48 research outputs found
La production scientifique issue de la formation initiale Ă la facultĂ© de mĂ©decine dâAngers entre 2002 et 2008 : de bonne qualitĂ© mais insuffisante
IntroductionLâactivitĂ© de publication scientifique issue de la formation initiale est mal connue. Nous avons Ă©valuĂ© la proportion des thĂšses et des mĂ©moires de spĂ©cialitĂ© aboutissant Ă une publication, leur impact en termes de points SIGAPS et les principaux obstacles Ă la publication de ces travaux. MĂ©thodes Les thĂšses de doctorat en mĂ©decine soutenues de 2002 à 2008 à la facultĂ© de mĂ©decine dâAngers ont Ă©tĂ© recensĂ©es Ă partir du systĂšme universitaire de documentation (SUDOC), et les mĂ©moires de spĂ©cialitĂ© directement auprĂšs des diplĂŽmĂ©s. Les publications ont Ă©tĂ© recherchĂ©es dans Medline via Pubmed, ISI Web of Knowledge et dans les trois rapports SIGAPS de 2002 à 2008. Une enquĂȘte cherchant Ă connaĂźtre les obstacles Ă la publication a Ă©tĂ© lancĂ©e auprĂšs de tous les directeurs de thĂšses et responsables de discipline impliquĂ©s. RĂ©sultats Cinq cent quatre-vingt-dix-huit thĂšses ont Ă©tĂ© soutenues, 311 (52 %) en mĂ©decine gĂ©nĂ©rale et 287 (48 %) en spĂ©cialitĂ©s. Cent soixante-cinq thĂšses ont donnĂ© lieu Ă publication (28 %) dont 97 (16 %) indexĂ©s dans Medline via Pubmed (soit 11 % en mĂ©decine gĂ©nĂ©rale et 22 % en spĂ©cialitĂ©). Trente-trois de ces 97 articles (35 %) ont Ă©tĂ© publiĂ©s dans des journaux de haute qualitĂ© classĂ©s A, B ou C de la classification SIGAPS. Ces articles issus des thĂšses ont reprĂ©sentĂ© 4,17 % du score SIGAPS du CHU calculĂ© sur un total de 2088 articles au cours de cette pĂ©riode. Deux cent quatre mĂ©moires de spĂ©cialitĂ©s ont donnĂ© lieu Ă 69 articles (33,8 %), dont 50 (24,5 %) indexĂ©s dans Medline. Les taux de publication des mĂ©moires de DES et de DESC ont Ă©tĂ© respectivement de 31 % (45/145) et de 40,7 % (24/59). Ils ont reprĂ©sentĂ© 1,9 % (432 points) du score total SIGAPS. Les principaux obstacles ressentis pour la publication ont Ă©tĂ© le manque de temps des directeurs, lâĂ©loignement des Ă©tudiants aprĂšs la soutenance et le manque de moyens logistiques. Conclusion La production scientifique issue de la formation initiale Ă la facultĂ© de mĂ©decine dâAngers a Ă©tĂ© de bonne qualitĂ© mais insuffisante quantitativement et peu contributive au financement du CHU malgrĂ© un nombre important de diplĂŽmĂ©s. Un soutien logistique mĂ©rite dâĂȘtre envisagĂ© afin de valoriser la production scientifique issue de la formation initiale
Follow-Up of Coiled Intracranial Aneurysms: Comparison of 3D Time-of-Flight MR Angiography at 3T and 1.5T in a Large Prospective Series
Thigh Ultrasound Monitoring Identifies Decreases in Quadriceps Femoris Thickness as a Frequent Observation in Critically Ill Children.
