Spiesser-Robelet L.,University of Paris Pantheon Sorbonne |
Spiesser-Robelet L.,Angers University Hospital Center |
Brunie V.,University of Paris Pantheon Sorbonne |
Brunie V.,Hopitaux Universitaires Henri Mondor |
And 2 more authors.
Journal of Human Lactation | Year: 2017
Background: Breastfeeding is a major public health issue in terms of its benefits to both mothers and infants. Despite recommendations, breastfeeding initiation and duration are low in many industrialized countries. Although human milk is viewed as the most appropriate food for infants, when it is perceived as contaminated, doubts about its quality can lead to negative behaviors concerning breastfeeding. This is especially true when mothers are taking medication. Research aim: The aim of this review is to evaluate the data in the literature on the knowledge, representations, attitudes, and behaviors of women with regard to taking medication while breastfeeding. These elements should aid our understanding of how the mothers' behaviors are constructed in this situation. Methods: The authors conducted a scoping review to map and analyze the available data from literature sources regarding breastfeeding mothers' knowledge, representations, attitudes, and behaviors about medicines. A staged approach to the scoping review was used. Results: Eighteen studies met the selection criteria. They described safety behaviors like noninitiation, duration reduction, breastfeeding cessation, and refusal to take medication in order to breastfeed. Most showed a conflict between taking medication and breastfeeding. Because the knowledge, representations, and attitudes behind such behaviors have received very little study, it is difficult to explain how these behaviors are constructed. Conclusion: The results of this review confirm the need for a qualitative study to explore the knowledge, representations, and attitudes of breastfeeding women faced with taking medications, so that we can understand their connection with observed behaviors and take appropriate educational action. © The Author(s) 2016.
Hutin E.,Hopitaux Universitaires Henri Mondor
NeuroRehabilitation | Year: 2013
BACKGROUND: High intensity and early initiation of rehabilitation have been extensively demonstrated to enhance neural plasticity and motor recovery after stroke. However, the optimal duration of rehabilitation programs in order to have the highest impact on motor outcomes has not been established. OBJECTIVES: To evaluate motor outcomes in subacute stroke survivors with moderate to severe upper limb paresis over an extended period of rehabilitation consisting of usual care augmented with a large number of upper limb robot-assisted sessions (54 ± 13 sessions). METHODS: Retrospective study in 10 inpatients. RESULTS: The results showed a gradual decrease in motor and functional impairments throughout the training period with a clinically meaningful increase in the Fugl-Meyer Assessment scores and in the Motor Status Scores (1st vs 37th day of the training, FMA,+ 48%, p = 0.018, MSS,+ 64%, p = 0.012; 37th vs. 79th day, FMA,+ 23%, p = 0.012, MSS,+ 30%, p = 0.017). In addition, there were improvements in hand kinematics recorded by the robot during a pointing task, with quantitative improvement (1st vs 40th day, movement efficacy,+ 97%, p = 0.0499; hand velocity,+ 335%, p = 0.013) prior to qualitative improvement (1st vs 80th day, number of hand trajectory reversals, -50%, p = 0.028; root mean square error of the trajectory/linear displacement, -52%, p = 0.059). CONCLUSIONS: Although this study was a retrospective analysis of a small sample of patients, the results suggested that a prolonged period of intensive upper limb rehabilitation, including robot-assisted training incorporated into a multidisciplinary program throughout the subacute phase after stroke resulted in significant improvements in patients with moderate to severe motor impairments. © 2013 - IOS Press and the authors. All rights reserved.
Saba G.,Hopitaux Universitaires Henri Mondor |
Moukheiber A.,Hopitaux Universitaires Henri Mondor |
Pelissolo A.,Hopitaux Universitaires Henri Mondor |
Pelissolo A.,University Paris Est Creteil
Current Psychiatry Reports | Year: 2015
Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation methods that became widely used as therapeutic tools during the past two decades especially in cases of depression and schizophrenia. Low frequency rTMS and cathodal effect of tDCS inhibits cortical functioning while high frequency and anodal effect of tDCS have the opposite effect. Prolonged and repetitive application of either methods leads to changes in excitability of the human cortex that outlast the period of stimulation. Both rTMS and tDCS induce functional changes in the brain-modulating neural activity at cortical level. This paper reviews rTMS and tDCS effects in clinical trials for obsessive-compulsive disorder (OCD). Low frequency rTMS, particularly targeting the supplementary motor area and the orbital frontal cortex, seems to be the most promising in terms of therapeutic efficacy while older studies targeting the prefrontal dorsal cortex were not as successful. tDCS clearly needs to be investigated in large scale and sufficiently powered randomized control studies. From a general point of view, these non-invasive techniques hold promise as novel therapeutic tools for OCD patients. © 2015, Springer Science+Business Media New York.
Mekontso Dessap A.,hopitaux universitaires Henri Mondor |
Mekontso Dessap A.,University Paris Est Creteil
Reanimation | Year: 2016
Volume overload is frequently encountered in intensive care unit patients, especially in patients with sepsis and/or mechanical ventilation. Volume overload is associated with a prolongation of mechanical ventilation in general and of the weaning period in particular. It is a major contributing factor to cardiovascular weaning failure, including failed spontaneous breathing trial and failed extubation. A strategy of restrictive fluid management shortens the duration of mechanical ventilation, including weaning length. © 2016, Société de réanimation de langue française (SRLF) and Springer-Verlag France.
Srinivasan H.,German Cancer Research Center |
Allory Y.,Hopitaux Universitaires Henri Mondor |
Sill M.,German Cancer Research Center |
Vordos D.,Hopitaux Universitaires Henri Mondor |
And 4 more authors.
