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Swanstrom L.L.,Oregon Health And Science University | Perretta S.,Hopitaux Universitaires
Annals of the New York Academy of Sciences | Year: 2011

The following on interventional endoscopy and single incision surgery contains commentaries on transluminal endoscopic esophageal surgery, flexible endoscopy, triangulation, advanced flexible operating platforms, experimental transesophageal procedures, and para- and intra-esophageal endoscopic surgery. © 2011 New York Academy of Sciences.


Echaniz-Laguna A.,Hopitaux Universitaires | Echaniz-Laguna A.,University of Strasbourg | De Seze J.,Hopitaux Universitaires | Chanson J.-B.,Hopitaux Universitaires
Journal of Neurology, Neurosurgery and Psychiatry | Year: 2012

Background: The prevalence and outcome of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients with solid organ transplantation is unknown, and there are no guidelines for the evaluation and treatment of such patients. Methods: An 8 year long monocentric prospective study was conducted in which, in a population of 1557 solid organ transplant recipients, the characteristics of 10 consecutive patients (0.6%) who developed a syndrome that fulfilled the clinical, biological and electrophysiological criteria for definite CIDP were investigated. Results: Five patients had liver transplantation, three had kidney transplantation, one had heart transplantation and one had lung transplantation. The mean interval between transplantation and CIDP was 10 months. Six patients developed CIDP after immunosuppressive therapy dosage was decreased and were treated with intravenous immunoglobulin (IVIG) and increased dosage of immunosuppressive therapy. Four patients were treated with IVIG only. Neuropathy improved in all cases, and CIDP had a monophasic course in all patients, with no relapse observed over a mean follow-up of 5 years. Conclusion: CIDP in solid organ transplant recipients is rare, appears in the first year after transplantation, has a monophasic course and is responsive to IVIG treatment. CIDP being treatable, it should be systematically considered in solid organ transplant recipients who develop a rapidly disabling sensorimotor polyneuropathy.


Echaniz-Laguna A.,Hopitaux Universitaires | Chanson J.-B.,Hopitaux Universitaires
Muscle and Nerve | Year: 2016

Introduction: Chronic muscle pain affects approximately 10% of the general population. It is unknown whether electromyographic (EMG) examination or muscle biopsy is most useful in this situation. Methods: In a 7-year, single-center prospective study we investigated the EMG and muscle pathology characteristics of patients with: (1) diffuse muscle pain lasting >1 year; (2) normal clinical examination; (3) normal extensive blood tests; and (4) no evidence of a coexisting disorder. Results: One hundred eighty consecutive patients were enrolled. In 178 patients (99%), EMG studies and muscle biopsies were normal. In 2 patients (1%), EMG studies demonstrated myotonia, and muscle biopsy showed mild myopathic features; 1 patient had myotonic dystrophy type 2, and the other had SCN4A-related muscle channelopathy. Conclusions: In this prospective study, EMG was an excellent screening test for diagnosing muscle disease in clinically normal patients with chronic diffuse muscle pain, and muscle biopsy was not useful. Muscle Nerve 54: 321–324, 2016. © 2016 Wiley Periodicals, Inc.


Rey D.,Hopitaux Universitaires
Expert Review of Anti-Infective Therapy | Year: 2011

Post-exposure prophylaxis (PEP) with antiretrovirals is now widely used worldwide after either occupational contact (with blood or another blood-containing fluid), or nonoccupational contact (mainly sexual or injection-drug use). It is assumed to reduce the risk of HIV transmission by at least 80%, although its efficacy has not been completely proven. Several countries have issued guidelines to help the clinician in their decision to offer PEP and to improve its cost-effectiveness. This article reviews the different antiretroviral combinations used, their safety profile, the recommendations and indications of PEP. The initial evaluation of an exposed individual is presented, as well as the follow-up during and after treatment. © 2011 Expert Reviews Ltd.


Wattiez A.,Hopitaux Universitaires | Puga M.,Hopitaux Universitaires | Albornoz J.,Hopitaux Universitaires | Faller E.,Hopitaux Universitaires
Best Practice and Research: Clinical Obstetrics and Gynaecology | Year: 2013

Endometriosis is a common disease affecting young women. Its clinical manifestations include pain and infertility, and it can dramatically affect quality of life. Treatments should be tailored to address the wishes of women according to the specific characteristics of the disease. Although many questions remain unanswered, strong evidence supports the use of laparoscopic surgery to improve pain and infertility. The systematisation of strategy is essential to make surgery more reproducible, safer and less time-consuming. Nevertheless, even in the most expert hands, complications may occur. Further investigations are needed to compare the different approaches. Outcomes must, however, include pain, fertility, organ dysfunction, and quality of life. © 2012 Published by Elsevier Ltd.


