361 results match your criteria: "centre hospitalier Sud-Francilien[Affiliation]"

Epidemiology of idiopathic nephrotic syndrome in children: endemic or epidemic?

Pediatr Nephrol

December 2016

Service de Néphrologie Pédiatrique, Hôpital Robert-Debré, APHP, Paris, France.

Background: The etiology of idiopathic nephrotic syndrome (INS) remains partially unknown. Viral infections have been reported to be associated with INS onset and relapse. The aim of this study was to describe the epidemiology of a population-based cohort of children with INS and propose a spatiotemporal analysis.

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The microbiological tests on breast milk performed when samples of pasteurized breast milk are added to hospital milk banks are covered by French regulations dating from December 3 2007. They involve counts of the aerobic total flora and of Staphylococcus aureus in a sample of milk before pasteurization, and culture after pasteurization to check that the treated milk is sterile. The regulations specify the nature of the agar plates to be used, together with the conditions for plating and incubation, but they lack detail in other areas.

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Under the authority of the French Biomedicine Agency, a new care pathway integrates refractory cardiac arrest patients into a process of organ donation. It is a medical, logistical and ethical challenge for the staff of the mobile emergency services.

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The evaluation of off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) randomized controlled trial: study design and rational.

J Foot Ankle Res

April 2017

Department of Endocrinology, Diabetes, and Nutrition, DHU FIRE, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris, France ; INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France ; Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris, France.

Background: Off-loading is essential for diabetic foot management, but remains understudied. The evaluation of Off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) trial aims to evaluate the efficacy of a new removable device "Orthèse Diabète" in the healing of diabetic foot.

Methods/design: ORTHODIAB is a French multi-centre randomized, open label trial, with a blinded end points evaluation by an adjudication committee according to the Prospective Randomized Open Blinded End-point.

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Insulin Infusion Set Use: European Perspectives and Recommendations.

Diabetes Technol Ther

September 2016

11 Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital; Institute of Functional Genomics, UMR CNRS 5203/INSERM U1191, University of Montpellier, Montpellier, France .

Insulin pump users worldwide depend on insulin infusion sets (IISs) for predictable delivery of insulin to the subcutaneous tissue. Yet emerging data indicates that IISs are associated with many pump-related adverse events and may contribute to potentially life-threatening problem of unexplained hyperglycemia. The relative scarcity of published research on IISs to date, the heterogeneity of regional IIS practices, and the increasing demand for international standards guiding their use prompted convening of a panel of diabetologists and diabetes nurse educators last February, in Milan, Italy, to discuss a framework for optimizing IIS practice in Europe.

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Hypnosis and movement disorders: State of the art and perspectives.

Rev Neurol (Paris)

May 2017

Sorbonne Universités, Université Pierre-et-Marie-Curie (UPMC), Faculté de médecine, 75006 Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, 75013 Paris, France.

Introduction: Hypnosis might represent an interesting complementary therapeutic approach to movement disorders, as it takes into account not only symptoms, but also well-being, and empowers patients to take a more active role in their treatment.

Methods: Our review of the literature on the use of hypnosis to treat movement disorders was done by systematically searching the PubMed database for reports published between 1984 and November 2015. The following variables were extracted from each selected paper: study design; sample size; type of movement disorder; hypnotic procedure; treatment duration; and efficacy.

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Preparing Drugs for Infusion Via Syringe Pump: A Key Step to Ensure Homogeneous Concentration.

Crit Care Nurse

August 2016

Bruno Garrigue is an anesthesia nurse and head of the prehospital emergency medicine service at Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France.Yann Dehu is an anesthesia nurse working in a surgical unit and a clinical research associate at Centre Hospitalier Sud-Francilien.Fabrice Girault is a registered nurse working in a prehospital emergency medicine service, Centre Hospitalier Sud-Francilien.Bruno Figadère is a medicinal chemist at Centre Nationale de Recherches Scientifiques (CNRS)/Universite Paris Sud-Faculte de Pharmacie Joint Laboratory, Chatenay-Malabry, France.Karine Leblanc is a chemical engineer at CNRS/Univ Paris Sud-Faculte de Pharmacie Joint Laboratory.Nicolas Briole is an emergency medicine physician at Centre Hospitalier Sud-Francilien.Georges Antoine Capitani is head of the acute care department at Centre Hospitalier Sud-Francilien.Steven Lagadec is a nurse in the prehospital emergency service and a clinical research associate at Centre Hospitalier Sud-Francilien.François-Xavier Laborne is a prehospital emergency practitioner and a methodologist and biostatistician in the clinical research unit of the Centre Hospitalier Sud-Francilien.

