Publications by authors named "Christian De Tymowski"

Background: Historically, women have been shown to underestimate their abilities, while men often assess themselves more accurately or overestimate. This study aims to determine self-assessment accuracy during online Objective Structured Clinical Examinations (OSCEs) according to gender.

Methods: A prospective study was conducted among fourth-year medical students at Paris Cité University during faculty training OSCEs, utilizing Zoom® software for remote participation.

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Objectives: Uric acid (UA) concentration is associated with increased risk of atrial fibrillation, but few studies have investigated this association after cardiac surgery. This study investigated the statistical association between postoperative atrial fibrillation (POAF) and preoperative UA concentration according to the type of cardiac surgery.

Methods: Consecutive patients undergoing cardiac surgery at a tertiary center from January to May 2019 were eligible.

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Introduction: Experimental studies in animals have yielded conflicting results on the role of Tumor Necrosis Factor (TNF) in sepsis and endotoxemia, with some reporting adaptive and others inappropriate effects. A meta-analysis of the available literature was performed to determine the factors explaining this discrepancy.

Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

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Background: Preoperative identification of patients with hemostasis abnormalities leading to an increased bleeding risk is based on routine hemostasis tests: prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet count. Because of their low predictive performance, guidelines recommend replacing them with structured bleeding risk questionnaires, but none is validated in this population.

Objectives: To assess the diagnostic accuracy of 3 strategies, performed at the preanesthesia visit before scheduled interventions, and to identify patients with hemostasis abnormalities leading to an increased bleeding risk METHODS: A multicenter study was performed in 7 French academic hospitals, involving patients scheduled for surgical intervention, without antiplatelet/anticoagulant treatment.

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Article Synopsis
  • - The study investigates the effectiveness of Objective Structured Clinical Examinations (OSCEs) for evaluating medical students, revealing that while in-person assessments provide depth, they also lead to inconsistencies due to varying examiner standards.
  • - Data from 900 medical students at Université Paris Cité was analyzed over multiple OSCE sessions, showing significant differences in scores based on staff who graded them, highlighting the need for a statistical method to account for this variability.
  • - The results indicate that both staff and student variances affect OSCE scores, with staff variability being notably impactful; implementing two raters for consensus grading can help enhance score reliability.
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  • A study was conducted to compare the outcomes of lung transplantation (LT) based on whether the surgery took place during the day or night.
  • The study included 253 patients between January 2015 and December 2020, with 66% undergoing surgery during the day and 34% at night.
  • Results showed that while mortality rates at 90 days and one year were similar for both groups, daytime procedures had a higher rate of one-year airway complications compared to nighttime surgeries.
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Background: Respiratory syncytial virus (RSV) infection is gaining interest due to the recent development of vaccines but is still misdiagnosed in the elderly. The primary objective was to compare all-cause mortality at day 30. Secondary objectives were to compare clinical presentation and rates of consolidative pneumonia, hospitalization, and intensive care unit (ICU) admission.

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Anticoagulation in patients with mechanical heart valves (MHV) is associated with a risk of major bleeding episodes (MBE). In case of MBE, anticoagulant interruption is advocated. However, there is lack of data regarding the thrombo-embolic events (TE) risk associated with anticoagulant interruption.

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Background & Aims: Ketamine-associated cholestatic liver injury is reported in patients with severe burn injury, but its association with patient outcome is unclear. We investigated the relationship between ketamine exposure, cholestatic liver injury, and outcome of critically ill patients with burn injury.

Methods: In a retrospective study, patients with severe burn injury were analysed across two periods: unrestricted ketamine prescription (ketamine-liberal) and capped ketamine dosage (ketamine-restricted).

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Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of or . The pathophysiology, epidemiology, clinical presentation, microbiological features, management and outcome of TSS are described in this review. Bacterial superantigenic exotoxins induces unconventional polyclonal lymphocyte activation, which leads to rapid shock, multiple organ failure syndrome, and death.

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Objectives: Following the reintroduction of aprotinin into the European market, the French Society of Cardiovascular and Thoracic Anaesthesiologists recommended its prophylactic use at half-dose for high-risk cardiac surgery patients. We examined whether the use of aprotinin instead of tranexamic acid could significantly reduce severe perioperative bleeding.

