Versailles Hospital

Le Chesnay, France

Versailles Hospital

Le Chesnay, France
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Melchior M.,French Institute of Health and Medical Research | Melchior M.,Paris-Sorbonne University | Younes N.,University of Versailles | Younes N.,Versailles Hospital
Social Psychiatry and Psychiatric Epidemiology | Year: 2015

Methods: Using data from a sample of French young adults surveyed in 2011 (TEMPO study, N = 1,214, 18–37 years old) and their parents who took part in a longitudinal cohort study, we used multiple logistic regression to examine the relationship between job insecurity, lifetime and recent unemployment and suicidal ideation in the past 12 months. Our analyses were adjusted for factors associated with suicidal risk including age, sex, educational attainment, living with a partner, insufficient social support, alcohol abuse, depression and parental history of depression.Purpose: Job insecurity, unemployment, and job strain can predict psychological distress and suicide risk. Young people, who are particularly at risk of suicide, may be especially vulnerable to the deterioration of labor market conditions as a result of the current economic crisis in Europe. We aimed to examine the effects of work and employment characteristics on suicidal ideation in a contemporary sample of young adults.Results: Five percent of the sample reported suicidal ideation in the preceding 12 months. Controlling for all covariates, the likelihood of suicidal ideation was associated with job insecurity (OR 2.24, 95 % CI 1.08–4.63), lifetime unemployment (OR 2.25, 95 % CI 1.17–4.29), and recent unemployment (OR 2.10, 95 % CI 1.04–4.25). After stratifying by educational attainment, the association between suicidal ideation and job insecurity was particularly notable for participants with low educational attainment (OR 9.28, 95 % CI 1.19–72.33).Conclusion: Young adults who have unstable and unfavorable employment characteristics are disproportionately likely to be suicidal, which should be monitored, particularly in times of economic downturn. © 2014, Springer-Verlag Berlin Heidelberg.


Micol J.-B.,University Paris - Sud | Micol J.-B.,Sloan Kettering Cancer Center | Duployez N.,University of Lille Nord de France | Boissel N.,University Paris Diderot | And 15 more authors.
Blood | Year: 2014

Acute myeloid leukemia (AML) with t(8;21) (q22;q22) is considered to have favorable risk; however, nearly half of t(8;21) patients are not cured, and recent studies have highlighted remarkable genetic heterogeneity in this subset of AML. Here we identify somatic mutations in additional sex combs-like 2 (ASXL2) in 22.7% (25/110) of patientswith t(8; 21), but not in patients with inv(16)/t(16;16) (0/60) or RUNX1-mutated AML (0/26). ASXL2 mutations were similarly frequent in adults and children t(8;21) and were mutually exclusive with ASXL1 mutations. Although overall survival was similar between ASXL1 and ASXL2 mutant t(8;21) AML patients and their wild-type counterparts, patients with ASXL1 or ASXL2 mutations had a cumulative incidence of relapse of 54.6% and 36.0%, respectively, compared with 25% in ASXL1/2 wild-type counterparts (P = .226). These results identify a high-frequency mutation in t(8;21) AML and identify the need for future studies to investigate the clinical and biological relevance of ASXL2 mutations in this unique subset of AML. © 2014 by The American Society of Hematology.


PubMed | Versailles Hospital and Saint Louis Hospital
Type: | Journal: European heart journal cardiovascular Imaging | Year: 2017

We sought to assess whether global longitudinal strain (GLS) measured early during treatment with anthracyclines (at a cumulative dose of 150mg/mEighty-six patients with Hodgkins disease, non-Hodgkins lymphoma, or acute leukaemia and receiving anthracyclines were prospectively included. Patients underwent complete echocardiography on four occasions: baseline (V1); after reaching a cumulative dose of 150mg/mGLS greater than -17.45%, obtained after 150mg/m


Younes N.,University of Versailles | Younes N.,Versailles Hospital | Melchior M.,Pierre Louis Institute for Epidemiology and Public Health | Melchior M.,Paris-Sorbonne University | And 8 more authors.
Journal of Affective Disorders | Year: 2015

