Emmanuel Simon - Academia.edu (original) (raw)
Papers by Emmanuel Simon
Ultrasound in Obstetrics & Gynecology, 2013
1st day (65 cases in lower segment and 8 cases in upper segment) with mean diameter of 4.15cm. Th... more 1st day (65 cases in lower segment and 8 cases in upper segment) with mean diameter of 4.15cm. The clinical characteristics such as parity, gestational age at delivery, birthweight, and use of oxytocin was not different between patients with intrauterine hematoma and those without hematoma. Moreover the need for transfusion and the hemoglobin difference between before and after delivery was not different between the two groups, either. Conclusions: The intrauterine hematoma was common in immediate postpartum period, and the presence of intrauterine hematoma was not associated with adverse clinical outcome.
Ultrasound in Obstetrics & Gynecology, 2013
from a continuous-wave Doppler ultrasound technique. The aim of this study was to investigate the... more from a continuous-wave Doppler ultrasound technique. The aim of this study was to investigate these two novel cardiovascular parameters in pregnancies complicated by hypertensive disorders compared to uncomplicated pregnancies. Methods: This was a prospective case-control study including a group of women presenting with hypertension in the second half of the pregnancy and a group of uncomplicated pregnancies recruited after 20 weeks' gestation. Cardiovascular parameters were assessed using a continuous-wave Doppler ultrasound technique (USCOM ). Pregnancies were followed up and the outcome ascertained. Mann-Whitney test and regression analysis were used for statistical analysis. Results: We recruited 94 women with hypertensive disorders in pregnancy and 106 controls. Compared to normotensive controls, the cases had significantly higher SMII (median 1.96 W/m2, IQR 1.64-2.40 vs 1.75 W/m2, IQR 1.47-2.03, p < 0.001), higher PKR (median 26.27, IQR 19.0-37.07 vs 20.94, IQR 15.69-27.73, p < 0.001), higher systemic vascular resistance index (median 2622dynes-sec/cm5/m2, IQR 2170-3023 vs 1877dynes-sec/cm5/m2, IQR 1561-2233, p < 0.001), but significantly lower cardiac index (median 3.34 L/min/m2, IQR 2.97-4.0 vs 3.72 L/min/m2, IQR 3.17-4.40, p = 0.003). Conclusions: Women presenting with hypertensive disorders in pregnancy demonstrate significant changes in cardiac contractility and dynamic arterial impedance. It remains to be established whether these indices may be used prospectively for the individualized triage and management of these pregnancies.
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, Jan 18, 2015
The aim of this study was to analyze the anatomical relation between the symphysis and the ischia... more The aim of this study was to analyze the anatomical relation between the symphysis and the ischial spines to obtain reliable landmarks for the assessment by Intrapartum Translabial Uultrasound (ITU) of fetal head descent. All Computed Tomography (CT) scans performed for breech presentations and for twin deliveries from 2006 to 2014 in a tertiary university hospital were collected for measurement and analysis by two operators. The Symphysis-left Ischial spine Angle (SIA) and the Symphysis-left Ischial spine Distance (SID) were measured on 3D reconstructions from a CT volume dataset. We calculated intra- and interobserver agreement for SIA and SID with 95% prediction intervals, created Bland-Altman plots created with 95% limits of agreement, and estimated the Intraclass Correlation Coefficient (ICC). A sagittal plane projection from the SIA allowed calculating a sagittal angle, corresponding to the Angle of Progression (AoP) for ITU. SIA and SID were obtained from CT images from 458 w...
