Sotteville-lès-Rouen, France
Sotteville-lès-Rouen, France

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Trouvin A.-P.,Service de Rhumatologie | Goeb V.,Service de Rhumatologie | Vandhuick T.,Service de Rhumatologie | Michelin P.,CHU hopitaux de Rouen | And 2 more authors.
Joint Bone Spine | Year: 2013

Sacrococcygeal dislocation is among the many causes of coccydynia. The etiological diagnosis of this fairly rare condition is difficult. Dynamic imaging is the only means of documenting the dislocation. We describe two cases of sacrococcygeal dislocation in patients presenting with coccydynia. Both patients reported a history of trauma in the more or less remote past, with no clear correlation with pain onset. Magnetic resonance imaging (MRI) of the sacrococcygeal junction showed local inflammatory lesions (bursitis, sacrococcygeal arthritis), providing a rationale for a local procedure. Analgesic therapy was inadequately effective and a local glucocorticoid injection into the sacrococcygeal junction was therefore recommended. One of the patients accepted this procedure and subsequently reported complete resolution of the symptoms. © 2012 Société française de rhumatologie.


PubMed | Lyon University Hospital Center, Service de pneumologie et allergologie pediatriques, Nice University Hospital Center, Service de pneumologie pediatrique and 9 more.
Type: Journal Article | Journal: European journal of pediatrics | Year: 2015

The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections.Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization. Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization. The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied. In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF. Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom.


Grimaldi C.,Marseille University Hospital Center | Berlioz-Baudoin M.,Nice University Hospital Center | Brouard J.,Caen University Hospital Center | Corvol H.,Service de pediatrie et pneumologie | And 9 more authors.
European Journal of Pediatrics | Year: 2015

The influence of the generalization of cystic fibrosis newborn screening (CFNBS) in France on sweat test (ST) prescription is unknown. In this French retrospective, descriptive, and multicenter study, we studied the indications, number, methods, and results of STs prescribed by a pediatric pulmonologist in children who had a negative CFNBS and an ST for respiratory symptoms in 2012. We included 502 children with 523 STs, performed with four different methods. The main indication was asthma (71.3 %), then chronic cough (52.4 %), atypical lower airway infections (42.2 %), and bronchiectasis (7 %). Four children had a diagnosis of CF (0.8 %), all presenting with chronic productive cough and recurrent respiratory infections. Conclusion: Asthma is the most frequent indication of ST in our cohort. Because of the systematic CFNBS in France, some prescriptions should be avoided, particularly in case of severe or moderate asthma with no other associated symptom. Moreover, methods of STs often do not follow the guidelines and need standardization.What is Known:• Newborn screening (NBS) has become the most frequent circumstance of the diagnosis of cystic fibrosis (CF) in France after its generalization.• The prescription of sweat test (ST) in children with respiratory symptoms who already had a negative NBS has not been studied.What is New:• In children with a negative CF NBS referred to a university hospital for respiratory diseases, despite important variations of ST methods, only 4 children among 502 have been diagnosed as CF.• Despite recommendations, ST prescription should be avoided in children with moderate to severe asthma and no other associated symptom. © 2015, Springer-Verlag Berlin Heidelberg.


Aubert O.,University Paris - Sud | Suberbielle C.,Laboratoire dHistocompatibilite Hopital Saint Louis APHP | Gauthe R.,CHU hopitaux de Rouen | Francois H.,University Paris - Sud | And 4 more authors.
Transplantation | Year: 2014

Background. This prospective monocentric study investigated the effect of corticosteroids plus bortezomib to reduce anti-HLA antibodies before renal transplantation. Methods. Included were 23 patients with stable immunization against HLA and awaiting a kidney transplant (KT). Treatment consisted of bortezomib (1.3 mg/m2) plus 40 mg of dexamethasone intravenously on days 1, 3, 8, and 10 (B+S). Class I and II anti-HLAs were determined using the single-antigen beads assay at day 0 (D0), month 1 (M1), M3, and M6. Results. Antibodies against 96 class I and 76 class II antigens were investigated and patients had a mean number of 49 (T21) antibodies against HLA on D0: 31 were against HLA class I and 17 were against HLA class II. At D0, the median was 10,734 (range, 1096Y18,513) for the highest mean fluorescent intensity (hAb) anti-class I antibodies and 11,189 (range, 1276Y19,176) for class II. By M3, 41% of patients had a greater than 25% decrease in class 1 hAbs and 60% by M6. By M3, 33% of patients had a greater than 25% decrease in class II hAbs and 42% by M6. At M6, 54% of anti-HLA antibodies had a sustained decrease by more than 25% and 36% were decreased by more than 50%. No predictive factors for decreased antibodies after bortezomib plus steroid therapy were identified. No serious adverse event was observed. Thereafter, 11 of 23 patients received successful transplants without having experienced acute rejection (follow-up, 18 months). Conclusions. B+S is an effective alternative therapy for reducing class I and II anti-HLA, regardless of other previous treatments. © 2014 by Lippincott Williams & Wilkins.


