CHRU de Brest

Brest, France

CHRU de Brest

Brest, France
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The invention relates to a method of obtaining a data structure representative of quantities of ionizing radiations received during a radiotherapy treatment (iSQR). According to the invention, such a method comprises: - a step of obtaining (100) at least one three dimensional image (i3D) representative of an anatomical region treated; - a step of integrating (110), within said three dimensional image (I3D), a plurality of data representative of radiotherapy treatment doses received, as a function of a set of dosimetric data previously obtained (EDD), delivering an integrated three dimensional image (l3Di); - a step of thresholding (120) of said three dimensional integrated image as a function of a set of thresholds, delivering a thresheld three dimensional image (i3Ds) comprising at least one anatomical volume per threshold of said threshold set; - a step of generating (130) said data structure representative of quantities of ionizing radiations (iSQR) on the basis of said at least one anatomical volume of said thresheld image (i3Ds).

Ponsard N.,CHRU de Brest | Brusadin G.,Gustave Roussy | Brusadin G.,University Paris Saclay | Schick U.,CHRU de Brest
Cancer/Radiotherapie | Year: 2017

The quality and risk manager works in a regulated framework, which delimits its missions. Nevertheless, the variety among the centers generates heterogeneous situations regarding the positioning and the range of action. A well-defined framework is needed in order to ratify the legitimacy and the recognition of quality and risk manager's main function. © 2017 Société française de radiothérapie oncologique (SFRO).

Roue J.-M.,CHRU de Brest | Kuhn P.,University of Strasbourg | Maastrup R.A.,Copenhagen University | Mitanchez D.,Hopital Armand Trousseau | And 2 more authors.
Archives of Disease in Childhood: Fetal and Neonatal Edition | Year: 2017

Despite the recent improvements in perinatal medical care leading to an increase in survival rates, adverse neurodevelopmental outcomes occur more frequently in preterm and/or high-risk infants. Medical risk factors for neurodevelopmental delays like male gender or intrauterine growth restriction and family sociocultural characteristics have been identified. Significant data have provided evidence of the detrimental impact of overhelming environmental sensory inputs, such as pain and stress, on the developing human brain and strategies aimed at preventing this impact. These strategies, such as free parental access or sleep protection, could be considered principles of care'. Implementation of these principles do not require additional research due to the body of evidence. We review the scientific evidence for these principles here. © Published by the BMJ Publishing Group Limited.

Thomas P.,University of Limoges | Chandes G.,University of Limoges | Hazif-Thomas C.,CHRU de Brest
NPG Neurologie - Psychiatrie - Geriatrie | Year: 2017

The purpose of this paper is to present the results of the applications of music therapy, and to analyze some of its effects on people with a probable diagnosis of Alzheimer's disease and related disorders. Meta-analysis results confirm the valuable effect of music therapy on anxiety and depression in patients with mild to moderate Alzheimer's disease. Music therapy continues to produce well-being for the patient in the advanced stages of the illness. It is effective in supporting the patient's resilience and that of their caregivers. The underlying mechanisms of this type of therapy are clarified. The music therapy adds meaning to care and contributes to preventing psychosocial risks. © 2017 Elsevier Masson SAS.

Houx L.,CHRU de Brest | Brochard S.,CHRU de Brest | Lempereur M.,CHRU de Brest | Remy-Neris O.,CHRU de Brest
Prosthetics and Orthotics International | Year: 2012

Background and Aim: In order to increase understanding of the biomechanical consequences of equinus foot on gait, we developed an orthosis to induce an adjustable degree of unilateral equinus. The aim of this study was to evaluate its feasibility and consequences on 3D ankle kinematics and kinetics.Technique: 3D gait analysis was carried out in 10 healthy children without the orthosis, with the non-adjusted orthosis and with the orthosis adjusted to +10°, 0°, -10°, -20° of ankle dorsiflexion and maximum plantarflexion (MP). The amount of dorsiflexion at initial contact was close to the goniometric measurement. Significant kinematic and kinetic changes occurred at -10°, -20° and MP. The mean maximum equinus at initial contact -21.65° ± 4.17 and during stance -11.61° ± 4.82 were larger than those obtained with previous described devices.Discussion: Our device was easy-to-use and induced an adjustable, well tolerated equinus. It provides a new way to simulate equinus and its biomechanical consequences on gait.Clinical relevanceThis study validated an orthotic device which induced an adjustable equinus. This device can be used to carry out biomechanical studies in children, increasing understanding of pathological problems and thus improving therapeutic management. © International Society for Prosthetics and Orthotics International 2011.

