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Hariri G, Luxey X, Wenger S, Dureau P, Hariri S, Charfeddine A, Lebreton G, Djavidi N, Lancelot A, Duceau B, Bouglé A. Capillary refill time assessment after fluid challenge in patients on venoarterial extracorporeal membrane oxygenation: A retrospective study. J Crit Care 2024; 82:154770. [PMID: 38461658 DOI: 10.1016/j.jcrc.2024.154770] [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: 12/04/2023] [Revised: 01/29/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Monitoring fluid therapy is challenging in patients assisted with Veno-arterial ECMO. The aim of our study was to evaluate the usefulness of capillary refill time to assess the response to fluid challenge in patients assisted with VA-ECMO. METHODS Retrospective monocentric study in a cardiac surgery ICU. We assess fluid responsiveness after a fluid challenge in patients on VA-ECMO. We recorded capillary refill time before and after fluid challenge and the evolution of global hemodynamic parameters. RESULTS A total of 27 patients were included. The main indications for VA-ECMO were post-cardiotomy cardiogenic shock (44%). Thirteen patients (42%) were responders and 14 non-responders (58%). In the responder group, the index CRT decreased significantly (1.7 [1.5; 2.1] vs. 1.2 [1; 1.3] s; p = 0.01), whereas it remained stable in the non-responder group (1.4 [1.1; 2.5] vs. 1.6 [0.9; 1.9] s; p = 0.22). Diagnosis performance of CRT variation to assess response after fluid challenge shows an AUC of 0.68 (p = 0.10) with a sensitivity of 79% [95% CI, 52-92] and a specificity of 69% [95% CI, 42-87], with a threshold at 23%. CONCLUSION In patients treated with VA-ECMO index capillary refill time is a reliable tool to assesses fluid responsiveness. SPECIALTY Critical care, Cardiac surgery, ECMO.
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Affiliation(s)
- Geoffroy Hariri
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Paris, France..
| | - Xavier Luxey
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France
| | - Stefanie Wenger
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Pauline Dureau
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Sarah Hariri
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France
| | - Ahmed Charfeddine
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France
| | - Guillaume Lebreton
- Sorbonne Université, AP-HP, Service de Chirurgie Cardiaque, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Nima Djavidi
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Aymeric Lancelot
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Baptiste Duceau
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
| | - Adrien Bouglé
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris F-75013, France.
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Talakoub T, Yusin J, Saff R, Hariri S. RECURRENT IMMEDIATE HYPERSENSITIVITY REACTION TO RADIOCONTRAST MEDIA DESPITE PREMEDICATION FOUND TO BE IGE-MEDIATED. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.232] [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: 10/27/2022]
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Czer L, Lam L, Hays R, Baiesc F, Kuo A, Hariri S, Moriguchi J, Arabia F, Volod O. Correlation of High Molecular Weight Von Willebrand Factor Multimer loss and Rotational Speed During Short Term Mechanical Circulatory Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.978] [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: 11/16/2022] Open
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McNamara LA, Topaz N, Wang X, Hariri S, Fox L, MacNeil JR. High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine. Am J Transplant 2017. [DOI: 10.1111/ajt.14426] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. A. McNamara
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - N. Topaz
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - X. Wang
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - S. Hariri
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - L. Fox
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - J. R. MacNeil
- Division of Bacterial Diseases; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
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Chesson HW, Markowitz LE, Hariri S, Ekwueme DU, Saraiya M. O16.4 The estimated impact and cost-effectiveness of nonavalent hpv vaccination in the united states. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Coutance G, Ouldamar S, Rouvier P, Saheb S, Suberbielle C, Bréchot N, Hariri S, Lebreton G, Leprince P, Varnous S. Late antibody-mediated rejection after heart transplantation: Mortality, graft function, and fulminant cardiac allograft vasculopathy. J Heart Lung Transplant 2015; 34:1050-7. [DOI: 10.1016/j.healun.2015.03.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/17/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022] Open
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Alsonosi A, Hariri S, Kajsík M, Oriešková M, Hanulík V, Röderová M, Petrželová J, Kollárová H, Drahovská H, Forsythe S, Holý O. The speciation and genotyping of Cronobacter isolates from hospitalised patients. Eur J Clin Microbiol Infect Dis 2015; 34:1979-88. [PMID: 26173692 PMCID: PMC4565866 DOI: 10.1007/s10096-015-2440-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [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: 02/24/2015] [Accepted: 06/26/2015] [Indexed: 12/01/2022]
