Maurice, P; Garel, J; Garel, C; Dhombres, F; Friszer, S; Guilbaud, L; Maisonneuve, E; Pointe, H Ducou Le; Blondiaux, E; Jouannic, J-M
In: BJOG, vol. 128, no. 2, pp. 376–383, 2021, ISSN: 1471-0528.
@article{pmid32112473,
title = {New insights in cerebral findings associated with fetal myelomeningocele: a retrospective cohort study in a single tertiary centre},
author = {P Maurice and J Garel and C Garel and F Dhombres and S Friszer and L Guilbaud and E Maisonneuve and H Ducou Le Pointe and E Blondiaux and J-M Jouannic},
doi = {10.1111/1471-0528.16185},
issn = {1471-0528},
year = {2021},
date = {2021-01-01},
journal = {BJOG},
volume = {128},
number = {2},
pages = {376--383},
abstract = {OBJECTIVE: To investigate cerebral anomalies other than Chiari type 2 malformation in fetuses with myelomeningocele (MMC).nnDESIGN: A retrospective cohort study in a single tertiary centre.nnSETTING: A review of associated cerebral anomalies in cases with prenatal diagnosis of myelomeningocele.nnPOPULATION: Seventy cases of fetal myelomeningocele.nnMETHODS: Ultrasound and MRI images were blindly reviewed. Postnatal imaging and results of the postmortem results were also reviewed. The association between cerebral anomalies and the following ultrasound findings was measured: level of the defect, ventriculomegaly, microcephaly and fetal talipes.nnMAIN OUTCOME MEASURES: A microcephaly was observed in 32/70 cases (46%) and a ventriculomegaly was observed in 39/70 cases (56%). Other cerebral anomalies were diagnosed in 47/70 (67%).nnRESULTS: Other cerebral anomalies were represented by 42/70 cases with abnormal CC (60%), 8/70 cases with perinodular heterotopia (PNH; 11%), 2/70 cases with abnormal gyration (3%). MRI performed only in fetal surgery cases confirmed the ulltrasound findings in all cases and provided additional findings in two cases (PNH). Risk ratios of fetal cerebral anomalies associated with MMC did not reach significance for microcephaly, ventriculomegaly, talipes or the level of the defect There was an overall good correlation between pre- and postnatal findings with a Kappa value of 0.79 [95% CI 0.57-1] and 82% agreement.nnCONCLUSION: Fetal brain anomalies other than Chiari type 2 malformation are frequently observed in fetuses with myelomeningocele, predominantly represented by CC anomalies. Whether these associated cerebral anomalies have an impact on selecting cases eligible for fetal surgery needs further evaluation.nnTWEETABLE ABSTRACT: Fetal cerebral anomalies other than Chiari type 2 malformation, microcephaly, and ventriculomegaly may be associated with MMC in up to 67% of the cases.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To investigate cerebral anomalies other than Chiari type 2 malformation in fetuses with myelomeningocele (MMC).nnDESIGN: A retrospective cohort study in a single tertiary centre.nnSETTING: A review of associated cerebral anomalies in cases with prenatal diagnosis of myelomeningocele.nnPOPULATION: Seventy cases of fetal myelomeningocele.nnMETHODS: Ultrasound and MRI images were blindly reviewed. Postnatal imaging and results of the postmortem results were also reviewed. The association between cerebral anomalies and the following ultrasound findings was measured: level of the defect, ventriculomegaly, microcephaly and fetal talipes.nnMAIN OUTCOME MEASURES: A microcephaly was observed in 32/70 cases (46%) and a ventriculomegaly was observed in 39/70 cases (56%). Other cerebral anomalies were diagnosed in 47/70 (67%).nnRESULTS: Other cerebral anomalies were represented by 42/70 cases with abnormal CC (60%), 8/70 cases with perinodular heterotopia (PNH; 11%), 2/70 cases with abnormal gyration (3%). MRI performed only in fetal surgery cases confirmed the ulltrasound findings in all cases and provided additional findings in two cases (PNH). Risk ratios of fetal cerebral anomalies associated with MMC did not reach significance for microcephaly, ventriculomegaly, talipes or the level of the defect There was an overall good correlation between pre- and postnatal findings with a Kappa value of 0.79 [95% CI 0.57-1] and 82% agreement.nnCONCLUSION: Fetal brain anomalies other than Chiari type 2 malformation are frequently observed in fetuses with myelomeningocele, predominantly represented by CC anomalies. Whether these associated cerebral anomalies have an impact on selecting cases eligible for fetal surgery needs further evaluation.nnTWEETABLE ABSTRACT: Fetal cerebral anomalies other than Chiari type 2 malformation, microcephaly, and ventriculomegaly may be associated with MMC in up to 67% of the cases.