Objective: Preparation of drug solutions used with electronic syringe infusion pumps plays a crucial role in the delivery of an accurate drug concentration. Is there a correlation between drug concentrations during syringe pump infusion and preparation protocols?

Method: Norepinephrine, insulin, and sufentanil were prepared in 3 different ways: (1) the drug was taken from the vial, then the solvent was added followed by an air bubble, and mixing was performed by turning the syringe top-to-bottom in a 180° shaking movement 5 consecutive times; (2) the drug was taken from the vial, then the solvent was added and not mixed; and (3) the solvent was taken from a stock solution, then the drug was added and not mixed. Concentrations of drugs were determined at different times during administration by reverse-phase high-performance liquid chromatography with ultraviolet detection.

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Peripheral T-cell lymphoma (PTCL) is a group of diseases with poor outcome and few therapeutic options. We aimed to assess the efficacy of bendamustine in real life cohort of patients.Between November 2009 and March 2015, 138 PTCL patients were treated with bendamustine in 27 centers.

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Objective: Skin-to-skin contact shows benefits in the relationship developed between a mother and her premature infant. In the skin-to-skin session, face-to-face exchanges are impossible in vertical infant positioning. We therefore undertook an observational, prospective, single-center study using kangaroo "supported diagonal flexion" (SDF) positioning.

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Background: The OPTIMA© (MSD, Courbevoie, France) questionnaire was developed to promote shared decisions and the set-up of specific micro-objectives in clinical practice by optimizing communication between type 2 diabetes (T2DM) patients and their physicians. The present study aimed to assess OPTIMA in clinical practice.

Methods: A cross-sectional multicenter observational study was conducted in France from 2012 to 2014.

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Prognosis of Philadelphia-positive (Ph(+)) acute lymphoblastic leukemia (ALL) in the elderly has improved during the imatinib era. We investigated dasatinib, another potent tyrosine kinase inhibitor, in combination with low-intensity chemotherapy. Patients older than age 55 years were included in the European Working Group on Adult ALL (EWALL) study number 01 for Ph(+) ALL (EWALL-PH-01 international study) and were treated with dasatinib 140 mg/day (100 mg/day over 70 years) with intrathecal chemotherapy, vincristine, and dexamethasone during induction.

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'The Move', an innovative simulation-based medical education program using roleplay to teach neurological semiology: Students' and teachers' perceptions.

Rev Neurol (Paris)

April 2017

Faculté de médecine, Sorbonne universités, université Pierre-et-Marie-Curie (UPMC), 91, boulevard de l'Hôpital, 75013 Paris, France; Service de médecine interne, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.

Introduction: Neurological disorders are frequently being managed by general practitioners. It is therefore critical that future physicians become comfortable with neurological examination and physical diagnosis. Graduating medical students often consider neurological examination as one of the clinical skills they are least comfortable with, and they even tend to be neurophobic.

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Background: De-escalation is strongly recommended for antibiotic stewardship. No studies have addressed this issue in the context of health care-associated intra-abdominal infections (HCIAI). We analyzed the factors that could interfere with this process and their clinical consequences in intensive care unit (ICU) patients with HCIAI.

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Objectives: To describe steroid-sparing in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ).

Methods: To evaluate the proportion of RA patients treated with more than 5 mg of prednisone (or equivalent)/day and starting TCZ who can receive less than 5 mg/day after 12 months without intensification of disease-modifying anti-rheumatic drugs (DMARDs), we conducted a non-interventional, multicentre, prospective study from 2011 to 2013. We included patients with moderate-to-severe RA, >18 years old, starting TCZ and receiving corticosteroids (GCs) at a dose greater than 5 mg/day of prednisone for at least 3 months.

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Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke.

Restor Neurol Neurosci

December 2016

CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, Boissise-Le-Roi, France.

Purpose: Kinematic assessments are increasingly used as motor outcome measures during upper limb robot-assisted training, in addition to clinical scales. However, their relevance has not been evaluated much.

Methods: Thirty-eight patients with severe sub-acute stroke (age 56 ± 17 [19-87] years; time since stroke, 55 ± 22 days) carried out 16 sessions (average 3/week, 35 ± 15 days) of upper limb robot-assisted training combined with standard therapy.

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New adipokines.

