Le Puy-en-Velay, France
Le Puy-en-Velay, France

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PubMed | Center Hospitalier Emile Roux, University of Economics in Prague, University of South Florida and Charles University
Type: Journal Article | Journal: Journal of bodywork and movement therapies | Year: 2016

The purpose of this study was to determine the relation between posturally increased intra-abdominal pressure and lower/upper esophageal sphincter pressure changes in patients with gastroesophageal reflux disease. We used high resolution manometry to measure pressure changes in lower and upper esophageal sphincter during bilateral leg rise. We also examined whether the rate of lower and upper esophageal sphincter pressure would increase during leg raise differentially in individuals with versus without normal resting pressure. Fifty eight patients with gastroesophageal reflux disease participated in the study. High resolution manometry was performed in relaxed supine position, then lower and upper esophageal sphincter pressure was measured. Finally, the subjects were instructed to keep their legs lifted while performing 90-degree flexion at the hips and knees and the pressure was measured again. Paired t-test and independent samples t-test were used. There was a significant increase in both lower (P<0.001) and upper esophageal sphincter pressure (P=0.034) during leg raise compared to the initial resting position. Individuals with initially higher pressure in lower esophageal sphincter (>10mmHg) exhibited a greater pressure increase during leg raise than those with initially lower pressure (pressure 10mmHg; P=0.002). Similarly individuals with higher resting upper esophageal sphincter pressure (>44mmHg) showed a greater pressure increase during leg raise than those with lower resting pressure (44mmHg; P<0.001). The results illustrate the influence of postural leg activities on intraesophageal pressure in patients with gastroesophageal reflux disease, indicating by means of high resolution manometry that diaphragmatic postural and sphincter function are likely interrelated in this population.


Morin T.,Center Hospitalier Of Bigorre | Pariente A.,Center Hospitalier Of Pau | Lahmek P.,Center Hospitalier Emile Roux | Rabaud C.,University of Lorraine | And 2 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2010

Objectives: To analyze the data (epidemiology, mode of transmission, course, and outcome) of a large series of patients with acute hepatitis C (AHC) in France. Methods: Prospective multicenter register, observational study. Results: A cohort of 126 patients with AHC was prospectively enrolled between 1999 and 2007. Fifteen (12%) were HIV coinfected. Suspected modes of hepatitis C virus transmission were drug use (38%), sexual contact (21%), nosocomial transmission (18%), and occupational exposure (12%). For 40% of the patients, AHC was revealed by jaundice. Spontaneous viral clearance occurred in 40% of the 72 patients observed for 3 months without treatment. Only jaundice and nosocomial/occupational transmission were predictive of spontaneous viral clearance. Ninety patients were treated with standard or pegylated interferonα alone (58%) or in combination with ribavirin (42%), for 24 weeks or less in 90%. In intention-to-treat, a sustained viral response was obtained in 58 of 78 (74%) hepatitis C virus monoinfected patients [19 of 22 (86%) with 24 weeks of pegylated interferon-α alone], but only six of 12 (50%) of HIV coinfected patients. Conclusion: AHC remains rare, and drug and sexual transmission are predominant. A 3-month follow-up after diagnosis avoids treatment for four out of 10 patients. Antiviral treatment is highly effective, 24 weeks of pegylated interferon-α alone being a good option. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Leclerc L.,Jean Monnet University | Leclerc L.,Ecole Nationale Superieure des Mines de Saint - Etienne CMP | Pourchez J.,Ecole Nationale Superieure des Mines de Saint - Etienne CMP | Aubert G.,CHU Saint Etienne | And 7 more authors.
Pharmaceutical Research | Year: 2014

