Norgaard K.,Hvidovre University Hospital |
Bruttomesso D.,University of Padua |
Mathieu C.,Catholic University of Leuven |
Frid A.,Skåne University Hospital |
And 3 more authors.
Diabetic Medicine | Year: 2011
Aims To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type1 diabetes. Methods In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with Type1 diabetes (40 women) currently treated with multiple daily injections, age 18-65years and HbA 1c≥8.2% (≥66mmol/mol) to 26weeks of treatment with either a sensor-augmented insulin pump (n=44) (Paradigm ® REAL-Time) or continued with multiple daily injections (n=39). Change in HbA 1c between baseline and 26weeks, sensor-derived endpoints and patient-reported outcomes were assessed. Results The trial was completed by 43/44 (98%) patients in the sensor-augmented insulin pump group and 35/39 (90%) patients in the multiple daily injections group. Mean HbA 1c at baseline and at 26weeks changed from 8.46% (sd0.95) (69mmol/mol) to 7.23% (sd0.65) (56mmol/mol) in the sensor-augmented insulin pump group and from 8.59% (sd0.82) (70mmol/mol) to 8.46% (sd1.04) (69mmol/mol) in the multiple daily injections group. Mean difference in change in HbA 1c after 26weeks was -1.21% (95% confidence interval -1.52 to -0.90, P<0.001) in favour of the sensor-augmented insulin pump group. This was achieved without an increase in percentage of time spent in hypoglycaemia: between-group difference 0.0% (95% confidence interval -1.6 to 1.7, P=0.96). There were four episodes of severe hypoglycaemia in the sensor-augmented insulin pump group and one episode in the multiple daily injections group (P=0.21). Problem Areas in Diabetes and Diabetes Treatment Satisfaction Questionnaire scores improved in the sensor-augmented insulin pump group. Conclusions Sensor augmented pump therapy effectively lowers HbA 1c in patients with Type1 diabetes suboptimally controlled with multiple daily injections. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
PubMed | Reseau de microbiologistes du Nord Pas de Calais, Center Hospitalier Of Bethune, Center Hospitalier Of Roubaix, Institut Universitaire de France and Center Hospitalier Of Valenciennes
Type: Journal Article | Journal: Medecine et maladies infectieuses | Year: 2016
Pivmecillinam is a safe beta-lactam for use in pregnancy. It has been widely used for the treatment of lower urinary tract infections (UTIs) in the Nordic countries where its efficacy, minor impact on the microbiota, and low level of resistance among the Escherichia coli strains have been proven. However, susceptibility data related to E.coli involved in asymptomatic bacteriuria and lower UTIs in pregnant women is lacking. We aimed to support the 2015 recommendations issued by the French Infectious Diseases Society (SPILF) on gestational UTI, with a particular focus on pivmecillinam.Antimicrobial susceptibility testing was performed by 12hospitals with a maternity department on 235 E.coli strains isolated from the urine of pregnant women. Susceptibility to mecillinam was tested by disk diffusion method using the 2015 recommendations of the antibiogram committee of the French microbiology society (CA-SFM).Global susceptibility to mecillinam was 86.4%. Susceptibility to mecillinam was 96.5% for strains susceptible to amoxicillin-clavulanic acid and 38.7% for resistant strains. All six extended-spectrum beta-lactamase-producing E.coli strains were susceptible to mecillinam.Given the efficacy and safety of pivmecillinam during pregnancy, it may be used for the documented treatment of asymptomatic bacteriuria and acute cystitis in pregnant women. It also represents an alternative for the treatment of multidrug-resistant bacterial infections.
Wery E.,Pole Femme |
Vambergue A.,Pole dEndocrinologie diabetologie |
Vambergue A.,Lille 2 University of Health and Law |
Le Goueff F.,Center Hospitalier Of Roubaix |
And 3 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2014
Background: To evaluate the impact of the new IADPSG thresholds on gestational diabetes mellitus (GDM) prevalence. Methods: Universal screening for GDM was performed in 200 consecutive patients at 24 to 28 weeks with 75 g oral glucose tolerance test. Results: The prevalence of GDM was 14.0%. We observed that among the 28 patients with GDM, 16 (57.1%) had only one abnormal value, 10 (35.7%) two abnormal values and only two (7.2%) had three abnormal values. For the 16 patients with one abnormal value, 13 of them (81.2%) have an abnormal fasting plasma glucose (FPG). Patients with GDM had an increased body mass index (29.6 kg/m2 vs 25.1 kg/m2, P < 0.001) and more important rates of familial history of type II diabetes (46.4% vs 21.5%, P < 0.005) and history of GDM in a previous pregnancy (21.4% vs 2.9%, P < 0.002) compared to non-GDM patients. Birth weight was increased in offspring of mothers with GDM (3451.3 g vs 3387.4 g, P < 0.05). Conclusion: Our study found an increased rate of GDM with the new IADPSG criteria compared to previous published data. Higher rates of GDM represent a challenge for the organization of perinatal teams involved in GDM care. © 2013 Elsevier Masson SAS. Tous droits réservés.