Ann Endocrinol (Paris)

February 2016

UMR_S 938 CDR-Saint-Antoine, faculté de médecine, Sorbonne Universities UPMC Paris 6, 27, rue de Chaligny, 75012 Paris, France; University Hospital ICAN Institute, 75013 Paris, France; Biochemistry Department, hôpital Tenon, AP-HP, 75020 Paris, France.

Adipose tissue is now widely recognized as "an organ" able to synthesize and secrete hundred factors collectively called adipokines. These secreted molecules exert pleiotropic actions, notably on the regulation of glucose and lipid metabolism, inflammation, reproduction, or angiogenesis. Over the past two decades, a considerable amount of work was performed on the two "star" adipokines, leptin and adiponectin, particularly because of their involvement in energy metabolism.

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Purpose: To test for differences in somatic, psychic and functioning outcomes associated with assaults across four groups of workers, of which three are structurally at high risk of occupational violence. To report and compare job characteristics, characteristics of the assault and medical findings in police officers and other workers at the time of a forensic examination performed shortly after they complained for being assaulted while working.

Methods: A two-centre prospective study recruiting adult survivors of workplace violence who lodged a complaint to the judicial authorities and were examined by forensic physicians in the Paris area, between 2010 and 2012 over a 27-month period, was conducted.

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Systemic Adiponectin Values in Humans Require Standardized Units.

Obes Surg

February 2016

UF Bio-marqueurs Inflammatoires et Métaboliques, Service de Biochimie et Hormonologie, AP-HP, Hôpital Tenon, 4 Rue de la Chine, F75020, Paris, France.

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Major physiological changes are governed by alternative splicing of RNA, and its misregulation may lead to specific diseases. With the use of a genome-wide approach, we show here that this splicing step can be modified by medication and demonstrate the effects of the biguanide metformin, on alternative splicing. The mechanism of action involves AMPK activation and downregulation of the RBM3 RNA-binding protein.

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Fibula free flap in the treatment of mandibular osteoradionecrosis.

Eur Ann Otorhinolaryngol Head Neck Dis

February 2016

Service ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.

Introduction: Mandibular osteoradionecrosis (mORN) is one of the major complications of radiation therapy in head and neck cancer. It is responsible for intractable pain and functional problems. Radical treatment, required in case of failure of conservative management, consists in wide resection of the necrotic tissue followed by reconstruction, notably by free flaps.

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Aims/hypothesis: Microvascular complications are a common feature of diabetes but additional research is needed regarding diabetic nephropathy endpoints in type 1 and type 2 diabetes.

Methods: We compared 277 type 1 diabetes patients with 942 type 2 diabetes patients, with clinical proteinuria and no endstage renal disease (ESRD) at baseline, prospectively followed for death, ESRD and decline in estimated glomerular filtration rate (eGFR, all available measures).

Results: The incidence rate of death was 67.

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Development and validation of the Nancy histological index for UC.

Gut

January 2017

Inserm U954, Genetic Nutrition and Exposure to Environmental Risks (NGERE), University of Lorraine, Vandoeuvre- lès-Nancy, France.

Article Synopsis
  • Researchers created and validated a new index called the Nancy index to measure disease activity in ulcerative colitis (UC) using biopsies and histological features.
  • The index incorporates three key features: ulceration, acute inflammatory infiltrate, and chronic inflammatory infiltrate, and is rated on a scale from 0 (no activity) to 4 (severe activity).
  • The Nancy index demonstrated strong reliability and responsiveness, correlating well with existing assessment tools, making it suitable for both clinical practice and research studies.
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Purpose: Over the last two decades, noninvasive ventilation (NIV) has been proposed in various causes of acute respiratory failure (ARF) but some indications are debated. Current trends in NIV use are unknown.

Methods: Comparison of three multicenter prospective audits including all patients receiving mechanical ventilation and conducted in 1997, 2002, and 2011 in francophone countries.

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Epidemiology and risk factors of multidrug-resistant bacteria in respiratory samples after lung transplantation.

Transpl Infect Dis

February 2016

Département d'Anesthésie Réanimation, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, Paris, France.

Background: Multidrug-resistant (MDR) bacteria are a growing concern worldwide. The aim of this study was to describe the epidemiology and risk factors of MDR bacteria detected in respiratory invasive samples during hospitalization in the intensive care unit (ICU) after lung transplantation (LT).

Methods: This study was based on a retrospective analysis of 176 patients hospitalized in the ICU after LT in 2006-2012.

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