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  1. Article ; Online: Comparison of open versus minimally invasive surgery in the treatment of thoracolumbar metastases.

    Ntilikina, Yves / Collinet, Arnaud / Tigan, Leonardo Viorel / Fabacher, Thibault / Steib, Jean-Paul / Charles, Yann Philippe

    Orthopaedics & traumatology, surgery & research : OTSR

    2022  Volume 108, Issue 4, Page(s) 103274

    Abstract: Introduction: Minimally invasive surgery (MIS) techniques have been developed for the surgical treatment of thoracolumbar spinal metastases to reduce the morbidity associated with the operation. The purpose of our study was to compare the mean length of ...

    Abstract Introduction: Minimally invasive surgery (MIS) techniques have been developed for the surgical treatment of thoracolumbar spinal metastases to reduce the morbidity associated with the operation. The purpose of our study was to compare the mean length of stay, change in pain levels, neurological symptoms, complications and survival after open versus MIS surgery.
    Material and methods: This is a single-center retrospective study based on a register of patients treated for vertebral metastases between January 2014 and October 2016. The collection included demographic data, cancer-related data, clinical data, the characteristics of the surgery, the length of stay, assessment of pain and the occurrence of death. These data were compared between open and MIS surgery groups.
    Results: Out of 59 patients, 35 were treated with open surgery and 24 were treated with MIS surgery. The two groups were comparable in terms of age, gender and body mass index. Breast, kidney, prostate and lung cancers were the most frequent primary tumors. Prognostic and instability scores were comparable. Short- and medium-term pain assessment showed comparable results. Median survival was 208 days in the open surgery group and 224days in the MIS group (p=0.5299).
    Conclusion: MIS techniques aim to limit the surgical approach and allow a faster introduction of adjuvant treatments than after open surgery. Our study did not find any differences between open and MIS surgery in terms of pain, neurological evolution or survival time in patients treated for thoracolumbar spinal metastases.
    Level of evidence: IV; retrospective study.
    MeSH term(s) Humans ; Male ; Minimally Invasive Surgical Procedures/methods ; Pain ; Retrospective Studies ; Spinal Fusion/methods ; Spinal Neoplasms/secondary ; Spinal Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-03-21
    Publishing country France
    Document type Journal Article
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2022.103274
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Experimental efficacy of the face shield and the mask against emitted and potentially received particles

    Rochoy, Michael / Fabacher, Thibault / Cosperec, Isabelle / Wendling, Jean-Michel

    medRxiv

    Abstract: The aim of this study was to evaluate the comparative performance of masks and face shields in different experimental configurations. An experimental setup with two mannequin heads positioned at 1.70m high and at 25 cm each other was used. A fogger ... ...

    Abstract The aim of this study was to evaluate the comparative performance of masks and face shields in different experimental configurations. An experimental setup with two mannequin heads positioned at 1.70m high and at 25 cm each other was used. A fogger generated a particle9s airflow with a speed of 5m/sec from the emitter to the receiver head mannequin. Our aerosol generator produced 3 000 times more particles than a physiological cough situation. A particle counter allowed us to evaluate the number of particles received on a mannequin head located at a very short distance of 25 cm. The amount of all particles up to the selected particle sizes were counted with an optical particle counter on channels 0.3 μm, 0.5 μm, 1 μm, 2.5 μm, 5 μm and 10 μm. The reduction factors with a protection worn by the receiver alone, by the emitter alone and then the double protection of emitter and receiver were calculated. When the receiver alone wore a face shield, the amount of total particles was reduced (54.8%), while the reduction was less when the receiver alone wore a mask (21.8%) (p = 0.003). Wearing a protection by the emitter alone reduced much more the level of particles received by 96.8% for both mask and face shield. The double protection allowed for even better results, but close to the protection of the emitter alone: 98% reduction for the face shields and 97.3% for the masks (p=0.022). Even with small particle size emission (≤0.3μm), results were of the same order. Considering our results, protection of the emitter alone or double protection is much more effective than protection of the receiver only. Face shield should be included as part of strategies to safely and significantly reduce transmission in the community setting, in addition to masks or for people with disabilities or medical intolerance to masks.
    Keywords covid19
    Language English
    Publishing date 2020-11-24
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.11.23.20237149
    Database COVID19

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  3. Article ; Online: Metabolic Benefit of Teleconsultation for Diabetes Management During the COVID-19 Pandemic: A French Observational Prospective Study.

    Meyer, Laurent / Flocard, Mathilde / Fabacher, Thibault / Bahougne, Thibault / Ortéga, Françoise / Paris, Dominique / Munch, Marion / Boullu-Sanchis, Sylvie / Canel, Clémence / Chappaz, Claire / Amoura, Lamia / Meyer, Nicolas / Kessler, Laurence

    Telemedicine journal and e-health : the official journal of the American Telemedicine Association

    2022  Volume 29, Issue 4, Page(s) 612–616

    Abstract: Aim: ...

