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Cohet M, De Runz A, Remen T, Brix M, Simon E. [Factors influencing drainage productivity in breast reduction: A retrospective study of 222 breasts]. ANN CHIR PLAST ESTH 2020; 66:144-150. [PMID: 32690427 DOI: 10.1016/j.anplas.2020.06.003] [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: 07/24/2019] [Revised: 05/29/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The objective of this study is to highlight the factors that influence drain productivity in reduction mastoplasty. MATERIALS AND METHODS We have retrospectively referenced from November 2015 to November 2017 all breast reduction performed in the plastic surgery, reconstructive and esthetic surgery department of the University Hospital of Nancy. A total of 222 breasts were analyzed by listing age, weight, height, Body Mass Index (BMI), smoking status, surgeon, technical used, hospitalization stay, breast volume removed, type and size of drain and their productivity. Multivariate analysis were realised. RESULTS 118 patients were included with an average age of 42.2 years. The average productivity of drains was 50 millilitres (ml). There was a significant difference in productivity of drainage according to the operator with a median ranging from 10ml to 60ml (P<0.0001). The median was 20ml for 10 Redon-Jost drains versus 50ml for the 16 Redon-Jost drains (P<0.0001). Multivariate analysis of the various factors influencing the total productivity of postoperative drainage showed a relative risk of 1.16 for smokers, 0.24 for one surgeon, 1.68 for the Skoog technique, and 1.000 for breast volume removed. CONCLUSION The drain productivity is not predictable before a breast reduction. Indeed, none of the characteristics studied have sufficient influence on the productivity of the drains.
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Affiliation(s)
- M Cohet
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - A De Runz
- Service de chirurgie esthétique, plastique et reconstructrice, 97, rue Claude-Bernard, 57070 Metz, France.
| | - T Remen
- Service de la PARC, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - M Brix
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - E Simon
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
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Kopp Q, Montoya D, Brix M, Dautel G, Simon E. [Analysis of microsurgical reconstruction activity in a university hospital: A 14-year historical cohort]. ANN CHIR PLAST ESTH 2019; 64:311-319. [PMID: 31047765 DOI: 10.1016/j.anplas.2019.03.005] [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: 01/27/2019] [Accepted: 03/14/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Each university hospital has its own specificities in microsurgical reconstructions. Activities may focus on breast reconstruction, ENT reconstruction or traumatic substance loss. This study analyzes the specificities at the University Hospital of Nancy, studies the indications, the operating data and the failure rates. METHOD We realized a historical cohort of microsurgical reconstructions at Nancy University Hospital from January 1, 2004 to December 31, 2017. All free flaps were included and analyzed. RESULTS A total of 359 free flaps were made. The failure rate was 9.47%. Forty eight different operators have been identified. Substance losses were essentially traumatic (56.8%). A total of 20 different flaps were use with 49% bone reconstruction. The fibula flap was the first flap used (26.5%). Arterial anastomoses were performed in termino-lateral in 44% and venous anastomoses were single in 70.5%. High BMI, diabetes, high blood pressure, atherosclerosis, and arterial or venous graft were identified as risk factors for failure (P<0.05). The smoking and the realisation of the intervention by a young operator have no impact on the success rate. CONCLUSION Our specificity is the bone reconstruction which represents a significant part of our activity. In the university center, the number of etiology of substance losses, operator and flap used is important but it still allows to obtain results in adequacy with the literature.
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Affiliation(s)
- Q Kopp
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France.
| | - D Montoya
- Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France
| | - M Brix
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France
| | - G Dautel
- Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France
| | - E Simon
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France
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Chan H, Cougnard-Grégoire A, Korobelnik JF, Delyfer MN, Touboul D, Coste V, Sarlangue J, Dutheil C, Paya C. Screening for retinopathy of prematurity by telemedicine in a tertiary level neonatal intensive care unit in France: Review of a six-year period. J Fr Ophtalmol 2018; 41:926-932. [PMID: 30442486 DOI: 10.1016/j.jfo.2018.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/16/2017] [Revised: 02/17/2018] [Accepted: 02/28/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To analyze the prevalence and risk factors for retinopathy of prematurity (ROP) and severe (treatment-requiring) ROP. METHODS A retrospective study was conducted in a level III neonatal unit in Bordeaux, France, from 2009 to 2015. Four hundred and nineteen preterm infants who were screened for ROP exclusively by RetCam were included. RESULTS ROP of any degree was diagnosed in 27.68% of infants. Stages 1, 2, 3 and 4 ROP was found in 44%, 46%, 9% and 1% of subjects, respectively. No stage 5 ROP was observed. 28/419 infants (6.6%) were treated exclusively with laser photocoagulation. No intravitreal anti-VEGF injections or surgical treatments were performed. No infants born at>31 weeks or with BW>1110g required ROP treatment. On multivariate analysis, risk factors for ROP development were low birth weight, low gestational age at birth, high duration of invasive mechanical ventilation, shock or use of vasopressors. On multivariate analysis, risk factors for severe, treatment-requiring ROP were male gender, gestational age≤27 weeks and Apgar score at 5minutes≤7. CONCLUSION In our 6-year series, ROP was successfully identified on screening exclusively by telemedicine, and no surgical treatment was required. This study identifies known ROP risk factors, but the Apgar score at 5minutes as a risk factor for severe ROP requires further studies in order to be confirmed.
