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Lecapitaine A.-L.,Center Hospitalier Intercommunal Robert Ballanger | Bakir R.,Center Hospitalier Intercommunal Robert Ballanger | Delassus J.-L.,Center Hospitalier Intercommunal Robert Ballanger | Gros H.,Center Hospitalier Intercommunal Robert Ballanger | Bouldouyre M.-A.,Center Hospitalier Intercommunal Robert Ballanger
Sante Publique | Year: 2017

Objectives: Systemic lupus erythematosus (SLE) is a disease requiring long-term follow-up. Most studies published in the literature concerned teaching hospitals. We wanted to study a population of SLE patients, their follow-up and therapeutic modalities in a general hospital in order to evaluate professional practices. Methods: We performed a descriptive and retrospective study with SLE patients followed at Centre Hospitalier Intercommunal Robert Ballanger in Aulnay sous Bois (Seine Saint-Denis) between March 2013 and March 2015. Results: Thirty-nine patients were included with various forms of the disease: 77% presented arthritis, 67% had skin involvement, 44%had haematological disorders, 26% had serosal involvement, 13% had kidney involvement, 13% had neuropsychiatric disorders, 8%had digestive tract involvement and2%had myocarditis. Thirty-five patients were treated with hydroxychloroquine and 12 were treated with immunosuppressive or biotherapy. Patients were seen 3 or 4 times a year as outpatients; 19 were hospitalized at least once in conventional wards and 27 were admitted at least once to a day hospital. Advice from a teaching hospital colleague was required for 6 patients, but only one patient was permanently followed in another hospital. Conclusion: Our patients had similar clinical features to those reported in large series, except for a lower prevalence of renal injuries. Therapeutic management was in accordance with guidelines, with frequent discussion with teaching hospitals. We identified measures to improve our follow-up: more cardiovascular prevention, more vaccinations and adjustment of hydroxychloroquine monitoring. © S.F.S.P. Tous droits réservés pour tous pays.


Mnafgui K.,University of Sfax | Mnafgui K.,Hospital of Sidi Bouzid | Hajji R.,Hospital of Sidi Bouzid | Derbali F.,Hospital of Sidi Bouzid | And 6 more authors.
Cardiovascular Toxicology | Year: 2015

The present study aimed to investigate the cardioprotective effect of hydroxytyrosol (HT) against isoproterenol-induced myocardial infarction in rats. Male rats were randomly divided into four groups, control, isoproterenol (Isop) and pretreated animals with HT in two different doses (2 and 5 mg/kg) orally for 7 days and intoxicated with isoproterenol (Isop + HT1) and (Isop + HT2) groups. Myocardial infarction in rats was induced subcutaneously by isoproterenol (100 mg/kg, s.c.) at an interval of 24 h on 6th and 7th day. On 8th day, electrocardiographic (ECG) pattern, gravimetric and biochemical parameters were assessed. Isoproterenol exhibited changes in ECG pattern, including significant ST-segment elevation and increase in the serum troponin-T level by 317 % as compared to control rats. Moreover, cardiac injury markers (creatine kinase-MB, lactate dehydrogenase, alanine aminotransferase) underwent a notable rise in serum of infarcted animals. Else, a disturbance in lipids profile and significant increase in lipase and angiotensin-converting enzyme (ACE) activities and heart weight ratio were observed in isoproterenol group. However, pre- and co-treatment with HT (2 and 5 mg/kg) improved the myocardium injury, restored the hemodynamic function and inhibited the ACE activity that prevent cardiac hypertrophy and remodeling. Overall, these findings demonstrated that HT exerted a potent cardioprotective effect against isoproterenol-induced myocardial infarction. © 2015 Springer Science+Business Media New York


Bauer S.,Center Hospitalier General Saint Jean | Pont A.,Center Hospitalier Intercommunal Robert Ballanger | Jaouen C.,Center Hospitalier General Saint Jean | Lecante V.,Center Hospitalier Intercommunal Andre Gregoire
Pharmacien Hospitalier et Clinicien | Year: 2014

