102 results match your criteria: "Centre hospitalier Saint Joseph-Saint Luc[Affiliation]"

Although using standardized reports is encouraged, most emergency radiological reports in France remain in free-text format that can be mined with natural language processing for epidemiological purposes, activity monitoring or data collection. These reports are obtained under various on-call conditions by radiologists with various backgrounds. Our aim was to investigate what influences the radiologists' written expressions.

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Background: Cardiogenic shock (CS) is a life-threatening condition characterized by circulatory insufficiency caused by an acute dysfunction of the heart pump. The pathophysiological approach to CS has recently been enriched by the tissue consequences of low flow, including inflammation, endothelial dysfunction, and alteration of the hypothalamic-pituitary-adrenal axis. The aim of the present trial is to evaluate the impact of early low-dose corticosteroid therapy on shock reversal in adults with CS.

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Oxaliplatin, a pivotal drug in the management of colorectal cancer, causes chemotherapy-induced peripheral neuropathy (CIPN) in a third of cancer survivors. Based on a previous cross-sectional study assessing oxaliplatin-related sensory CIPN in colorectal cancer survivors, a secondary analysis was designed to explore the possibility that different clusters of patients may co-exist among a cohort of patients with oxaliplatin-related CIPN. Other objectives were to characterize these clusters considering CIPN severity, anxiety, depression, health-related quality of life (HRQOL), patients' characteristics and oxaliplatin treatments.

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Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease.

J Am Coll Cardiol

November 2021

Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France.

Article Synopsis
  • The FUTURE trial investigated whether using fractional flow reserve (FFR) to guide treatment in multivessel coronary artery disease (CAD) is more effective than traditional approaches.
  • The study was a randomized trial involving 927 patients, comparing outcomes of an FFR-guided strategy with a standard strategy without FFR, focusing on major adverse cardiac events over one year.
  • Results showed no significant differences in major adverse events or mortality between the two groups, indicating that FFR guidance did not provide a clear benefit in managing multivessel CAD.
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Ankle dorsiflexion after isolated medial versus complete proximal gastrocnemius recession: A cadaveric study.

Foot (Edinb)

December 2021

Centre de Chirurgie Orthopédique & Traumatologique, C.H.R.U Tours, 37044, Tours Cedex, France; Faculté de Médecine de Tours, 10, Boulevard Tonnelé, 37032 Tours Cedex 1, France.

Purpose: Gastrocnemius recession has been described in the treatment of gastrocnemius contracture. The aims of this study were: (1) to assess the change in ankle dorsiflexion after isolated medial gastrocnemius recession performed according to L.S.

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In hospitalized patients, staphylococcal blood infection is common and mortality is high. Rapid diagnosis using molecular assay aims to identify the presence of Staphylococcus aureus and its resistance to methicillin as soon as the blood culture is positive. We evaluate performance of GeneXpert MRSA/SA Blood Culture assay (Cepheid®) before and after interpretation of the positivity levels of the various probes estimated by the Cycle threshold (Ct), as well as its contribution to the characterization of coagulase-negative staphylococci blood cultures not offered by the supplier.

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Background: Acute respiratory distress syndrome (ARDS) is a severe complication of COVID-19 pneumonia, with a mortality rate amounting to 34-50% in moderate and severe ARDS, and is associated with prolonged duration of invasive mechanical ventilation. Such as in non-COVID ARDS, harmful mechanical ventilation settings might be associated with worse outcomes. Reducing the tidal volume down to 4 mL kg of predicted body weight (PBW) to provide ultra-low tidal volume ventilation (ULTV) is an appealing technique to minimize ventilator-inducted lung injury.

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Determinants of COVID-19 vaccine hesitancy in French hospitals.

Infect Dis Now

November 2021

Infectiologie, Centre Hospitalier de Valence, 179, avenue du Maréchal Juin, 26953 Valence, France.

Objectives: COVID-19 vaccines have become the new hope for stemming the pandemic. We aimed to assess pre-launch vaccine acceptance among hospital workers in the Auvergne-Rhône-Alpes Administrative Region of France.

Methods: We performed a cross sectional study involving all hospital workers in 11 Auvergne-Rhône-Alpes hospitals in December 2020.

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We report the case of a 23-year-old patient with very marked hepatic cytolysis (ASAT: 18N; ALAT: 44N) associated with biological icterus and mucocutaneous jaundice. Initially, no etiology was identified due to the absence of toxic consumption, the negativity of hepatotropic virus serologies and tests for autoimmune pathologies. Following the appearance of cutaneous signs three weeks after the onset of hepatic involvement, a syphilis serology was performed, which proved positive and led to the diagnosis of secondary syphilis.

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Article Synopsis
  • This study investigated if colchicine, an anti-inflammatory medication, could reduce heart damage and remodeling after a ST-segment-elevation myocardial infarction (a type of heart attack) by comparing it to a placebo in a double-blind trial.
  • The trial included 192 patients, with no significant differences in heart damage or remodeling observed between the colchicine and placebo groups at both 5 days and 3 months post-treatment.
  • However, patients taking colchicine experienced higher rates of gastrointestinal side effects compared to those on the placebo, suggesting a potential drawback of the treatment.
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Background: Critically ill patients with obesity may have an increased risk of difficult intubation and subsequent severe hypoxemia. We hypothesized that pre-oxygenation with noninvasive ventilation before intubation as compared with high-flow nasal cannula oxygen may decrease the risk of severe hypoxemia in patients with obesity.