Cell therapy for prenatal repair of myelomeningocele: A systematic review
Dugas, A; Larghero, J; Zérah, M; Jouannic, J M; Guilbaud, L
In: Curr Res Transl Med, vol. 68, no. 4, pp. 183–189, 2020, ISSN: 2452-3186.
@article{pmid32624428,
title = {Cell therapy for prenatal repair of myelomeningocele: A systematic review},
author = {A Dugas and J Larghero and M Zérah and J M Jouannic and L Guilbaud},
doi = {10.1016/j.retram.2020.04.004},
issn = {2452-3186},
year = {2020},
date = {2020-11-01},
journal = {Curr Res Transl Med},
volume = {68},
number = {4},
pages = {183--189},
abstract = {Myelomeningocele (MMC) is a spinal cord congenital defect that leads to paraplegia, bladder incontinence and bowel dysfunction. A randomized human trial demonstrated that in utero surgical repair of the MMC defect improves lower limb motor function. However, functional recovery remains incomplete. Stem cell therapy has recently generated great interest in the field of prenatal repair of MMC. In this systematic review we attempt to provide an overview of the current application of stem cells in different animal models of MMC. Publications were retrieved from PubMed and Cochrane Library databases. This process yielded twenty-two studies for inclusion in this review, experimenting five different types of stem cells: human embryonic stem cells, neural stem cells, induced pluripotent stem cells, human amniotic fluid stem cells, and mesenchymal stem cells (MSCs). Rodents and ovine were the two major species used for animal model studies. The source, the aims, and the main results were analyzed. Stem cell therapy appears to be a promising candidate for prenatal repair of MMC, especially MSCs. Further explorations in ovine and rodent models, reporting clinical and functional results, are necessary before an application in humans.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Myelomeningocele (MMC) is a spinal cord congenital defect that leads to paraplegia, bladder incontinence and bowel dysfunction. A randomized human trial demonstrated that in utero surgical repair of the MMC defect improves lower limb motor function. However, functional recovery remains incomplete. Stem cell therapy has recently generated great interest in the field of prenatal repair of MMC. In this systematic review we attempt to provide an overview of the current application of stem cells in different animal models of MMC. Publications were retrieved from PubMed and Cochrane Library databases. This process yielded twenty-two studies for inclusion in this review, experimenting five different types of stem cells: human embryonic stem cells, neural stem cells, induced pluripotent stem cells, human amniotic fluid stem cells, and mesenchymal stem cells (MSCs). Rodents and ovine were the two major species used for animal model studies. The source, the aims, and the main results were analyzed. Stem cell therapy appears to be a promising candidate for prenatal repair of MMC, especially MSCs. Further explorations in ovine and rodent models, reporting clinical and functional results, are necessary before an application in humans.
Cassart, Marie; Garel, Catherine
In: Pediatr Radiol, vol. 50, no. 12, pp. 1794–1798, 2020, ISSN: 1432-1998.
