CHU Amiens Picardie

Amiens, France

CHU Amiens Picardie

Amiens, France
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Dupont H.,CHU Amiens Picardie | Dupont H.,French Institute of Health and Medical Research | Massias L.,Pharmacology Toxicology Laboratory | Massias L.,University Paris Diderot | And 3 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2017

Background: Only limited pharmacokinetic data are available for anidulafungin in ICU patients, especially in patients treated for severe intra-abdominal infection (IAI). Methods: This was a prospective multicentre observational study in ICU patients with suspected yeast IAI. All patients received an intravenous loading dose of 200mg of anidulafungin, followed by 100 mg/day. Thirteen blood samples were drawn between day 1 and day 5 for pharmacokinetic analysis. Samples were analysed by an HPLC-tandemMS method. Demographics and SAPS2 and SOFA scores were recorded. Results: Fourteen patients with a median age (IQR) of 62 years (48-70) and with a mean BMI of 30.5 kg/m2 were included from three centres; 57.1% were women. Their median (IQR) SAPS2 score was 54 (45-67) and their median (IQR) SOFA score was 8 (7-12). Six patients with community-acquired IAI and eight patients with nosocomial-acquired IAI were included. Twelve yeasts were isolated: six Candida albicans, two Candida glabrata, two Candida tropicalis, one Candida parapsilosis and one Candida krusei. Pharmacokinetic parameters were as follows [mean (% coefficient of variation)]: Cmax (mg/L) = 6.0 (29%); Tmax (h) = 1.6 (25.8%); Cmin (mg/L) = 3.2 (36.8%); AUC0-24 (mg·h/L) = 88.9 (38.6%); t1/2 (h) = 42.1 (68.2%); CL (L/h) = 1.2 (42.3%); and V (L) = 72.8 (87.8%). A two-compartment model best described the anidulafungin concentrations in the population pharmacokinetic study. Conclusions: The pharmacokinetic parameters of anidulafungin in critically ill ICU patients with complicated IAI are similar to those observed in the literature. However, an increased V and a longer t1/2 were observed in this study. (EudraCT No. 2010-018695-25). © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.


Lebeau N.,CHU Amiens Picardie | Bayle M.,CHU Amiens Picardie | Belhaouane R.,CHU Amiens Picardie | Chelli M.,CHU Amiens Picardie | And 3 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2017

Introduction: Total hip arthroplasty (THA) requires bone reconstruction in case of severe acetabular injury, with risk of dislocation, especially postoperatively. Dual-mobility cups have proved effective in preventing dislocation in THA revision for instability, but their behavior when cemented in a metal reinforcement has been little studied. Objectives: The present study assessed results for a dual-mobility cup cemented in a metal reinforcement, in terms of aseptic loosening and postoperative instability. Material and methods: A single-center continuous series of 62 patients receiving such an assembly in THA revision was assessed retrospectively at a minimum 5 years' follow-up. Failure due to aseptic loosening or instability and implant survival at last follow-up were analyzed. Results: Radiological and clinical analysis was performed at a mean 77 months' follow-up. Mean Merle-d'Aubigné-Postel score was 14, Harris score 73 and Oxford-12 score 23.9 at last follow-up. Complications comprised 5 cases of loosening and 2 of dislocation. Loosening risk was significantly greater in case of. <. 2. mm cement thickness between cup and reinforcement. Eight-year infection-free survival was 91.9%. Discussion: The present clinical results were comparable to those in series using the same kind of assembly; the dislocation rate was low, but the rate of aseptic loosening was higher than reported elsewhere. Cement thickness between cup and reinforcement was a determining factor for stability. Cup design may also be relevant to loosening. This technique seemed to be a good option in THA revision with severe bone loss. Level of evidence: IV, retrospective study. © 2017 Elsevier Masson SAS.


Dupont H.,CHU Amiens Picardie | Dupont H.,University of Picardie Jules Verne | Gaillot O.,Lille University Hospital Center | Goetgheluck A.-S.,Laboratoire Of Biologie Medicale | And 11 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2016