Methods: Post hoc subgroup analysis of critically ill patients with obesity (body mass index ≥ 30 kg·m) from a multicenter randomized controlled trial comparing preoxygenation with noninvasive ventilation and high-flow nasal oxygen before intubation of patients with acute hypoxemic respiratory failure (PaO/FiO < 300 mm Hg).

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Third generation cephalosporins are frequently used in the first-line treatment of Gram-negative rod (GNR) bacteremia but are unsuitable in the case of extended-spectrum-beta-lactamase-producing Enterobacterales (ESBL-E) or non-fermenting GNR infections. The aim of this study was to develop and evaluate a simple and rapid two-test protocol involving oxidase and β-Lacta tests performed directly on positive blood culture broth as a preliminary screen for non-fermenting or third generation cephalosporins-resistant GNR. The diagnostic performance of this approach was evaluated on 294 bottles for the oxidase test and 267 bottles for the β-Lacta Test.

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Article Synopsis
  • The study investigated COVID-19 seroprevalence among hospital staff in Lyon, France, revealing a 9% overall rate, with higher rates in healthcare staff, especially those working directly with COVID-19 patients.
  • Risk factors for higher seroprevalence included contact with confirmed COVID-19 cases at home and work; however, the ICU staff showed lower seropositivity rates.
  • The findings suggest that while healthcare workers are at risk, ICU staff may have better protective measures or lower exposure in comparison to those in COVID-19 units or emergency departments.
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Our aim was to develop practical models built with simple clinical and radiological features to help diagnosing Coronavirus disease 2019 [COVID-19] in a real-life emergency cohort. To do so, 513 consecutive adult patients suspected of having COVID-19 from 15 emergency departments from 2020-03-13 to 2020-04-14 were included as long as chest CT-scans and real-time polymerase chain reaction (RT-PCR) results were available (244 [47.6%] with a positive RT-PCR).

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CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME AND POSTERIOR OCULAR INVOLVEMENT: Case Series of 11 Patients and Literature Review.

Retina

November 2021

AP-HP, Cochin Hospital, Internal Medicine Department, Centre de Référence Maladies Auto-immunes et Systémiques Rares de l'Ile de France, AP-HP, Cochin Hospital, Paris, France.

Purpose: To describe the posterior ophthalmic manifestations of catastrophic antiphospholipid syndrome.

Methods: Retrospective case series of patients presenting with catastrophic antiphospholipid syndrome and posterior segment ocular manifestations. The main outcomes were the type of posterior segment manifestations at catastrophic antiphospholipid syndrome diagnosis, specifically retinal vascular occlusion, vasculitis, or choroidopathy, and the final best-corrected visual acuity.

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  • Gastrointestinal (GI) involvement in systemic necrotizing vasculitis is linked to a poor prognosis, and its impact can differ based on clinical presentation and specific vasculitis subtypes.
  • A study assessed 213 patients with various types of vasculitis who had GI complications, finding that 39% experienced severe outcomes like ICU admission, surgery, or death within six months.
  • Key risk factors for these poor outcomes included specific vasculitis subtype (especially polyarteritis nodosa), certain symptoms (like abdominal guarding and melena), and lab results (like high leukocyte counts and low hemoglobin levels), leading to the development of an effective risk prediction model.
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Objectives: To evaluate the impact of COVID-19's lockdown on radiological examinations in emergency services.

Methods: Retrospective, multicentre analysis of radiological examinations requested, via our teleradiology network, from 2017 to 2020 during two timeframes (calendar weeks 5-8 and then 12-15). We included CT scans or MRIs performed for strokes, multiple traumas (Body-CT), cranial traumas (CTr) and acute non-traumatic abdominal pain (ANTAP).

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  • Inflammatory processes significantly worsen myocardial damage during ischemia-reperfusion injury in STEMI, leading to serious complications like heart failure and poor recovery.
  • Colchicine, known for its strong anti-inflammatory effects, has shown a promising 50% reduction in infarct size in a phase II trial, compared to placebo, for acute STEMI patients undergoing primary percutaneous coronary intervention (PPCI).
  • The ongoing COVERT-MI trial aims to confirm these findings by comparing a short course of colchicine treatment to placebo in STEMI patients, measuring infarct size and other cardiac health indicators over 5 days.
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Background: Several randomized clinical trials have shown that non-invasive ventilation (NIV) applied immediately after extubation may prevent reintubation in patients at high-risk of extubation failure. However, most of studies included patients with chronic respiratory disorders as well as patients without underlying respiratory disease. To date, no study has shown decreased risk of reintubation with prophylactic NIV after extubation among patients with chronic obstructive pulmonary disease (COPD).

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Background: The management of bone defect due to trauma or surgical debridement is a current problem in orthopedic trauma surgery, often complicated by infection and bone nonunion. The graft is one of the most challenging variables in surgical treatment. Bioactive Glass (BAG) as a biocompatible and osteogenic product is a promising bone substitute showing good results in maxillo-facial-, spine surgery and treatment of osteomyelitis.

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The COVID-19 pandemic, caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread worldwide. Serological testing for SARS-CoV-2-specific antibodies plays an important role in understanding and controlling the pandemic, notably through epidemiological surveillance. Well-validated and highly specific SARS-CoV-2 serological assays are urgently needed.

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