@article{pmid32556810,
title = {European overview of current practice of fetal imaging by pediatric radiologists: a new task force is launched},
author = {Marie Cassart and Catherine Garel},
doi = {10.1007/s00247-020-04710-4},
issn = {1432-1998},
year = {2020},
date = {2020-11-01},
journal = {Pediatr Radiol},
volume = {50},
number = {12},
pages = {1794--1798},
abstract = {A new task force dedicated to prenatal imaging was created in 2018 by the European Society of Pediatric Radiology. In order to establish a network of European prenatal imaging practice, we sent a questionnaire to radiologists practicing prenatal imaging in Europe. The questions were related to the type of institution, the local legislation for termination of pregnancy, the type of imaging modality and the following items regarding magnetic resonance imaging (MRI): magnetic field, gestational age at which it is performed, use of maternal sedation, number of examinations per year, proportion of cerebral versus body indications and proportion of repeated examinations. We collected responses from 20 European countries, 52 cities and 67 institutions (82% public). In most countries, the upper gestational age limit for termination of pregnancy is 24 weeks of gestation. In some countries, it is earlier and in other countries, there is no limit. Very few radiologists practice fetal ultrasonography and computed tomography. In some countries, fetal MRI is mainly performed before 24 weeks of pregnancy, while in others, it is mainly performed in the third trimester. Neurological indications are by far predominant and 30% of the institutions have access to a 3-tesla (T) unit for fetal MRI. Maternal sedation is rarely used. The number of scans per year is highly variable with an average of 140, which is not necessarily correlated to the size of the population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A new task force dedicated to prenatal imaging was created in 2018 by the European Society of Pediatric Radiology. In order to establish a network of European prenatal imaging practice, we sent a questionnaire to radiologists practicing prenatal imaging in Europe. The questions were related to the type of institution, the local legislation for termination of pregnancy, the type of imaging modality and the following items regarding magnetic resonance imaging (MRI): magnetic field, gestational age at which it is performed, use of maternal sedation, number of examinations per year, proportion of cerebral versus body indications and proportion of repeated examinations. We collected responses from 20 European countries, 52 cities and 67 institutions (82% public). In most countries, the upper gestational age limit for termination of pregnancy is 24 weeks of gestation. In some countries, it is earlier and in other countries, there is no limit. Very few radiologists practice fetal ultrasonography and computed tomography. In some countries, fetal MRI is mainly performed before 24 weeks of pregnancy, while in others, it is mainly performed in the third trimester. Neurological indications are by far predominant and 30% of the institutions have access to a 3-tesla (T) unit for fetal MRI. Maternal sedation is rarely used. The number of scans per year is highly variable with an average of 140, which is not necessarily correlated to the size of the population.
Prevention of Neural Tube Defects by Folic Acid Supplementation: A National Population-Based Study
de la Fournière, Benoît; Dhombres, Ferdinand; Maurice, Paul; de Foucaud, Sabine; Lallemant, Pauline; Zérah, Michel; Guilbaud, Lucie; Jouannic, Jean-Marie
In: Nutrients, vol. 12, no. 10, 2020, ISSN: 2072-6643.
@article{pmid33081287,
title = {Prevention of Neural Tube Defects by Folic Acid Supplementation: A National Population-Based Study},
author = {Benoît de la Fournière and Ferdinand Dhombres and Paul Maurice and Sabine de Foucaud and Pauline Lallemant and Michel Zérah and Lucie Guilbaud and Jean-Marie Jouannic},
doi = {10.3390/nu12103170},
issn = {2072-6643},
year = {2020},
date = {2020-10-01},
journal = {Nutrients},
volume = {12},
number = {10},
abstract = {Folic acid supplementation is recommended for neural tube defect prevention during pregnancy. We conducted an observational, retrospective national registry study to determine the rate of dispensing of periconceptional folic acid after prescription in a sample of French women representative of the general population. Our study population ( = 186,061) was a representative sample of the French population, recorded in the Health Data System database on pharmacy dispensing of medication and mandatory reporting of pregnancy. Between 2006 and 2016, 14.3% of pregnant women had a prescription for folic acid supplementation during the month preceding conception and for the first 12 weeks of pregnancy. Of these prescriptions, 30.9% were issued before the start of pregnancy. This percentage was lower for first pregnancies. The rate of pharmacy dispensing during the preconception period increased progressively from 3.8% to 8.3% between 2006 and 2016. In France, the rate of pharmacy dispensing of periconceptional folic acid after medical prescription is very low and does not follow international recommendations. It seems essential to implement awareness-raising policies targeting the general population and physicians regarding effective periconceptional supplementation, particularly starting in the preconception period. Clarification of international recommendations and fortification of flour could improve the efficacy of folate supplementation at population level.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Folic acid supplementation is recommended for neural tube defect prevention during pregnancy. We conducted an observational, retrospective national registry study to determine the rate of dispensing of periconceptional folic acid after prescription in a sample of French women representative of the general population. Our study population ( = 186,061) was a representative sample of the French population, recorded in the Health Data System database on pharmacy dispensing of medication and mandatory reporting of pregnancy. Between 2006 and 2016, 14.3% of pregnant women had a prescription for folic acid supplementation during the month preceding conception and for the first 12 weeks of pregnancy. Of these prescriptions, 30.9% were issued before the start of pregnancy. This percentage was lower for first pregnancies. The rate of pharmacy dispensing during the preconception period increased progressively from 3.8% to 8.3% between 2006 and 2016. In France, the rate of pharmacy dispensing of periconceptional folic acid after medical prescription is very low and does not follow international recommendations. It seems essential to implement awareness-raising policies targeting the general population and physicians regarding effective periconceptional supplementation, particularly starting in the preconception period. Clarification of international recommendations and fortification of flour could improve the efficacy of folate supplementation at population level.
