Niccolai P.,CH Princesse Grace de Monaco |
Ouchchane L.,CHU Clermont Ferrand |
Ouchchane L.,University Clermont |
Ouchchane L.,French National Center for Scientific Research |
And 17 more authors.
Canadian Journal of Surgery | Year: 2015
Background: A greater incidence of persistent pain after inguinal herniorrhaphy is suspected with the open mesh procedure than with laparoscopy (transabdominal preperitoneal), but the involvement of neuropathy needs to be clarified. Methods: We examined the cumulative incidence of neuropathic persistent pain, defined as self-report of pain at the surgical site with neuropathic aspects, within 6 months after surgery in 2 prospective subcohorts of a multicentre study. We compared open mesh with laparoscopy using different analysis, including a propensity-matched analysis with the propensity score built from a multivariable analysis using a generalized linear model. Results: Considering the full patient sample (242 open mesh v. 126 laparoscopy), the raw odds ratio for neuropathic persistent pain after inguinal herniorrhaphy was 4.3. It reached 6.8 with the propensity-matched analysis conducted on pooled subgroups of 194 patients undergoing open mesh and 125 undergoing laparoscopy (95% confidence interval 1.5-30.4, p = 0.012). A risk factor analysis of these pooled subgroups revealed that history of peripheral neuropathy was an independent risk factor for persistent neuropathic pain, while older age was protective. Conclusion: We found a greater risk of persistent pain with open mesh than with laparoscopy that may be explained by direct or indirect lesion of nerve terminations. Strategies to identify and preserve nerve terminations with the open mesh procedure are needed. ©2015 8872147 Canada Inc.
Colomb F.,University of Lille Nord de France |
Vidal O.,University of Lille Nord de France |
Bobowski M.,University of Lille Nord de France |
Krzewinski-Recchi M.-A.,University of Lille Nord de France |
And 6 more authors.
Biochemical Journal | Year: 2014
We have shown previously that the pro-inflammatory cytokine TNF (tumour necrosis factor) could drive sLex (sialyl-Lewisx) biosynthesis through the up-regulation of the BX transcript isoform of the ST3GAL4 (ST3 β-galactoside α-2,3-sialyltransferase 4) sialyltransferase gene in lung epithelial cells and human bronchial mucosa. In the present study, we show that the TNF-induced up-regulation of the ST3GAL4 BX transcript is mediated by MSK1/2 (mitogen- and stressactivated kinase 1/2) through the ERK (extracellular-signalregulated kinase) and p38 MAPK (mitogen-activated protein kinase) pathways, and increases sLex expression on highmolecular-mass glycoproteins in inflamed airway epithelium.We also show that the TNF-induced sLex expression increases the adhesion of the Pseudomonas aeruginosa PAO1 and PAK strains to lung epithelial cells in a FliD-dependent manner. These results suggest that ERK and p38 MAPK, and the downstream kinase MSK1/2, should be considered as potential targets to hamper inflammation, bronchial mucin glycosylation changes and P. aeruginosa binding in the lung of patients suffering from lung diseases such as chronic bronchitis or cystic fibrosis. © 2014 Biochemical Society.
Descazeaud A.,Limoges University Hospital Center |
Azzousi A.R.,Angers University Hospital Center |
Ballereau C.,Clinique de la Louviere |
Bruyere F.,CHU de Tours |
And 8 more authors.
Journal of Endourology | Year: 2010
Purpose: To evaluate blood loss during transurethral resection of the prostate (TURP), and its predictive factors, using the chromium 51 (51Cr) labeling method. Patients and Methods: From January to June 2008, 41 patients who underwent TURP for symptomatic benign prostatic hyperplasia (BPH) at four French urology centers were included in the analysis. Red cells volume was measured by the 51Cr method 1 day before TURP, and on postoperative day 3. Overall blood loss was estimated by multiplication of red cells volume loss and preoperative venous hematocrit value. Results: Mean preoperative red cells volume was 1997mL. Mean loss of red cells volume was 209ml, which corresponds to an estimated blood loss of 507mL. Mean delta of hematocrit and hemoglobin were 1.4% and 0.71g/dL, respectively. In univariate analysis, prostate volume, weight of resected tissue, preoperative red cells volume, and resection time were significantly and directly associated with loss of red cells volume (P=0.038, P=0.004, P=0.002, and P=0.039, respectively). Bipolar and monopolar TURP did not lead to significant difference of red cells loss. In multivariate analysis, both preoperative red cells volume and weight of resected tissue were independent predictors of red cells loss (P=0.017 and P=0.048 respectively). Conclusion: We present the first study to measure blood loss secondary to TURP using the 51Cr method. This technique allowed evaluating blood loss not only during the surgical procedure but also during the postoperative period. We learned from this study that, on average, blood loss from the procedure until postoperative day 3 was more than 500mL, which is larger than previously reported amounts as measured by other methods. Because significant blood loss might occur during the postoperative period, the 51Cr method should be used to measure blood loss when evaluating new emerging techniques to manage BPH. Copyright 2010, Mary Ann Liebert, Inc.
