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Grabot C, Brard M, Hilaire D, Drame M, Gbaguidi GN, Elenga N, Tuttle S, Hatchuel Y, Levy M, Flechelles O, Felix A. Description and outcomes of Afro-Caribbean children treated for multisystem inflammatory syndrome in the French West Indies. Heliyon 2023; 9:e22642. [PMID: 38046139 PMCID: PMC10687232 DOI: 10.1016/j.heliyon.2023.e22642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/06/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Several studies have reported a higher frequency and greater morbidity and mortality of multisystem inflammatory syndrome in children (MIS-C) of black African descent. Objectives We aimed to describe the clinical, laboratory and echocardiographic characteristics as well as outcomes of children with MIS-C requiring admission to a pediatric intensive care unit (PICU) in the French West Indies (FWI), where the majority of the population is Afro-Caribbean. Methods Ambidirectional observational cohort study between April 1, 2020 and August 31, 2022. Children (age ≤18 years) with MIS-C and organ failure were included. Every patient was monitored and treated following the same protocol, with repeated biological tests, echocardiography, intravenous steroids and polyvalent immunoglobulins. The primary outcomes were clinical, laboratory and echocardiography characteristics. Results Forty children (median age 7 years, range: 5-11) were included. The majority (77 %) were included prospectively. Thirty-five (87 %) had gastrointestinal symptoms, 30 (75 %) presented initial heart failure (with persisting diastolic dysfunction at day 7) and 18 (45 %) had pericarditis. Sixteen (40 %) were in cardiogenic shock and required inotropic support. Median duration of inotropic support and hospitalization in PICU were respectively 4 and 5 days. The evolution curves of the inflammatory variables matched after treatment. The clinical outcomes were favorable. The Delta variant was associated with the highest incidence of MIS-C. Conclusion This is the first description of MIS-C course among children of Afro-Caribbean descent. The outcomes were good, without any death or cardiac sequelae. Our work does not support an ethnic susceptibility for severity of MIS-C in Afro-Caribbean population.
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Affiliation(s)
- Charlène Grabot
- Pediatric Intensive Care Unit, University Hospital of Martinique, Fort-de-France, France
| | - Mélanie Brard
- Antilles-Guyane M3C Pediatric Cardiology Center, University Hospital of Martinique, Fort-de-France, Martinique, France
| | - Daphnée Hilaire
- Department of Pediatrics, Guadeloupe University Hospital, Pointe-à-Pitre, France
| | - Moustapha Drame
- Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Gwladys Nadia Gbaguidi
- Scientific Researcher (EMERGEN Referent), Santé publique France Antilles, Guyane, France
| | - Narcisse Elenga
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Saskia Tuttle
- Antilles-Guyane M3C Pediatric Cardiology Center, University Hospital of Martinique, Fort-de-France, Martinique, France
| | - Yves Hatchuel
- Department of General Pediatrics, Competence Center for Rheumatic, Autoimmune and Systemic diseases in Children (RAISE) Antilles-Guyane, Martinique University Hospital, Fort-de France, France
| | - Michaël Levy
- Pediatric Intensive Care Unit, University Hospital Robert-Debré, Paris Cité University, Paris, France
| | - Olivier Flechelles
- Pediatric Intensive Care Unit, University Hospital of Martinique, Fort-de-France, France
| | - Arthur Felix
- Department of General Pediatrics, Competence Center for Rheumatic, Autoimmune and Systemic diseases in Children (RAISE) Antilles-Guyane, Martinique University Hospital, Fort-de France, France
- Department of Pediatrics, Reference Center for RAISE, University Hospital Robert-Debré, Paris, France
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Brossier D, Flechelles O, Sauthier M, Engert C, Chahir Y, Emeriaud G, Cheriet F, Jouvet P, de Montigny S. Evaluation of the SIMULRESP: A simulation software of child and teenager cardiorespiratory physiology. Pediatr Pulmonol 2023; 58:2832-2840. [PMID: 37530484 DOI: 10.1002/ppul.26595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/16/2022] [Accepted: 06/30/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Mathematical models based on the physiology when programmed as a software can be used to teach cardiorespiratory physiology and to forecast the effect of various ventilatory support strategies. We developed a cardiorespiratory simulator for children called "SimulResp." The purpose of this study was to evaluate the quality of SimulResp. METHODS SimulResp quality was evaluated on accuracy, robustness, repeatability, and reproducibility. Blood gas values (pH, PaCO2 , PaO2, and SaO2 ) were simulated for several subjects with different characteristics and in different situations and compared to expected values available as reference. The correlation between reference and simulated data was evaluated by the coefficient of determination and Intraclass correlation coefficient. The agreement was evaluated with the Bland & Altman analysis. RESULTS SimulResp produced healthy child physiological values within normal range (pH 7.40 ± 0.5; PaCO2 40 ± 5 mmHg; PaO2 90 ± 10 mmHg; SaO2 97 ± 3%) starting from a weight of 25-35 kg, regardless of ventilator support. SimulResp failed to simulate accurate values for subjects under 25 kg and/or affected with pulmonary disease and mechanically ventilated. Based on the repeatability was considered as excellent and the reproducibility as mild to good. SimulResp's prediction remains stable within time. CONCLUSIONS The cardiorespiratory simulator SimulResp requires further development before future integration into a clinical decision support system.
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Affiliation(s)
- David Brossier
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- Pediatric Intensive Care Unit, CHU de Caen, Caen, France
- School of Medicine, Université Caen Normandie, Caen, France
- Université de Lille, ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Université Caen Normandie, GREYC, Caen, France
| | - Olivier Flechelles
- Pediatric and Neonatal Intensive Care Unit, CHU de Martinique, Fort de France, France
| | - Michael Sauthier
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- Pediatric Intensive Care Unit, CHU Sainte Justine, Montreal, Canada
| | - Catherine Engert
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
| | | | - Guillaume Emeriaud
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- Pediatric Intensive Care Unit, CHU Sainte Justine, Montreal, Canada
| | - Farida Cheriet
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- École Polytechnique de Montréal, Montréal, Canada
| | - Philippe Jouvet
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- Pediatric Intensive Care Unit, CHU Sainte Justine, Montreal, Canada
| | - Simon de Montigny
- CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada
- École de santé publique, Université de Montréal, Montréal, Canada
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Grant R, Flechelles O, Elenga N, Tressières B, Gaete S, Hebert JC, Schaub B, Djossou F, Mallard A, Delver L, Ryan C, Funk AL, Cabié A, Fontanet A, Hoen B. Consequences of In Utero Zika Virus Exposure and Adverse Pregnancy and Early Childhood Outcomes: A Prospective Cohort Study. Viruses 2022; 14:v14122755. [PMID: 36560760 PMCID: PMC9788325 DOI: 10.3390/v14122755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
We aimed to describe adverse pregnancy outcomes among women who had symptomatic, RT-PCR-confirmed ZIKV infection and early childhood outcomes among their infants. We enrolled pregnant women with symptomatic, RT-PCR-confirmed ZIKV infection in a prospective cohort study, and their infants in a prospective pediatric cohort study. We defined adverse pregnancy and early childhood outcomes based on selected neurologic, ophthalmologic, auditory, musculoskeletal, and anthropometric abnormalities. We used RT-PCR and serologic tests to determine the ZIKV infection status of the child. Between 10 March and 24 November 2016, we enrolled 546 pregnant women with RT-PCR-confirmed ZIKV infection. The overall risk of adverse pregnancy and early childhood outcomes possibly related to in utero ZIKV exposure was 15.7% (95% CI: 12.8-19.0), distributed as follows: 3.6% (95% CI: 2.3-5.6) severe sequelae or fatality; 2.7% (95% CI: 1.6-4.5) major abnormalities; 9.4% (95% CI:7.1-12.2) mild abnormalities. The risk of severe sequelae or fatality was higher when ZIKV infection occurred during the first trimester (7.0%), compared to the second (2.7%) or third trimester (1.4%) (p = 0.02). Among the infants for whom ZIKV infection status could be determined, the vertical transmission rate was 3.0% (5/167) (95% CI: 1.1-7.2). Among pregnant women with symptomatic, RT-PCR-confirmed ZIKV infection, severe or major pregnancy or early childhood outcomes were present in 6.3% of fetuses and infants. Severe outcomes occurred more frequently in fetuses and infants whose mothers had been infected in the first trimester.