Brochard S.,CHRU de Brest | Alter K.,U.S. National Institutes of Health | Damiano D.,U.S. National Institutes of Health
Muscle and Nerve | Year: 2014

Introduction: We characterized bilateral shoulder strength and the balance of antagonist/agonist muscle pairs in children with brachial plexus palsy (BPP) and with typical development (TD). Methods: In 15 children with unilateral BPP and 11 with TD, bilateral maximal isometric shoulder strength in flexion/extension, internal/external rotation, and abduction/adduction was recorded using a hand-held dynamometer. Correlation between strength and active range of motion were evaluated using the Mallet score. Results: Children with BPP had strength asymmetry in all muscles, whereas children with TD had significant strength asymmetry for flexors and abductors. In children with BPP, extensors and external rotators were the weakest muscles, leading to sagittal and transverse plane muscle imbalances. Higher strength values were related to better active range of motion. Conclusions: This study highlights the importance of documenting shoulder strength profiles in children with BPP which may help predict deformity development. © 2013 Wiley Periodicals, Inc.

Le Borgne S.,CHRU de Brest
NPG Neurologie - Psychiatrie - Geriatrie | Year: 2014

Falls are a frequent phenomenon among the elderly and sometimes fraught with consequences. Some falls question the clinician as to their mental determinism and as for their suicidal intentionality. Certain clinical situations are sometimes in favor of a suicidal initiative of the elderly person through his/her fall. All this makes falls a means of non-verbal communication; when the words are running out, the subject lets go and falls. The suicidal risk increases as the person gets older. The prevention of the suicidal risk involves a screening for nervous breakdown, often under-diagnosed and under-treated. © 2014 Elsevier Masson SAS.

Robinet G.,CHRU de Brest
Revue des Maladies Respiratoires Actualites | Year: 2014

Brain metastases have a poor prognosis. However, there are local therapies which may provide a cure for cancers with few or no metastases. © 2014 Elsevier Masson SAS.

PubMed | CHRU de Brest and Service de reanimation medicale
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2016

Hospital-acquired anemia is common, especially in the most critically ill patients. It may be associated with poor patient outcomes. It may result from increased blood loss, impaired red cell production or reduced red cell life span. Multiple associated factors may contribute simultaneously or sequentially to the decrease in hemoglobin level. Some of them are related to the underlying disease and others are iatrogenic. Clinicians should be aware of the importance and consequences of iatrogenic anemia caused by diagnostic blood sampling. Strategies and measures to minimize iatrogenic blood loss should be prioritized. They may reduce the risk of developing anemia and then red blood cells transfusion requirement.

PubMed | University of Western Brittany, CHRU de Brest and service dhygiene hospitaliere
Type: Journal Article | Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie | Year: 2016

Flexible cystoscopes are high temperature sensitive devices that must undergo high-level disinfection according to Spaulding classification. The objective of this study is to provide epidemiological data on the monitoring of microbiological quality of cystoscopes used in a teaching hospital, in order to determine the compliance rate of disinfection and to describe the main identified microorganisms.Prospective study of all the results of microbiological samples taken for 8 years at the Brest teaching hospital. The analysis results were interpreted according to the ministerial recommendations.During the study, 87 microbiological tests were performed. The rate of non-compliant samples was 19.5% (17/87). This rate reached 24.5% (12/49) of the programmed controls. The microorganisms identified were present in small amounts, corresponding mainly to bacteria from the environment.The rate of non-compliance of the microbiological tests performed on cystoscopes is relatively high (19.5%), but the infectious risk seems limited. Hidden microorganisms are present in small quantities and identified germs are not known to be responsible for urinary tract infections. Educating professionals responsible for cystoscopes reprocessing and conducting regular audits may help to ensure a good level of cystoscope disinfection.

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