Gaume, M; Pietton, R; Vialle, R; Chaves, C; Langlais, T
In: Arch Pediatr, vol. 27, no. 6, pp. 333–337, 2020, ISSN: 1769-664X.
@article{pmid32563619,
title = {Is daily walking distance affected in adolescent idiopathic scoliosis? An original prospective study using the pedometer on smartphones},
author = {M Gaume and R Pietton and R Vialle and C Chaves and T Langlais},
doi = {10.1016/j.arcped.2020.04.002},
issn = {1769-664X},
year = {2020},
date = {2020-08-01},
journal = {Arch Pediatr},
volume = {27},
number = {6},
pages = {333--337},
abstract = {BACKGROUND DATA: Little is known about daily walking distance levels, which accounts for approximately 80% of overall physical activity per day, in adolescents with idiopathic scoliosis (AIS).nnOBJECTIVE: The aim of this study was to assess the level of walking distance in AIS treated by bracing or not, comparing this activity with that of a control group. We used an original method based on smartphone pedometers for studying walking distance in everyday life.nnMETHODS: Nineteen AIS patients, aged 14.1 (13-17) years, and 25 asymptomatic patients, aged 12.9 (12-14) years were included prospectively. The 19 AIS cases comprised 9 untreated individuals and 10 with ongoing night brace treatment. The mean walking distance per day as estimated by the pedometer application on smartphones for 2 months was assessed. Weekly sports activities (hours per week) were also reported.nnRESULTS: During the first month, the mean walking distance was 2.58±0.65 km/day for control patients, 2.31±1.38 km/day for untreated AIS, and 3.65±0.72 km/day for AIS patients treated with a night brace. During the second month, the mean walking distance was 2.60±0.73 km/day for control patients, 2.40±1.41 km/day for untreated AIS, and 3.70±0.72 km/day for AIS patients treated with a night brace. Statistical analysis between groups showed a statistically significant difference with a higher level of daily walking distance in adolescents treated with a night brace compared with other groups.nnCONCLUSION: The pedometer on smartphones is a cost-effective and friendly tool to assess adolescents' level of walking distance. Our results indicate no restriction in terms of daily walking distance between adolescents without scoliosis and those with idiopathic scoliosis.nnLEVEL OF EVIDENCE: Level II.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND DATA: Little is known about daily walking distance levels, which accounts for approximately 80% of overall physical activity per day, in adolescents with idiopathic scoliosis (AIS).nnOBJECTIVE: The aim of this study was to assess the level of walking distance in AIS treated by bracing or not, comparing this activity with that of a control group. We used an original method based on smartphone pedometers for studying walking distance in everyday life.nnMETHODS: Nineteen AIS patients, aged 14.1 (13-17) years, and 25 asymptomatic patients, aged 12.9 (12-14) years were included prospectively. The 19 AIS cases comprised 9 untreated individuals and 10 with ongoing night brace treatment. The mean walking distance per day as estimated by the pedometer application on smartphones for 2 months was assessed. Weekly sports activities (hours per week) were also reported.nnRESULTS: During the first month, the mean walking distance was 2.58±0.65 km/day for control patients, 2.31±1.38 km/day for untreated AIS, and 3.65±0.72 km/day for AIS patients treated with a night brace. During the second month, the mean walking distance was 2.60±0.73 km/day for control patients, 2.40±1.41 km/day for untreated AIS, and 3.70±0.72 km/day for AIS patients treated with a night brace. Statistical analysis between groups showed a statistically significant difference with a higher level of daily walking distance in adolescents treated with a night brace compared with other groups.nnCONCLUSION: The pedometer on smartphones is a cost-effective and friendly tool to assess adolescents’ level of walking distance. Our results indicate no restriction in terms of daily walking distance between adolescents without scoliosis and those with idiopathic scoliosis.nnLEVEL OF EVIDENCE: Level II.