OBJECTIVES: Significant muscle wasting develops in critically ill adults, with subsequent worse outcomes. In the pediatric setting, occurrence and effects of muscle wasting are undescribed; this is in part due to a lack of validated, objective methods for assessing muscle wasting. A single measurement of quadriceps femoris thickness has failed to show consistent reproducibility. We hypothesized that averaging repeated measurements could afford good reproducibility to allow for quadriceps femoris thickness decline detection and monitoring. DESIGN: A prospective bedside observational study. SETTING: Two PICUs. PATIENTS: Mechanically ventilated critically ill children were 15 years and younger. INTERVENTIONS: Transverse and longitudinal axis measurements of quadriceps femoris anterior thickness were undertaken using bedside ultrasound. The average of four measurement values was recorded. The location of measurement was marked for consistency within subsequent measurements by the same or another trained operator, to assess intra- and interoperator repeatability and reproducibility of the technique. Where feasible, serial measurements were undertaken until the time of extubation in a group of children with prolonged PICU stay (> 5 d). MEASUREMENTS AND MAIN RESULTS: Seventy-three children were enrolled to assess intra- and interoperator ultrasound reliability. Their median (25-75 interquartile range) age and weight were 30 months (4.5-96) and 10 kg (5-23.5). In the intraoperator repeatability study, mean relative difference in quadriceps femoris muscle thickness was 0.36% ± 2.5% (lower and upper limits of agreement: -4.5/+5.2%). In the interoperator reproducibility study, intraclass correlation coefficient was 0.998. In the 17 children monitored over their PICU stay, quadriceps femoris thickness significantly decreased at day 5 by 9.8% (p = 0.006) and by 13.3% (< 0.001) at the last performed measurement. CONCLUSIONS: Quadriceps femoris thickness decrease, proposed as a surrogate for muscle mass, is an early, frequent, and intense phenomenon in PICU. Quadriceps femoris ultrasonography is a reliable technique to monitor this process and in future could help to guide rehabilitation and nutrition interventions.The study was founded by ALLP (Association Lyonnaise de Logistique posthospitaliÚre) 2015 grant. FVV has received consultant honoraria from Nutricia and Baxter and grants from Baxter, Nestle, Institut Aguettant, ALLP and Fresenius Kabi. For the remaining authors none were declared
Bifunctional Adsorbent-Catalytic Nanoparticles for the Refining of Renewable Feedstocks
Exploration de la variabilité génétique présente dans cinq peuplements naturels de pin Laricio de Corse (Pinus nigra ssp. laricio var. corsicana Loud.)
International audienc
Exploration de la variabilité génétique présente dans cinq peuplements naturels de pin Laricio de Corse (Pinus nigra ssp. laricio var. corsicana Loud.)
La sĂ©rovaccination et le suivi des nouveau-nĂ©s de mĂšres porteuses dâune hĂ©patite B. Ătude rĂ©alisĂ©e entre le 1er janvier 2000 et le 31 dĂ©cembre 2010
Contrast-Enhanced and Time-of-Flight MRA at 3T Compared with DSA for the Follow-Up of Intracranial Aneurysms Treated with the WEB Device
International audienceBACKGROUND AND PURPOSE:Imaging follow-up at 3T of intracranial aneurysms treated with the WEB Device has not been evaluated yet. Our aim was to assess the diagnostic accuracy of 3D-time-of-flight MRA and contrast-enhanced MRA at 3T against DSA, as the criterion standard, for the follow-up of aneurysms treated with the Woven EndoBridge (WEB) system.MATERIALS AND METHODS:From June 2011 to December 2014, patients treated with the WEB in our institution, then followed for â„6 months after treatment by MRA at 3T (3D-TOF-MRA and contrast-enhanced MRA) and DSA within 48 hours were included. Aneurysm occlusion was assessed with a simplified 2-grade scale (adequate occlusion [total occlusion + neck remnant] versus aneurysm remnant). Interobserver and intermodality agreement was evaluated by calculating the linear weighted Îș. MRA test characteristics and predictive values were calculated from a 2 Ă 2 contingency table, by using DSA data as the standard of reference.RESULTS:Twenty-six patients with 26 WEB-treated aneurysms were included. The interobserver reproducibility was good with DSA (Îș = 0.71) and contrast-enhanced-MRA (Îș = 0.65) compared with moderate with 3D-TOF-MRA (Îș = 0.47). Intermodality agreement with DSA was fair with both contrast-enhanced MRA (Îș = 0.36) and 3D-TOF-MRA (Îș = 0.36) for the evaluation of total occlusion. For aneurysm remnant detection, the prevalence was low (15%), on the basis of DSA, and both MRA techniques showed low sensitivity (25%), high specificity (100%), very good positive predictive value (100%), and very good negative predictive value (88%).CONCLUSIONS:Despite acceptable interobserver reproducibility and predictive values, the low sensitivity of contrast-enhanced MRA and 3D-TOF-MRA for aneurysm remnant detection suggests that MRA is a useful screening procedure for WEB-treated aneurysms, but similar to stents and flow diverters, DSA remains the criterion standard for follow-up