Introduction The traceability of implantable medical device (IMD) is statutory (decree No. 2006-1497 of 29th November 2006) and must meet several objectives: traceability for sterility and/or contamination, financial traceability, adherence to the guidelines of therapeutic use. The aim of this study is to focus on key points of the tracking of IMD in three hospitals (A, B and C), and persistent difficulties. Materials and methods Quality indicators have been determinated by the descriptive study of three circuits of traceability of IMD. We could think about improvement points, with a review of the literature. Results The use of a computerized tracking of the IMD is the mean to keep safe the circuit in these three hospitals. Traceability rates are 90% (C) and 100% (A and B). The guideline of therapeutic use is respected in two hospitals. The more the staff is important (number and time spent) and trained, the better the traceability is. The hospital A avoided a loss of 99,000 euros while the hospital C lost 9900 euros. Discussion These hospitals are confronted to several difficulties with the use of a computerized tracking circuit. Staff implication (pharmacy, computer department and operating room department), softwares, non-harmonized identification systems of IMD are essentials points that must be taken into account in quality of tracking of IMD. We think that a national study, with the same quality indicators, should help hospitals improve their tracking of IMD. © 2013 Elsevier Masson SAS.


PubMed | Center Hospitalier Intercommunal Robert Ballanger, University of Sfax and Hospital of Sidi Bouzid
Type: Journal Article | Journal: Cardiovascular toxicology | Year: 2016

This study aimed to evaluate the antithrombotic, anti-inflammatory and anti-cardiac remodeling properties of eugenol in isoproterenol-induced myocardial infarction in rats. Male Wistar rats were randomly divided into four groups, control, iso [100mg/kg body weight was injected subcutaneously into rats at an interval of 24h for 2days (6th and 7th day) to induce MI] and pretreated animals with clopidogrel (0.2mg/kg) and eugenol (50mg/kg) orally for 7days and intoxicated with isoproterenol (Iso+Clop) and (Iso+EG) groups. Isoproterenol-induced myocardial infarcted rats showed notable changes in the ECG pattern, increase in heart weight index, deterioration in the hemodynamic function and rise in plasma level of troponin-T, CK-MB and LDH and ALT by 316, 74, 172 and 45%, respectively, with histological myocardium necrosis and cells inflammatory infiltration. In addition, significant increases in plasma levels of inflammatory biomarkers such as fibrinogen, 1, 2, 1, 2 and globulins with decrease level of albumin were observed in infarcted rats as compared to normal ones. Else, the angiotensin-converting enzyme (ACE) activity in plasma, kidney and heart of the isoproterenol-induced rats was significantly increased by 34, 47 and 93%, respectively, as compared to normal group. However, the administration of eugenol induced a clear improvement in cardiac biomarkers injury, reduced inflammatory mediators proteins, increased heart activities of superoxide dismutase and glutathione peroxidase with reduce in thiobarbituric acid-reactive substances content and inhibition of ventricular remodeling process through inhibition of ACE activity. Overall, eugenol evidences high preventive effects from cardiac remodeling process.


PubMed | University of Sfax, Hospital of Sidi Bouzid, University of Nice Sophia Antipolis, National and Kapodistrian University of Athens and 2 more.
Type: Journal Article | Journal: Toxicology mechanisms and methods | Year: 2015

