Regional University Hospital of Lille

University of Technology of Compiègne, France

Regional University Hospital of Lille

University of Technology of Compiègne, France
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Poncelet E.,Womens Imaging Center | Rock A.,Hopital Saint Philibert | Quinton J.-F.,Lille University of Science and Technology | Cosson M.,Regional University Hospital of Lille | And 4 more authors.
Diagnostic and Interventional Imaging | Year: 2017

Purpose: The goal of this study was to compare conventional X-ray defecography and dynamic magnetic resonance (MR) defecography in the diagnosis of pelvic floor prolapse of the posterior compartment. Material and methods: Fifty women with a mean age of 65.5 years (range: 53-72 years) who underwent X-ray defecography and MR defecography for clinical suspicion of posterior compartment dysfunction, were included in this retrospective study. X-ray defecography and dynamic MR defecography were reviewed separately for the presence of pelvic organ prolapse. The results of the combination of X-ray defecography and MR defecography were used as the standard of reference. Differences in sensitivities between X-ray defecography and MR defecography were compared using the McNemar test. Results: With the gold standard, we evidenced a total of 22 cases of peritoneocele (17 elytroceles, 3 hedroceles and 2 elytroceles+hedroceles), including 15 cases of enterocele, 28 patients with rectocele including 16 that retained contrast, 37 cases of rectal prolapse, and 11 cases of anismus. The sensitivities of X-ray defecography were 90.9% for the diagnosis of peritoneocele, 71.4% for rectocele, 81.1% for rectal prolapse and 63.6% for anismus. The sensitivities of MR defecography for the same diagnoses were 86.4%, 78.6%, 62.2% and 63.6%, respectively. For all these pathologies, no significant differences between X-ray defecography and MR defecography were found. Conclusion: Dynamic MR defecography is equivalent to X-ray defecography for the diagnosis of abnormalities of the posterior compartment of the pelvic floor. © 2016 Éditions françaises de radiologie.

Giraudet G.,Regional University Hospital of Lille | Lucot J.P.,Regional University Hospital of Lille | Lucot J.P.,Hospital of Bethune | Sanz F.,Jeanne Of Flandre Hospital | And 4 more authors.
Journal of Gynecology Obstetrics and Human Reproduction | Year: 2017

Objective: The aim of our study was to evaluate the feasibility of vaginal hysterectomy in an ambulatory care system and the best way to perform it between conventional and bipolar vessel sealing system ligatures. Patients and methods: This was a prospective study of 32 patients with vaginal hysterectomy at Lille University Hospital between December 2013 and May 2015. Two surgical techniques were compared: conventional suture ligature (CSL) and electrosurgical bipolar vessel sealing (BVS). Patients stayed in classical hospitalization but were managed how if they were in an ambulatory unit to evaluate their capacity to come back home the same evening of the surgery. The evaluation of same-day discharge was based on Post Anesthetic Discharge Scoring System (PADSS) score. ≥. 9/10 and Visual Analogic Scale (VAS) score. ≤. 4/10. Other data collected were: operative time, uterus weight, peroperative bleeding, PADSS score at the 8th postoperative hour, VAS score at the 4th, 6th, 8th, 12th and 24th postoperative hours, the presence of postoperative nausea/vomiting and rehospitalization. Results: In the BVS group, 93.8% of patients validated the combined score (PADSS + VAS) on the evening of the intervention against 50% of patients in the CSL group (P <. 0.05). Hundred percent of BVS group patients were discharged on the day after surgery against 87.5% in the CSL group. The VAS was significantly lower in the BVS group at the 8th (1.4), 12th (1.2) and 24th (1.3) postoperative hours. Operative time was significantly shorter in the BVS group. We found more events such as nausea/vomiting in the CSL group. Conclusion: Vaginal hysterectomy is feasible in an ambulatory care system most of times. By reducing postoperative pain, electrosurgical bipolar vessel sealing would promote outpatient hospitalization. © 2017 Elsevier Masson SAS.

Audrezet M.-P.,Institut Universitaire de France | Corbiere C.,University Hospital Necker Enfants Malades | Lebbah S.,University Hospital Necker Enfants Malades | Moriniere V.,University Hospital Necker Enfants Malades | And 25 more authors.
Journal of the American Society of Nephrology | Year: 2016

Prenatal forms of autosomal dominant polycystic kidney disease (ADPKD) are rare but can be recurrent in some families, suggesting a common genetic modifying background. Few patients have been reported carrying, in addition to the familial mutation, variation(s) in polycystic kidney disease 1 (PKD1) or HNF1 homeobox B (HNF1B), inherited from the unaffected parent, or biallelic polycystic kidney and hepatic disease 1 (PKHD1) mutations. To assess the frequency of additional variations in PKD1, PKD2, HNF1B, andPKHD1 associated with the familialPKDmutation in earlyADPKD, these four geneswere screened in 42 patients with earlyADPKD in 41 families. Two patientswere associatedwith de novo PKD1 mutations. Forty patients occurred in 39 families with known ADPKD and were associated with PKD1 mutation in 36 families and with PKD2 mutation in two families (no mutation identified in one family). Additional PKD variation(s) (inherited from the unaffected parent when tested) were identified in 15 of 42 patients (37.2%), whereas these variations were observed in 25 of 174 (14.4%,P=0.001)patientswith adultADPKD.NoHNF1Bvariations or PKHD1biallelicmutationswere identified.These results suggestthat,at least insomepatients, the severity of the cystic disease is inversely correlated with the level of polycystin 1 function.