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Affiliation(s)
- Rebecca Grant
- Emerging Disease Epidemiology Unit, Institut Pasteur, 75015 Paris, France
- Sorbonne Université, 75006 Paris, France
| | - Olivier Flechelles
- Centre Hospitalier Universitaire de la Martinique, 97261 Fort-de-France, France
| | | | - Benoît Tressières
- Centre d’Investigation Clinique Antilles—Guyane, 97142 Pointe-à-Pitre, France
| | - Stanie Gaete
- Karubiotec™, Centre Hospitalier Universitaire de la Guadeloupe, 97142 Pointe-à-Pitre, France
| | | | - Bruno Schaub
- Centre Hospitalier Universitaire de la Martinique, 97261 Fort-de-France, France
| | - Felix Djossou
- Centre Hospitalier de Cayenne, Cayenne 97306, French Guiana
| | - Adeline Mallard
- Centre Hospitalier Universitaire de la Guadeloupe, 97142 Pointe-à-Pitre, France
| | - Lucetta Delver
- Centre Hospitalier de Basse-Terre, 97109 Basse-Terre, France
| | - Catherine Ryan
- Centre Hospitalier Universitaire de la Guadeloupe, 97142 Pointe-à-Pitre, France
| | - Anna L. Funk
- Emerging Disease Epidemiology Unit, Institut Pasteur, 75015 Paris, France
| | - André Cabié
- Centre Hospitalier Universitaire de la Martinique, 97261 Fort-de-France, France
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Université des Antilles, INSERM, EFS, 34394 Montpellier, France
- Centre d′Investigation Clinique 1424, INSERM, 97261 Fort-de-France, France
| | - Arnaud Fontanet
- Emerging Disease Epidemiology Unit, Institut Pasteur, 75015 Paris, France
- Conservatoire National des Arts et Métiers, 75003 Paris, France
- Correspondence: (A.F.); (B.H.)
| | - Bruno Hoen
- Centre d’Investigation Clinique Antilles—Guyane, 97142 Pointe-à-Pitre, France
- Correspondence: (A.F.); (B.H.)
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Rambaud J, Flechelles O. French West Indies castaway children as a result of the COVID-19 outbreak. Acta Paediatr 2020; 109:1915. [PMID: 32488896 PMCID: PMC7300716 DOI: 10.1111/apa.15387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jérôme Rambaud
- Pediatric and Neonatal Intensive Care Unit, Armand-Trousseau Hospital, Sorbonne University, Paris, France.,Pediatric and Neonatal Intensive Care Unit, Chu Fort de France, Martinique, France
| | - Olivier Flechelles
- Pediatric and Neonatal Intensive Care Unit, Chu Fort de France, Martinique, France
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Gouyon B, Martin-Mons S, Iacobelli S, Razafimahefa H, Kermorvant-Duchemin E, Brat R, Caeymaex L, Couringa Y, Alexandre C, Lafon C, Ramful D, Bonsante F, Binson G, Flamein F, Moussy-Durandy A, Di Maio M, Mazeiras G, Girard O, Desbruyeres C, Mourdie J, Escourrou G, Flechelles O, Abasse S, Rosenthal JM, Pages AS, Dorsi M, Karaoui L, ElGellab A, Le Bail Dantec F, Yangui MA, Norbert K, Kugbe Y, Lorrain S, Pignolet A, Garnier EM, Lapillonne A, Mitanchez D, Jacqz-Aigrain E, Gouyon JB. Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research. PLoS One 2019; 14:e0222667. [PMID: 31536560 PMCID: PMC6752821 DOI: 10.1371/journal.pone.0222667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives The primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW. Material and methods The research is a two-year observational cohort study (2017–2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse. Results The study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (p<0.0001). In addition, 69.2% of the 351 different combinations of an medication INN and a route of administration have no indication for the first month of life according to the French SmPC. Ninety-five percent of premature infants with GA less than 32 weeks received at least one medication not cited in SmPC. Conclusion Neonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.
