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Faecal calprotectin and magnetic resonance imaging in detecting Crohn's disease endoscopic postoperative recurrence

World Journal of Gastroenterology 2018年第5期24卷 641-650页

作者： Pierre Baillet Guillaume Cadiot Marion Goutte Felix Goutorbe Hedia Brixi Christine Hoeffel Christophe Allimant Maud Reymond Hélène Obritin-Guilhen Benoit Magnin Gilles Bommelaer Bruno Pereira Constance Hordonneau Anthony Buisson Université Clermont Auvergne CHU Clermont-Ferrand Service de radiologie chu de reims Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm 3iHP CHU Clermont-Ferrand Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm U1071 CH de Bayonne Service d’Hépato-Gastro Entérologie chu de reims Service de radiologie chu Clermont-Ferrand DRCI Unité de Biostatistiques

AIM To assess magnetic resonance imaging(MRI) and faecal calprotectin to detect endoscopic postoperative recurrence in patients with Crohn's disease(CD).METHODS From two tertiary centers, all patients with CD who underwent ileocolonic resection were consecutively and prospectively included. All the patients underwent MRI and endoscopy within the first year after surgery or after the restoration of intestinal continuity [median = 6 mo(5.0-9.3)]. The stools were collected the day before the colonoscopy to evaluate faecal calprotectin level. Endoscopic postoperative recurrence(POR) was defined as Rutgeerts' index ≥ i2b. The MRI was analyzed independently by two radiologists blinded from clinical *** Apparent diffusion coefficient(ADC) was lower in patients with endoscopic POR compared to those with no recurrence(2.03 ± 0.32 vs 2.27 ± 0.38 × 10^(-3) mm^2/s, P = 0.032). Clermont score(10.4 ± 5.8 vs 7.4 ± 4.5, P = 0.038) and relative contrast enhancement(RCE)(129.4% ± 62.8% vs 76.4% ± 32.6%, P = 0.007) were significantly associated with endoscopic POR contrary to the magnetic resonance index of activity(Ma RIA)(7.3 ± 4.5 vs 4.8 ± 3.7; P = 0.15) and MR scoring system(P = 0.056). ADC 100%(sensitivity = 0.75, specificity = 0.81, PPV = 0.75, NPV = 0.81) were the best cutoff values to identify endoscopic POR. Clermont score > 6.4(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74), Ma RIA > 3.76(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74) and a MR scoring system ≥ MR1(sensitivity = 0.54, specificity = 0.82, PPV = 0.70, and NPV = 0.70) demonstrated interesting performances to detect endoscopic POR. Faecal calprotectin values were significantly higher in patients with endoscopic POR(114 ± 54.5 μg/g vs 354.8 ± 432.5 μg/g; P = 0.0075). Faecal calprotectin > 100 μg/g demonstrated high perfor

关键词： Faecal calprotectin Magnetic resonance imaging Postoperative recurrence Crohn’s disease Clermont score Magnetic resonance index of activity

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Double ischemic ileal stenosis secondary to mesenteric injury after blunt abdominal trauma

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World Journal of Gastroenterology 2008年第1期14卷 143-145页

作者： Valérie Bougard Claude Avisse Martine Patey denis Germain Nathalie Levy-Chazal Jean-Franois delattre Service de Chirurgie Viscérale Digestive et Endocrinienne CHU Reims Hpital Robert Debré Reims France Martine Patey Laboratoire Central d’Anatomie et de Cytologie Pathologiques CHU Reims Hpital Robert Debré Reims France denis Germain Laboratoire Photographique CHU ReimsHpital Robert Debré Reims France

The authors describe a rare case in which blunt abdominal trauma resulted in mesenteric injury with delayed double ischemic ileal stenosis. Abdominal computed tomography demonstrated stenotic ileal loop with mural thickening. At surgery, a double stenotic bowel loop was found adjacent to a healed defect in the mesentery. Histological examination of the two resected segments showed fibrotic and ischemic lesions within the mesentery. Ischemic intestinal stenosis from mesenteric injury should be considered in the differential diagnosis in patients suffering from intestinal occlusion with a history of blunt abdominal ***.