Abstract
The World Health Organization (WHO) has recognised all Cronobacter species as human pathogens. Among premature neonates and immunocompromised infants, these infections can be life-threatening, with clinical presentations of septicaemia, meningitis and necrotising enterocolitis. The neurological sequelae can be permanent and the mortality rate as high as 40-80%. Despite the highlighted issues of neonatal infections, the majority of Cronobacter infections are in the elderly population suffering from serious underlying disease or malignancy and include wound and urinary tract infections, osteomyelitis, bacteraemia and septicaemia. However, no age profiling studies have speciated or genotyped the Cronobacter isolates. A clinical collection of 51 Cronobacter strains from two hospitals were speciated and genotyped using 7-loci multilocus sequence typing (MLST), rpoB gene sequence analysis, O-antigen typing and pulsed-field gel electrophoresis (PFGE). The isolates were predominated by C. sakazakii sequence type 4 (63%, 32/51) and C. malonaticus sequence type 7 (33%, 17/51). These had been isolated from throat and sputum samples of all age groups, as well as recal and faecal swabs. There was no apparent relatedness between the age of the patient and the Cronobacter species isolated. Despite the high clonality of Cronobacter, PFGE profiles differentiated strains across the sequence types into 15 pulsotypes. There was almost complete agreement between O-antigen typing and rpoB gene sequence analysis and MLST profiling. This study shows the value of applying MLST to bacterial population studies with strains from two patient cohorts, combined with PFGE for further discrimination of strains.
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Affiliation(s)
- A Alsonosi
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK
| | - S Hariri
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK
| | - M Kajsík
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - M Oriešková
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - V Hanulík
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - M Röderová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - J Petrželová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - H Kollárová
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - H Drahovská
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - S Forsythe
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK.
| | - O Holý
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
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Jalid A, Hariri S, Laghzale NE. Influence of sample size on flatness estimation and uncertainty in three-dimensional measurement. Int J Metrol Qual Eng 2015. [DOI: 10.1051/ijmqe/2015002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Markowitz LE, Hariri S, Dunne EF, Steinau M, Unger ER. Reply to Groner et al and Pei et al. J Infect Dis 2014; 209:1304-5. [DOI: 10.1093/infdis/jit835] [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: 11/14/2022] Open
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Galeone A, Varnous S, Barreda E, Hariri S, Pavie A, Leprince P. Impact of Cardiac Arrest Resuscitated Donors on Heart Recipients Outcome. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.310] [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: 11/24/2022] Open
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11
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Coutance G, Ouldamar S, Rouvier P, Suberbielle C, Saheb S, Hariri S, Brechot N, Lebreton G, Leprince P, Varnous S. Late Antibody-Mediated Rejection Due To De-Novo Donor-Specific Anti-HLA Antibodies in Heart Transplant Recipients: A Cohort of 20 Consecutive Patients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.481] [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] Open
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Lebreton G, Hariri S, Schoell T, Mastroianni C, Fenouillère P, eprince P. Conduite d’une assistance circulatoire temporaire par ECMO veinoartérielle. Réanimation 2013. [DOI: 10.1007/s13546-014-0881-1] [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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13
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Markowitz LE, Hariri S, Lin C, Dunne E, Steinau M, McQuillan G, Unger ER. P3.371 Reduction in HPV Prevalence Among Young Women Following Introduction of HPV Vaccine in the United States and Estimated Vaccine Effectiveness. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0824] [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: 11/03/2022]