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Affiliation(s)
- Béatrice Gouyon
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Séverine Martin-Mons
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Silvia Iacobelli
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | - Roselyne Brat
- Centre Hospitalier Régional d’Orléans, Orléans, France
| | | | - Yvan Couringa
- Centre Hospitalier Andrée-Rosemon, Guyane Française, France
| | | | | | - Duksha Ramful
- Centre Hospitalier Universitaire de La Réunion – Site Nord, Saint Denis, Réunion, France
| | - Francesco Bonsante
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | | | | | - Gaël Mazeiras
- Centre Hospitalier de la Côte Basque, Bayonne, France
| | | | | | - Julien Mourdie
- Hôpital Jacques Monod – Groupe Hospitalier du Havre, Montivilliers, France
| | | | - Olivier Flechelles
- Centre Hospitalier Universitaire de Fort-de-France, Fort de France, Martinique, France
| | | | | | - Anne-Sophie Pages
- Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Marine Dorsi
- Centre Hospitalier Territorial Gaston-Bourret, Dumbéa, Nouvelle Calédonie, France
| | | | | | | | | | | | - Yaovi Kugbe
- Centre Hospitalier de l’Ouest Guyanais – Franck Joly, Saint Laurent du Maroni, Guyane Française, France
| | - Simon Lorrain
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Anaelle Pignolet
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Elodie Marie Garnier
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | | | - Jean-Bernard Gouyon
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
- * E-mail:
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Affiliation(s)
- Mehdi Mejdoubi
- University Hospital of Martinique, Fort-de-France, Martinique
| | - Alice Monthieux
- University Hospital of Martinique, Fort-de-France, Martinique
| | - Tiphaine Cassan
- University Hospital of Martinique, Fort-de-France, Martinique
| | | | | | - Clara Adenet
- University Hospital of Martinique, Fort-de-France, Martinique
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Benjamin M, Jolivet E, Desbois N, Pignol J, Ketterer-Martinon S, Pierre-Louis L, Flechelles O. Colonisation à levures chez les prématurés de moins de 1500g hospitalisés en réanimation néonatale. Arch Pediatr 2016; 23:887-94. [DOI: 10.1016/j.arcped.2016.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Revised: 02/25/2016] [Accepted: 05/20/2016] [Indexed: 11/24/2022]
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Volumenie JL, Desseauve D, Flechelles O. Influence of obesity on route of delivery in a population of African descent in Martinique. Int J Gynaecol Obstet 2015; 131:187-91. [PMID: 26341175 DOI: 10.1016/j.ijgo.2015.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 05/12/2015] [Accepted: 07/29/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether obesity is an independent risk factor for cesarean delivery in Martinique. METHODS A retrospective study was performed using data for deliveries that occurred at the University Hospital of Fort de France between January and September 2010. Women were divided into four groups on the basis of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters; < 25 [group 1], 25-29 [group 2], 30-39 [group 3], and ≥ 40 [group 4]). Independent risk factors for cesarean delivery were identified through multivariate analysis. RESULTS Overall, 1286 women were included. Mean weight gain was lower in groups 2 (9.9 kg, 95% CI 9.2-10.7), 3 (5.7 kg, 4.7-6.7), and 4 (1.0 kg,-1.5 to 3.5), than in group 1 (12.3 kg, 11.9-12.7; P < 0.001 for all). In univariate analysis, cesarean deliveries were more frequent among nulliparous women in group 2 (P = 0.007) and group 3 (P = 0.053) than among those in group 1. In multivariate analysis, BMI was not associated with cesarean delivery (BMI 25-29: adjusted odds ratio 0.64, 95% CI 0.33-1.25; BMI ≥ 30: 0.61, 0.29-1.39). CONCLUSION Obesity was not an independent risk factor for cesarean delivery. Weight control and a positive attitude towards trial of labor in obese women could have led to the findings.
