Fuks D.,University of Picardy |
Regimbeau J.M.,University of Picardy |
Le Treut Y.-P.,Hopital Conception |
Bachellier P.,Hopital Hautepierre |
And 2 more authors.
World Journal of Surgery | Year: 2011
Background: Incidental gallbladder cancer (GBC) is frequently discovered on the specimen when cholecystectomy for a benign disease is performed. The objective of the present study was to assess the management of incidental GBC patients in a French registry. Methods: Data on patients with GBC treated between 1998 and 2008 were retrospectively collated in a French, multicenter database. Results: The registry contained 218 patients with incidental GBC (67 men and 151 women; median age = 64 years; age range = 31-88). One hundred forty-eight (68%) patients underwent re-resection after a median time interval of 48 days (range = 2-245). The most common complete procedure (66% of cases) was 4b + 5 segmentectomy with lymphadenectomy but not bile duct resection. Port-site excision was performed in 54 patients. The mortality and morbidity rates were 3 and 37%, respectively. Resection of the common bile duct (43%) increased postoperative complications (60 vs. 23%, p = 0.0001). Local residual tumor was found in 83 (56%) patients; it was significantly correlated with the T stage and influenced long-term survival. R0 was obtained in 143 (97%) patients and port-site invasion was histologically confirmed in one patient (1.8%). After a median follow-up period of 34 months, the 1-, 3-, and 5-year survival rates for the 148 patients with re-resection were 76, 54, and 41%, respectively. Re-resection significantly increased survival in patients with T2 (p = 0.0001) and T3 (p = 0.04) disease. Resection of the common bile duct increased neither R0 resection nor overall survival (p = 0.06). Conclusion: This study validates the concept of re-resection in T2 and T3 GBC. Bile duct resection increases postoperative morbidity but does not improve survival. There is currently a modification in the surgical management of incidental GBC, with minor liver resection and no common bile duct resection. © 2011 Société Internationale de Chirurgie.
Choukri F.,Saint Louis Hospital APHP |
Menotti J.,Saint Louis Hospital APHP |
Sarfati C.,Saint Louis Hospital APHP |
Lucet J.-C.,University Paris Diderot |
And 4 more authors.
Clinical Infectious Diseases | Year: 2010
Background. Airborne transmission of Pneumocystis has been demonstrated in animal models and is highly probable in humans. However, information concerning burdens of Pneumocystis jirovecii (human-derived Pneumocystis) in exhaled air from infected patients is lacking. Our objective is to evaluate P. jirovecii air diffusion in patients with Pneumocystis pneumonia. Methods. Patients admitted with Pneumocystis pneumonia were prospectively enrolled from 9 January 2008 to 21 July 2009. Air samples (1.5 m3) were collected on liquid medium with a commercial sampler at 1-, 3-, 5-, and 8-m distances from patients' heads. Air control samples were collected away from Pneumocystis pneumonia patient wards and outdoors. Samples were examined for P. jirovecii detection and quantification using a real-time polymerase chain reaction assay targeting the mitochondrial large subunit ribosomal RNA gene. Results. Forty patients were diagnosed as having Pneumocystis pneumonia. Air sampling was performed in the environment for 19 of them. At a 1-m distance from patients' heads, P. jirovecii DNA was detected in 15 (79.8%) of 19 patients, with fungal burdens ranging from to gene copies/m3. These 7.5 Times; 103 4.5 × 106 levels decreased with distance from the patients (P < .002). Nevertheless, 4 (33.3%) of the 12 samples taken at 8 m, in the corridor adjacent to their room, were still positive. Forty control samples were collected and remained negative. Conclusion. This study provides the first quantitative data on the spread of P. jirovecii in exhaled air from infected patients. It sustains the risk of P. jirovecii direct transmission in close contact with patients with Pneumocystis pneumonia and leads the way for initiating a quantitative risk assessment for airborne transmission of P. jirovecii. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Porion A.,University of Picardy |
Aparicio X.,University of Picardy |
Megalakaki O.,University of Picardy |
Robert A.,University of Picardy |
Baccino T.,Paris 8 University
Computers in Human Behavior | Year: 2016
We compared the effects of two media (paper vs. computer) on reading comprehension and memorization among students in their third or fourth year of secondary school. To assess comprehension, we constructed and validated a text with a carefully controlled hierarchical structure, accompanied by a questionnaire containing three types of questions (surface, semantic, inference). Memory of the text was assessed with a test based on the Remember-Know (R/K) paradigm. The results of the comprehension and R/K tests indicated that there was no difference between the two media. Regardless of medium, surface comprehension was better than either semantic or inference comprehension. The R/K test indicated that memorization was better for the surface elements of the text (more R than K responses). In conclusion, overall results show that if we fulfil all the conditions of paper-based versus computerized presentation (text structure, presentation on a single page, screen size, several types of questions measuring comprehension and memory performances), reading performances are not significantly different. © 2015 Elsevier Ltd.