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Schmidt M, Bréchot N, Hariri S, Guiguet M, Luyt CE, Makri R, Leprince P, Trouillet JL, Pavie A, Chastre J, Combes A. Nosocomial infections in adult cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation. Clin Infect Dis 2012; 55:1633-41. [PMID: 22990851 DOI: 10.1093/cid/cis783] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Incidence and impact on adult patients' outcomes of nosocomial infections (NIs) occurring during venoarterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock have rarely been described. METHODS We retrospectively reviewed the charts of a large series of patients who received VA-ECMO in our intensive care unit (ICU) from January 2003 through December 2009. Incidence, types, risk factors, and impact on outcomes of NIs occurring during ECMO support were analyzed. RESULTS Among 220 patients (49 ± 16 years old, simplified acute physiology score (SAPS) II 61 ± 20) who underwent ECMO support for >48 hours for a total of 2942 ECMO days, 142 (64%) developed NIs. Ventilator-associated pneumonia (VAP), bloodstream infections, cannula infections, and mediastinitis infections occurred in 55%, 18%, 10% and 11% of the patients, respectively. More critical condition at ICU admission, but not antibiotics at the time of ECMO cannulation, was associated with subsequently developing NIs (hazard ratio, 0.73; 95% confidence interval [CI], .50-1.05; P = .09). Infected patients had longer durations of mechanical ventilation, ECMO support, and hospital stays. Independent predictors of death were infection with severe sepsis or septic shock (odds ratio, 1.93; 95% CI, 1.26-2.94; P = .002) and SAPS II, whereas immunosuppression and myocarditis as the reason for ECMO support were associated with better outcomes. CONCLUSIONS Cardiogenic shock patients who received the latest generation VA-ECMO still had a high risk of developing NIs, particularly VAP. Strategies aimed at preventing these infections may improve the outcomes of these critically ill patients.
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Affiliation(s)
- Matthieu Schmidt
- Service de Réanimation Médicale, Institut de Cardiologie, Paris Cedex 13, France
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Scherrer V, Lasgi C, Hariri S, Dureuil B, Savouré A, Tamion F, Doguet F. Radiofrequency Ablation under Extracorporeal Membrane Oxygenation for Atrial Tachycardia in Postpartum. J Card Surg 2012; 27:647-9. [DOI: 10.1111/j.1540-8191.2012.01487.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Niccola L, Mehta N, Julian P, Bilinski A, Sosa L, Meek J, Hariri S, Markowitz L, Hadler J. P1-S6.43 HPV vaccine coverage among high-risk women: racial and socioeconomic disparities and barriers. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.267] [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: 11/04/2022]
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Mark J, Hariri S, Ilunga R, Forhan S, Likibi M, Kamb ML, Lewis D. O5-S2.04 Evaluation of sexually transmitted infection clinical services in Gauteng Province, South Africa: knowledge, attitudes, and beliefs among health care providers. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.160] [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: 11/04/2022]
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Powell SE, Hariri S, Steinau M, Bauer H, Bennett N, Bloch K, Schafer S, Niccolai L, Unger ER, Markowitz L. O1-S02.06 Detection of cervical cancer precursors and associated HPV types in the USA: HPV-IMPACT preliminary results. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.12] [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: 11/04/2022]
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Moubarak G, Martins RP, Zuily S, Mechulan A, Hariri S, Guiot A. Attitudes of cardiology residents toward interactions with the pharmaceutical industry. Int J Cardiol 2011; 146:461-2. [PMID: 21122930 DOI: 10.1016/j.ijcard.2010.10.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Accepted: 10/26/2010] [Indexed: 11/19/2022]
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Hariri S, Gouin P, Tuech JJ, Veber B, Dureuil B. Clostridium difficile infection causing multiple organ failure and small-bowel enteritis. Clin Res Hepatol Gastroenterol 2011; 35:142-4. [PMID: 21809490 DOI: 10.1016/j.clinre.2010.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Moubarak G, Guiot A, Benhamou Y, Benhamou A, Hariri S. Facebook activity of residents and fellows and its impact on the doctor-patient relationship. J Med Ethics 2011; 37:101-4. [PMID: 21160080 DOI: 10.1136/jme.2010.036293] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
AIM Facebook is an increasingly popular online social networking site. The purpose of this study was to describe the Facebook activity of residents and fellows and their opinions regarding the impact of Facebook on the doctor-patient relationship. METHODS An anonymous questionnaire was emailed to 405 residents and fellows at the Rouen University Hospital, France, in October 2009. RESULTS Of the 202 participants who returned the questionnaire (50%), 147 (73%) had a Facebook profile. Among responders, 138 (99%) displayed their real name on their profile, 136 (97%) their birthdates, 128 (91%) a personal photograph, 83 (59%) their current university and 76 (55%) their current position. Default privacy settings were changed by 61% of users, more frequently if they were registered for >1 year (p=0.02). If a patient requested them as a 'friend', 152 (85%) participants would automatically decline the request, 26 (15%) would decide on an individual basis and none would automatically accept the request. Eighty-eight participants (48%) believed that the doctor-patient relationship would be altered if patients discovered that their doctor had a Facebook account, but 139 (76%) considered that it would change only if the patient had open access to their doctor's profile, independent of its content. CONCLUSIONS Residents and fellows frequently use Facebook and display personal information on their profiles. Insufficient privacy protection might have an impact the doctor-patient relationship.