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Affiliation(s)
- Jean-Luc Volumenie
- Department of Obstetrics, Pôle Femme-Mère-Enfant, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique.
| | - David Desseauve
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire la Milétrie, Poitiers, France
| | - Olivier Flechelles
- Department of Obstetrics, Pôle Femme-Mère-Enfant, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
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Ozun J, Glaizal M, Flechelles O, Pujol G, Rollin B, Tichadou L, Hayek-Lanthois M, de Haro L. Un cas d’intoxication pédiatrique en Martinique par ingestion de feuilles crues de manioc. Toxicologie Analytique et Clinique 2014. [DOI: 10.1016/j.toxac.2014.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zaglam N, Jouvet P, Flechelles O, Emeriaud G, Cheriet F. Computer-aided diagnosis system for the Acute Respiratory Distress Syndrome from chest radiographs. Comput Biol Med 2014; 52:41-8. [PMID: 24999539 DOI: 10.1016/j.compbiomed.2014.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/14/2014] [Accepted: 06/12/2014] [Indexed: 01/06/2023]
Abstract
This paper presents a computer-aided diagnosis (CAD) system for the assessment of Acute Respiratory Distress Syndrome (ARDS) from chest radiographs. Our method consists in automatically extracting intercostal patches from chest radiographs belonging to the test database using a semiautomatic segmentation method of the ribs. Statistical and spectral features are computed from each patch then a method of feature transformation is applied using the Linear Discriminant Analysis (LDA). A training database of 321 patches was classified by an expert in two classes, a class of normal patches and a class of abnormal patches. Patches belonging to the test database are then classified using the SVM classifier. Finally, the rate of abnormal patches is calculated for each quadrant to decide if the chest radiograph presents an ARDS. The method has been evaluated on 90 radiographs where 53 images present ARDS. The results show a sensitivity of 90.6% at a specificity of 86.5%.
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Affiliation(s)
- Nesrine Zaglam
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada H3T 1C5; The Department of Computer Engineering, Ecole Polytechnique de Montréal, Montreal, Canada H3T 1J4.
| | - Philippe Jouvet
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada H3T 1C5
| | | | | | - Farida Cheriet
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada H3T 1C5; The Department of Computer Engineering, Ecole Polytechnique de Montréal, Montreal, Canada H3T 1J4
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François-Coridon H, Sika A, Trabanino C, Tölg C, Pignol J, Jolivet E, Flechelles O, Colombani J. SFCP CO-70 - Survenue de cas groupés de lactobézoards en réanimation néonatale. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Flechelles O, Ho A, Hernert P, Emeriaud G, Zaglam N, Cheriet F, Jouvet PA. Simulations for mechanical ventilation in children: review and future prospects. Crit Care Res Pract 2013; 2013:943281. [PMID: 23533735 PMCID: PMC3606750 DOI: 10.1155/2013/943281] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 02/03/2013] [Indexed: 11/18/2022] Open
Abstract
Mechanical ventilation is a very effective therapy, but with many complications. Simulators are used in many fields, including medicine, to enhance safety issues. In the intensive care unit, they are used for teaching cardiorespiratory physiology and ventilation, for testing ventilator performance, for forecasting the effect of ventilatory support, and to determine optimal ventilatory management. They are also used in research and development of clinical decision support systems (CDSSs) and explicit computerized protocols in closed loop. For all those reasons, cardiorespiratory simulators are one of the tools that help to decrease mechanical ventilation duration and complications. This paper describes the different types of simulators described in the literature for physiologic simulation and modeling of the respiratory system, including a new simulator (SimulResp), and proposes a validation process for these simulators.