Ferrier, Clément; Khoshnood, Babak; Dhombres, Ferdinand; Randrianaivo, Hanitra; Perthus, Isabelle; Jouannic, Jean-Marie; Durand-Zaleski, Isabelle
In: BMJ Open, vol. 10, no. 7, pp. e036566, 2020, ISSN: 2044-6055.
@article{pmid32690745,
title = {Cost and outcomes of the ultrasound screening program for birth defects over time: a population-based study in France},
author = {Clément Ferrier and Babak Khoshnood and Ferdinand Dhombres and Hanitra Randrianaivo and Isabelle Perthus and Jean-Marie Jouannic and Isabelle Durand-Zaleski},
doi = {10.1136/bmjopen-2019-036566},
issn = {2044-6055},
year = {2020},
date = {2020-07-01},
journal = {BMJ Open},
volume = {10},
number = {7},
pages = {e036566},
abstract = {OBJECTIVE: To assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.nnDESIGN: A population-based study.nnSETTING: National Public Health Insurance claim database.nnPARTICIPANTS: All pregnant women in the 'Echantillon Généraliste des Bénéficiaires', a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.nnMAIN OUTCOMES MEASURES: Trends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down's syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.nnRESULTS: During the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.nnCONCLUSION: Even if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.nnDESIGN: A population-based study.nnSETTING: National Public Health Insurance claim database.nnPARTICIPANTS: All pregnant women in the ‘Echantillon Généraliste des Bénéficiaires’, a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.nnMAIN OUTCOMES MEASURES: Trends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down’s syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.nnRESULTS: During the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.nnCONCLUSION: Even if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.
Stepwise Management of Severe Thoracogenic Scoliosis in Burned Child
Langlais, Tristan; Pietton, Raphaël; Laurent, Romain; Cassier, Sophie; Constant, Isabelle; Mimoun, Maurice; Vialle, Raphaël
2020, ISSN: 1878-8769.
@misc{pmid31870815,
title = {Stepwise Management of Severe Thoracogenic Scoliosis in Burned Child},
author = {Tristan Langlais and Raphaël Pietton and Romain Laurent and Sophie Cassier and Isabelle Constant and Maurice Mimoun and Raphaël Vialle},
doi = {10.1016/j.wneu.2019.12.079},
issn = {1878-8769},
year = {2020},
date = {2020-04-01},
journal = {World Neurosurg},
volume = {136},
pages = {399--402.e2},
abstract = {BACKGROUND: Skin and soft tissue retraction secondary to burns of the trunk may induce severe and progressive thoracogenic spinal deformities in children. Its management is rarely described.nnCASE DESCRIPTION: Our study reports a case of severe thoracic scoliosis in a 13-year-old adolescent, secondary to soft tissue retraction due to trunk burn in early childhood. The Cobb angle of the scoliosis was 100 degrees. The 3-stage surgical strategy consisted of scar excision and skin graft in the first stage, halo gravity traction in the second stage, and posterior correction and fusion of the spine in the third and final stage. The postoperative course was satisfactory, and late follow-up at 1 year showed stable correction of the spine, with satisfactory coronal and sagittal balance and good healing of skin and soft tissues.nnDISCUSSION: While spinal deformities secondary to burns are rare, they require specific, sequential, and multidisciplinary medical and surgical management. Our surgical strategy was to treat skin and soft tissues retractions first and then address spinal deformity. We used halo-gravity traction between the 2 surgical stages to help improve the spine deformity correction while reducing the risk of neurologic complications.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
BACKGROUND: Skin and soft tissue retraction secondary to burns of the trunk may induce severe and progressive thoracogenic spinal deformities in children. Its management is rarely described.nnCASE DESCRIPTION: Our study reports a case of severe thoracic scoliosis in a 13-year-old adolescent, secondary to soft tissue retraction due to trunk burn in early childhood. The Cobb angle of the scoliosis was 100 degrees. The 3-stage surgical strategy consisted of scar excision and skin graft in the first stage, halo gravity traction in the second stage, and posterior correction and fusion of the spine in the third and final stage. The postoperative course was satisfactory, and late follow-up at 1 year showed stable correction of the spine, with satisfactory coronal and sagittal balance and good healing of skin and soft tissues.nnDISCUSSION: While spinal deformities secondary to burns are rare, they require specific, sequential, and multidisciplinary medical and surgical management. Our surgical strategy was to treat skin and soft tissues retractions first and then address spinal deformity. We used halo-gravity traction between the 2 surgical stages to help improve the spine deformity correction while reducing the risk of neurologic complications.