An interregional surveillance program was conducted in the northwestern part of France to determine the prevalence of carbapenem-nonsusceptible Enterobacteriaceae (CNSE) isolates and their susceptibility to ceftazidime-avibactam and aztreonam-avibactam combinations. Nonduplicate CNSE clinical isolates were prospectively collected from six hospitals between June 2012 and November 2013. MICs of ceftazidime and aztreonam, alone or combined with a fixed concentration of avibactam (4 μg/ml), and those of carbapenems (comparator agents) were determined. MICs of ertapenem in combination with phenylalanine arginine-naphthylamide dihydrochloride (PAβN) were also determined to assess active efflux. Genes encoding carbapenemases, plasmid-mediated AmpC enzymes, extended-spectrum β-lactamases (ESBLs), and major outer membrane proteins (OMPs) were amplified and sequenced. OMPs were also extracted for SDS-PAGE analysis. Among the 139 CNSE isolates, mainly Enterobacter spp. and Klebsiella pneumoniae, 123 (88.4%) were ertapenem nonsusceptible, 12 (8.6%) exhibited reduced susceptibility to all carbapenems, and 4 Proteeae isolates (2.9%) were resistant to imipenem. Carbapenemase production was detected in only two isolates (producing OXA-48 and IMI-3). In contrast, OMP deficiency, in association with AmpCs and/or ESBLs (mainly CTX-M-9, SHV-12, and CTX-M-15), was largely identified among CNSE isolates. The ceftazidime-avibactam and aztreonam-avibactam combinations exhibited potent activity against CNSE isolates (MIC50/MIC90, 1/1 μg/ml and 0.5/0.5 μg/ml, respectively) compared to that of ceftazidime and aztreonam alone (MIC50/MIC90, 512/512 μg/ml and 128/512 μg/ml, respectively). This study reveals the in vitro activity of ceftazidime-avibactam and aztreonam-avibactam combinations against a large collection of porin-deficient enterobacterial isolates that are representative of the CNSE recovered in the northern part of France. Copyright © 2015, American Society for Microbiology. All Rights Reserved.


Cauchy F.,University Paris Est Creteil | Regimbeau J.M.,CHU Amiens Picardie | Fuks D.,CHU Amiens Picardie | Balladur P.,University Paris Est Creteil | And 2 more authors.
Pancreatology | Year: 2014

Objectives: To evaluate the influence of a biliary obstruction (BO) requiring biliary bypass on both short and long-term outcomes of patients undergoing Frey's procedure for chronic pancreatitis (CP). Methods: From 1999 to 2010, 33 consecutive patients underwent Frey's procedure for CP in two centers. Seventeen (54%) patients underwent biliary bypass to treat an associated BO. Characteristics and outcomes of these patients were compared to those of 16 others without BO. Results: Patients with BO had more severe disease including lower BMI and larger pancreatic head (4 cm vs. 6 cm, p 0.021). The operative mortality was nil. Patients with BO experienced more overall postoperative complications (71% vs. 31%, p 0.024) but similar major complication rates (18% vs. 6%, p 0.316) compared to those without BO. After a median follow-up of 51 (1e96) months, 91% of the patients experienced either partial or complete relief of their symptoms and 36% exhibited deterioration of their endocrine function. Multivariate analysis revealed preoperative BO to be associated with longterm impairment of endocrine function (OR: 43.249; 95% CI 2.221e84.277; p 0.013). Conclusion: In patients undergoing Frey's procedure for CP, associated BO can be safely managed using biliary bypass. However, the severity of CP in these patients is responsible for a higher risk of long-term endocrine insufficiency. Copyright © 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.


PubMed | CHU Amiens Picardie and University Paris Est Creteil
Type: Journal Article | Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] | Year: 2014

To evaluate the influence of a biliary obstruction (BO) requiring biliary bypass on both short and long-term outcomes of patients undergoing Freys procedure for chronic pancreatitis (CP).From 1999 to 2010, 33 consecutive patients underwent Freys procedure for CP in two centers. Seventeen (54%) patients underwent biliary bypass to treat an associated BO. Characteristics and outcomes of these patients were compared to those of 16 others without BO.Patients with BO had more severe disease including lower BMI and larger pancreatic head (4 cm vs. 6 cm, p = 0.021). The operative mortality was nil. Patients with BO experienced more overall postoperative complications (71% vs. 31%, p = 0.024) but similar major complication rates (18% vs. 6%, p = 0.316) compared to those without BO. After a median follow-up of 51 (1-96) months, 91% of the patients experienced either partial or complete relief of their symptoms and 36% exhibited deterioration of their endocrine function. Multivariate analysis revealed preoperative BO to be associated with long-term impairment of endocrine function (OR: 43.249; 95% CI 2.221-84.277; p = 0.013).In patients undergoing Freys procedure for CP, associated BO can be safely managed using biliary bypass. However, the severity of CP in these patients is responsible for a higher risk of long-term endocrine insufficiency.