Deschildre A.,Unite de Pneumologie Allergologie Pediatrique |
Beghin L.,French Institute of Health and Medical Research |
Salleron J.,University of Lille Nord de France |
Iliescu C.,French Institute of Health and Medical Research |
And 8 more authors.
European Respiratory Journal | Year: 2012
Some children with severe asthma develop frequent exacerbations despite intensive treatment. We sought to assess the outcome (severe exacerbations and healthcare use, lung function, quality of life and maintenance treatment) of a strategy based on daily home spirometry with teletransmission to an expert medical centre and whether it differs from that of a conventional strategy. 50 children with severe uncontrolled asthma were enrolled in a 12-month prospective study and were randomised into two groups: 1) treatment managed with daily home spirometry and medical feedback (HM) and 2) conventional treatment (CT). The children's mean age was 10.9 yrs (95% confidence interval 10.2-11.6). 44 children completed the study (21 in the HM group and 23 in the CT group). The median number of severe exacerbations per patient was 2.0 (interquartile range 1.0-4.0) in the HM group and 3.0 (1.0-4.0) in the CT group (p50.38 with adjustment for age). There were no significant differences between the two groups for unscheduled visits (HM 5.0 (3.0-7.0), CT 3.0 (2.0-7.0); p50.30), lung function (pre-β 2-agonist forced expiratory volume in 1 s (FEV1) p50.13), Paediatric Asthma Quality of Life Questionnaire scores (p50.61) and median daily dose of inhaled corticosteroids (p50.86). A treatment strategy based on daily FEV1 monitoring with medical feedback did not reduce severe asthma exacerbations. Copyright©ERS 2012.
Bonnet C.T.,French National Center for Scientific Research |
Lepeut M.,Center Hospitalier Of Roubaix
Journal of Motor Behavior | Year: 2011
In quiet stance, it is understood that healthy individuals control their posture primarily by a peripheral mechanism for anteroposterior sway and by a proximal mechanism for medialateral sway. The authors proposed the hypothesis that patients suffering from disease-related deficiencies, at their feet and legs, may exaggeratedly adopt proximal control mechanisms at their hip in the anteroposterior and medialateral axes. They critically reviewed the literature to test the proximal control hypothesis against published findings. The selected articles analyzed postural control mechanisms in individuals with diabetic peripheral neuropathy and in healthy controls. The data selected were kinematic and electromyographic. In the anteroposterior axis, 4 authors had previously tested the proposed hypothesis, but the findings are contrasted. In the medialateral axis, one study failed to validate the tested hypothesis. Overall, the published studies did not conform with the proximal control hypothesis. However, these studies did not specifically or deeply test such a hypothesis. The lack of results is critical because individuals suffering from peripheral disease-related deficiencies may be unstable, in part, because of a change in postural control mechanisms. For improvement of their stability and appropriate interventions, scientific explorations of the proximal control hypothesis should be investigated. Two proposals are made to move forward. © Taylor & Francis Group, LLC.
Nandrino J.-L.,Charles de Gaulle University - Lille 3 |
Gandolphe M.-C.,Charles de Gaulle University - Lille 3 |
Alexandre C.,Charles de Gaulle University - Lille 3 |
Kmiecik E.,Charles de Gaulle University - Lille 3 |
And 2 more authors.
Drug and Alcohol Dependence | Year: 2014
Background: Many studies of patients with alcohol dependence (AD) have highlighted their difficulty in identifying both their own emotional state and those of a social partner. We examined (1) the cognitive and affective theory of mind (ToM) abilities of AD patients and (2) how the efficiency of their autobiographical memory (AM) can affect the effectiveness of ToM ability. Method: In a cross-sectional design, AD patients (N= 50) and healthy controls (N= 30) completed a ToM movie paradigm (Versailles-Situational Intention Reading, V-SIR) in which they inferred the intentions of characters in movies depicting social interactions, and the "Reading the Mind in the Eyes" Test (RMET), which assessed the emotional dimension of the ToM. AM was investigated using the "Autobiographical Memory Interview" (AMI) to assess both episodic and semantic components of AM. Results: Concerning ToM, patients with AD showed lower performance in the RMET than control participants, whereas no difference was observed on the V-SIR test. AD patients had lower scores than controls on the AMI, for both episodic and semantic components and for different periods of life. A multiple linear regression analysis also showed that AM deficits might predict lower ToM performance, especially for the RMET task. Conclusions: Patients with AD have a specific affective ToM deficit. They used episodic memories to perceive the emotions of others, whereas controls used preferentially semantic memories to perform the task. Both these deficits could constitute a risk of relapse and should be a target for psychotherapeutic interventions. © 2014 Elsevier Ireland Ltd.