    Abstract Aim:
    MeSH term(s) Humans ; COVID-19/epidemiology ; Prospective Studies ; Telemedicine ; Glycated Hemoglobin ; Pandemics ; Remote Consultation ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/therapy
    Chemical Substances Glycated Hemoglobin
    Language English
    Publishing date 2022-08-09
    Publishing country United States
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2035659-6
    ISSN 1556-3669 ; 1530-5627
    ISSN (online) 1556-3669
    ISSN 1530-5627
    DOI 10.1089/tmj.2022.0090
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Prise en charge par téléconsultation des patients diabétiques dans le contexte de la pandémie de la Covid-19: étude prospective observationnelle

    Flocard, Mathilde / Meyer, Laurent / Fabacher, Thibault / Bahougne, Thibault / Ortéga, Françoise / Paris, Dominique / Munch, Marion / Boullu-Sanchis, Sylvie / Canel, Clémence / Chappaz, Claire / Kessler, Laurence

    Abstract: La pandémie à coronavirus 2019 (COVID-19) a contraint les pouvoirs publics français à instaurer un confinement à domicile de la population, avec un impact potentiel sur l’équilibre glycémique des patients diabétiques. Dans ce contexte, la télémédecine ... ...

    Abstract La pandémie à coronavirus 2019 (COVID-19) a contraint les pouvoirs publics français à instaurer un confinement à domicile de la population, avec un impact potentiel sur l’équilibre glycémique des patients diabétiques. Dans ce contexte, la télémédecine semble être un outil pertinent pour assurer le suivi de ces patients. Nous avons réalisé une étude prospective observationnelle, aux Hôpitaux Universitaires de Strasbourg, ainsi que dans un cabinet libéral de la ville, afin d’évaluer l’équilibre glycémique à 3 mois de 491 patients diabétiques, suivis par téléconsultation (n = 338) ou dont la consultation en présentiel a été reportée à 6 mois (n = 153). Des questionnaires de satisfaction patients et médecins ont été recueillis pour apprécier l’impact des actions de télémédecine. À 3 mois, une réduction moyenne non significative de -0,33 % du taux d’hémoglobine glyquée (HbA1c) était observée dans le groupe suivi par téléconsultation (n = 175) contre -0,13 % dans le groupe sans téléconsultation (n = 92). Dans le groupe téléconsultation, l’HbA1c diminuait de 7,65 ± 1,19 % à 7,18 ± 0,9 % pour les patients suivis à l’hôpital (n = 97), et de 7,28 ± 0,80 % à 7,11 ± 0,79 % pour les patients suivis en ville (n = 78). Quatre-vingt-douze pourcents des patients se sont déclarés satisfaits de leur téléconsultation, positionnant la téléconsultation comme une alternative à une consultation en présentiel et la recommanderaient à un autre patient diabétique. Alors que sept diabétologues sur huit n’avaient jamais effectué de téléconsultation, tous souhaitent continuer cette modalité de suivi après la crise sanitaire. Au regard des données manquantes - en lien avec les difficultés de recueil pendant la pandémie - la tendance à l’amélioration de l’équilibre glycémique observée dans le groupe téléconsultation doit être confirmée par une évaluation à 6 mois de l’équilibre glycémique des patients. The COVID-19 pandemic has compelled the French government to impose confinement measures to stem the spread of the coronavirus. These measures may have had a potential impact on the glycemic control of diabetic patients. Within this context, telemedicine appears to be a viable option for follow-up appointments of diabetic patients. To assess this theory, we simultaneously led a prospective observational study during the novel coronavirus pandemic at Strasbourg’s teaching hospital and at a private medical office to evaluate glycemic control in 491 diabetic patients either attending a telehealth appointment (n=338) or whom in-person consultation had been postponed by 6 months (n=153). Surveys were collected to assess both the patients’ and the physicians’ satisfaction. A decrease in average glycated hemoglobin (HbA1c) was observed among patients from the telehealth appointment group: ΔHbA1c = -0.33% (n=175) as well as the other group: ΔHbA1c = -0.13% (n=92) 3 months after the beginning of the study. Patients belonging to the telehealth appointment group at Strasbourg’s teaching hospital (n=97) experienced a decrease in their HbA1c average from 7.65 ± 1.19% to 7.18 ± 0.9%, while patients from the same group attending a private medical office (n=78) also experienced a decrease from 7.28 ± 0.80% to 7.11 ± 0.79%. Ninety-two percent of patients were satisfied with the telehealth appointment, think it could be a virtual alternative to in-person consultation and would recommend it to other diabetic patients. Even though seven out of eight diabetologists had never offered telehealth appointments to their patients prior to the COVID-19 pandemic, all of them hope to provide such services to their patients once the health crisis is over. The tendency towards a decrease in HbA1c levels within our cohort should be qualified due to missing data caused by the disruption in data collection during the COVID-19 pandemic. Evaluation and assessment of the cohort’s glycemic control 6 months after the beginning of the study could help confirm these results.
    Keywords covid19
    Publisher Elsevier; PMC
    Document type Article ; Online
    DOI 10.1016/j.mmm.2020.11.002
    Database COVID19

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