关键词：腹部外伤肠系膜损伤肠狭窄腹部外科学

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Management of skin toxicities during panitumumab treatment in metastatic colorectal cancer

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World Journal of Gastroenterology 2019年第29期25卷 4007-4018页

作者： Olivier Bouche Meher Ben Abdelghani Jean-Luc Labourey Simon Triby René-Jean Bensadoun Thomas Jouary Gaétan des Guetz department of Gastroenterology and Digestive Oncology Hopital Robert Debre CHU ReimsReims 51000France Oncology department Centre Paul StraussStrasbourg 67000France Oncology department Centre HospitalierCarcassonne 11000France Medical department AMGEN FranceBoulogne-Billancourt 92100France Radiation Oncology Centre de Haute EnergieNice 06000France dermatology department Hopital Saint-Andre CHU de BordeauxBordeaux 33000France Oncology department Avicenne HospitalBobigny 93000France

BACKGROUND Anti-epidermal growth factor receptor therapy is associated with skin adverse events not previously reported with conventional chemotherapy. Prophylactic actions are recommended, but routine clinical management of these toxicities and their impact on quality of life remain unknown. AIM To assess the dermatological toxicities reported after panitumumab initiation, their impact on the quality of life and the clinical practices for their management. METHODS Patients included in this prospective multicenter observational study were over 18 years of age and began treatment with panitumumab for wild-type KRAS metastatic colorectal cancer. The incidence of dermatological toxicities, clinical practices for their management and impact on quality of life were recorded during a 6-mo follow-up. RESULTS Overall, 229 patients (males, 57.6%;mean age, 66.2 years) were included. At day 15, 59.3% of patients had dermatological toxicity;the rate peaked at month 2 (74.7%) and decreased at month 6 (46.5%). The most frequent dermatological toxicities were rash/acneiform rash, xerosis and skin cracks. At least one preventive treatment was administered to 65.9% of patients (oral antibiotics, 84.1%;emollients, 75.5%;both, 62.9%). The rates of patients who received at least one curative treatment peaked at month 2 (63.4%) and decreased at month 6 (44.8%). The impact of the dermatological toxicities on quality of life was limited as assessed with dermatology Life Quality Index scores and inconvenience visual analogic scale score. The rates of topical corticosteroids administration and visits to specialists were low. CONCLUSION The rates of the different skin toxicities peaked at various times and were improved at the end of follow-up. Nevertheless, their clinical management could be optimized with a better adherence to current recommendations. The impact of skin toxicities on patient’s quality of life appeared to be limited.

关键词： Metastatic colorectal cancer Epidermal growth factor receptor inhibitors Panitumumab Skin toxicity Quality of life

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Veno-Venous Extra-Corporeal Membrane Oxygenation (ECMO) in a Child with Hemoptysis and Fontan Circulation

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Open Journal of Pediatrics 2020年第2期10卷 280-287页

作者： Claudine Kumba Gauthier Loron Anais Mons Claude Marcus Francis Grossenbacher Nathalie Bednarek-Weirauch Vito Giovanni Ruggieri Emre Belli Jean-Marc Malinovsky Pierre Mauran department of Anesthesia and Critical Care CHU Reims Reims France department of Pediatric Anesthesia and Critical Care HU Necker Enfants Malades University Hospital Assistance Publique Hopitaux de Paris Paris France department of Pediatric and Neonatal Intensive Care CHU Reims Reims France department of Radiology CHU Reims Reims France department of Intensive Care and Emergency Medicine CHU Reims Reims France department of Thoracic and Cardiovascular Surgery CHU Reims Reims France department of Pediatric Cardiac Surgery Marie Lannelongue Hospital Le Plessis Robinson France department of Pediatric Cardiology and Congenital Heart Diseases American Memorial Hospital CHU Reims Reims France

Background: Extracorporeal membrane oxygenation is a rescue life support technique used in life threatening conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children depends on age and varies from pulmonary to cardiac pathologies. In some cases, it may be used as a bridge to a therapeutic procedure. We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas exchange. The latter can result in respiratory failure and consequent asphyxia. When hemoptysis occurs in a patient with a univentricular heart and a Fontan circulation, management of this clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair whi