Deram A.,University of Lille Nord de France |
Genin M.,University of Lille Nord de France |
Noel C.,Service de Nephrologie |
Cuny D.,University of Lille Nord de France |
And 85 more authors.
PLoS ONE | Year: 2014
Background: Strong geographic variations in the incidence of end-stage renal disease (ESRD) are observed in developed countries. The reasons for these variations are unknown. They may reflect regional inequalities in the populations sociodemographic characteristics, related diseases, or medical practice patterns. In France, at the district level, the highest incidence rates have been found in the Nord-Pas-de-Calais region. This area, with a high population density and homogeneous healthcare provision, represents a geographic situation which is quite suitable for the study, over small areas, of spatial disparities in the incidence of ESRD, together with their correlation with a deprivation index and other risk factors.Methods: The Renal Epidemiology and Information Network is a national registry, which lists all ESRD patients in France. All cases included in the Nord-Pas-de-Calais registry between 2005 and 2011 were extracted. Adjusted and smoothed standardized incidence ratio (SIR) was calculated for each of the 170 cantons, thanks to a hierarchical Bayesian model. The correlation between ESRD incidence and deprivation was assessed using the quintiles of Townsend index. Relative risk (RR) and credible intervals (CI) were estimated for each quintile.Results: Significant spatial disparities in ESRD incidence were found within the Nord-Pas-de-Calais region. The sex- and ageadjusted, smoothed SIRs varied from 0.66 to 1.64. Although no correlation is found with diabetic or vascular nephropathy, the smoothed SIRs are correlated with the Townsend index (RR: 1.18, 95% CI [1.00-1.34] for Q2; 1.28, 95% CI [1.11-1.47] for Q3; 1.30, 95% CI [1.14-1.51] for Q4; 1.44, 95% CI [1.32-1.74] for Q5).Conclusion: For the first time at this aggregation level in France, this study reveals significant geographic differences in ESRD incidence. Unlike the time of renal replacement care, deprivation is certainly a determinant in this phenomenon. This association is probably independent of the patients financial ability to gain access to healthcare. © 2014 Occelli et al.
PubMed | Clinique du Tonkin, CHG Vichy, Clinique de La Louviere, French Institute of Health and Medical Research and 9 more.
Type: Comparative Study | Journal: Canadian journal of surgery. Journal canadien de chirurgie | Year: 2015
A greater incidence of persistent pain after inguinal herniorrhaphy is suspected with the open mesh procedure than with laparoscopy (transabdominal preperitoneal), but the involvement of neuropathy needs to be clarified.We examined the cumulative incidence of neuropathic persistent pain, defined as self-report of pain at the surgical site with neuropathic aspects, within 6 months after surgery in 2 prospective subcohorts of a multicentre study. We compared open mesh with laparoscopy using different analysis, including a propensity-matched analysis with the propensity score built from a multivariable analysis using a generalized linear model.Considering the full patient sample (242 open mesh v. 126 laparoscopy), the raw odds ratio for neuropathic persistent pain after inguinal herniorrhaphy was 4.3. It reached 6.8 with the propensity-matched analysis conducted on pooled subgroups of 194 patients undergoing open mesh and 125 undergoing laparoscopy (95% confidence interval 1.5-30.4, p = 0.012). A risk factor analysis of these pooled subgroups revealed that history of peripheral neuropathy was an independent risk factor for persistent neuropathic pain, while older age was protective.We found a greater risk of persistent pain with open mesh than with laparoscopy that may be explained by direct or indirect lesion of nerve terminations. Strategies to identify and preserve nerve terminations with the open mesh procedure are needed.