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Affiliation(s)
- Ghassan Moubarak
- Service de Cardiologie, Hôpital Lariboisière - Assistance Publique-Hôpitaux de Paris, 2, rue Ambroise Paré, 75010 Paris, France.
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Moubarak G, Hariri G, Hariri S. [Will the use of Facebook by medical students modify their relationship with patients?]. Rev Prat 2010; 60:600-602. [PMID: 20564838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Ghassan Moubarak
- Service de cardiologie, hôpital Lariboisière, AP-HP, université Paris-7 Denis-Diderot 75010 Paris.
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Alhussein A, Capelle J, Gilgert J, Tidu A, Hariri S, Azari Z. Influence of sand movement in the Sahara on the erosion of pipeline network. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100642018] [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: 11/14/2022] Open
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Borel M, Veber B, Villette-Baron K, Hariri S, Dureuil B, Hervé C. [Refusal of care in the intensive care: how makes decision?]. ACTA ACUST UNITED AC 2009; 28:954-61. [PMID: 19942395 DOI: 10.1016/j.annfar.2009.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 10/15/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Decision-making bringing to an admission or not in intensive care is complex. The aim of this study is to analyze with an ethical point of view the making decision process leading to the refusal and its consequences. It is proposed a setting in prospect through the principles of beneficence, non-maleficience, respect for autonomy, justice, and the Leonetti law. PATIENTS AND METHODS Prospective study in surgical reanimation at the University Hospital of Rouen over 9 months (November 2007-September 2008). Systematic collection for each non-admitted patient of the general characters, the methods of decision making, immediate becoming and within 48 h Constitution of two groups: patients for whom an admission in intensive care could be an unreasonable situation of obstinacy, and patients for whom an admission in reanimation would not be about unreasonable if it occurred. RESULTS One hundred and fifty situations were analyzed. The potentially unreasonable character of an admission does not involve necessarily a refusal of care in intensive care. The question of the lack of place and equity in the access to the care is real but relative according to the typology of the patients. The research of the respect of the autonomy of the patient is difficult but could be facilitated. The Leonetti law does not appear to be able to be a framework with the situation of refusal of care in intensive care. CONCLUSION It is not a question of going towards a systematic admission in intensive care of any patient proposed, but to make sure that so if there is a refusal, it is carried out according to a step ethically acceptable.
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Affiliation(s)
- M Borel
- Département d'anesthésie-réanimation-Samu, CHU Charles-Nicolle, 1, rue Germont, 76000 Rouen, France.