Pietton, Raphael; Bouloussa, Houssam; Vergari, Claudio; Skalli, Wafa; Vialle, Raphael
In: J Pediatr Orthop, vol. 40, no. 1, pp. 36–41, 2020, ISSN: 1539-2570.
@article{pmid31815860,
title = {Rib Cage Measurement Reproducibility Using Biplanar Stereoradiographic 3D Reconstructions in Adolescent Idiopathic Scoliosis},
author = {Raphael Pietton and Houssam Bouloussa and Claudio Vergari and Wafa Skalli and Raphael Vialle},
doi = {10.1097/BPO.0000000000001095},
issn = {1539-2570},
year = {2020},
date = {2020-01-01},
journal = {J Pediatr Orthop},
volume = {40},
number = {1},
pages = {36--41},
abstract = {BACKGROUND: A reproducibility study of preoperative rib cage three-dimensional (3D) measurements was conducted for patients with Adolescent Idiopathic Scoliosis (AIS). No prior reliability study has been performed for preoperative 3D reconstructions of the rib cage by using stereoradiography in patients with preoperative AIS. Our objective was to assess the reliability of rib cage 3D reconstructions using biplanar stereoradiography in patients with AIS before surgery.nnMETHODS: This series includes 21 patients with Lenke 1 or 2 scoliosis (74±20 degrees). All patients underwent low-dose standing biplanar radiographs. Two operators performed reconstructions twice each. Intraoperator repeatability, interoperator reproducibility, and intraclass coefficients (ICC) were calculated and compared between groups.nnRESULTS: The average rib cage volume was 4.71 L (SD±0.75 L). Two SD was 0.19 L with a coefficient of variation of 4.1%; ICC was 0.968. The thoracic index was 0.6 (SD±0.1). Two SD was 0.03 with a coefficient of variation of 4.7% and a ICC of 0.820. As for the Spinal Penetration Index (6.4%; SD±2.4), 2SD was 0.9% with a coefficient of variation of 14.3% and a ICC of 0.901. The 3D rib hump 2SD (average 27±8 degrees) was 1.4 degrees. The coefficient of variation and ICC were respectively 5.1% and 0.991.nnCONCLUSIONS: Three-dimensional reconstruction of the rib cage using biplanar stereoradiography is a reliable method to estimate preoperative thoracic parameters in patients with AIS.nnLEVEL OF EVIDENCE: Level IV-diagnostic study.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: A reproducibility study of preoperative rib cage three-dimensional (3D) measurements was conducted for patients with Adolescent Idiopathic Scoliosis (AIS). No prior reliability study has been performed for preoperative 3D reconstructions of the rib cage by using stereoradiography in patients with preoperative AIS. Our objective was to assess the reliability of rib cage 3D reconstructions using biplanar stereoradiography in patients with AIS before surgery.nnMETHODS: This series includes 21 patients with Lenke 1 or 2 scoliosis (74±20 degrees). All patients underwent low-dose standing biplanar radiographs. Two operators performed reconstructions twice each. Intraoperator repeatability, interoperator reproducibility, and intraclass coefficients (ICC) were calculated and compared between groups.nnRESULTS: The average rib cage volume was 4.71 L (SD±0.75 L). Two SD was 0.19 L with a coefficient of variation of 4.1%; ICC was 0.968. The thoracic index was 0.6 (SD±0.1). Two SD was 0.03 with a coefficient of variation of 4.7% and a ICC of 0.820. As for the Spinal Penetration Index (6.4%; SD±2.4), 2SD was 0.9% with a coefficient of variation of 14.3% and a ICC of 0.901. The 3D rib hump 2SD (average 27±8 degrees) was 1.4 degrees. The coefficient of variation and ICC were respectively 5.1% and 0.991.nnCONCLUSIONS: Three-dimensional reconstruction of the rib cage using biplanar stereoradiography is a reliable method to estimate preoperative thoracic parameters in patients with AIS.nnLEVEL OF EVIDENCE: Level IV-diagnostic study.