Sabbagh C.,University of Picardy Medical Center |
Verhaeghe P.,University of Picardy Medical Center |
Dhahri A.,University of Picardy Medical Center |
Brehant O.,University of Picardy Medical Center |
And 3 more authors.
Obesity Surgery | Year: 2010
Background: Sleeve gastrectomy (SG) is an alternative to gastric bypass and laparoscopic adjustable gastric banding (GB). Methods: From January 2004 to January 2006, 111 patients with a follow-up longer than 24 months were prospectively followed. Three treatment groups were defined. Sleeve gastrectomy as first procedure (SGFP; n=50), sleeve gastrectomy after failure of GB (SG after GB; n=9) and GB (n=52). We compared morbidity, mortality, length of stay, number of procedures under general anaesthesia, excess weight loss (EWL) and quality of life. Results: Mean initial body mass index (BMI) was 50.4 (SG), 50.8 (SG after GB) and 43.8 (GB; p=0.000001). Mean operating time was 97.1 min (SGFP), 122.2 min (SG after GB) and 69.8 min (GB; p<0.0001). The reoperation rate under general anaesthesia was 2% (SGFP), 11% (SG after GB) and 30.76% (GB; p=0.00001).The fistula rate was 2% (SGFP), 0% (SG after GB) and 0% (GB). BMI at 24 months was 33.8 (SGFP), 35.3 (SG after GB) and 33.2 (GB; NS). EWL at 24 months was 67.4 (SGFP), 60.3 (SG after GB) and 58.6 (GB; NS). In the SGFP group and in the SG after GB group, the mean quality-of-life score was 1.1. In the GB group, the mean score was 0.95 (NS). Conclusions: Initial BMI was significantly higher in the SG group but was no longer significantly different from the BMI of the GB group at 12 and 24 months. Excess BMI loss was higher after SG than after GB. This reduction of BMI was considered to be a success for GB. Thus, results of SG should be considered as a success. Quality of life was not significantly different between the three groups. These results validated SG as first procedure or after failure of GB. © 2009 Springer Science + Business Media, LLC.
Gomonay O.V.,Kharkiv Polytechnic Institute |
Lukyanchuk I.,University of Picardy
Metallofizika i Noveishie Tekhnologii | Year: 2014
The exchange bias at ferromagnetic (FM)/antiferromagnetic (AF) interfaces strongly depends upon the state of antiferromagnetic layer, which is sensitive to mechanical stresses due to its strong magnetoelastic coupling. In a given paper, we consider magnetoelastic effects, which arise at FM/AF interface due to misfit of lattices and magnetic ordering. We show how magnetostriction affects mutual orientation of the AF and FM vectors as well as magnetic easy-axis direction in thin AF layer. The results obtained can be used for tailoring of exchange-biased systems.
Robert B.,University of Picardy |
Chivot C.,University of Picardy |
Fuks D.,University of Picardy |
Gondry-Jouet C.,University of Picardy |
And 2 more authors.