Background General Practitioners (GPs) play a central role in suicide prevention. This study aims to compare the characteristics of individuals who attempt suicide to those who complete suicide in a same primary care setting. Methods We compared the characteristics and GP's management of all patients with attempted (N=498, SA) or completed suicide (N=141, SC) reported to the GPs' French Sentinelles surveillance system (2009-2013). Results Compared to patients who attempted suicide, those who completed suicide were more likely to be male, older and to have used a more lethal method; for men they were less likely to have a history of previous suicide attempt and prior contacts with their GP. In terms of GPs' management, we found no differences between the SA and SC groups in the identification of psychological difficulties and in the care, but GPs were more likely to provide psychological support to the SA group. During the last consultation, the SC group expressed suicidal ideas more frequently than the SA group (26.7% vs. 14.8%, p<0.01), only for women. Limitations The network may have missed cases and selected more serious SA. Conclusions Individuals who commit suicide differ from those who attempt suicide in terms of demographic characteristics and by sex, of history of suicide attempt, previous contact and expressed suicidal ideas. We show that GPs do not act more intensively with patients who will commit suicide, as if they do not foresee them. Current prevention programs particularly in primary care should be tailored. © 2014 Elsevier B.V. All rights reserved.


Anseeuw K.,ZNA Stuivenberg | Delvau N.,Cliniques Universitaires Saint Luc | Burillo-Putze G.,Hospital Universitario Of Canarias | De Iaco F.,A.S.L. | And 4 more authors.
European Journal of Emergency Medicine | Year: 2013

Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


PubMed | Jean Monnet University, Delafontaine Hospital, University Paris Diderot and Versailles Hospital
Type: Review | Journal: Annals of intensive care | Year: 2017

Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was to compare the benefit and harm of restrictive versus liberal RBCT strategies in order to guide physicians on RBCT strategies in patients with severe sepsis or septic shock. Four outcomes were assessed: death, nosocomial infection (NI), acute lung injury (ALI) and acute kidney injury (AKI). Studies assessing RBCT strategies or RBCT impact on outcome and including intensive care unit (ICU) patients with sepsis were assessed. Two systematic reviews were achieved: first for the randomized controlled studies (RCTs) and second for the observational studies. MEDLINE, EMBASE, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Clinical Trials.gov were analyzed up to March 01, 2015. Der Simonian and Laird random-effects models were used to report pooled odds ratios (ORs). Subgroup analyses and meta-regressions were performed to explore studies heterogeneity. One RCT was finally included. The restrictive RBCT strategy was not associated with harm or benefit compared to liberal strategy. Twelve cohort studies were included, of which nine focused on mortality rate. RBCT was not associated with increased mortality rate (overall pooled OR was 1.10 [0.75, 1.60]; I


Verdonk P.,Ghent University | Beaufils P.,Versailles Hospital | Bellemans J.,University Hospitals Leuven | Djian P.,Institute Of Lappareil Locomoteur Nollet | And 5 more authors.
American Journal of Sports Medicine | Year: 2012

Background: A novel, biodegradable, polyurethane scaffold was designed to fulfill an unmet clinical need in the treatment of patients with painful irreparable partial meniscal defects.Hypothesis: The use of an acellular polyurethane scaffold for new tissue generation in irreparable partial meniscal defects provides both pain relief and improved functionality.Study Design: Case series; Level of evidence, 4.Methods: Fifty-two patients with irreparable partial meniscal defects (34 medial and 18 lateral, 88% with 1-3 previous surgeries on the index meniscus) were implanted with a polyurethane scaffold in a prospective, single-arm, multicenter, proof-of-principle study. Safety was assessed by the rate of scaffold-related serious adverse events (SAEs) and the International Cartilage Repair Society articular cartilage scoring system comparing magnetic resonance imaging (MRI) at 24 months to MRI at baseline (1 week). Kaplan-Meier time to treatment failure distributions were performed. Clinical outcomes were measured comparing visual analog scale, International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scores at 24 months from baseline (entry into study).Results: Clinically and statistically significant improvements (P <.0001) compared with baseline were reported in all clinical outcome scores (baseline/24 months): visual analog scale (45.7/20.3), International Knee Documentation Committee (45.4/70.1), KOOS symptoms (64.6/78.3), KOOS pain (57.5/78.6), KOOS activities of daily living (68.8/84.2), KOOS sports (30.5/59.0), KOOS quality of life (33.9/56.6), and Lysholm (60.1/80.7), demonstrating improvements in both pain and function. The incidence of treatment failure was 9 (17.3%) patients, of which 3 patients (8.8%) had medial meniscal defects and 6 patients (33.3%) had lateral meniscal defects. There were 9 SAEs requiring reoperation. Stable or improved International Cartilage Repair Society cartilage grades were observed in 92.5% of patients between baseline and 24 months.Conclusion: At 2 years after implantation, safety and clinical outcome data from this study support the use of the polyurethane scaffold for the treatment of irreparable, painful, partial meniscal defects. © 2012 The Author(s).


