Center Hospitalier Darmentieres

Armentières, France

Center Hospitalier Darmentieres

Armentières, France

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Badr S.,Center Hospitalier dArmentieres | Badr S.,Lille University Hospital Center | Laurent N.,Center Hospitalier dArmentieres | Laurent N.,Center Hospitalier Of Valenciennes | And 8 more authors.
Diagnostic and Interventional Imaging | Year: 2014

To date, analysis of the vascularisation of breast lesions mainly relies on MR imaging. However, the accessibility of MRI is sometimes limited and has led to the development of new means of imaging, such as dual-energy contrast-enhanced mammography, which provides data on the vascularisation of the breast along with the usual morphological information. The purpose of this paper is to present this new imaging technique as well as the recent references, illustrated by clinical reports derived from our everyday practice to focus on the advantages and disadvantages of this new breast exploration. Dual-energy contrast-enhanced mammography is a recent, seemingly promising technique, in the management of breast cancer. The main advantages consist of its easy installation, the good tolerance and the comfort in the interpretation of difficult to read mammograms. However, the indications and the role of dual-energy contrast-enhanced mammography still have to be determined within the diagnostic strategy of breast tumours. New studies are expected, especially to compare dual-energy contrast-enhanced mammography with breast MRI. © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.


PubMed | Center Hospitalier dArmentieres and Lille University Hospital Center
Type: Comparative Study | Journal: Diagnostic and interventional imaging | Year: 2014

To date, analysis of the vascularisation of breast lesions mainly relies on MR imaging. However, the accessibility of MRI is sometimes limited and has led to the development of new means of imaging, such as dual-energy contrast-enhanced mammography, which provides data on the vascularisation of the breast along with the usual morphological information. The purpose of this paper is to present this new imaging technique as well as the recent references, illustrated by clinical reports derived from our everyday practice to focus on the advantages and disadvantages of this new breast exploration. Dual-energy contrast-enhanced mammography is a recent, seemingly promising technique, in the management of breast cancer. The main advantages consist of its easy installation, the good tolerance and the comfort in the interpretation of difficult to read mammograms. However, the indications and the role of dual-energy contrast-enhanced mammography still have to be determined within the diagnostic strategy of breast tumours. New studies are expected, especially to compare dual-energy contrast-enhanced mammography with breast MRI.


Parsy C.,Center Hospitalier Of Valenciennes | Cosson M.,Service de Chirurgie Gynecologique | Quinton J.-F.,Service de Gastro enterologie | Laurent N.,Center Hospitalier Of Valenciennes | And 5 more authors.
Gynecologie Obstetrique Fertilite | Year: 2015

Pelvic floor disorders are frequent and source of symptoms which can be invalidating for patients. Between them, hedrocele is a pathology often unknown and clinically difficult to diagnose. It is a herniation of fat pad, small bowel or sigmoid colon in the recto-uterine pouch (cul-de-sac of Douglas) exercising a mass effect on the anterior wall of the rectum. Pelvic magnetic resonance imaging with morphological sequences and dynamic sequences in thrust can be very useful, allowing a comprehensive study of pelvic floor dysfunction and confirming the complete diagnosis, especially before surgery. We suggest you some examples to illustrate this pathology in order to emphasize the importance of its diagnosis, especially preoperative. A better understanding of this pelvic floor dysfunction would improve the care of patients. © 2015 Published by Elsevier Masson SAS.


Wulveryck C.,Center Hospitalier Darmentieres | Brzychcy C.,Hopital Jeanne de Flandre | Corbillon A.,Ecole de sages femmes du CHRU de Lille
Revue de Medecine Perinatale | Year: 2014

Objectives: Ultrasound is an examination carrying huge expectations thanks to the light it can cast on hidden phenomena and inner structures. Yet, it is first and foremost a medical imaging examination, and parents give high hopes on the sonographer. When the ultrasound takes place, there are most of the time misunderstandings because of the differences between the affective expectations of the future parents and the medical aim of the practitioner. The aim of this study is to analyze the words and the behaviors of the sonographer, through parents’ opinions, in order to study on their impacts on the imaginary child.Patients and methods: Semi-structured interviews were led with 24 couples expecting their first child. They spoke about their experiences with ultrasound and how the words and the behaviors of the sonographer could have impacted on their imaginary child.Results: It has been highlighted that the role of the sonographer can modify the parental representations even if this influence can vary according to the situations. Couples also talked about their expectations regarding the emotional support from the sonographer during the examination.Discussion and conclusion: Parents give much importance to the quality of the relationship with the practitioner which has an impact on the imaginary child and its evolution. Results reappraise the sonographer’s role in the building process of the parent-child link. © 2014, Springer-Verlag France.


Descamps-Pouchelle I.-M.,Center Hospitalier dArmentieres | Mortreux F.,Center Hospitalier dArmentieres | Sergent-Roumier A.-S.,Center Hospitalier dArmentieres | Gressier B.,Center Hospitalier dArmentieres | Gressier B.,Lille 2 University of Health and Law
Annales de Biologie Clinique | Year: 2010

In front of the increase of frequentation of emergency departments for pathological situations associated with tetanic risk, and the difficulty to know if the patients are immunized or not, the consequence is an unsuitable consumption of vaccination and/or antitetanic immunoglobulins. At the emergency department of Armentieres's hospital, in a perspective of an accreditation and following a medical request, we wanted to improve patient's care with tetanic risk wound by using a quick test for the detection of specific antitetanic antibodies (tetanos Fumouze® test), under laboratory's authority. This test would allow a quickly and reliable immunity evaluation of patients with tetanic risk wound. The use of this point-of-care test was made possible with a good cooperation between clinicians, biologists and nurses. After six months, we wanted to evaluate monitoring and respect for qualities procedures established by laboratory and the medical and cost impact of this test.