Purpose: Improvement of clinical outcome in patients with sinuses disorders involves targeting delivery of nebulized drug into the maxillary sinuses. We investigated the impact of nebulization conditions (with and without 100 Hz acoustic airflow), particle size (9.9 μm, 2.8 μm, 550 nm and 230 nm) and breathing pattern (nasal vs. no nasal breathing) on enhancement of aerosol delivery into the sinuses using a realistic nasal replica developed by our team. Methods: After segmentation of the airways by means of high-resolution computed tomography scans, a well-characterized nasal replica was created using a rapid prototyping technology. A total of 168 intrasinus aerosol depositions were performed with changes of aerosol particle size and breathing patterns under different nebulization conditions using gentamicin as a marker. Results: The results demonstrate that the fraction of aerosol deposited in the maxillary sinuses is enhanced by use of submicrometric aerosols, e.g. 8.155 ± 1.476 mg/L of gentamicin in the left maxillary sinus for the 2.8 μm particles vs. 2.056 ± 0.0474 for the 550 nm particles. Utilization of 100-Hz acoustic airflow nebulization also produced a 2- to 3-fold increase in drug deposition in the maxillary sinuses (e.g. 8.155 ± 1.476 vs. 3.990 ± 1.690 for the 2.8 μm particles). Conclusions: Our study clearly shows that optimum deposition was achieved using submicrometric particles and 100-Hz acoustic airflow nebulization with no nasal breathing. It is hoped that our new respiratory nasal replica will greatly facilitate the development of more effective delivery systems in the future. © 2014 Springer Science+Business Media New York.


Nahon S.,Center Hospitalier le Raincy Montfermeil | Lahmek P.,Center Hospitalier Emile Roux | Durance C.,Center Hospitalier le Raincy Montfermeil | Olympie A.,Association Francois Aupetit | And 3 more authors.
Inflammatory Bowel Diseases | Year: 2012

Background: Little is known in inflammatory bowel disease (IBD) regarding risk factors for psychological distress. The aim of this work was to study the disease characteristics and socioeconomic factors associated with anxiety and depression in IBD. Methods: From December 2008 to June 2009, 1663 patients with IBD (1450 were members of the Association Francois Aupetit, French association of IBD patients) answered a questionnaire about psychological and socioeconomic factors and adherence to treatment. In this study we focused the analysis on the characteristics of IBD (type, location, severity, treatment) and socioeconomic factors (professional, educational, and marital status and Evaluation of Precarity and Inequalities in Health Examination Centers [EPICES] score of socioeconomic deprivation; score established in medical centers in France; http://www.cetaf.asso.fr) associated with depression and anxiety. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Comparison between groups according to the existence of depression or anxiety was carried out using univariate and multivariate analysis. Results: In all, 181 patients (11%) were depressed; 689 patients (41%) were anxious. By multivariate analysis, factors associated with anxiety were: severe disease (P = 0.04), flares (P = 0.05), nonadherence to treatment (P = 0.03), disabled or unemployed status (P = 0.002), and socioeconomic deprivation (P < 0.0001). Factors associated with depression were: age (P = 0.004), flares (P = 0.03), disabled or unemployed status (P = 0.03), and socioeconomic deprivation (P < 0.0001). Conclusions: In this large cohort of IBD patients, risk factors for anxiety and depression were severe and active disease and socioeconomic deprivation. Psychological interventions would be useful when these factors are identified. (Inflamm Bowel Dis 2012;) Copyright © 2012 Crohn's & Colitis Foundation of America, Inc.


Morin T.,Center Hospitalier Of Bigorre | Pariente A.,Center Hospitalier | Lahmek P.,Center Hospitalier Emile Roux
European Journal of Gastroenterology and Hepatology | Year: 2011

Background: Although risk factors and useful preventive measures are largely known, specific data about the course and prognosis of acute hepatitis C among healthcare workers is lacking. Aim: To analyze the data, course, and outcome of a series of patients with occupationally transmitted acute hepatitis C in France. Methods and Setting: An observational multicenter study based on two consecutive acute hepatitis C cohorts, retrospective then prospective, registered between 1993 and 2007, mostly in general hospitals. Results: A cohort of 23 patients with occupationally transmitted hepatitis C virus (HCV) was set up. Occupational accident registration was done in 14 (61%) cases. They were mainly women (n=14), with a mean age of 43 years. The disease was diagnosed during surveillance after exposure in 16 patients, and nine had hyperbilirubinemia. Early treatment was applied to nine of them, with eight who sustained viral response (SVR). Fourteen underwent surveillance: spontaneous viral clearance occurred in nine of them, with two relapses. Five patients with persistent HCV RNA 12 weeks after the diagnosis were then treated, with four SVR. Conclusion: Information and prevention of healthcare workers concerning occupational HCV transmission need to be improved, and all blood-exposure accidents should be registered. Spontaneous viral clearance occurred in half of the patients. Antiviral treatment was highly effective, with a SVR of 86%. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Millat G.,Laboratoire Of Cardiogenetique Moleculaire | Millat G.,University of Lyon | Janin A.,Laboratoire Of Cardiogenetique Moleculaire | Janin A.,University of Lyon | And 3 more authors.
European Journal of Medical Genetics | Year: 2015