Daroux M.,Research Division | Daroux M.,Regional University Hospital of Lille | Prevost G.,Research Division | Prevost G.,Regional University Hospital of Lille | And 8 more authors.
Diabetes and Metabolism | Year: 2010

Glycation is the process whereby sugars bind to the free amine residues of proteins. These newly formed modified molecular species are known as 'advanced glycation end-products', or AGEs. AGE toxicity may occur through at least three mechanisms: interaction with the receptor for AGEs (RAGE); tissue deposition; and in situ glycation. AGEs trigger proinflammatory, profibrotic and procoagulant cellular responses that are capable of damaging tissues, often targeting particular organs. In diabetic patients, the conditions needed to promote AGE formation are all present, and are further accentuated by accompanying renal failure. The aim of this review is to outline the involvement of AGEs in the various forms of renal pathology associated with diabetic and non-diabetic nephropathies. AGEs are present in all renal compartments in diabetic patients, including the vessels, glomeruli, tubules and interstitium. Many cell types may be activated-specifically, endothelial, tubular and mesangial cells, and podocytes. AGEs play a major role in the accumulation of extracellular matrix, as occurs in diabetic glomerulosclerosis, and are also involved in most diabetic (renovascular, microangiopathic and glomerular) and non-diabetic renal injury associated with progressive glomerulosclerosis and ageing. © 2009 Elsevier Masson SAS. All rights reserved.

Carpentier C.,University of Lille Nord de France | Carpentier C.,Regional University Hospital of Lille | Ghanem D.,University of Lille Nord de France | Ghanem D.,Regional University Hospital of Lille | And 27 more authors.
Biochimica et Biophysica Acta - Molecular Basis of Disease | Year: 2014

The splicing of the microtubule-associated protein Tau is regulated during development and is found to be deregulated in a growing number of pathological conditions such as myotonic dystrophy type I (DM1), in which a reduced number of isoforms is expressed in the adult brain. DM1 is caused by a dynamic and unstable CTG repeat expansion in the DMPK gene, resulting in an RNA bearing long CUG repeats (n>50) that accumulates in nuclear foci and sequesters CUG-binding splicing factors of the muscleblind-like (MBNL) family, involved in the splicing of Tau pre-mRNA among others. However, the precise mechanism leading to Tau mis-splicing and the role of MBNL splicing factors in this process are poorly understood. We therefore used new Tau minigenes that we developed for this purpose to determine how MBNL1 and MBNL2 interact to regulate Tau exon 2 splicing. We demonstrate that an intronic region 250 nucleotides downstream of Tau exon 2 contains cis-regulatory splicing enhancers that are sensitive to MBNL and that bind directly to MBNL1. Both MBNL1 and MBNL2 act as enhancers of Tau exon 2 inclusion. Intriguingly, the interaction of MBNL1 and MBNL2 is required to fully reverse the mis-splicing of Tau exon 2 induced by the trans-dominant effect of long CUG repeats, similar to the DM1 condition. In conclusion, both MBNL1 and MBNL2 are involved in the regulation of Tau exon 2 splicing and the mis-splicing of Tau in DM1 is due to the combined inactivation of both. © 2014 Elsevier B.V.

PubMed | Regional University Hospital of Lille, Lancaster University, Northeastern University, University College London and Imperial College London
Type: | Journal: Scientific reports | Year: 2016

The impaired maturation of bone-forming osteoblasts results in reduced bone formation and subsequent bone weakening, which leads to a number of conditions such as osteogenesis imperfecta (OI). Transplantation of human fetal mesenchymal stem cells has been proposed as skeletal anabolic therapy to enhance bone formation, but the mechanisms underlying the contribution of the donor cells to bone health are poorly understood and require further elucidation. Here, we show that intraperitoneal injection of human amniotic mesenchymal stem cells (AFSCs) into a mouse model of OI (oim mice) reduced fracture susceptibility, increased bone strength, improved bone quality and micro-architecture, normalised bone remodelling and reduced TNF and TGF sigalling. Donor cells engrafted into bones and differentiated into osteoblasts but importantly, also promoted endogenous osteogenesis and the maturation of resident osteoblasts. Together, these findings identify AFSC transplantation as a countermeasure to bone fragility. These data have wider implications for bone health and fracture reduction.