Methods: This multicentre, retrospective, historical study included cardiac surgery patients treated with aprotinin or tranexamic acid between December 2017 and September 2020.

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Article Synopsis
  • - The study investigates the risk factors and incidence of prolonged mechanical ventilation (PMV) after lung transplantation (LT) in patients at Bichat Claude Bernard Hospital from 2016 to 2020, finding that 28% required PMV for an average of 34 days.
  • - Significant independent risk factors for PMV include higher body mass index (BMI), diabetes in the recipient, ECMO support during surgery, and receiving more than 5 red blood cell transfusions.
  • - One-year survival rates show a concerning increase in mortality for patients on PMV (44%) compared to those without it (15%), highlighting the need to consider preoperative risk factors like BMI and diabetes in recipient selection.
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Background: The outcomes of lung transplantation (LT) recipients who received a graft from a brain-dead donor after successful resuscitation from cardiac arrest (CA donors) have been poorly described. This study compared the one-year survival of LT recipients depending on the CA status of the donor.

Methods: This prospective observational single-centre study analysed all consecutive patients who underwent LT at Bichat Claude Bernard Hospital, Paris, between January 2016 and December 2020.

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High-density lipoproteins (HDLs), whose main role is the reverse transport of cholesterol, also have pleiotropic anti-inflammatory, antioxidant, anti-apoptotic and anti-infectious properties. During sepsis, HDL cholesterol (HDL-C) concentration is low, HDL particle functionality is altered, and these modifications are correlated with poor outcomes. Based on the protective effects of HDL, we hypothesized that HDL-C levels could be associated with lung transplantation (LT) outcome.

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(1) Background: Cephalosporins (CA) are the first-line antibiotic prophylaxis recommended to prevent surgical site infection (SSI) after cardiac surgery. The combination of vancomycin/gentamicin (VGA) might represent a good alternative, but few studies have evaluated its efficacy in SSI prevention. (2) Methods: A single-centre retrospective study was conducted over a 13-year period in all consecutive adult patients undergoing elective cardiac surgery.

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Background: Airway complications are frequent after lung transplantation (LT), as they affect up to 23% of recipients. The implication of perioperative extracorporeal membrane oxygenation (ECMO) support and haemodynamic instability has never been specifically assessed. The first aim of this study was to explore the impact of perioperative ECMO support on bronchial anastomotic dehiscence (BAD) at Day 90 after LT.

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Article Synopsis
  • * A study in an ICU involving 219 septic patients showed that 15% had sepsis-associated liver dysfunction, which was associated with lower HDL levels.
  • * Despite the lower HDL-C concentrations in patients with liver dysfunction, no overall relationship was found between lipoprotein levels and liver dysfunction markers affecting outcomes.
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Background: The effect of red blood cell (RBC) transfusion on mortality after lung transplantation (LT) was assessed in some retrospective studies, with contradictory results. The first aim of this study was to assess the 90-day survival of LT recipients according to massive intraoperative transfusion (MIOT).

Methods: This prospective, observational, single-centre study analysed the intraoperative transfusion (IOT) of all consecutive LT recipients between January 2016 and February 2019.

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Background: Early pneumonia is an independent risk factor for 1-y mortality after lung transplantation (LTx). Pseudomonas aeruginosa is the most common isolate in early pneumonia and is also associated with an increased risk of chronic lung allograft dysfunction. The aim of our study was to evaluate the efficacy of secondary prophylaxis with inhaled colistin (IC) in preventing the recurrence of P aeruginosa or extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) pneumonia in the postoperative period in the intensive care unit after LTx.

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Introduction: Patients receiving extracorporeal membrane oxygenation (ECMO) often require renal replacement therapy (RRT). The challenge of inserting a dialysis catheter (DC) could be solved by direct connection of RRT lines on an ECMO circuit (DCRE) without published guidelines. This study aimed to describe the practice of RRT in patients on ECMO, including the DCRE as well as the perception and concerns related to this technique.

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Introduction: Lactate albumin ratio (LAR) has been used as a prognostic marker associated with organ failure in critically ill septic patients. LAR and its association with outcomes has never been studied in burned patients. The aim of this study was to evaluate the ability of LAR to predict 28-day mortality.

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