Proteomics | Year: 2014
About 70% of newly diagnosed cases of bladder cancer are low-stage, low-grade, non muscle-invasive. Standard treatment is transurethral resection. About 60% of the tumors will recur, however, and in part progress to become invasive. Therefore, surveillance cystoscopy is performed after resection. However, in the USA and Europe alone, about 54 000 new patients per year undergo repeated cystoscopies over several years, who do not experience recurrence. Analysing in a pilot study resected tumors from patients with (n = 19) and without local recurrence (n = 6) after a period of 5 years by means of an antibody microarray that targeted 724 cancer-related proteins, we identified 255 proteins with significantly differential abundance. Most are involved in the regulation and execution of apoptosis and cell proliferation. A multivariate classifier was constructed based on 20 proteins. It facilitates the prediction of recurrence with a sensitivity of 80% and a specificity of 100%. As a measure of overall accuracy, the area under the curve value was found to be 91%. After validation in additional sample cohorts with a similarly long follow-up, such a signature could support decision making about the stringency of surveillance or even different treatment options. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Contou D.,Hopitaux Universitaires Henri Mondor |
Fragnoli C.,Hopitaux Universitaires Henri Mondor |
Cordoba-Izquierdo A.,Hopitaux Universitaires Henri Mondor |
Boissier F.,Hopitaux Universitaires Henri Mondor |
And 4 more authors.
Respiratory Care | Year: 2013
Background: Failure of noninvasive ventilation (NIV) is common in patients with COPD admitted to the ICU for acute hypercapnic respiratory failure (AHRF). We aimed to assess the rate of NIV failure and to identify early predictors of intubation under NIV in patients admitted for AHRF of all origins in an experienced unit. Methods: This was an observational cohort study using data prospectively collected over a 3-year period after the implementation of a nurse-driven NIV protocol in a 24-bed medical ICU of a French university hospital. Results: Among 242 subjects receiving NIV for AHRF (PaCO2 > 45 mm Hg), 67 had cardiogenic pulmonary edema (CPE), 146 had acute-on-chronic respiratory failure (AOCRF) (including 99 subjects with COPD and 47 with other chronic respiratory diseases), and 29 had non-AOCRF (mostly pneumonia). Overall, the rates of intubation and ICU mortality were respectively 15% and 5%. The intubation rates were 4% in CPE, 15% in AOCRF, and 38% in non-AOCRF (P <.001). After adjustment, non-AOCRF was independently associated with NIV failure, as well as acidosis (pH < 7.30) and severe hypoxemia (PaO2/FIO2 ≤ 200 mm Hg) after 1 hour of NIV initiation, whereas altered consciousness on admission and ventilatory settings had no influence on outcome. Conclusions: With a nurse-driven NIV protocol, the intubation rate was reduced to 15% in patients receiving NIV for AHRF, with a mortality rate of only 5%. Whereas the risk of NIV failure is associated with hypoxemia and acidosis after initiation of NIV, it is also markedly influenced by the presence or absence of an underlying chronic respiratory disease. © 2013 Daedalus Enterprises.
Gilioli C.,Hopitaux Universitaires Henri Mondor
Soins Cadres de Sante | Year: 2014
Supporting a student in the production of a dissertation in particular goes beyond technical and methodological support, it is a moral commitment. Considering the ethical dimension of such a situation which is by defi nition limited and temporary comes down to analysing an active commitment which is not often examined. It is therefore necessary to agree before any development on what the very concept of ethics means in order to be able to consider the moral implications of what such an activity is bound to arouse © 2014 Elsevier Masson SAS. All rights reserved.
Rwabihama J.-P.,Hopitaux universitaires Henri Mondor
Ethique et Sante | Year: 2014
This is a tribute to Edmund Pellegrino, professor of internal medicine and medical ethics at Georgetown University, died at age of 92after more than 65years in medicine and university administration. His research work, focused on the doctor-patient relationship, human dignity and bioethics challenges, have been published in more then 20books and 600scientific articles. This text aims to honor his memory and underline some points of his philosophy applied to medicine. © 2014 .
Meimoun M.,Hopitaux Universitaires Henri Mondor |
Bayle N.,Hopitaux Universitaires Henri Mondor |
Baude M.,Hopitaux Universitaires Henri Mondor |
Gracies J.-M.,Hopitaux Universitaires Henri Mondor
Revue Neurologique | Year: 2015
Neurorestoration of motor command in spastic paresis requires a double action of stimulation and guidance of central nervous system plasticity. Beyond drug therapies, electrical stimulation and cell therapies, which may stimulate plasticity without precisely guiding it, two interventions seem capable of driving plasticity with a double stimulation and guidance component: the lesion itself (lesion-induced plasticity) and durable behavior modifications (behavior-induced plasticity). Modern literature makes it clear that the intensity of the neuronal and physical training is a primary condition to foster behavior-induced plasticity. When it comes to working on movement, intensity can be achieved by the combination of two key components, one is the difficulty of the trained movement, the other is the number of repetitions or the daily duration of the practice. A number of recent studies shed light on promising recovery prospects, particularly using the emergence of new technologies such as robot-assisted therapy and concepts such as guided self-rehabilitation contracts. © 2014 Elsevier Masson SAS.
Gilioli C.,Hopitaux universitaires Henri Mondor
Soins Psychiatrie | Year: 2015
Mental disorders lead patients along paths of irrationality. Insanity is perceived as excessiveness, often associated with violence. Risk in psychiatry is omnipresent and nursing practice is performed within a narrow safety zone. The media coverage of sensitive situations does not help. Ensuring the patient's recovery, respecting the fundamental principles of individual freedom while assuring the utmost safety of others is the constant challenge facing caregivers in psychiatry. © 2015 Elsevier Masson SAS.