Myocardial infarction remains the major cause of global death due to cardiovascular diseases. This study aimed to assess the protective role of oleuropein in attenuating the cardiac remodeling in isoproterenol-induced myocardial infarction in rats.Male Wistar rats were randomly divided into four groups, control, isoproterenol (Isop) and pretreated animals with oleuropein at two different doses (20 and 40mg/kg) orally for 7 days and intoxicated with isoproterenol (Isop+Oleu20) and (Isop+Oleu40) groups. The subcutaneous injection of isoproterenol (100mg/kg body weight) to untreated rats for two consecutive days showed significant increases in ST-segment elevation, heart weight index and alteration in the ECG pattern and hemodynamic function. Else, serum levels of cardiac troponin-T, creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) underwent a notable rise in serum of Isop group by (345, 82, 73 and 106%, respectively) as compared to normal rats. Isoproterenol-induced myocardial injury was evidenced by alteration in serum lipids profile and increased activities of pancreatic lipase by 94% and angiotensin-converting enzyme (ACE) by 78% which reflects the occurrence of cardiac remodeling process. The histopathological findings of the infarcted group showed myocardium necrosis and cells inflammatory infiltration. However, the treatment with oleuropein gave a good protection of the myocardium by decreasing cardiac injury markers specially troponin-T, restoring hemodynamic parameters and attenuating cardiac remodeling process through inhibition of ACE activity.Oleuropein offers high preventive effects from cardiac remodeling process in rats with acute myocardial infarction.


PubMed | Center Hospitalier Intercommunal Robert Ballanger, University of Sfax, University of Monastir and Hospital of Sidi Bouzid
Type: Journal Article | Journal: Cardiovascular toxicology | Year: 2016

The present study aimed to investigate the cardioprotective effect of hydroxytyrosol (HT) against isoproterenol-induced myocardial infarction in rats. Male rats were randomly divided into four groups, control, isoproterenol (Isop) and pretreated animals with HT in two different doses (2 and 5mg/kg) orally for 7days and intoxicated with isoproterenol (Isop+HT1) and (Isop+HT2) groups. Myocardial infarction in rats was induced subcutaneously by isoproterenol (100mg/kg, s.c.) at an interval of 24h on 6th and 7th day. On 8th day, electrocardiographic (ECG) pattern, gravimetric and biochemical parameters were assessed. Isoproterenol exhibited changes in ECG pattern, including significant ST-segment elevation and increase in the serum troponin-T level by 317% as compared to control rats. Moreover, cardiac injury markers (creatine kinase-MB, lactate dehydrogenase, alanine aminotransferase) underwent a notable rise in serum of infarcted animals. Else, a disturbance in lipids profile and significant increase in lipase and angiotensin-converting enzyme (ACE) activities and heart weight ratio were observed in isoproterenol group. However, pre- and co-treatment with HT (2 and 5mg/kg) improved the myocardium injury, restored the hemodynamic function and inhibited the ACE activity that prevent cardiac hypertrophy and remodeling. Overall, these findings demonstrated that HT exerted a potent cardioprotective effect against isoproterenol-induced myocardial infarction.


Bauer S.,Pharmacie hospitaliere | Bouldouyre M.-A.,Center hospitalier intercommunal Robert Ballanger | Oufella A.,Pharmacie hospitaliere | Palmari P.,Center hospitalier intercommunal Robert Ballanger | And 3 more authors.
Medecine et Maladies Infectieuses | Year: 2012

Introduction: We studied the impact of a weekly multidisciplinary staff meeting (MSM) on the quality of antibiotherapy for bone and joint infections in orthopedic surgery, as part of professional practice assessment. Materials and methods: We retrospectively studied the file of patients hospitalized for bone and joint infection. We compared antibiotherapy compliance to good use (bacteriology, dose, length of treatment, length of adaptation to microbiology), and outcome at six months for patients with bone and joint infections, before (March 2007 to March 2009) and after (March 2009 to March 2011) implementation of the multidisciplinary staff meeting. We identified 28 patient files (32 infections) before MSM and 26 patient files (28 infections) after MSM. Results: Antibiotherapy was adapted in 47% of cases before MSM, versus 96% after (P<0.0001). The dose was optimum in 72% of infections before MSM, versus 89% after (P=0.11) and the length of antibiotherapy complied with recommendations in 41% of infections before MSM, versus 86% after (P=0.0005). The average time of antibiotic adaptation to the antibiogram changed from 2 days before MSM to 1.7 days after (P=0.43). Forty seven per cent of patients were cured at six months before MSM, versus 57% after (P=0.45); the rate of treatment failure at six months decreased from 25% before MSM to 18% after (P=0.75). Conclusion: The effectiveness of antibiotherapy significantly improved concerning the spectrum and treatment duration (P≤0.0005) after implementing MSMs in orthopedic surgery. But the clinical impact at six months was not significant due to the small population sample. © 2012 Elsevier Masson SAS.


