📇 Rhumatologue ·

MME Stephanie PHAM

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2 raisons identifiées

Praticien-chercheur
13 articles scientifiques publiés — formation continue solide
Expérience confirmée
32 ans d'exercice en rhumatologie — recul clinique solide

Rhumatologue

RPPS 10001356848

Expérience confirmée

32ans d'exercice (thèse 1994)

📊 Reconnaissance scientifique : 2/100📝 6 articles publiés

✨ Génération du profil synthétique IA en cours…

Thèses universitaires

Comparaison des biopsies bronchiques et des biopsies de glandes salivaires accessoires chez l'asthmatique
1994

Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.

Top publications · les plus citées

Inhaled corticosteroids and Churg-Strauss syndrome: a report of five cases

The European respiratory journal · 2000

📚 45 citations🎯 RCR 1.49🔓 Open Access📄 PDF gratuit ↗

Effect of Intraoperative Arterial Hypotension on the Risk of Perioperative Stroke After Noncardiac Surgery: A Retrospective Multicenter Cohort Study

Anesthesia and analgesia · 2021

📚 29 citations🎯 RCR 2.52Top 20% NIH🩺 Clinique

Lire l'abstract Crossref ↓

BACKGROUND: Intraoperative cerebral blood flow is mainly determined by cerebral perfusion pressure and cerebral autoregulation of vasomotor tone. About 1% of patients undergoing noncardiac surgery develop ischemic stroke. We hypothesized that intraoperative hypotension within a range frequently observed in clinical practice is associated with an increased risk of perioperative ischemic stroke within 7 days after surgery. METHODS: Adult noncardiac surgical patients undergoing general anesthesia at Beth Israel Deaconess Medical Center and Massachusetts General Hospital between 2005 and 2017 were included in this retrospective cohort study. The primary exposure was intraoperative hypotension, defined as a decrease in mean arterial pressure (MAP) below 55 mm Hg, categorized into no intraoperative hypotension, short (<15 minutes, median [interquartile range {IQR}], 2 minutes [1–5 minutes]) and prolonged (≥15 minutes, median [IQR], 21 minutes [17–31 minutes]) durations. The primary outcome was a new diagnosis of early perioperative ischemic stroke within 7 days after surgery. In secondary analyses, we assessed the effect of a MAP decrease by >30% from baseline on perioperative stroke. Analyses were adjusted for the preoperative STRoke After Surgery (STRAS) prediction score, work relative value units, and duration of surgery. RESULTS: Among 358,391 included patients, a total of 1553 (0.4%) experienced an early perioperative ischemic stroke. About 42% and 3% of patients had a MAP of below 55 mm Hg for a short and a prolonged duration, and 49% and 29% had a MAP decrease by >30% from baseline for a short and a prolonged duration, respectively. In an adjusted analysis, neither a MAP <55 mm Hg (short duration: adjusted odds ratio [ORadj], 0.95; 95% confidence interval [CI], 0.85–1.07; P = .417 and prolonged duration: ORadj, 1.18; 95% CI, 0.91–1.55; P = .220) nor a MAP decrease >30% (short duration: ORadj, 0.97; 95% CI, 0.67–1.42; P = .883 and prolonged duration: ORadj, 1.30; 95% CI, 0.89–1.90; P = .176) was associated with early perioperative stroke. A high a priori stroke risk quantified based on preoperatively available risk factors (STRAS prediction score) was associated with longer intraoperative hypotension (adjusted incidence rate ratio, 1.04; 95% CI, 1.04–1.05; P < .001 per 5 points of the STRAS prediction score). CONCLUSIONS: This study found no evidence to conclude that intraoperative hypotension within the range studied was associated with early perioperative stroke within 7 days after surgery. These findings emphasize the importance of perioperative cerebral blood flow autoregulation to prevent ischemic stroke.

High-resolution Micro-CT evaluation of mid- to long-term effects of estrogen deficiency on rat trabecular bone

Academic radiology · 2003

📚 29 citations

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MME Stephanie PHAM

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Thèses universitaires

Activité de recherche & publications

Lieu de consultation

Tarifs & secteur de conventionnement

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Top publications · les plus citées

Publications scientifiques (13) — classées par pathologie

Transversal5

Épidémiologie & registres2

Pédiatrie2

Génétique1

Goutte1

IA en rhumatologie1

Vascularites1

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