Abdominal Imaging | Year: 2013
Aim: Percutaneous drainage of abdominal and pelvic abscesses is a first-line alternative to surgery. Anterior and lateral approaches are limited by the presence of obstacles, such as the pelvic bones, bowel, bladder, and iliac vessels. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous, transgluteal approach by reviewing our clinical experience and the literature. Materials and methods: We reviewed demographic, clinical and morphological data in the medical records of 30 patients having undergone percutaneous, computed tomography (CT)-guided, transgluteal drainage. In particular, we studied the duration of catheter drainage, the types of microorganisms in biological fluid cultures, complications related to procedures and the patient's short-term treatment outcome. Results: From January 2005 to October 2011, 345 patients underwent CT-guided percutaneous drainage of pelvis abscesses in our institution. A transgluteal approach was adopted in 30 cases (10 women and 20 men; mean age: 52.6 [range 14-88]). The fluid collections were related to post-operative complications in 26 patients (86.7 %) and inflammatory or infectious intra-abdominal disease in the remaining 4 patients (acute diverticulitis: n = 2; appendicitis: n = 1; Crohn's disease: n = 1) (13.3 %). The mean duration of drainage was 8.7 days (range 3-33). Laboratory cultures were positive in 27 patients (90 %) and Escherichia coli was the most frequently present microorganism (in 77.8 % of the positive samples). A transpiriformis approach (n = 5) was more frequently associated with immediate procedural pain (n = 3). No major complications were observed, either during or after the transgluteal procedure. Drainage was successful in 29 patients (96.7 %). One patient died from massive, acute cerebral stroke 14 days after drainage. Conclusion: When an anterior approach is unfeasible, transgluteal, percutaneous, CT-guided drainage is a safe, well tolerated and effective procedure. Major complications are rare. This type of drainage is an alternative to surgery for the treatment of deep pelvic abscesses (especially for post-surgical collections). © 2012 Springer Science+Business Media, LLC.
Gignon M.,University of Picardy |
Gignon M.,Amiens University Hospital |
Gignon M.,University of Paris 13 |
Ammirati C.,University of Picardy |
And 4 more authors.
Journal of Emergency Nursing | Year: 2014
Objective: The purpose of this study was to assess patient understanding of ED discharge instructions. It is essential for ED patients to understand their discharge instructions. ED staff face unique challenges when providing information in a distraction-filled, limited-time setting, often with no knowledge of the patient's medical history. Methods: A qualitative study was conducted with a sample of patients discharged from our emergency department. Data were collected via a semi-structured interview. Results: A total of 36 patients participated in the study; 29 patients were discharged with a drug prescription, and complementary investigations were scheduled for 3 patients. Most patients were satisfied with the time staff spent explaining the discharge instructions. However, some patients admitted that they did not intend to fully comply with the medical prescription. Nearly half of the patients reported difficulties understanding their drug prescription (the dose or purpose of the treatment). Most patients said that their poor understanding primarily was related to lack of clarity of the written prescription. Discussion: Even the most comprehensive instructions may not be clearly understood. Despite the patients' high stated levels of satisfaction with communication in the emergency department, more than half of patients failed to comply with important discharge information. Health care staff must be aware of the importance of discharge information. Further research is needed to improve the patient discharge process. © 2014 Emergency Nurses Association.
Sabbagh C.,University Hospital |
Verhaeghe P.,University Hospital |
Brehant O.,University Hospital |
Browet F.,University Hospital |
And 3 more authors.