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Hariri S, Yoon P, Moonesinghe R, Valdez R, Khoury M. Evaluation of Family History as a Screening Tool for Detecting Undiagnosed Diabetes. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s76-d] [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: 11/15/2022] Open
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Abstract
BACKGROUND New techniques in imaging and surgery have made 3-dimensional anatomical knowledge an increasingly important goal of medical education. This study compared the efficacy of 2 supplemental, self-study methods for learning shoulder joint anatomy to determine which method provides for greater transfer of learning to the clinical setting. METHODS Two groups of medical students studied shoulder joint anatomy using either a second-generation virtual reality surgical simulator or images from a textbook. They were then asked to identify anatomical structures of the shoulder joint as they appeared in a videotape of a live arthroscopic procedure. RESULTS The mean identification scores, out of a possible score of 7, were 3.1 +/- 1.3 for the simulator group and 2.9 +/- 1.5 for the textbook group (P = 0.70). Student ratings of the 2 methods on a 5-point Likert scale were significantly different. The simulator group rated the simulator more highly as an effective learning tool than the textbook group rated the textbook (means of 3.2 +/- 0.7 and 2.6 +/- 0.5, respectively, P = 0.02). Furthermore, the simulator group indicated that they were more likely to use the simulator as a learning tool if it were available to them than the textbook group was willing to use the textbook (means of 4.0 +/- 1.2 and 3.0 +/- 0.9, respectively, P = 0.02). CONCLUSION Our results show that this surgical simulator is at least as effective as textbook images for learning anatomy and could enhance student learning through increased motivation. These findings provide insight into simulator development and strategies for learning anatomy. Possible explanations and future research directions are discussed.
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Affiliation(s)
- S Hariri
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
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28
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Abbasi HR, Grzeszczuk R, Chin S, Fahrig R, Holz H, Hariri S, Kim D, Adler J, Shahidi R. Clinical fluoroscopic fiducial-based registration of the vertebral body in spinal neuronavigation. Stud Health Technol Inform 2001; 81:1-7. [PMID: 11317719] [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: 02/19/2023]
Abstract
We present a system involving a computer-instrumented fluoroscope for the purpose of 3D navigation and guidance using pre-operative diagnostic scans as a reference. The goal of the project is to devise a computer-assisted tool that will improve the accuracy, reduce risk, minimize the invasiveness, and shorten the time it takes to perform a variety of neurosurgical and orthopedic procedures of the spine. For this purpose we propose an apparatus that will track surgical tools and localize them with respect to the patient's 3D anatomy and pre-operative 3D diagnostic scans using intraoperative fluoroscopy for in situ registration and embedded fiducials. Preliminary studies have found a fiducial registration error (FRE) of 1.41 mm and a Target Localization Error (TLE) of 0.48 mm. The resulting system leverages equipment already commonly available in the operating room (OR), providing an important new functionality that is free of many current limitations, while keeping costs contained.
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Affiliation(s)
- H R Abbasi
- Image Guidance Laboratories, Stanford University, USA
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29
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Abbasi HR, Hariri S, Martin D, Risinger M, Heit G. Neuronavigational epilepsy focus mapping. Stud Health Technol Inform 2001; 81:8-10. [PMID: 11317822] [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: 02/19/2023]
Abstract
The localization of a seizure focus for resective surgery often requires invasive monitoring for precise localization of the target as well as structures to avoid. We report on the use of intra-operative surgical navigation to precisely localize and co-register subdural electrodes to regions of know radiographic pathology. Additionally, the navigation system was used to develop intra-operative electrode maps. These maps were subsequently used in the sub-acute recording phase to assign electrographic pathology and function (e.g. speech) to a specific cortical surface anatomy. This permitted for more precise planning of surgery and better assessment of potential risk, based on functional as well as anatomical criterion.