关键词： Extracorporeal Membrane Oxygenation Fontan Circulation Univentricular Heart Tricuspid Atresia Children One Lung Ventilation Mobile ECMO Team Pediatric Anesthesia and Critical Care Angio-Embolization Interventional Radiology Pediatric Cardiology Pediatric Cardiac Surgery Trans-Thoracic Echocardiography Aortic Velocity Time Integral Fluid Responsiveness Goal Directed Fluid and Hemodynamic Therapy

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French Spine Surgery Society guidelines for management of spinal surgeries during COVID-19 pandemic

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World Journal of Clinical Cases 2020年第10期8卷 1756-1762页

作者： Solène Prost Yann Philippe Charles Jérome Allain Jean-Luc Barat Henri d'Astorg Manuel delhaye Chistophe Eap Fahed Zairi Pierre Guigui Brice Ilharreborde Jean Meyblum Jean-Charles Le Huec Nicolas Lonjon Guillaume Lot Olivier Hamel Guillaume Riouallon Stéphane Litrico Patrick Tropiano Benjamin Blondel Aix-Marseille Université APHMCNRSISMCHU TimoneUnitéde Chirurgie RachidienneMarseille 13005France Service de Chirurgie du Rachis Hopitaux Universitaires de StrasbourgStrasbourg 67200France Institut Parisien du dos Paris 75005France Service de Neurochirurgie Hopital privéClairval-Ramsay santéMarseille 13009France Unitéde Chirurgie du Rachis Centre Orthopédique SantyLyon 69008France Centre Francilien du dos Versailles 78000France chu reims Hopital Maison BlancheNeurochirurgieReims 51100France Hopital PrivéLe Bois Ramsay Santé Lille 59000France Hopital Européen Georges-Pompidou HEGP Paris 75015France Service de Chirurgie Orthopédique Pédiatrique CHU Robert DebréAPHPUniversitéde ParisParis 75019France Service de Chirurgie Orthopédique Groupe Hospitalier Paris Saint-JosephParis 75014France Polyclinique Bordeaux Nord Aquitaine Bordeaux 33300France Service de Neurochirurgie Hopital Gui de ChauliacMontpellier 34090France Hopital-Fondation Rothschild Service de NeurochirurgieParis 75019France Clinique des Cèdres Service de Neurochirurgie Chateau D’AlliezCornebarrieu 31700France Hopital Paris Saint-Joseph Paris 75014France Unitéde Chirurgie Rachidienne Hopital Pasteur 2CHU de NiceNice 06001France

Since the outbreak of coronavirus disease 2019(COVID-19)in december 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the *** regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical *** also report French experience in a COVID-19 cluster region illustrated by two clinical *** hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.

关键词： COVID-19 Spine Surgery Guidelines Organization Cluster region

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面先露:32例足月妊娠的回顾性研究(法)

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世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 29-30页

作者： Ducarme G. Ceccaldi P.-F. Chesnoy V. 张新艳 Service de gynécologie-obstétrique institut Mère-Enfant Alix-de-ChampagneCHU de Reims45rue Cognacq-Jay51092 Reims cedexFrance

Objective:To determine the etiologic factors,circumstances of diagnosis,obstetrical management and complications of face presentation and to value the maternal and foetal prognosis of this presentation. Patients and methods:Thirty-two cases of face presentation have been observed in the maternity wards of reims and Troyes over the last 12 years. Results:The incidence of face presentation was 0.7 per 1000 deliveries. Spontaneous vaginal delivery occurredwith mento-anterior presentation 73%of the time and caesarean section was performed in 100%of mento-posterior presentation. There was no increasing rate of foetal or maternal mortality and morbidity with vaginal delivery. Discussion and conclusion:Face presentation is an unusual complication of pregnancy with obstetric factors that predispose the foetus to face presentation. The low foetal and maternal mortality and morbidity substantiate the effectiveness of conservative management in face presentation.