Kany J.,Clinique de l'Union | Amouyel T.,Chu Amiens Picardie | Flamand O.,Clinique Saint Joseph | Katz D.,Clinique du Ter | Valenti P.,Clinique Jouvenet
International Orthopaedics | Year: 2014

Purpose: The frequency of total shoulder arthroplasty (TSA) implantation is constantly increasing. This leads to revisions because of stem or glenoid component loosening, infection, instability or glenoid subsidence. Significant rotator cuff lesions and/or bone loss necessitate reverse shoulder arthroplasty (RSA) with bone reconstruction, which is a demanding procedure. Our hypothesis is that a platform system (versatile humeral stem with metal back glenoid component) makes revision surgery less demanding and less time consuming, and helps reduce the risks of complication. The purpose of this study is to analyse our revision experience with such a system to support our hypothesis. Methods: We present 29 revision cases of a convertible platform shoulder system: five hemi arthroplasties (HA), eight TSA with cemented glenoid (TSACG) and 16 TSA with metal backed glenoid component (TSAMB). Three TSACG were switched to TSAMB, and 26 other arthroplasties were switched to RSA. The pre-operative Constant score was 27 (range, 0–38). Our revision incidence was 5.4 % (29 revisions out of 537 shoulder arthroplasties over five years). Results: At revision, Constant score was 60 (range, 42–85). The humeral stem (versatile with TSA and RSA) was kept in three out of four cases. Most of the time it was changed because of too high a position, making it impossible to reduce the RSA. Nevertheless, 12 PTAMB were switched in 12 RSA without any metal backed revisions. Conclusion: A platform shoulder system allows much easier revisions. © 2014, SICOT aisbl.


Gerard M.,Caen University Hospital Center | Morin G.,CHU Amiens Picardie | Bourillon A.,Biochemistry | Colson C.,Caen University Hospital Center | And 7 more authors.
European Journal of Medical Genetics | Year: 2015

The cobalamin type C deficiency is a rare condition that results from impaired biosynthesis of both methylcobalamin (MeCbl) and adenosylcobalamin (AdoCbl). Hemizygous mutations of the HCFC1 gene explain the majority of clinically and biologically compatible cblC patients without MMACHC mutations (. OMIM 309541). We report a family with two maternal half-brothers with multiple congenital anomalies and HCFC1 gene mutation in the second Kelch domain. Both presented with dysmorphic features (flat profile, cleft lip for one), increased nuchal translucency, prenatal onset microcephaly and hypospadias. Additionally to early onset intractable epilepsy and profound neurocognitive impairment, this familial observation suggests that HCFC1 gene should be considered in boys with midline malformations, even without proven cobalamin C deficiency. © 2015 Elsevier Masson SAS.


Khiati S.,French Institute of Health and Medical Research | Khiati S.,University of Bordeaux 1 | Luvino D.,Aix - Marseille University | Oumzil K.,French Institute of Health and Medical Research | And 5 more authors.
ACS Nano | Year: 2011

The use of delivery vehicles to selectively transport anticancer agents to tumors is very attractive to address both toxicity and efficacy issues. We report a novel approach based on hybrid nucleoside-lipids allowing the efficient encapsulation and delivery of cisplatin. We demonstrate that the nucleoside polar heads guide the self-assembly of the aggregates into highly loaded and stable nanoparticles. The nanoparticles, which are efficient vehicles for the delivery of cisplatin into different sensitive and resistant cancer cell lines, can overcome the disadvantages and limitations of drug delivery systems previously reported. © 2011 American Chemical Society.


Sarhan F.-R.,CHU Amiens Picardie | Lecocq F.,Hopital Lariboisiere Fernand Widal AP HP
Kinesitherapie | Year: 2015

Summary The reform of the physiotherapist's education implies an increase in the salaries. However, the agreement signed in 2010 does not seem in line with our expectations. © 2015 Elsevier Masson SAS.


PubMed | CHU Amiens Picardie
Type: Journal Article | Journal: The Journal of hand surgery | Year: 2015

To evaluate the long-term clinical, functional, and radiological outcomes in 30 patients with at least 15 years of follow-up.We performed a retrospective study that identified 73 patients. Thirty patients agreed to participate and were included. The mean follow-up was 18 years (range, 15-24 years). There were 14 cases of perilunate dislocation and 16 cases of perilunate fracture-dislocation (including 13 transscaphoid perilunate fracture-dislocations). At the last follow-up, the clinical and functional evaluation was based on the range of motion, grip strength, the Mayo wrist score, the Quick Disabilities of the Arm Shoulder and Hand score, and the Patient-Rated Wrist Evaluation score. Radiological abnormalities, according to the Herzberg classification, were 5 type A1 cases, 7 type B, 16 type B1, and 2 type C.The mean flexion-extension arc, radial-ulnar abduction arc, and pronation-supination arc were, respectively, 68%, 67%, and 80%, relative to the contralateral side. The mean grip strength was 70%, relative to the contralateral side. The mean Mayo wrist score was 70, and the mean Quick Disabilities of the Arm Shoulder and Hand and Patient-Rated Wrist Evaluation scores were, respectively, 20 and 21. Five patients had secondary procedure. Six patients had a complex regional pain syndrome type1.Although arthritis occurred in 70% of cases, its clinical and functional impact appeared to be low. However, the 2 lowest Mayo wrist scores corresponded to the patients with the most advanced arthritis. Complex regional pain syndrome appeared to have an impact on long-term outcomes.Therapeutic IV.

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