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Affiliation(s)
- Olivier Flechelles
- Pediatric ICU, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada H3T 1C5
- Pediatric and Neonatal ICU, MFME Hospital, Fort de France, 97261 Martinique, France
| | - Annie Ho
- Pediatric ICU, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada H3T 1C5
| | - Patrice Hernert
- Research Center of Sainte-Justine Hospital, Montreal, QC, Canada H3T 1C5
| | - Guillaume Emeriaud
- Pediatric ICU, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada H3T 1C5
| | - Nesrine Zaglam
- Pediatric ICU, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada H3T 1C5
- Research Center of Sainte-Justine Hospital, Montreal, QC, Canada H3T 1C5
| | - Farida Cheriet
- Research Center of Sainte-Justine Hospital, Montreal, QC, Canada H3T 1C5
- École Polytechnique de Montréal, Montreal QC, Canada H3T 1J4
| | - Philippe A. Jouvet
- Pediatric ICU, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada H3T 1C5
- Research Center of Sainte-Justine Hospital, Montreal, QC, Canada H3T 1C5
- Soins Intensifs Pédiatriques, Hôpital Sainte Justine, 3175 Chemin Côte Sainte Catherine, Montréal, QC, Canada H3T 1C5
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Merouani A, Flechelles O, Jouvet P. Acute kidney injury in children. Minerva Pediatr 2012; 64:121-133. [PMID: 22495187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Acute kidney injury (AKI) affects 5% of critically ill hospitalized children and is a risk factor for increased morbidity and mortality. The current review focuses on new definitions of acute kidney injury, standardized to reflect the entire spectrum of the disease, as well as on ongoing research to identify early biomarkers of kidney injury. Its also provides an overview of current practice and available therapies, with emphasis on new strategies for the prevention and pharmacological treatment of diarrhea-associated hemolytic uremic syndrome. Furthermore, a decision-making algorithm is presented for the use of renal replacement therapies in critically ill children with AKI.
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Affiliation(s)
- A Merouani
- Department of Pediatric Nephrology, University of Montreal, Quebec, Canada.
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Flechelles O, Schneider P, Lesesve JF, Baruchel A, Vannier JP, Tron P, Schaison G. [Imerslund's disease. Clinical and biological aspects. Apropos of 6 cases]. Arch Pediatr 1997; 4:862-6. [PMID: 9345569 DOI: 10.1016/s0929-693x(97)88156-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Imerslund syndrome, a recessive autosomal disease, initially described by Imerslund and Grasbeck in 1960, associates megaloblastic anemia and proteinuria. CASE REPORT We report on six cases, studied in five different families. All patients (mean age: 3.5 years) had clinical symptoms of anemia, three had malabsorption, proteinuria was present in five, at the time of diagnosis. Hemogram and decreased serum vitamin B12 levels were consistent with the diagnosis in all cases. Intra-muscular injections of cyanocobalamine was instituted on a life-time basis and the long term prognosis is good. CONCLUSION The diagnosis should be evoked when the three typical features are present: macrocytic anemia, decreased serum B12 level and proteinuria. It will be confirmed by the bone marrow megaloblastic aspects and the Schilling test findings.
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Affiliation(s)
- O Flechelles
- Service de pédiatrie et génétique médicale, hôpital Charles-Nicolle, Rouen, France
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