Multicentric evaluation of the adherence to Peristeen® transanal irrigation system in children
Lallemant-Dudek, P; Cretolle, C; Hameury, F; Lemelle, J L; Ranke, A; Louis-Borrione, C; Forin, V
In: Ann Phys Rehabil Med, vol. 63, no. 1, pp. 28–32, 2020, ISSN: 1877-0665.
@article{pmid31051275,
title = {Multicentric evaluation of the adherence to Peristeen® transanal irrigation system in children},
author = {P Lallemant-Dudek and C Cretolle and F Hameury and J L Lemelle and A Ranke and C Louis-Borrione and V Forin},
doi = {10.1016/j.rehab.2019.04.003},
issn = {1877-0665},
year = {2020},
date = {2020-01-01},
journal = {Ann Phys Rehabil Med},
volume = {63},
number = {1},
pages = {28--32},
abstract = {BACKGROUND: Since 2009 in France, the Peristeen® transanal irrigation (TAI) device has represented an alternative treatment of faecal incontinence (FI).nnOBJECTIVE: The primary objective of this study was to assess the mid-term adherence to TAI in paediatric patients. The secondary objective was to identify factors determining TAI continuation.nnMETHODS: This observational study conducted in 5 French paediatric centres prospectively reviewed from March to May 2012 all children educated in TAI for at least 9months.nnRESULTS: We included 149 children (mean [SD] age 10.6 [4.1] years) educated in TAI. Children mainly had neurogenic disorders (52.3%) or congenital malformations (30.9%). The main symptoms motivating TAI initiation were recurring faecaloma (59.7%) and daily FI (65.1%). At last follow-up (mean 14 [7.4] months), 129 (86.6%) children continued the TAI procedure, independent of pathology or age. The main motivation was resolution of FI and/or constipation (77.3%). In total, 107 (82.9%) children fulfilled the initial therapeutic contract established with their healthcare professional before TAI initiation was met. Twenty children had stopped the TAI when they answered the questionnaire, at a mean duration of 16 (8.4) months. The reasons were mainly "lack of motivation" (45%), "poor tolerance" (35%), "difficulties" performing the procedure (35%) and "inefficacy" (30%). Factors related to continuation were performing at least one TAI procedure under a nurse's supervision during the initial training and prescribing TAI at a daily frequency (P=0.014 and P=0.04). Continuing constipation treatment after the training session was a factor in discontinuation (P=0.024).nnCONCLUSION: This study reports a very high mid-term adherence to TAI in a paediatric cohort, provided that the training is pragmatic, personalized and repeated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Since 2009 in France, the Peristeen® transanal irrigation (TAI) device has represented an alternative treatment of faecal incontinence (FI).nnOBJECTIVE: The primary objective of this study was to assess the mid-term adherence to TAI in paediatric patients. The secondary objective was to identify factors determining TAI continuation.nnMETHODS: This observational study conducted in 5 French paediatric centres prospectively reviewed from March to May 2012 all children educated in TAI for at least 9months.nnRESULTS: We included 149 children (mean [SD] age 10.6 [4.1] years) educated in TAI. Children mainly had neurogenic disorders (52.3%) or congenital malformations (30.9%). The main symptoms motivating TAI initiation were recurring faecaloma (59.7%) and daily FI (65.1%). At last follow-up (mean 14 [7.4] months), 129 (86.6%) children continued the TAI procedure, independent of pathology or age. The main motivation was resolution of FI and/or constipation (77.3%). In total, 107 (82.9%) children fulfilled the initial therapeutic contract established with their healthcare professional before TAI initiation was met. Twenty children had stopped the TAI when they answered the questionnaire, at a mean duration of 16 (8.4) months. The reasons were mainly “lack of motivation” (45%), “poor tolerance” (35%), “difficulties” performing the procedure (35%) and “inefficacy” (30%). Factors related to continuation were performing at least one TAI procedure under a nurse’s supervision during the initial training and prescribing TAI at a daily frequency (P=0.014 and P=0.04). Continuing constipation treatment after the training session was a factor in discontinuation (P=0.024).nnCONCLUSION: This study reports a very high mid-term adherence to TAI in a paediatric cohort, provided that the training is pragmatic, personalized and repeated.
