usually made
histologically on surgical biopsy but MRI and CT scan sometimes provide a
preliminary indication. Although a consensus for management of this disease has
not been achieved, the authors recommend radical removal of all involved tissues
accompanied by internal fixation and bone-graft-assisted fusion.
PMID: 19577779 [PubMed - in process]
20. Gastroenterol Clin Biol. 2009 Dec;33(12):1106-13.
Control of pelvic symptoms in patients with rectal cancer and synchronous
metastases.
Tougeron D, Di Fiore F, Lefebure B, Hamidou H, Tuech JJ, Michot F, Paillot B,
Michel P.
Digestive Oncology Unit, Department of Gastroenterology, Northwest Cancéropôle,
Rouen University Hospital, 1 rue de Germont, Rouen cedex, France.
davidtougeron@hotmail.fr
Comment in:
Gastroenterol Clin Biol. 2009 Dec;33(12):1098-100.
OBJECTIVE: The optimal treatment strategy for rectal cancer (RC) with synchronous
metastases remains an issue of debate. The aim of this study was to evaluate the
impact of surgery and radiation on the control of pelvic symptoms in this
setting. METHODS: Consecutive patients with RC and synchronous metastases were
retrospectively assessed and divided into four treatment groups: surgical
resection of rectal tumor (S); radiotherapy with/without chemotherapy followed by
surgery (CRTS); chemoradiotherapy (CRT); and chemotherapy only (CT). Each group
was evaluated in terms of duration of pelvic symptom-free periods (relative to
overall survival). RESULTS: A total of 96 patients were evaluated: S: n=30; CRTS:
n=21; CRT: n=27; and CT: n=18. After treatment, pelvic symptoms persisted in
14.7% patients (S=0%, CRTS=7.1%, CRT=31.8%, CT=25%; P=0.01). The relative pelvic
symptom-free periods were 93.0% in the S group, 83.1% in the CRTS group, 53.0% in
the CRT group and 53.2% in the CT group (P<0.01). On multivariate analysis, only
surgical treatment correlated with a significant relative pelvic symptom-free
period (P<0.01), with an adjusted hazards ratio of 2.80 [95% CI: 1.79-4.39].
CONCLUSION: Our results suggest that rectal resection was the most effective
therapeutic procedure in selected patients with RC and synchronous metastases,
offering the patients the longest pelvic symptom-free periods.
PMID: 19423254 [PubMed - in process]
