Hopital University Antoine Beclere

Sainte-Foy-lès-Lyon, France

Hopital University Antoine Beclere

Sainte-Foy-lès-Lyon, France
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Troude P.,Ined | Troude P.,French Institute of Health and Medical Research | Troude P.,University Paris - Sud | Squires J.,University of Oregon | And 9 more authors.
Early Human Development | Year: 2011

Background: The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment. Aims: To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population. Study design: Follow-up study by postal questionnaire at 12 and 36. months, using the ASQ. Subjects: 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs. Outcome measure: Response rates and French ASQ results at 12 and 36. months. The ASQ was scored as indicated in the manual. Results: A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36. months they tended to be associated with both birth and family socio-demographic characteristics. Conclusions: Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed. © 2011 Elsevier Ltd.

Donatelli G.,Unite d'Endoscopie Interventionnelle | Donatelli G.,University of Rome La Sapienza | Dumont J.-L.,Unite d'Endoscopie Interventionnelle | Cereatti F.,University of Rome La Sapienza | And 12 more authors.
Obesity Surgery | Year: 2015

Background: Leaks are considered one of the major complications of laparoscopic sleeve gastrectomy (LSG) with a reported rate up to 7 %. Drainage of the collection coupled with SEMS deployment is the most frequent treatment. Its success is variable and burdened by high morbidity and not irrelevant mortality. The aim of this paper is to suggest and establish a new approach by endoscopic internal drainage (EID) for the management of leaks. Methods: Since March 2013, 67 patients presenting leak following LSG were treated with deployment of double pigtail plastic stents across orifice leak, positioning one end inside the collection and the other end in remnant stomach. The aim of EID is to internally drain the collection and at the same time promote leak healing. Results: Double pigtails stent were successfully delivered in 66 out of 67 patients (98.5 %). Fifty patients were cured by EID after a mean time of 57.5 days and an average of 3.14 endoscopic sessions. Two died for event not related to EID. Nine are still under treatment; five failure had been registered. Six patients developed late stenosis treated endoscopically. Conclusions: EID proved to be a valid, curative, and safe mini-invasive approach for treatment of leaks following SG. EID achieves complete drainage of perigastric collections and stimulates mucosal growth over the stent. EID is well tolerated, allows early re-alimentation, and it is burdened by fewer complications than others technique. Long-term follow-up confirms good outcomes with no motility or feeding alterations. © 2015, Springer Science+Business Media New York.

Donatelli G.,Unite dEndoscopie Interventionnelle | Ferretti S.,Hopital University Antoine Beclere | Vergeau B.M.,Unite dEndoscopie Interventionnelle | Dhumane P.,Lilavati Hospital and Research Center | And 9 more authors.
Obesity Surgery | Year: 2014

Background: Endoscopic treatment of gastric leaks (GL) following sleeve gastrectomy (SG) involves different techniques; however, standard management is not yet established. We report our experience about endoscopic internal drainage of leaks using pigtail stents coupled with enteral nutrition (EDEN) for 4 to 6 weeks until healing is achieved. Methods: In 21 pts (18 F, 41 years), one or two plastic pigtail stents were delivered across the leak 25.6 days (4-98) post-surgery. In all patients, nasojejunal tube was inserted. Check endoscopy was done at 4 to 6 weeks with either restenting if persistent leak, or removal if no extravasation of contrast in peritoneal cavity, or closure with an Over-the-Scope Clip® (OTSC®) if contrast opacifying the crossing stent without concomitant peritoneal extravasation. Results: Twenty-one out of 21 (100 %) patients underwent check endoscopy at average of 30.15 days (26-45) from stenting. In 7/21 (33.3 %) patients leak sealed, 2/7 needed OTSC®. Second check endoscopy, 26.7 days (25-42) later, showed sealed leak in 10 out 14; 6/10 had OTSC®. Four required restenting. One patient, 28 days later, needed OTSC®. One healed at 135 days and another 180 days after four and seven changes, respectively. One patient is currently under treatment. In 20/21 (95.2 %), GL have healed with EID treatment of 55.5 days (26-∈180); all are asymptomatic on a normal diet at average follow-up of 150.3 days (20-276). Conclusions: EDEN is a promising therapeutic approach for treating leaks following SG. Multiple endoscopic sessions may be required. © 2014 Springer Science+Business Media.

Barbare J.-C.,CHU dAmiens | Franco D.,Hopital University Antoine Beclere | Andre T.,Hopital University Saint Antoine | Bronowicki J.-P.,University of Lorraine | And 5 more authors.
Bulletin du Cancer | Year: 2014

The treatment of hepatocellular carcinoma (HCC) is difficult due to the underlying cirrhosis which has its own influence on therapeutic issues. An inquiry was performed in centres with specialized multidisciplinary team meetings dedicated to HCC (HCC-MTM) or in centres with non-specialized (digestive oncology or general oncology) multidisciplinary team meetings (NS-MTM). The number of cases of HCCs taken in charge yearly was significantly higher in HCC-MTM than in NS-MTM (p=0,0014). Interventional radiologists and transplant surgeons were more frequently implied in HCC-MTM than in NS-MTM (respectively p=0,009 and p=0,02). On site availability of every treatment of HCC was higher in RCP-MTM than in NS-MTM (p=0,015). There were no inclusion in clinical trials in 40.5% of NS-MTM versus only 17.6% of HCC-MTM (p=0,0086). In three clinical cases out of seven there were discrepancies between the therapeutic options of HCC-MTM and NS-MTM. In all three cases, the treatment offered to the patient by HCC-MTM was more consistent with clinical standards. These results prompt to perform more studies on the quality of management of patients with HCCs by MTMs. ©John Libbey Eurotext.

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