Procedures and results of endoscopy for the treatment of complications after bariatric surgery [Modalités et résultats de la prise en charge endoscopique des complications de la chirurgie bariatrique]
Decoster S.,Service des Maladies de lAppareil Digestif |
Branche J.,Service des Maladies de lAppareil Digestif |
Caiazzo R.,Service de Chirurgie Generale et Endocrinienne |
Bulois P.,Clinique de la Louviere |
And 3 more authors.
Acta Endoscopica | Year: 2013
Bariatric surgery is more and more practiced and appears to be the most efficient treatment against morbid obesity after failure of a medical treatment. Treatment of surgical complications is a matter for multidisciplinary approach including endoscopy. With a review of our own experience on 53 patients since 2009, we will expose an update to clarify the procedures and results of endoscopy for surgical complications treatment after bariatric surgery. © 2013 Springer-Verlag France.
Colomb F.,University of Lille Nord de France |
Krzewinski-Recchi M.-A.,University of Lille Nord de France |
El MacHhour F.,French Institute of Health and Medical Research |
Mensier E.,Clinique de la Louviere |
And 6 more authors.
Biochimie | Year: 2012
Bronchial mucins from severely infected patients suffering from lung diseases such as chronic bronchitis or cystic fibrosis exhibit increased amounts of sialyl-Lewisx (NeuAcα2-3Galβ1-4[Fucα1-3]GlcNAc- R, sLex) glycan structures. In cystic fibrosis, sLex and its sulfated form 6-sulfo-sialyl-Lewisx (NeuAcα2-3Galβ1- 4[Fucα1-3](HO3S-6)GlcNAc-R, 6-sulfo-sLex) serve as receptors for Pseudomonas aeruginosa and are involved in the chronicity of airway infection. However, little is known about the molecular mechanisms regulating the changes in glycosylation and sulfation of mucins in airways. Herein, we show that the pro-inflammatory cytokine TNF increases the expression of α2,3-sialyltransferase gene ST3GAL4, both in human bronchial mucosa and in A549 lung carcinoma cells. The role of sialyltransferase ST3Gal IV in sLex biosynthesis was confirmed by siRNA silencing of ST3GAL4 gene. BX is the major transcript isoform expressed in healthy bronchial mucosa and in A549 cells, and is up-regulated by TNF in both models. Bioinformatics analysis and luciferase assays have confirmed that the 2 kb genomic sequence surrounding BX exon contains a promoter region regulated by TNF-related transcription factors. These results support further work aiming at the development of anti-inflammatory strategy to reduce chronic airway infection in diseases such as cystic fibrosis. © 2012 Published by Elsevier Masson SAS. All rights reserved.
Legendre A.,Pediatric Cardiology Unit |
Chantepie A.,Pediatric Cardiology Unit |
Belli E.,Marie Lannelongue Hospital |
Vouhe P.R.,University of Paris Descartes |
And 5 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2010
Objectives: The long-term patency rate of coronary artery bypass grafting for which arterial grafts are used is known to be high in the pediatric population. However, this issue remains uncertain in children under 3 years of age. Here, we report the outcome in this specific population. Methods: From July 1988 to July 2007, 18 children less than 3 years of age (age at operation, 0.1-35 months; median, 4 months) underwent 20 coronary artery bypass graft operations using an arterial graft. Indications for bypass grafting were coronary artery complications related to the arterial switch operation for transposition of the great arteries in 12 patients (coronary obstruction in 8 patients, peroperative coronary anomalies precluding coronary transfer in 4 patients), congenital anomalies of the coronary arteries in 4 patients, and Kawasaki disease in 2 patients. Results: After a mean follow-up of 55 months (range, 1-176 months; median, 41 months), patency of 19 bypass grafts was assessed. One was occluded and 2 have necessitated a percutaneous procedure. Two patients died suddenly (1 with an occluded graft and 1 with a patent graft and hypertrophic myocardiopathy) 3.5 and 4.6 months, respectively, after bypass grafting. Conclusions: Coronary artery bypass grafting should be considered as a possible alternative for coronary revascularization in young children. Although our series shows quite a good patency rate, this procedure remains a technical challenge and requires careful follow-up. © 2010 The American Association for Thoracic Surgery.