A very recent study suggested that HCN4 mutations could be associated with sinusal bradycardia and myocardial non compaction. A French family with 3 affected sisters presenting the same clinical phenotype (sinus bradycardia in combination with non compaction cardiomyopathy (NCCM)) have benefited both from a systematic cardiovascular exploration and molecular investigations. The molecular analysis, performed by NGS sequencing, led to identify only one likely-disease causing variation: p.Gly482Arg on HCN4 gene. Our results confirm the genetic evidence for the involvement of the HCN4 mutations in the combined bradycardia-NCCM phenotype and illustrates that, in front of this combined clinical phenotype, HCN4 mutations has to be suspected. © 2015 Elsevier Masson SAS.


Bould M.D.,Childrens Hospital of Eastern Ontario | Boet S.,St Michaels Hospital | Riem N.,St Michaels Hospital | Sossou A.,Center Hospitalier Emile Roux | Bruppacher H.R.,McMaster University
Anaesthesia | Year: 2010

While previous studies have investigated the country of origin of anaesthetic publications, they have generally used a medline computer search to identify original articles and have often excluded non-English language articles. We undertook a hand-search of journals in the Journal Citation Reports® using the subject category of Anesthesiology. We quantified the number of original articles, editorials, review articles, case reports and correspondence attributed to each country. We also calculated the proportion of articles of each type from countries of each national income category. We analysed 9684 articles published in 2007 and 2008. The United States published more original articles than any other country. High-income countries published 89.2% of original articles, middle-income countries 10.5%, and low-income countries just 0.3%. There were more articles published by middle-income countries during the study period than a decade earlier, notably from Turkey, China and India. We discuss barriers to publications from low-income countries. © 2010 The Association of Anaesthetists of Great Britain and Ireland.


Durand M.,Center Hospitalier Emile Roux | Durand M.,Jean Monnet University | Pourchez J.,LINA | Pourchez J.,French Institute of Health and Medical Research | And 7 more authors.
Rhinology | Year: 2011

Background: For many years, researchers have been interested in investigating airflow and aerosol deposition in the nasal cavities. The nasal airways appear to be a complex geometrical system. Thus, in vitro experimental studies are frequently conducted with a more or less biomimetic nasal replica. Aim: This study is devoted to the development of an anatomically realistic nose model with bilateral nasal cavities, i.e. nasal anatomy, airway geometry and aerodynamic properties as close as possible to in vivo behaviour. Methods: A specific plastination technique of cephalic extremities was developed by the Anatomy Laboratory at the Saint-Etienne University in the last 10 years. The plastinated models obtained were anatomically, geometrically and aerodynamically validated using several techniques (endoscopy, CT scans, acoustic rhinometry and rhinomanometry). Results: Our plastination model exhibited a high level of anatomic quality, including a very good mucosa preservation. Aerodynamical and geometrical investigations highlighted a global behaviour of plastinated models perfectly in accordance with a nasal decongested healthy subject. Conclusions: The present plastination model provides a realistic cast of nasal airways, and may be a useful tool for nasal flow, drug delivery and aerosol deposition studies.


Alzheimer patients are generally viewed as "demented", in other words deprived of mind. Their cognitive functions gradually decline, and alongside their bodies become weaker. Yet when caregivers take the trouble to gain access to these individuals, the discourse that emerges is clearly "mindful". In the midst of this confusion of time and place, how can we capture the traces of their living memory, and their bodily experience? We opted to have these individuals make drawings of themselves so as to objectify the traces of mind in bodies that are deteriorating. This paper describes this process in an ethical approach to the other. © 2015 Elsevier Masson SAS.


PubMed | Center hospitalier Emile Roux
Type: Comparative Study | Journal: European annals of otorhinolaryngology, head and neck diseases | Year: 2012

Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model.Scintigraphic analysis of (81m)Kr gas ventilation and of sonic aerosol ((99m)Tc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay.Associating the 100Hz sound to (81m)Kr gas ensured paranasal sinus ventilation in healthy volunteers. (99m)Tc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P<0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect.The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.

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