Sibert L.,CHU HOpitaux de Rouen | Sibert L.,University of Rouen | Lacarriere E.,CHU HOpitaux de Rouen | Safsaf A.,CHU HOpitaux de Rouen | And 3 more authors.
Presse Medicale | Year: 2014

The morphological and histological changes related to testicular aging are: volume decrease, arteriolar sclerosis, degeneration of Leydig cells and Sertoli, depletion of germ cells and thickening of the tunica albuginea testis.The participation in testicular androgen decline in aging is related to the decrease in the number of Leydig cells associated with alterations in the functioning of the hypothalamic-pituitary axis. Sperm volume, concentration and total number, motility and morphology of sperm decrease with aging male.The interindividual variability of sperm parameters, the variability of methodologies for data collection and selection of patients must be careful in interpreting the published results.Overall, the quality of sperm decreases progressively with age, without any age limit that can be individualized.Alterations of spermatogenesis do not seem significantly compromising fertility in the elderly.The clinical impact of testicular aging implies androgen production decrease and diseases associated with aging. © 2014 Elsevier Masson SAS.


Wolff N.,CRF Les Embruns | Paye-Jaouen A.,CHU Robert Debre | Boillot B.,Grenoble University Hospital Center | Grise P.,CHU Hopitaux de Rouen
Pelvi-perineologie | Year: 2011

Bladder exstrophy-epispadias complex (BEEC) is a rare malfunction of the urinary system, and its severity varies depending on whether it is partial or complete. Treatment is always by surgery and in two stages: (1) a neonatal bladder closure procedure and (2) bladder enlargement when the patient is about 4 years old, which often involves multiple steps, including reconstruction of the bladder neck. It may be necessary to resort to an urinary tract diversion. Genital repair is necessary for boys presenting epispadias, often associated with a tortuous urethra and a short penis. The surgical steps are many and complicated, but the objective is to allow these children to become continent, while preserving their upper urinary system and ensuring the best possible quality of life in terms of their future sexuality. © 2011 Springer-Verlag France.


PubMed | CHU Hopitaux de Rouen and University of Rouen
Type: Journal Article | Journal: Presse medicale (Paris, France : 1983) | Year: 2014

The morphological and histological changes related to testicular aging are: volume decrease, arteriolar sclerosis, degeneration of Leydig cells and Sertoli, depletion of germ cells and thickening of the tunica albuginea testis. The participation in testicular androgen decline in aging is related to the decrease in the number of Leydig cells associated with alterations in the functioning of the hypothalamic-pituitary axis Sperm volume, concentration and total number, motility and morphology of sperm decrease with aging male. The interindividual variability of sperm parameters, the variability of methodologies for data collection and selection of patients must be careful in interpreting the published results. Overall, the quality of sperm decreases progressively with age, without any age limit that can be individualized. Alterations of spermatogenesis do not seem significantly compromising fertility in the elderly. The clinical impact of testicular aging implies androgen production decrease and diseases associated with aging.


Silva E.F.,Hopital Saint Louis | Charreau I.,French Institute of Health and Medical Research | Gourmel B.,University Paris Diderot | Mourah S.,University Paris Diderot | And 7 more authors.
Journal of Infectious Diseases | Year: 2013

Stored plasma specimens from 164 participants in the ANRS 138 trial were analyzed to determine interleukin 6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and D-dimer levels at baseline and weeks 24 and 48. These virologically suppressed, treatment-experienced patients were randomly assigned to undergo an immediate switch (IS) or a deferred switch (DS; at week 24) from an enfuvirtide-based antiretroviral therapy (ART) regimen to a raltegravir-based regimen. At week 24, a significant decrease from baseline was observed in the IS arm, compared with the DS arm, for IL-6 level (-30% vs +10%; P <. 002), hsCRP level (-46% vs +15%; P <. 0001), and D-dimer level (-40% vs +6%; P <. 0001). At week 48, there was a reproducible decrease in levels of all biomarkers in the DS arm. © 2013 The Author.


PubMed | CHU Hopitaux de Rouen
Type: Journal Article | Journal: The Journal of clinical psychiatry | Year: 2011

Animal studies have shown sex differences in the impact of prenatal maternal stress on the offspring. The aim of this prospective case-control study was to assess the effect of prenatal depression on newborn and 1-year-old infant characteristics as related to gender, controlling for confounding variables.We screened 205 pregnant women from April 2004 to November 2006 for depressive symptoms. Inclusion in the prenatal depression group (n = 34) was based on meeting DSM-IV criteria for major depressive episode. We excluded postnatal depression from the control group (n = 79) by routine screening at 2 and 6 months. Newborn and 1-year-old infant characteristics were evaluated with the Neonatal Behavioral Assessment Scale (NBAS) and the Infant-Toddler Social and Emotional Assessment, respectively.Despite our use of numerous exclusion criteria (eg, at-risk pregnancy, preterm delivery), prenatal depression highly correlated with anxiety and stress scores. Male newborns of mothers with prenatal depression had lower scores than controls on the motor skills and regulation of states NBAS clusters (P = .03 and P = .026, respectively). At 1 year, infants of prenatally depressed mothers presented higher scores on generalized anxiety (P = .002), particularly in males (P = .009); activity/impulsivity (P = .042); and sleep problems (P = .023) than controls.As in animal studies, depression during pregnancy may affect infant development in a way that is related to gender. Early gender differences observed to be associated with depression, stress, and anxiety during pregnancy may be a key to understanding the higher prevalence in males of child psychiatric disorders.

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