Ronan Garlantézec

Determining the technical and clinical factors associated with pain for children undergoing botulinum toxin injections under nitrous oxide and anesthetic cream.

AIMS To determine technical and clinical factors associated with pain when using an analgesic protocol with 50% nitrous oxide/oxygen and anesthetic cream (lidocaine and prilocaine, Emla(®)) for children with cerebral palsy undergoing botulinum toxin injections. METHODS Monocentric prospective study including 50 children newly injected with a mean age of 6.6 years (± 4.32, range 1-18) and 199 injected muscles. Pain was evaluated using the Childrens Hospital of Eastern Ontario Pain Scale (CHEOPS). The following variables were noted: gender, age, weight, Gross Motor Function Classification System, type of cerebral palsy (hemiplegic, diplegic, tetraplegic), muscles injected and severe cognitive impairment. The procedure was broken down into three phases for the purpose of pain evaluation: puncture, muscle localization using electrostimulation and injection of botulinum toxin. RESULTS The mean CHEOPS score was 8.16 (± 3.5) and 38% of scores were above the therapeutic threshold of 9. The injection phase was significantly more painful (6.77 ± 3.30) than the puncture (4.88 ± 2.03) and localization (5.46 ± 2.68) phases. The adductor muscles were less painful than other muscles. Children with more severe cognitive impairment seemed to perceive higher levels of pain than the others. Other clinical factors were not associated with pain score. CONCLUSION Clinical characteristics seem not strongly correlated to the success or failure of the 50% nitrous oxide/oxygen-Emla(®) protocol and this pain treatment protocol does not prevent equally all phases of botulinum toxin injections. Future research on the products and its dilution might help to reduce pain level.

Investigation and control of a nosocomial norovirus outbreak in a long-term care facility.

Author(s): Marc Carpentier, MD; Jordan Ollivro, MD; Raoul Baron, MD; Mickaël Le Galudec, MD; Chantal Fauchier, MD; Adissa Minoui-Tran, MD; Christopher Payan, Pharm D, PhD; Benoist Lejeune, MD, PhD; Ronan Garlantézec, MD, PhD Source: Infection Control and Hospital Epidemiology, Vol. 32, No. 10 (October 2011), pp. 10521055 Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America Stable URL: http://www.jstor.org/stable/10.1086/662017 . Accessed: 18/05/2014 03:31

Coronary angioplasty is associated with a better neurological outcome in the era of modern management of out-of-hospital cardiac arrest

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. Coronary angioplasty is associated with a better neurological outcome in the era of modern management of out-of-hospital cardiac arrest. Christine Vaillant, Guillaume Leurent, Ronan Garlantezec, Christophe Thebault, Raphael Martins, Emilie Bot, Isabelle Coudert, Dominique Boulmier, Hervé Le Breton, Marc Bedossa

Medication, rehabilitation and health care consumption in adults with cerebral palsy: A population based study.

Objective: To evaluate medication, rehabilitation and healthcare consumption in adults with CP as a function of Gross Motor Function Classification System (GMFCS) level. Design: Questionnaire-based cross-sectional study. Setting: Brittany, a French county. Subjects: Adults with cerebral palsy. Interventions: Questionnaires relating to drugs, orthotic devices, mobility aids, rehabilitation and medical input were sent to 435 members of a unique regional French network dedicated to adults with cerebral palsy. The questionnaire was completed by the participant or a helper if necessary. Results: Of the 282 responders, 7.8% had a GMFCS level of I, 14.2% II, 17.7% III, 29.1% IV and 31.2% V. Participants consumed a large amount of healthcare. Almost three-quarters took orally administered drugs, of which antispastic and antiepileptic drugs were among the most frequent. Nearly all patients had at least one type of rehabilitation, 87.2% had physiotherapy, 78% used at least one mobility aid and 69.5% used at least one orthotic device. The frequency of numerous inputs increased with GMFCS level. Specificities were found for each GMFCS level, e.g. participants with GMFCS level IV and V had a high level of medical input and a greater use of trunk-supporting devices, antireflux and laxative. Profiles could be established based on GMFCS levels. Conclusions: Adults with cerebral palsy use a large amount of drugs, mobility aids, orthotic devices, rehabilitation and medical input. Healthcare is targeted at cerebral palsy-related issues. GMFCS is a determinant of healthcare consumption and thus a useful tool for clinical practice to target care appropriately.

From childhood to adulthood: health care use in individuals with cerebral palsy

To analyse the health care usage of individuals with cerebral palsy (CP) as a function of age and ambulatory status.

TCT-130 Complete Myocardial Revascularisation is not Associated with a Better Prognosis in Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction. Insight from the multicenter prospective ORBI registry.

Guidelines recommend a complete myocardial revascularisation in Cardiogenic shock (CS) complicating ST-segment elevation myocardial infarction (STEMI). However, the impact on the prognosis of residuals stenosis of the coronary arteries is still unclear. We aimed to determine if a complete myocardial

Prise en charge médico-sociale des enfants paralysés cérébraux bretons : résultats préliminaires

ats ne permettaient pas de reconnaître un intérêt pour l’utilisation de la crème nesthésique pour diminuer le vécu douloureux des injections de toxine botuliique chez les enfants et adolescents paralysés cérébraux. Le nombre de patients e cette étude était insuffisant pour être significatif sur le plan statistique. onclusion.– Ce travail ne permet pas de justifier l’utilité de l’application d’une rème anesthésique avant d’effectuer des injections de toxine botulinique chez ’enfant et l’adolescent paralysé cérébral afin de diminuer la douleur induite. our en savoir plus ambart G, Mette F, Pellot AS, Richard I. Ann Read Med Phys 2007 0;5:275–279. ritos S, Tasseel-Ponche S, Artz H, Verhaeghe M, Cuvelier C. Hôpital Trousseau, aris 2010.