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Affiliation(s)
- H Chan
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France.
| | - A Cougnard-Grégoire
- Inserm (institut national de la santé et de la recherche médicale), U897-épidemiologie-biostatistique, Bordeaux, France
| | - J F Korobelnik
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France; Inserm (institut national de la santé et de la recherche médicale), U897-épidemiologie-biostatistique, Bordeaux, France
| | - M N Delyfer
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France; Inserm (institut national de la santé et de la recherche médicale), U897-épidemiologie-biostatistique, Bordeaux, France
| | - D Touboul
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - V Coste
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - J Sarlangue
- Service de néonatologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - C Dutheil
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France; Université de Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - C Paya
- Service d'ophtalmologie, centre hospitalier universitaire (CHU de Bordeaux), place Amélie-Raba-Léon, 33000 Bordeaux, France.
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Berger V, Germain C, Lacomère R, Bader C, Gerbouin O, Bénard A. [Consensus approach: Prior to the construction of an evaluation scale of risk constipation patients hospitalized for nursing practice]. Rev Epidemiol Sante Publique 2018; 66:301-309. [PMID: 30181005 DOI: 10.1016/j.respe.2018.07.002] [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] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/16/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Constipation is a frequent issue during hospitalization. Multiple causes such as the existence of irregular habits, lack of exercise as well as medical history have been identified. Drugs such as strong painkillers, central nervous system therapies and treatments of the digestive tract are a major cause of constipation. Additionally, unbalanced diet, fluid deficiency, and anxiety may aggravate constipation. The consideration of all these risk factors being under the responsibility of nurses. The difficulty to take into account such a multifactorial aetiology in nursing practice and the fact that there is no easy to use and validated tool to assess the risk of constipation in current nurse practice has led us to consider the development of a Risk Assessment scale of Constipation in Patient Hospitalized (ERCoPH) to facilitate preventive management of this trouble. We present here the first step of the elaboration of this scale, the identification of risk factors through a consensus approach after a systematic literature review. METHODS The key informants consensus-based approach proposed by Pineault and Daveluy is based on five steps: (1) a literature review to identify risk factors for constipation; (2) the elaboration of a questionnaire containing the factors identified in the first step; (3) pre-select a panel of experts; (4) submission the questionnaire to the panel; (5) analysis the results of the consensus survey. Only factors that received a rating>6 by at least 80 % of the experts were retained. RESULTS The systematic literature review identified 69 risk factors submitted to the 23 experts of the panel. Fifteen risk factors were retained after analyzing the answers of the experts. The Scientific Committee added eight risk factors because of their importance in the literature and decided to group together some factors of the same domain. CONCLUSION A total of 19 risk factors were selected and grouped by major class (age, physical activity, medication, social data, food/hydration, medical and surgical history and environmental data). These factors have been tested among 300 patients enrolled in different clinical settings as part of the construction and validation of ERCoPH.
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Affiliation(s)
- V Berger
- Direction des soins, CHU de Bordeaux, Place Amélie Rabat Léon, 33000 Bordeaux, France.
| | - C Germain
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
| | - R Lacomère
- Direction de la recherche clinique et de l'innovation, CHU de Bordeaux, 33000 Bordeaux, France
| | - C Bader
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
| | - O Gerbouin
- Pôle des produits de santé, CHU de de Bordeaux, 33000 Bordeaux, France
| | - A Bénard
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
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Pascal S, Philandrianos C, Bertrand B, Bardot J, Degardin N, Casanova D. [The complications of skin expansion in paediatrics: Diagnostic, taking over and prevention]. ANN CHIR PLAST ESTH 2016; 61:750-763. [PMID: 27289549 DOI: 10.1016/j.anplas.2016.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/25/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
Abstract
Skin expansion is a difficult and long process in which can occur more or less serious complications. Overall complications rates describe in the literature vary between 13 and 37%. We can categorize them in major complications, which can lead to a failure maybe even an aggravation of the anterior status, and in minor complications that do not compromise the expansion process but can alter it. The main major complications are infection, skin suffering and necrosis which can lead to prosthesis exposition, leaks and technical problems with equipment dysfunctions that may cause difficulties or a failure of the inflations. The main minor complications are hematomas, seromas, valve or tube exposition, pains with paraesthesias caused by neighbouring organs compression, pathologic and unsightly scares and can lead to an important psychological impact. These complications can be due to a precarious skin's state, a material dysfunction or unpredictable technical problems but also by an inappropriate preoperative indication or planning. The emerging of a complication, however, is not synonymous to a failure of the procedure; a satisfactory reconstruction may still be obtained in 75% of all cases. The purpose of this article is to help to identify the situations at risk of complications in order to prevent, detect and treat them early.