关键词：面先露颏前位产科处理颏后位阴道分娩阴道自然分娩产科因素

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丙戊酸钠的可接受性和耐受性,一种新型持续有效的颗粒制剂可以单药治疗3岁以上癫痫儿童

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世界核心医学期刊文摘（儿科学分册） 2006年第A3期2卷 41-42页

作者： Motte J. Pedespan J.M. Sevestre M. Chiron C. 王经纬 Service de Pédiatrie A American Memorial Hospital CHU 47 rue Cognac-Jay 51092 Reims France

Sodium valproate (VPA) is an anti-epileptic drug which was until now administered to children as drinkable or injectable form. A new galenic form of this compound has been developed asmicrogranules with prolonged release (Micropakine LP; MPK). This new galenic form of VPA allows a greater stability of the plasmatic rates, thus limiting the risk of amount-dependent adverse effects at the time of the peaks, and of less effectiveness at the time of the fall of the circulating rates. The main objective of this study was to evaluate the acceptability of the new galenic form of VPA, in monotherapy, for epileptic children with ≥ 3 years old. The evaluation was performed at day (D)90 by the patients using a hedonic visual scale. The secondary objectives were to evaluate the acceptability by the parents, the treatment compliance, the percentage of patients free of seizure at D 90, and the tolerance. Finally, the authors compared all these data to those recovered at the baseline in patients already treated by the previous drinkable VPA. A total of 307 patients were involved by 76 hospital neuropediatric physicians. The population was constituted by 110 children 5 years, P denced for all children previously treated at D1 by drinkable form of VPA. The treatment was well respected by the patients, which were compliant in 80% of the cases. The adherence to treatment was good since the treatment compliance was 87%

关键词：丙戊酸钠颗粒制剂可接受性抗癫痫药物血浆药物浓度新型制剂依从性用药方式微小颗粒颗粒型

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Factors associated with DAA virological treatment failure and resistance-associated substitutions description in HIV/HCV coinfected patients

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World Journal of Hepatology 2018年第11期10卷 856-866页

作者： Dominique Salmon Pascale Trimoulet Camille Gilbert Caroline Solas Eva Lafourcade Julie Chas Lionel Piroth Karine Lacombe Christine Katlama Gilles Peytavin Hugues Aumaitre Laurent Alric Franoois Boué Philippe Morlat Isabelle Poizot-Martin Eric Billaud Eric Rosenthal Alissa Naqvi Patrick Miailhes Firouzé Bani-Sadr Laure Esterle Patrizia Carrieri Franoois Dabis Philippe Sogni Linda Wittkop 无 Assistance Publique des Hopitaux de Paris Hopitaux Universitaires Paris CentreHopital Hotel DieuUnitédes Maladies infectieuses et tropicalesParis 75004France Université Paris descartes Sorbonne Paris CitéParis 75006France Trimoulet CHU de BordeauxHopital PellegrinLaboratoire de VirologieBordeaux 33000France Trimoulet CNRS-UMR 5234Microbiologie fondamentale et PathogénicitéUniversitéde BordeauxBordeaux 3000France Philippe Morlat Laure EsterleFrancois DabisLinda WittkopUniv.BordeauxISPEDInsermBordeaux Population Health Research Centerteam MORPH3EUSUMR 1219CIC-EC 1401Bordeaux F-33000France APHM Hopital La TimoneLaboratoire de Pharmacocinétique et ToxicologieMarseille 13005France Centre Hospitalier Universitaire de Dijon Département d'InfectiologieDijon cedex 21079France INSERM-CIC 1342 Universitéde Bourgogne Dijon 21000France Assistance Publique des Hopitaux de Paris GHUEP site Saint-AntoineServices Maladies infectieuses et tropicalesParis 75011France UniversitéPierre et Marie Curie UMR S1136Institut Pierre Louis d' Epidémiologie et de SantéPubliqueParis 75646France UniversitéParis-Sorbonne Paris 75005France Assistance Publique des Hopitaux de Paris Hopital PitiéSalpêtrière Services Maladies infectieuses et tropicalesParis 75013France Assistance Publique des Hopitaux de Paris Hopital Bichat-Claude BernardLaboratoire de PharmacologieParis 75877France IAME UMR 1137Sorbonne Paris CitéINSERMUniversitéParis DiderotParis 75890France Centre Hospitalier de Perpignan Service Maladies infectieuses et tropicalesPerpignan 66000Franc Centre Hospitalier Universitaire de Toulouse Hopital PurpanService Médecine interne-Pole DigestifToulouse 31300France UMR 152 IRD UniversitéToulouseⅢ Paul SabatierToulouse 31330France Hopital Antoine-Béclère Assistance Publique des Hopitaux de ParisUniversitéParis SudService Médecine interne et immunologieClamart 92140France Centre Hospitalier Universitaire de Bordeaux Service de médecine interneHopital Saint-AndréBordeaux 33000France Uni

AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions(RAS).METHODS Human immunodeficiency virus(HIV)/hepatitis C virus(HCV) coinfected patients starting a first direct-acting antiviral(DAA) regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defined as:(1) non-response [HCV-RNA remained detectable during treatment, at end of treatment(EOT)]; and(2) relapse(HCVRNA suppressed at EOT but detectable thereafter). Sequencing analysis was performed to describe prevalence of drug class-specific RAS. Factors associated with failure were determined using logistic regression *** Among 559 patients, 77% had suppressed plasma HIV-RNA defined failures(3, 14%) and non-responses(2, 9%). Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5 A or NS5 B RAS were detected in 10/14 patients with samples available for sequencing analysis. After adjustment for age, sex, ribavirin use, HCV genotype and treatment duration, low platelet count was the only factor significantly associated with a higher risk of failure(OR: 6.5; 95%CI: 1.8-22.6). CONCLUSION Only 3.9% HIV-HCV coinfected patients failed DAA regimens and RAS were found in 70% of those failing. Low platelet count was independently associated with virological failure.

关键词：耐药性治疗方法患者肝病

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221例慢性丙肝患者抗病毒治疗期间甲状腺功能紊乱的长期病程和危险因素

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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 22-23页

作者： Moncoucy X. Leymarie F. delemer B. G. Thiéfin 杨雪娟 Service d'Hépato-Gastroentérologie CHU Robert Debré 51092 Reims Cedex

Aim-To identify the predictive factors of dysthyroidismduring treatment for chronic viral hepatitis C and to evaluate the longterm outcome of these patients. Methods-Patients treated for chronic viral hepatitis C between 1990 and 2001 were analyzed retrospectively. Patients with dysthyroidism before treatment and patients positive for hepatitis B surface antigen or human immunodeficiency virus antibodies were excluded. Dysthyroidism was defined by an abnormal serum TSH level on two separate occasions. Results-221 consecutive patients were included. Among them, a hundred were treated twice by interferon alpha, 21 had 3 treatments and 3 had 4 treatments. Fifteen of these patients (7%) had dysthyroidism during antiviral therapy. There was no significant difference in the frequency of dysthyroidism during the first and the second treatment [respectively 4.1%(N= 9) and 6%(N= 6)]. Female gender and the presence of antimicrosome or antithyroperoxydase (anti-TPO) antibodies before antiviral treatment were predictive factors of dysthyroidism. Treatment by interferon and ribavirin did not increase the risk of dysthyroidism compared to monotherapy with interferon. Pegylated interferon (N = 49) was not a risk factor compared to standard interferon. Thirteen patients had hypothyroidism (2 of them as a result of biphasic thyroiditis) and 2 had hyperthyroidism. The antiviral treatment was continued in 11 patients. Seven out of 13 patients with hypothyroidism required an indefinite treatment (follow-up: 15 to 90 months). Conclusions-In our series, 7%of patients with chronic viral hepatitis C hada dysthyroidism during antiviral therapy. Predictive factors were female gender and positive antimicrosome or anti-TPO antibodies before treatment. Absence of dystdyroidism during a first antiviral treatment did not preclude from the risk of dysthyroidismduring a second treatment.

关键词：慢性丙肝抗病毒 α干扰素丙肝患者聚乙二醇干扰素时间测定微粒体过氧化物酶前有

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采用CT纹理分析预测肝细胞癌手术切除后生存率

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国际医学放射学杂志 2019年第3期 369-369页

作者：罗嗣频 L.B.defour S.Mule A.Tenenhaus T.piardi D.Sommacale C.Hoeffel chu reims Serv Hepatogastroenterol & Cancerol Digest

摘要目的探讨经手术切除治疗肝细胞癌(HCC)的病人术前CT增强检查影像纹理参数能否预测术后总体生存率及无复发生存率。方法对本中心2010—2015年HCC切除

关键词：肝细胞癌手术切除生存率 CT

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