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Affiliation(s)
- H R Abbasi
- Department of Neurosurgery, Stanford University Medical Center, USA
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30
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Abbasi HR, Hariri S, Martin D, Shahidi R. A comparative statistical analysis of neuronavigation systems in a clinical setting. Stud Health Technol Inform 2001; 81:11-7. [PMID: 11317722] [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: 02/19/2023]
Abstract
The use of neuronavigation (NN) in neurosurgery has become ubiquitous. A growing number of neurosurgeons are utilizing NN for a wide variety of purposes, including optimizing the surgical approach (macrosurgery) and locating small areas of interest (microsurgery). The goal of our team is to apply rapid advances in hardware and software technology to the field of NN, challenging and ultimately updating current NN assumptions. To identify possible areas in which new technology may improve the surgical applications of NN, we have assessed the accuracy of neuronavigational measurements in the Radionics and BrainLab systems. Using a phantom skull, we measured how accurate the visualization of a navigational probe's tip was in these systems, taking a total of 2180 measurements. We found that, despite current NN tenets, error is maximal at the six marker count and minimal in the spreaded marker setting; that is, placing less markers around the area of interest maximizes accuracy and active tracking does not necessarily increase accuracy. Comparing the two systems, we also found that accuracy of NN machines differs both overall and in different axes. As researchers continue to apply technological advances to the NN field, an increasing number of currently held tenets will be revised, making NN an even more useful tool in neurosurgery.
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Affiliation(s)
- H R Abbasi
- Department of Neurosurgery-Stanford University, Pasteur Dr. 300-R S008, Stanford, CA 94305, USA 300
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31
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Hariri S, Abbasi HR, Chin S, Steinberg G, Shahidi R. Quantification of the gravity-dependent change in the C-arm image center for image compensation in fluoroscopic spinal neuronavigation. Stud Health Technol Inform 2001; 81:177-9. [PMID: 11317734] [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: 04/16/2023]
Abstract
In the quest to develop a viable, frameless spinal navigation system, many researchers are utilizing the C-arm fluoroscope. However, there is a significant problem with the C-arm that must be quantified: the gravity-dependent sag effect resulting from the geometry of the C-arm and aggravated by the inequity of weight at each end of the C-arm. This study quantified the C-arm sag effect, giving researchers the protocol and data needed to develop a program that accounts for this distortion. The development of spinal navigation algorithms that account for the C-arm sag effect should produce a more accurate spinal navigation system.
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Affiliation(s)
- S Hariri
- Image Guidance Laboratory, Department of Neurosurgery, Stanford School of Medicine, USA
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Abstract
In the last 7 years, 18 patients with large alopecia (approximately one-third of hair-bearing scalp) were treated with 31 tissue expansion procedures. In the previous 44 patients, with various degrees of alopecia treated with conventional tissue expansion technique, the major complication rates were as high as reported in the relevant literature. The clinical experience gained with these cases led us to make some modifications in the surgical technique. We applied some simple surgical maneuvers and Z-plasties to the last 18 cases with large alopecia. The major complication rate of 3.2% observed in this study is comparable to the lower complication rates of 6-12% reported in the literature for different degrees of alopecia. We believe that these simple modifications and meticulous approach improve the results of conventional treatment of alopecia with tissue expansion and flap. In this paper, details of the insertion technique and reconstructive procedures and their relevance to the success rate of the aesthetic treatment of the large alopecia are discussed.
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Abstract
Endoscopic surgical approaches for chronic frontal sinusitis require the reestablishment of adequate frontal sinus ventilation and drainage for relief of symptoms. After the resection of anterior ethmoid mucosal disease and cellular structure, the anterior to posterior depth of the nasofrontal beak to the base of skull at the insertion of the ethmoidal bulla (frontal sinus ostium) often represents a critical margin for functional success. However, little information concerning this dimension is available. Depending on intraoperative surgical judgment of this distance, extended endoscopic surgical procedures involving additional bone resection may be indicated. These approaches may be hazardous due to the proximity of the cranial cavity and orbit. In addition, secondary stenosis can result from the subsequent inflammatory response. Improved CT imaging, high resolution sagittal reformatting, and computer workstations provide the ability to obtain direct preoperative measurements of the frontal recess. We used a paramedian sagittal section and recorded the maximal anterior to posterior depth from the nasofrontal beak to the base of skull at the insertion of the ethmoidal bulla in 20 patients, 31 sides, undergoing primary endoscopic frontoethmoidectomy. In addition, we found a positive correlation between this distance and agger nasi air cell size measured in the same 31 sides.
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Affiliation(s)
- J B Jacobs
- Department of Otolaryngology, New York University School of Medicine, NY 10016, USA
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