📇 Rhumatologue ·
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2 raisons identifiées
Auteur de référence en rhumatologie
20 articles scientifiques publiés — un praticien à la pointe de la recherche
Référence presse grand public
Cité 1 fois dans les médias — pédagogie reconnue
✨ Génération du profil synthétique IA en cours…
Secteur de conventionnement non disponible (médecin hospitalier ou non présent dans l'Annuaire santé CNAM des libéraux conventionnés).
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Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).
Source : Google News (recherche par nom complet — homonymes possibles, vérifier le contenu).
📰 Midi Libre · 03/08/2020
<a href="https://news.google.com/rss/articles/CBMizwFBVV95cUxNWGlCLU95Q1I2bFNpQldHLVlTUndtc0NSRWRoaEdUZzZhOWp3WENSUGVFazVLdU1fR3I2Q244WlBWbDZ0aDJPZjRMNWk5eFplVUtzdEJ1Zk5fME9zOXBuWlhDa3BGcUhkZG8wN2owRlMzcmQwRllvM093S1BBM2dLcDBKclM3aEs2SVlQVGRuQlJnLVZwWXp4aF9CakNGZEQxcXJTemNqWWpLYkV3MEFNTl9jd1Z4WE03WU
Medical physics · 2018
PurposeTo perform a benchmark of a new DACS‐integrated patient skin dose mapping solution using on‐phantom measurements with Gafchromic® films.Materials and methodsTo calculate cumulative patient skin dose distribution with 1‐cm2 resolution, a Radiation Dose Monitor (RDM, Medsquare), using the Radiation Dose Structured Report (RDSR), tabulated backscatter and mass energy absorption coefficients together with site‐specific corrections for table, mattress attenuation, and air kerma calibration factor. Peak skin dose (PSD) and two‐dimensional (2D) skin dose distributions calculated with RDM were compared against on‐phantom measurements with XR‐RV3 Gafchromic® films considering two widely used x‐ray equipment. Seventeen different settings which include simple and multiple beam projections with extreme angulations (up to 75°), all available fields‐of‐view (FOVs 48–11 cm), additional collimation, variable table height and lateral positions, and variable phantom thickness (12, 20, and 30 cm) were involved.ResultsDue to a careful calibration of films using clinical beam qualities, 22.8% (k = 2) overall measurement uncertainty was achieved. Calculated and measured PSD values agreed with an average difference of 10% ± 7% and 9% ± 7% for 34 test conditions performed on Siemens Artis Zee and GEMS Innova IGS interventional systems, respectively. Finally, RDM's 2D skin dose maps closely matched those registered on XR‐RV3 films considering the 1‐cm2 resolution. While RDM correctly reproduced beam overlapping due to variable tube projections, FOV, table positions, etc., few challenges were identified related to conversion of rectangular fields to square areas in the RDSR and a stair‐step effect visible for large tube projections (>45°).ConclusionThe accuracy of RDM's DACS‐integrated skin dose mapping software was acceptable considering measurement uncertainties associated with Gafchromic® films.
La Revue de medecine interne · 2002
Circulation · 2022
Background: Cerebral microbleeds (CMBs) have been observed in healthy elderly people undergoing systematic brain magnetic resonance imaging. The potential role of acute triggers on the appearance of CMBs remains unknown. We aimed to describe the incidence of new CMBs after transcatheter aortic valve replacement (TAVR) and to identify clinical and procedural factors associated with new CMBs including hemostatic measures and anticoagulation management. Methods: We evaluated a prospective cohort of patients with symptomatic aortic stenosis referred for TAVR for CMBs (METHYSTROKE [Identification of Epigenetic Risk Factors for Ischemic Complication During the TAVR Procedure in the Elderly]). Standardized neurologic assessment, brain magnetic resonance imaging, and analysis of hemostatic measures including von Willebrand factor were performed before and after TAVR. Numbers and location of microbleeds on preprocedural magnetic resonance imaging and of new microbleeds on postprocedural magnetic resonance imaging were reported by 2 independent neuroradiologists blinded to clinical data. Measures associated with new microbleeds and postprocedural outcome including neurologic functional outcome at 6 months were also examined. Results: A total of 84 patients (47% men, 80.9±5.7 years of age) were included. On preprocedural magnetic resonance imaging, 22 patients (26% [95% CI, 17%–37%]) had at least 1 microbleed. After TAVR, new microbleeds were observed in 19 (23% [95% CI, 14%–33%]) patients. The occurrence of new microbleeds was independent of the presence of microbleeds at baseline and of diffusion-weighted imaging hypersignals. In univariable analysis, a previous history of bleeding ( P =0.01), a higher total dose of heparin ( P =0.02), a prolonged procedure ( P =0.03), absence of protamine reversion ( P =0.04), higher final activated partial thromboplastin time ( P =0.05), lower final von Willebrand factor high-molecular-weight:multimer ratio ( P =0.007), and lower final closure time with adenosine–diphosphate ( P =0.02) were associated with the occurrence of new postprocedural microbleeds. In multivariable analysis, a prolonged procedure (odds ratio, 1.22 [95% CI, 1.03–1.73] for every 5 minutes of fluoroscopy time; P =0.02) and postprocedural acquired von Willebrand factor defect (odds ratio, 1.42 [95% CI, 1.08–1.89] for every lower 0.1 unit of high-molecular-weight:multimer ratio; P =0.004) were independently associated with the occurrence of new postprocedural microbleeds. New CMBs were not associated with changes in neurologic functional outcome or quality of life at 6 months. Conclusions: One out of 4 patients undergoing TAVR has CMBs before the procedure and 1 out of 4 patients develops new CMBs. Procedural or antithrombotic management and persistence of acquired von Willebrand factor defect were associated with the occurrence of new CMBs. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02972008.
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
Medical physics · 2018 · Journal Article
Habib Geryes B, Hadid-Beurrier L, Waryn MJ, Jean-Pierre A, et al.
Infection control and hospital epidemiology · 2006 · Comparative Study
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La Revue de medecine interne · 2002 · Case Reports
Roth S, Delmont E, Heudier P, Kaphan R, et al.
Circulation · 2022 · Journal Article
Van Belle E, Debry N, Vincent F, Kuchcinski G, et al.
La semaine des hopitaux : organe fonde par l'Association d'enseignement medical des hopitaux de Paris · 1969 · Journal Article
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Revue du rhumatisme et des maladies osteo-articulaires · 1969 · Case Reports
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