Chandoul W.,École Centrale Lille | Camus H.,École Centrale Lille | Zoghlami N.,École Centrale Lille | Hammadi S.,École Centrale Lille | Martinot A.,Regional University Hospital of Lille
Proceedings - 2014 International Conference on Control, Decision and Information Technologies, CoDIT 2014 | Year: 2014

This work aims to assess the effective demand of healthcare treatment load in the Pediatric Emergency Department (PED) as a treatment time requested and focus on the treatment time remained. So we defined a metrics assessing the Total Demand Load (TDL) of healthcare treatment in the PED which is more robust to reflect the whole patients' healthcare demand than the simple attending patients count. In addition, we demonstrate that we have to avoid being limited on the physical presence of patients because a high occupancy rate does not necessarily mean that there is a high demand of healthcare treatment. This study was based on Length Of Stay (LOS) estimation according to the patient diagnostic and his number of additional tests. The patient process progression is modeled by a time buffer system allowing the instantly track of each patient. It is a way to improve the quality of service and information delivery. This method offers a priority mechanism, it is also a robust management and decision aided tool. Besides, the time buffers system will encourage physicians to respect the time needed for each patient profile suggested in order to maximize the objective of improving the performing. Such system will make them aware about three important points: The healthcare Treatment process progress, the eventual overflowing/ time excess, the eventual high acuity. From patients' viewpoint, it will reassure parents who can follow the healthcare treatment progression of their children instantly. © 2014 IEEE.

Othman S.B.,École Centrale Lille | Hammadi S.,École Centrale Lille | Quilliot A.,University Blaise Pascal | Martinot A.,Regional University Hospital of Lille | Renard J.-M.,Lille University of Science and Technology
Studies in Health Technology and Informatics | Year: 2015

Health organization management is facing a high amount of complexity due to the inherent dynamics of the processes and the distributed organization of hospitals. It is therefore necessary for health care institutions to focus on this issue in order to deal with patients' requirements and satisfy their needs. The main objective of this study is to develop and implement a Decision Support System which can help physicians to better manage their organization, to anticipate the overcrowding feature, and to establish avoidance proposals for it. This work is a part of HOST project (Hospital: Optimization, Simulation, and Crowding Avoidance) of the French National Research Agency (ANR). It aims to optimize the functioning of the Pediatric Emergency Department characterized by stochastic arrivals of patients which leads to its overcrowding and services overload. Our study is a set of tools to smooth out patient flows, enhance care quality and minimize long waiting times and costs due to resources allocation. So we defined a decision aided tool based on Multi-agent Systems where actors negotiate and cooperate under some constraints in a dynamic environment. These entities which can be either physical agents representing real actors in the health care institution or software agents allowing the implementation of optimizing tools, cooperate to satisfy the demands of patients while respecting emergency degrees. This paper is concerned with agents' negotiation. It proposes a new approach for multi-skill tasks scheduling based on interactions between agents. © 2015 IMIA and IOS Press.

Daroux M.,Doctor Duchenne Hospital | Daroux M.,Regional University Hospital of Lille | Shenouda M.,Doctor Duchenne Hospital | Bacri J.-L.,Valenciennes Hospital | And 3 more authors.
Journal of Nephrology | Year: 2013

Background: In patients with chronic kidney disease, vitamin D insufficiency is highly prevalent. It can be corrected by supplementation with either vitamin D2 or vitamin D3. Recent studies in patients without impaired kidney function suggest that vitamin D3 is more efficient than vitamin D2 in correcting vitamin D insufficiency. However, no direct comparison has been made in hemodialysis (HD) patients. Methods: Thirty-nine HD patients with serum 25-hydroxyvitamin D (25(OH)D) levels ≤20 ng/mL were enrolled in this comparative, prospective pilot study. They were divided into 3 groups and treated over a 3-month period. Each patient received oral doses of 200,000 international units (IU) vitamin D per month according to the following treatment schedule: (i) vitamin D2 in small fractionated doses at each HD session, 3 times per week (group D2S); (ii) vitamin D2 once a month (group D2M); or (iii) vitamin D3 once a month (group D3M). Changes in serum 25(OH)D levels were measured at the end of the study. Results: Posttreatment serum 25(OH)D levels increased significantly in all groups. The mean ± SD serum 25(OH)D value for group D3M patients (40 ± 13 ng/ mL) was significantly higher than that for groups D2M (25 ± 9 ng/mL, p<0.01) and D2S patients (25 ± 9 ng/ mL, p<0.01). Serum 25(OH)D increased to levels >30 ng/mL in 84% of group D3M patients, but in only 15% and 27% of group D2M and D2S subjects, respectively. Conclusion: Vitamin D3 is more effective than vitamin D2 in providing adequate 25(OH)D serum levels in HD patients. © 2012 Società Italiana di Nefrologia - ISSN 1121-8428.

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