The accident and emergency department is a place where female victims of domestic abuse may arrive with various symptoms. The systematic screening of female victims was studied and implemented by an A&E team in the Paris region and has now been extended to all the hospital's departments where female victims may arrive for treatment. © 2014 Elsevier Masson SAS. All rights reserved.


Daroukh A.,Center hospitalier intercommunal Robert Ballanger | Delaunay C.,Center hospitalier intercommunal Robert Ballanger | Bigot S.,Center hospitalier intercommunal Robert Ballanger | Ceci J.M.,Center hospitalier intercommunal Robert Ballanger | And 6 more authors.
Medecine et Maladies Infectieuses | Year: 2014

Objectives: We had for aim to determine the characteristics of carbapenemase-producing enterobacteria (CPE) carriers and to assess the economic impact of isolation measures leading to loss of activity (closed beds, prolonged hospital stays) and additional personnel hours. Patients and methods: We conducted a retrospective study for 2. years (2012/2013), in a French general hospital, focusing on CPE carriers with clinical case description. The costs were estimated by comparing the activity of concerned units (excluding the ICU) during periods with CPE carriers or contacts, during the same periods of the year (n-1), plus additional hours and rectal swabs. Results: Sixteen EPC carriers were identified: 10 men and 6 women, 65. ±. 10. years of age. Seven patients acquired EPC in hospital during 2 outbreaks in 2012. Four patients presented with an infection (peritonitis, catheter infection, and 2 cases of obstructive pyelonephritis) with a favorable outcome. The median length of stay was 21. days [4,150]. Six patients died, 1 death was indirectly due to CPE because of inappropriate empiric antibiotic therapy. A decrease in activity was observed compared to the previous year with an estimated 547,303. € loss. The 1779 additional hours cost 63,870. €, and 716 screening samples cost 30,931. €. The total additional cost was estimated at 642,104. € for the institution. Conclusions: Specialized teams for CPE carriers and isolation of contact patients, required to avoid/control epidemics, have an important additional cost. An appreciation of their support is needed, as well as participation of rehabilitation units. © 2014 Elsevier Masson SAS.


PubMed | Center hospitalier intercommunal Robert Ballanger
Type: Journal Article | Journal: Medecine et maladies infectieuses | Year: 2014

We had for aim to determine the characteristics of carbapenemase-producing enterobacteria (CPE) carriers and to assess the economic impact of isolation measures leading to loss of activity (closed beds, prolonged hospital stays) and additional personnel hours.We conducted a retrospective study for 2years (2012/2013), in a French general hospital, focusing on CPE carriers with clinical case description. The costs were estimated by comparing the activity of concerned units (excluding the ICU) during periods with CPE carriers or contacts, during the same periods of the year (n-1), plus additional hours and rectal swabs.Sixteen EPC carriers were identified: 10 men and 6 women, 6510years of age. Seven patients acquired EPC in hospital during 2 outbreaks in 2012. Four patients presented with an infection (peritonitis, catheter infection, and 2 cases of obstructive pyelonephritis) with a favorable outcome. The median length of stay was 21days [4,150]. Six patients died, 1 death was indirectly due to CPE because of inappropriate empiric antibiotic therapy. A decrease in activity was observed compared to the previous year with an estimated 547,303 loss. The 1779 additional hours cost 63,870, and 716 screening samples cost 30,931. The total additional cost was estimated at 642,104 for the institution.Specialized teams for CPE carriers and isolation of contact patients, required to avoid/control epidemics, have an important additional cost. An appreciation of their support is needed, as well as participation of rehabilitation units.

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