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Le Touquet – Paris-Plage, France

Bergounioux J.,Pediatric Intensive Care Unit | Rambaud C.,Hospital Raymond Poincare | Bustarret O.,Pediatric Intensive Care Unit | Michot C.,French Institute of Health and Medical Research | And 8 more authors.
Journal of Pediatrics | Year: 2012

We report 2 cases of fatal rhabdomyolysis in children carrying an LPIN1 mutations preceded by similar electrocardiogram changes, including diffuse symmetrical high-amplitude T waves. Our report underlines the severity of this disease and the need for active management of episodes of rhabdomyolysis in a pediatric intensive care unit. Copyright © 2012 Mosby Inc.

Chartier-Kastler E.,Hospital Raymond Poincare | Lauge I.,Paraplegifunktionen | Ruffion A.,Hospital Henry Gabrielle | Charvier K.,Hospital Henry Gabrielle | Biering-Sorensen F.,Copenhagen University
Spinal Cord | Year: 2011

Study design: Self-catheterising males aged ≥ 18 years with spinal cord lesion and normal/impaired urethral sensation were enrolled in this comparative, randomised, crossover and open-labelled multicentre trial. Objectives: When possible, intermittent catheterisation is the preferred method of bladder emptying for neurogenic bladder dysfunction. Hydrophilic-coated catheters have improved safety and ease of use, and a new compact catheter for men has been developed to improve discretion. Methods: Participants self-catheterised at least four times daily for 14 days with a standard or compact catheter. The primary outcome measure was discomfort, using a visual analogue scale. Non-inferiority was defined as a difference in mean discomfort score of <0.9 cm. Other assessments included ease of use, discretion and the degree of pain, stinging or resistance. Results: A total of 36 individuals participated and 30 were included in the intention-to-treat analysis. The mean difference between catheters for participant discomfort was -0.347 cm (95% confidence intervals: -1.493, 0.800). There were significant differences (P≤0.0001) in favour of the compact catheter for disposal and discretion, and inserting, storing, carrying and controlling the catheter. Fewer participants experienced resistance with the compact catheter. Participants were less likely to touch the coated part of the compact catheter. One adverse event was reported for each catheter. Conclusions: The coated compact catheter is at least as acceptable to the user as the standard catheter, with no inferiority observed in the level of discomfort. Secondary endpoints suggest that there are advantages of using the compact catheter, particularly with regard to discretion and ease of use. Setting: France/Denmark. © 2011 International Spinal Cord Society All rights reserved.

Erdem H.,GATA Haydarpasa Training Hospital | Stahl J.P.,Joseph Fourier University | Inan A.,Haydarpasa Numune Training and Research Hospital | Kilic S.,Gulhane Medical Academy | And 37 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2014

The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n=21) and France (n=15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p<0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries. © 2014 Springer-Verlag.

Jameson R.,Hospital Raymond Poincare | Garreau De Loubresse C.,Hospital Raymond Poincare | Maqdes A.,Hospital Raymond Poincare
European Spine Journal | Year: 2010

Since the rarefaction of neurosyphilis, axial neuroarthropathy is mostly secondary to spinal cord pathologies. Peripheral manifestations of neuroarthropathy resulting from Guillain-Barré syndrome have already been reported but to our knowledge, this is the first case of a patient diagnosed with axial involvement. After the acute phase, a 47-year-old woman suffered of paraparesia with a partial loss of sensibility under the tenth thoracic vertebra. As a consequence, she developed first of all neuroarthropathy of both knees and few years later, a spinal involvement was discovered. Multiple surgeries of both knees and of the spine were required, due to non-union, relapse, and infection. Natural evolution of Charcot spine remains unknown. Surgical treatment is recommended but even with circumferential fusion, failures do frequently occur. This observation allows us to report an original case and to discuss the etiology of axial neuroarthropathy, the classical radiographic findings, and the inherent difficulties of its treatment. © Springer-Verlag 2009.

Moreau S.,Hospital Raymond Poincare | Lonjon G.,Hospital Raymond Poincare | Jameson R.,Hospital Raymond Poincare | Judet T.,Hospital Raymond Poincare | Garreau de Loubresse C.,Hospital Raymond Poincare
Orthopaedics and Traumatology: Surgery and Research | Year: 2014

Introduction: Spinal neuroarthropathy (SNA), also called "Charcot spine", is very uncommon disease of unknown etiology. Kronig first reported this pathology in 1884 on a patient with Tabes dorsalis (also known as syphilitic myelopathy). As syphilis tends to disappear in developed countries, spinal cord lesion is the most frequent etiology of SNA. Objectives: To describe clinical and radiographic results in 12patients suffering from spinal neuroarthropathy (SNA). Methods: Twelve patients diagnosed with SNA were included in the study. All patients were wheelchair users. The average delay between the neurological disease and the diagnosis of SNA was 18. years. All patients were initially treated conservatively. Surgery was only indicated in persistent symptomatic or instable cases, and for infected SNA. Surgery was a circumferential arthrodesis. Results: From 12patients, with a median follow-up of 4. years, five patients were operated on and 7patients were still conservatively treated. Two patients with back pain and evolutive destruction were declined for surgery. One suffered of bilateral hip ankylosis and extensive spinal surgery would have confined him to bed, and one due to an evolutive bedsore. One patient improved with a complete regression of back pain. Conclusion: Nowadays, surgical treatment is recommended with an extensive and circumferential fusion, in order to prevent relapses. Good radiographic outcome is reported but functional results have not been studied. Natural evolution of SNA remains unknown but can be less disabling than surgery. This pathologic mobility can contribute to patient's autonomy and can therefore be considered as opportune. Conservative therapy can be considered for SNA. Level of evidence: Level IV. © 2014 Elsevier Masson SAS.

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