PubMed | Center Hospitalier Of Tourcoing, Center Hospitalier Of Roubaix, Lille University of Science and Technology and Hopital geriatrique << Les Bateliers >>
Type: | Journal: L'Encephale | Year: 2016
Alzheimers disease is a common disease in nursing homes. Evolution is constantly negative and specific treatments, which are only symptomatic, are subject to controversy. In a context of media exposure, the Transparency Committee of the Haute Autorit de sant (HAS) downgraded their medical service in October 2011, seeing it as weak.Assess the evolution of the consumption of specific treatments for Alzheimers disease; assess changes in the quality of monitoring in specific consultation.This is a retrospective and descriptive study, cross-sectional in three times (T0January 2011, T1October 2011and T2June 2012), in 6nursing homes of Lille and its surroundings.In total, 262residents with dementia and present at least once during the three times of the study were included. Their mean age was 85.8years. Among them, 40% had Alzheimers disease clearly identified. At T0, 76.7% of patients present who were supposed to receive a specific treatment of Alzheimers disease were actually receiving such treatment, 73.6% at T1and 71.6% at T2. After 17months of observation, the discontinuation rate of anticholinesterase was 34%, 24% for anti-glutamate. The monitoring in specific consultations decreased slightly between the three stages.Our work did not show major impact of the media campaign against specific drugs for Alzheimers disease. There is however a trend towards a decrease of their consumption in people with dementia living in nursing homes with no obvious link between monitoring in specific consultation and specific prescription. This trend would ask to be confirmed by a study on a larger scale.
Guiliano M.,University of Lille Nord de France |
Closset E.,University of Lille Nord de France |
Therby D.,Center Hospitalier Of Roubaix |
LeGoueff F.,Center Hospitalier Of Roubaix |
And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2014
Objectives: Uterine rupture is a rare but potentially catastrophic complication of pregnancy that requires rapid diagnosis. Classically, its signs and symptoms combine pain, fetal heart rate (FHR) abnormalities, and vaginal bleeding. The purpose of this study is to identify these signs and symptoms as well as the immediate complications of complete and incomplete (partial) ruptures of the uterine wall, whether or not they follow a previous cesarean delivery. Study design: Retrospective study of case records from two university hospital maternity units, from 1987 to 2008. Results: In a total of 97,028 births during the study period, we identified 52 uterine ruptures (0.05%): 25 complete and 27 partial. Most (89%) occurred in women with a previous cesarean delivery. In complete ruptures, FHR abnormalities were the most frequent sign (82%), while the complete triad of FHR abnormalities-pain-vaginal bleeding was present in only 9%. The signs and symptoms of partial ruptures were very different; these were asymptomatic in half the cases (48%). Neonatal mortality reached 13.6% among the complete ruptures; 27 and 40% of these newborns had pH < 6.80 and pH < 7.0, respectively. Among the incomplete ruptures, only 7.7% of the newborns had a pH < 7.0 and there were no deaths. Conclusion: Although complete rupture of the uterus has a severe neonatal prognosis, the complete set of standard symptoms is present in less than 10% of cases. FHR abnormalities are by far the most frequent sign. © 2014 Elsevier Ireland Ltd. All rights reserved.
Lombard M.,Center Hospitalier Of Roubaix
Kinesitherapie | Year: 2016
Bereavement, incessantly present in clinical practice, is a central issue for health-care professionals in their work at the patient's bedside. Research has therefore successively approached the question from a wide variety angles. Starting from the place the deceased occupies at the outcome of loss, the main authors on the subject progressively turn towards the symptomatology of the mourner, or else consider the psychological changes wrought, focusing more on what is going on in the subject's unconscious in terms of loss. Theory has neglected to deal with the most deeply unconscious processes, an aspect hitherto left to one side in considering loss. Level of evidence: Not applicable. © 2016 Elsevier Masson SAS.
Lombard M.,Center Hospitalier Of Roubaix
Kinesitherapie | Year: 2016
From compromise to sacrifice, the history of mourning today celebrates its centenary. Looking back on the first, notably Freudian, theories reveals the nuances added by successive later approaches. From the deceased to the bereaved, the focus of the expert, like a pendulum, while successively highlighting the main protagonists, overlooks the main actor, situated in between, where the link lies. Jean Allouch calls this a "little bit of self", in a metaphor of a pound of flesh linking the bereaved subject to the object of love, and which is to be left to the deceased by way of a freely conceded sacrifice. Where Sigmund Freud, a century ago, described mourning as a work of substitution, the author now sees it as an act of sheer loss. We are witnessing a change of paradigm: the bereaved lose their status, slipping from the position of (desired) possessor to that of a kidnap victim, suddenly "desiring", experiencing lack. Mourning then comes to look like a scenario in which clients of some mysterious laboratory entrust it with a precious possession that comes back to them as a specimen - and, at this price, the bereaved can let it go.... Level of evidence: Not applicable. © 2016 Elsevier Masson SAS.