Delaunay C.,De lYvette Private Hospital | Petit I.,Biomnis Biological Laboratory | Learmonth I.D.,Southmead Hospital | Oger P.,Versailles Hospital | Vendittoli P.A.,University of Montréal
Orthopaedics and Traumatology: Surgery and Research | Year: 2010

With certain concerns recently reported on metal-on-metal bearing couples in total hip arthroplasty, this study's objective is to review the current knowledge concerning release of metal ions and its potential consequences. Each metal-on-metal implant presents different tribological properties. The analytical techniques for metals are accurate and the Co ion rates seem acceptable up to 2. μg/L. A delayed type IV hypersensitivity reaction (atypical lymphocytic vasculitis-associated lesion [ALVAL]) may be the source of arthroplasty failure. Idiosyncratic, it remains unpredictable even using cutaneous tests and apparently is rare (0.3%). Today, there are no scientific or epidemiologic data supporting a risk of carcinogenesis or teratogenesis related to the use of a metal-on-metal bearings couple. Solid pseudotumors nearly exclusively are observed with resurfacing procedures, carrying a high annual revision rate in women under 40 years of age, occurring particularly in cases of acetabular malposition and with use of cast molded Cr-Co alloys. Osteolysis manifests through complete and progressive radiolucent lines or through cavitary lesions stemming from ALVAL-type alterations or impingement problems or implant incompatibility. The formation of wear debris exceeding the biological tolerance is possible with implant malposition, subluxation, and jamming of the femoral head in cases of cup deformity. Moreover, each implant presents different metal ion production; assessment of their performance and safety is required before their clinical use. With the knowledge available today, metal-on-metal bearing couples are contraindicated in cases of metal allergies or end stage renal dysfunction and small size resurfacing should cautiously be used. © 2010.


We describe a 17-year-old patient presenting perimyocarditis as the initial manifestation of the adult-onset Still's disease. Corticotherapy was rapidly successful but induced major acute hepatitis in relation with Epstein-Barr virus reactivation. After 1 year, even if the global outcome is favourable, a slightly lowered ejection fraction still persists. Former case reports and differential diagnosis with reactive haemophagocytic syndrome would be discussed.


Meckenstock R.,Versailles Hospital
BMJ case reports | Year: 2011

There are many similarities between mycobacteriosis, in particular, tuberculosis, and sarcoidosis such as predominant intrathoracic localisation (even if all organs and tissues may be concerned), great variability of phenotypic expression, and granulomatous inflammatory reaction, caseous necrosis not being an absolute criterion of tuberculosis. Moreover, microbial (or mycobacterial?) agents may play a role in the pathogenesis of sarcoidosis which remains a diagnosis of exclusion particularly in atypical cases. The authors report a case of a non-immunocompromised female patient who presented, simultaneously, isolated axillary tubercular adenitis and neuro-sarcoidosis without any other localisation. This case illustrates the difficulty to distinguish between both of these two diseases and thus to choose an adequate treatment when diagnosis is not proven. Moreover, our patient (human leucocyte antigen B27 positive) presented symptoms of spondylarthritis which also may have a nosological link with tuberculosis or sarcoidosis.

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