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Affiliation(s)
- S Pascal
- Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - C Philandrianos
- Chirurgie plastique reconstructrice et esthétique, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
| | - B Bertrand
- Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J Bardot
- Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - N Degardin
- Chirurgie plastique pédiatrique, hôpital de la Timone Enfants, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - D Casanova
- Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
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Baggio S, Mohler-Kuo M, Dupuis M, Henchoz Y, Studer J, N'Goran AA, Gmel G. Substance use capital: Social resources enhancing youth substance use. Rev Epidemiol Sante Publique 2016; 64:255-62. [PMID: 27594693 DOI: 10.1016/j.respe.2016.01.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/02/2014] [Revised: 01/04/2016] [Accepted: 01/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Social capital is described as a protective factor against youth substance use, but it may also be associated with behaviours that do not enhance health. The present study hypothesized that 'substance use capital', i.e. resources favourable to substance use, is a risk factor for substance use and misuse. METHODS We used baseline data from the ongoing Cohort Study on Substance Use Risk Factors (C-SURF) that included a representative sample of young Swiss men (n=5623). Substance use (alcohol, cannabis, 15 illicit drugs, lifetime use, hazardous use and dependence), substance use capital (parental and peer attitudes towards substance use, parental and peer drug use, perceived norms of substance use) and aspects of social capital (relationships with parents and peers) were assessed. Logistic regressions were used to examine the associations between substance-related resources and social resources, and substance use. RESULTS Results showed that substance-related resources were associated with an increased risk of substance use (OR between 1.25 and 4.67), whereas social resources' associations with substance use were commonly protective but weaker than substance-related resources. Thus, a drug-friendly environment facilitated substance use and misuse. Moreover, the results showed that peer environments were more drug-friendly than familial environments. CONCLUSION In conclusion, this study highlighted a concept of 'substance use capital', which may be useful for advancing both theoretical and applied knowledge of substance use. Indeed, substance use is not only associated with a lack of social resources, but also with specific drug-friendly social resources coming from environment and background.
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Affiliation(s)
- S Baggio
- University of Lausanne, Geopolis building, 1015 Lausanne, Switzerland; Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - M Mohler-Kuo
- Institute of social and preventive medicine, university of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - M Dupuis
- University of Lausanne, Geopolis building, 1015 Lausanne, Switzerland.
| | - Y Henchoz
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - J Studer
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - A A N'Goran
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - G Gmel
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland; Addiction Switzerland, Case postale 870, 1001 Lausanne, Switzerland; Centre for addiction and mental health, 250, College street, M5T 1R8 Toronto, Ontario, Canada; University of the West of England, Frenchay Campus, Coldharbour Lane, BS16 1QY Bristol, United Kingdom.
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Messerer L, Bouzbid S, Gourbdji E, Mansouri R, Bachi F. [Seroprevalence of toxoplasmosis in pregnant women in Annaba, Algeria]. Rev Epidemiol Sante Publique 2014; 62:160-5. [PMID: 24661506 DOI: 10.1016/j.respe.2013.11.072] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 09/15/2012] [Revised: 07/25/2013] [Accepted: 11/27/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of the study was to estimate the seroprevalence and risk factors of toxoplasmosis in pregnant women in the department of Annaba, Algeria. METHODS We performed a cross-sectional study with analytical purposes. The study was collaboration between the laboratory of Parasitology-Mycology, Faculty of Medicine of Annaba and Parasite Biology Department at the Pasteur Institute of Algeria. A total of 1028 pregnant women who underwent prenatal diagnosis/visit were included over a period of 4 years from January 2006 to December 2009. Immunoglobulin G and M were assayed, using the microparticle enzyme method. The avidity test was used to determine the date of contamination according to age of pregnancy. Search for the parasite was made by inoculation of the placenta and cord blood in white mice. The study compared mother-to-child serological profiles using Western Blot (WB) IgG and IgM. Direct (not well-cooked meat) and indirect (presence of cat, gardening) indicators were recorded to search for parasite exposure. RESULTS Seroprevalence was 47.8 % (95 % CI: 44.8 to 51.0) and the rate of active toxoplasmosis was 1.1 % (95 % CI 0.6 to 1.8). According to their immune status, this was the first serology for 41 % (CI95 %: 38.0-44.0) of women; 12 % (CI95 %: 10.5-14.6) of primiparous women had only one serology test during their entire pregnancy. Major risk factors were consumption of poorly-cooked meat and exposure to cats. CONCLUSION Toxoplasmosis during pregnancy is a serious issue and an effective prevention program is needed.
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Affiliation(s)
- L Messerer
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie.
| | - S Bouzbid
- Service d'épidémiologie et de médecine préventive, CHU d'Annaba, Annaba, Algérie
| | - E Gourbdji
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
| | - R Mansouri
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie
| | - F Bachi
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
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