Hochart-Behra A.-C.,Center hospitalier dArmentieres | Paris A.,Center hospitalier dArmentieres | Descamps I.-M.,Center hospitalier dArmentieres | Gressier B.,Center hospitalier dArmentieres | Gressier B.,Lille 2 University of Health and Law
Immuno-Analyse et Biologie Specialisee | Year: 2013

Anemia is the most common abnormality of the blood count. A rigorous and hierarchical approach allows understanding of its etiology. The blood smear examination remains a milestone of reasoning. Detection of spherocytes is common in anemia with mechanical or immunological causes. However, some morphological characteristics of red blood cells can orient the diagnosis towards congenital hemolytic anemia. Thus, in the case of our observation, visualization of pincered erythrocytes let us suspect a spherocytosis caused by a defect of band 3 protein in the erythrocyte membrane. This was confirmed by an increase in erythrocyte osmotic fragility. Specialized but less accessible methods bring a definitive diagnosis. The late diagnosis of this anomaly is explained by the moderate intensity of hemolysis. Complex entanglement of various etiologies of anemia for seniors is another source of diagnostic difficulty. For our patient, a hemorrhagic part linked to an anti-vitamin K overdose and an inflammatory part cannot indeed be excluded in the anemia explanation. © 2013 Elsevier Masson SAS.


Gauthier N.,Center Hospitalier dArmentieres | Jezequel J.,Center Hospitalier dArmentieres | Desaintfuscien E.,Center Hospitalier dArmentieres | Guenault N.,Center Hospitalier dArmentieres | Bonenfant C.,Center Hospitalier dArmentieres
Pharmacien Hospitalier | Year: 2011

Introduction: In order to face up to tracing user needs and processing on implantable medical devices (IMD), hospital pharmacies have to improve their own circuit of information. In that way, Afssaps and Europharmat association expressed advices towards IMD manufacturers regarding harmonization of the present coding systems. Material and methods: An inventory of fixtures has been carried out in our hospital complex with the aim of defining difficulties encountered during the recording of a software designed for traceability and economical processing of 22 IMD from eight laboratories. Results: Only five of them fulfilled the recommended standards of harmonization. Mismatches over coding systems can compromise the reliability of the recorded data. Indeed, the unreadable bar codes, sometimes containing incomplete data, require manual data entries, which gives raise to potential practice errors with, in addition, a lost of time for the pharmacy staff. Conclusion: An explanatory mailing about the encountered problems has been sent to the concerned suppliers. We are expecting an improvement of the present coding systems over their medical devices. © 2011 Elsevier Masson SAS. All rights reserved.


Auffret M.,Center hospitalier dArmentieres | Descamps A.,Center hospitalier dArmentieres | Thomas C.,Center hospitalier dArmentieres | Bonenfant C.,Center hospitalier dArmentieres | And 2 more authors.
Journal de Pharmacie Clinique | Year: 2012

Docetaxel is widely used in the treatment of breast cancer or lung cancer. Its digestive and haematological toxicities are well known. We present here the case of a neutropenic enterocolitis, rarely described adverse but potentially fatal following administration of docetaxel. A 60-year-old woman, who received three courses of FEC (5-fluorouracil, epirubicin, cyclophosphamide) followed by three courses of docetaxel appears to emergencies seven days after her last course of docetaxel therapy for fever with severe headache, abdominal pain, diarrhea and vomiting associated to neutropenia. The diagnosis of infectious colitis was then placed and an antibiotherapy with ceftriaxone and metronidazole was instituted. The evolution of the patient was marked by a worsening of his condition required her transfer to intensive care unit where the evolution was favorable after rehydration, a quiescence of the intestine and broad-spectrum antibiotics by piperacillin-tazobactam and ciprofloxacin. In the absence of bacteriological documentation, the responsibility of docetaxel in this neutropenic enterocolitis was decided. The clinical signs of neutropenic enterocolitis are non-specific and diagnosis is difficult. The mechanism involved is not known but one hypothesis is the occurrence of initial ulceration of the gastrointestinal mucosa, associated with neutropenia, an imbalance of intestinal flora, and a decrease in blood flow to the cecum, thus promoting bacterial overgrowth and bacterial translocation. Mortality associated with this event is significant and estimated at between 40 and 50% by some authors. The neutropenic enterocolitis should be considered in any patient treated with docetaxel with signs of colitis. The management is symptomatic and a broad-spectrum antibiotics are recommended. There are no recommendations concerning the reintroduction of docetaxel after a neutropenic enterocolitis, although some authors advocate its discontinuation.


PubMed | Center Hospitalier Darmentieres
Type: Case Reports | Journal: Annales francaises d'anesthesie et de reanimation | Year: 2011

We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 g/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days.


Alluin A.,Center hospitalier dArmentieres | Jezequel J.,Center hospitalier dArmentieres | Gauthier N.,Center hospitalier dArmentieres | Desmaretz J.-L.,Center hospitalier dArmentieres | Canevet C.,Center hospitalier dArmentieres
Annales Francaises d'Anesthesie et de Reanimation | Year: 2011

We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437. μg/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days. © 2011 Elsevier Masson SAS.

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