Lang P.-O.,Hopitaux Universitaires
Geriatrie et Psychologie Neuropsychiatrie du Vieillissement | Year: 2011

The burden of illness and healthcare resource utilisation associated with herpes zoster in individuals aged 60 years or above is substantial, causing severe loss of quality of life. In the absence of antiviral therapy, up to 45% of over 60 year-olds experience pain which persists for months to years. The importance of preventive strategies for PHN is becoming widely recognised. The aim of the present reviewis not only to present the herpes zoster-associated burden, but also to detail the effectiveness of the preventive approaches currently available.


Uebelhart B.,hopitaux universitaires
Joint Bone Spine | Year: 2016

Bariatric surgery currently relies on combinations of restrictive and malabsorptive procedures. Early decreases in bone mineral density (BMD) have been reported. However, the accuracy of dual-energy X-ray absorptiometry used to measure BMD can be diminished by the major weight loss, whereas quantitative computed tomography (QCT) measurements are less affected. The nutritional deficiencies induced by mixed bariatric surgery procedures, together with changes in hormones produced by adipocytes and/or the gastrointestinal tract, are often associated with elevations in serum levels of bone resorption markers. Although the data are limited, the incidence of fractures does not seem higher after bariatric surgery than in non-operated obese patients. © 2016 Société française de rhumatologie.


Dhumane P.W.,Hopitaux Universitaires | Diana M.,Hopitaux Universitaires | Leroy J.,Hopitaux Universitaires | Marescaux J.,Hopitaux Universitaires
Journal of Minimal Access Surgery | Year: 2011

Minimally Invasive Single Site (MISS) surgery is a better terminology to explain the novel concept of scarless surgery, which is increasingly making its way into clinical practice. But, there are some difficulties. We review the existing technologies for MISS surgery with regards to single-port devices, endoscope and camera, instruments, retractors and also the future perspectives for the evolution of MISS surgery. While we need to move ahead cautiously and wait for the development of appropriate technology, we believe that the "Ultimate form of Minimally Invasive Surgery" will be a hybrid form of MISS surgery and Natural Orifice Transluminal Endoscopic Surgery, complimented by technological innovations from the fields of robotics and computer-assisted surgery.


Charloux A.,Hopitaux universitaires
Revue Francaise d'Allergologie | Year: 2014

Practicing sports may increase the risk of developing or aggravating asthma, depending for one thing on the environment in which the sport is performed: for example, in chlorinated swimming pools, in cold, dry air for winter/mountain sports, and with exposure to interior or exterior airborne allergens and pollutants. For athletes, particularly those practicing endurance sports, the high level of ventilation required under these conditions puts them at an increased risk of atopy and asthma. In contrast, the few published studies focusing on recreational sports have not reported an increase in asthma prevalence or its symptoms; nevertheless, more studies are needed. Only scuba diving is contra-indicated for patients with active asthma. But asthmatic sports-men and sports-women must be made aware of the potential risks of aggregation of their asthma in the situations noted above. In such individuals, their asthma must be controlled and exercise-induced bronchospasm prevented. © 2014 Elsevier Masson SAS.


Cribier B.,Hopitaux Universitaires
Annales de Dermatologie et de Venereologie | Year: 2010

Through its anatomical, topographical, and functional distinctiveness, more than all other parts of the body, the hand is the interface between humans and their environment. All types of stimulus produce cutaneous signs in the hands, notably cold, light, pressure, contact, etc. Exposure to light makes it the region where photodermatosis is expressed, but also a particular site for cutaneous carcinogenesis. The countless chemical substances that the hand encounters can create specific or particular diseases in this location (irritative dermitis, contact eczema, hyperkeratosis, atrophy, etc.). The hand is also the site of infectious dermatosis transmission (erysipeloid, orf, mycobacteriosis, etc.), sometimes exotic (chromomycosis, histoplasmosis), and the site of plant penetration (protothecosis or more commonly thorns and splinters). The complexity of its vascularization and its many bones, joints, and tendons explain why it is a preferred area for signs of systemic diseases (diverse forms of lupus, dermatomyositis, inflammatory rheumatism, etc.). The nail unit alone shows innumerable signs of exogenic diseases, but also reflects certain internal diseases localized here with often characteristic signs. Here more than anywhere else, dermatology opens out to all of medicine. © 2010 Elsevier Masson SAS.

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