Maurice, Paul; Letourneau, Alexandra; Benachi, Alexandra; Jouannic, Jean-Marie
In: Prenat Diagn, vol. 39, no. 13, pp. 1269–1272, 2019, ISSN: 1097-0223.
@article{pmid31671210,
title = {Feticide in second- and third-trimester termination of pregnancy for fetal anomalies: Results of a national survey},
author = {Paul Maurice and Alexandra Letourneau and Alexandra Benachi and Jean-Marie Jouannic},
doi = {10.1002/pd.5594},
issn = {1097-0223},
year = {2019},
date = {2019-12-01},
journal = {Prenat Diagn},
volume = {39},
number = {13},
pages = {1269--1272},
abstract = {OBJECTIVE: To conduct an audit of the practice of feticide in second- and third-trimester termination of pregnancy for fetal anomalies (TOPFA) in prenatal diagnosis (PD) centers in France.nnRESULTS: A questionnaire was sent out to the 49 French PD centers and completed by 39/49 centers; 5350 TOPFAs were performed. The gestational age after which feticide was performed was 20 weeks in two centers (5%), 22 weeks in 28 centers (72%), 23 weeks in four centers (10%), and 24 weeks in five centers (13%). Fifteen of 39 centers reported that feticide was not performed in all cases, because of a fetal abnormality associated with a high probability of rapid neonatal death (13 centers), pregnant woman's refusal (11 centers), and technical impossibility of performing feticide (one center). Feticide was done using xylocaine in 38 of the 39 centers and using KCl in the remaining center. All but one of the centers before feticide used fetal anesthesia. Feticide was done on the day of induction of labor in 35/39 centers (90%), after maternal epidural analgesia in 33 centers, or after maternal subcutaneous local anesthesia in two centers. Feticide was done the day before induction of labor in two centers.nnCONCLUSION: In France, most TOPFAs performed in second and third trimesters are associated with feticide, which is most often done after fetal anesthesia.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To conduct an audit of the practice of feticide in second- and third-trimester termination of pregnancy for fetal anomalies (TOPFA) in prenatal diagnosis (PD) centers in France.nnRESULTS: A questionnaire was sent out to the 49 French PD centers and completed by 39/49 centers; 5350 TOPFAs were performed. The gestational age after which feticide was performed was 20 weeks in two centers (5%), 22 weeks in 28 centers (72%), 23 weeks in four centers (10%), and 24 weeks in five centers (13%). Fifteen of 39 centers reported that feticide was not performed in all cases, because of a fetal abnormality associated with a high probability of rapid neonatal death (13 centers), pregnant woman’s refusal (11 centers), and technical impossibility of performing feticide (one center). Feticide was done using xylocaine in 38 of the 39 centers and using KCl in the remaining center. All but one of the centers before feticide used fetal anesthesia. Feticide was done on the day of induction of labor in 35/39 centers (90%), after maternal epidural analgesia in 33 centers, or after maternal subcutaneous local anesthesia in two centers. Feticide was done the day before induction of labor in two centers.nnCONCLUSION: In France, most TOPFAs performed in second and third trimesters are associated with feticide, which is most often done after fetal anesthesia.