Hernia | Year: 2012
Introduction: Open tension-free hernioplasty using prosthetic meshes dramatically reduced recurrence rates after hernia or incisional hernia repair and has become the rule. Mesh infections (MI) are the major complication of prosthetic material. The aim of this study was to assess the efficacy of partial removal of mesh (PRM) therapy in the treatment of MI. Materials and methods: From January 2000 to April 2010, from a prospective database, we retrospectively selected patients who underwent surgery for MI. We studied the epidemiological data (sex, age, obesity, diabetes, smoking), the operating time of the initial intervention, the presence of intestinal injuries during the first intervention, the average interval between initial surgical procedure and MI, the location of the hernia, the average size of the hernia, type of mesh used, the position of the mesh, type of surgery performed, the number through interventions required to achieve a cure, the cumulative duration of hospital stay and hernia recurrence rates. Results: Twenty-five patients were supported for a MI in our institution. There were 9 women (36 %) and 16 men (64 %). The median age was 59 years (range 37-78). There were 4 inguinal hernias (16 %), 15 incisional hernias (60 %) and 6 multirecurrent incisional hernias (24 %). It was performed a PRM in 92 % of cases (n = 23), a total excision of the prosthesis in 4 % of cases (n = 1) and no removal of prosthesis in 4 % of cases (n = 1). The average number of reoperations before healing was 1 (range 1-5). The mean cumulative duration of hospitalization until healing was 9.5 days (range 2-43). No visceral resection was performed. Conclusion: PRM is feasible in most cases allowing first to spare the capital parietal patients and secondly to avoid major surgery. In case of failure, total removal of the mesh can be discussed. © 2012 Springer-Verlag.
de Dominicis F.,University of Picardy |
Leborgne L.,University of Picardy |
Raymond A.,University of Picardy |
Berna P.,University of Picardy
Interactive Cardiovascular and Thoracic Surgery | Year: 2011
Isolated unilateral pulmonary artery agenesis is a rare congenital anomaly that may be complicated with hemoptysis, recurrent pulmonary infections or pulmonary hypertension. To our knowledge the occurrence of a coronary syndrome associated with a coronary-to-bronchial artery saccular aneurysmal collateralization has never been described before. A 44-year-old female presented a congenital right pulmonary artery agenesis associated with a hypotrophic and multicystic right lung complicated with recurrent bronchitis. This patient had a coronary syndrome for which the coronary artery imaging showed a coronary-to-bronchial artery collateralization with an aneurysm at this level. It gives rise to a coronary syndrome by coronary steal. Two bronchial collaterals arising from a diaphragmatic artery and the subclavian artery were also found on the computed tomography (CT)-scan. This last collateral also showed another saccular aneurysm. We first performed an embolization of those two aneurysms in order to decrease the risk of hemorrhage and coronary steal, before performing a right pneumonectomy. In this case, the surgery was indicated because of the pathological lung and the risk of postembolization ischaemia. The postoperative course was uneventful and the patient was doing well six months later. © 2011 Published by European Association for Cardio-Thoracic Surgery.
PubMed | University of Picardy
Type: Journal Article | Journal: Journal of visceral surgery | Year: 2016
Interventional radiology plays an important role in the management of deep pelvic abscesses. Percutaneous drainage is currently considered as the first-line alternative to surgery. A transgluteal computed tomography (CT)-guided approach allows to access to deep infected collections avoiding many anatomical obstacles (vessels, nerves, bowel, bladder). The objective of this study was to assess the safety and efficacy of a transgluteal approach by reviewing our clinical experience.We reviewed medical records of patients having undergone percutaneous CT-guided transgluteal drainage for deep pelvic abscesses. We focused on the duration of catheter drainage, the complications related to the procedures and the rate of complete resolution.Between 2005 and 2013, 39patients (27women and 12men; mean age: 52.5) underwent transgluteal approach CT-guided percutaneous drainage of pelvis abscesses in our department. The origins of abscesses were postoperative complications in 34patients (87.2%) and infectious intra-abdominal disease in 5patients (12.8%). The mean duration of drainage was 8.3days (range: 3-33). Laboratory cultures were positive in 35patients (89.7%) and Escherichia coli was present in 71.4% of the positive samples. No major complication was observed. Drainage was successful in 38patients (97.4%). A transpiriformis approach was more significantly associated with intra-procedural pain (P=0.003).Percutaneous CT-guided drainage with a transgluteal approach is a safe, well-tolerated and effective alternative to surgery for deep pelvic abscesses. This approach should be considered as the first-line intention for the treatment of deep pelvic abscesses.