2015 IEEE International Ultrasonics Symposium (IUS), 2015
![Research paper thumbnail of [Chi2 test for two by two percentage comparison table]](https://attachments.academia-assets.com/42803421/thumbnails/1.jpg)
](Gynécologie Obstétrique & Fertilité
![Research paper thumbnail of [Choledochal cyst rupture during pregnancy]](https://attachments.academia-assets.com/42803426/thumbnails/1.jpg)
](Gastroentérologie Clinique et Biologique
![Research paper thumbnail of [Is staging bone scan useful in patients with small invasive breast carcinoma?]](https://attachments.academia-assets.com/42803420/thumbnails/1.jpg)
](Gynécologie Obstétrique & Fertilité
Cette étude rétrospective, portant sur 517 patientes ayant un cancer infiltrant du sein classé pT... more Cette étude rétrospective, portant sur 517 patientes ayant un cancer infiltrant du sein classé pT1, évalue la pertinence de la scintigraphie osseuse dans le dépistage des métastases au moment du bilan initial de la maladie, ainsi que les coûts engendrés par un tel dépistage. La réalisation systématique d'une scintigraphie en postopératoire n'a pas permis de dépister les deux seuls cas de métastases osseuses synchrones de cette population. Aucune métastase osseuse n'a été dépistée dans les sous-groupes ayant le plus grand risque métastatique (rentabilité faible pour l'ensemble des pT1). Le taux de faux-positif de la scintigraphie est élevé (17 %). Le surcoût global est évalué à 110 770 euros, soit 215 euros par patiente (208 à 232 euros dans les groupes à risque). ß 2008 Elsevier Masson SAS. Tous droits réservés.
Fetal diagnosis and therapy, Jan 23, 2015
Ultrasound in Obstetrics & Gynecology, 2014
Objectives: To assess the prevalence and timing of prenatal detection of anencephaly in the Nethe... more Objectives: To assess the prevalence and timing of prenatal detection of anencephaly in the Netherlands during a five year period. Methods: A retrospective cohort study was undertaken in the Northwest and the Northeast of the Netherlands. A case-list of all pre-and postnatally diagnosed cases of anencephaly, with or without additional anomalies, was compiled. Cases were included if the estimated due date was between August 1, 2008 and July 31, 2013. Results: During the study period 110 cases of anencephaly were diagnosed. Overall prevalence of anencephaly was 5.4 per 10.000 pregnancies. The majority of the cases (60%) was detected before 14 weeks gestation. The detection rate before 14 weeks of pregnancy was significantly higher in the Northwest compared to the Northeast. (p = .003). During the study period, gestational age at the time of detection did not change significantly (p = .579). The percentage of cases with reported additional (chromosomal) anomalies was 24.5%. Conclusions: The majority of the anencephaly cases in this study was diagnosed prior to the mid-trimester scan. Early detection requires that scans are performed by sonographers trained and experienced in recognizing fetal anomalies in the first trimester. Pregnant women should be informed that an ultrasound scan in early pregnancy can reveal serious anomalies like anencephaly.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
The purpose of this study was to assess the feasibility of using a contrast agent for the sonogra... more The purpose of this study was to assess the feasibility of using a contrast agent for the sonographic examination of adnexal tumors and identify discriminating parameters in the preoperative diagnosis of malignant tumors. We conducted a prospective descriptive monocenter study that analyzed validated echographic criteria and parameters of the enhancement curve obtained by sonographic contrast agent injection. Patients included were referred for a second opinion after the discovery of a suspicious ovarian image. The final diagnosis was reached after surgery and an anatomopathologic examination. Fifty-two tumors were analyzed. Morphologic and Doppler criteria analyses were conducted as described in the literature. The significant parameters of the enhancement curve were the time-intensity curve total area and the duration of activity of the contrast agent during the first phase of decay (P < .002). The performance of the contrast agent was lower than that of the examiner's subj...
Les pathologies obstétriques liéesà un dysfonctionnement placentaire constituent un enjeu de sant... more Les pathologies obstétriques liéesà un dysfonctionnement placentaire constituent un enjeu de santé publique important. Dans le cas du Retard de Croissance Intra-Utérin (RCIU), on constate une modification significative de l'architecture villositaire en comparaison d'un placenta sain, modifiant la valeur absolue du moduleélastique et vraisemblablement la loi de dépendance en fréquence de ce paramètre. A ce jour, les propriétés biomécaniques du placenta n'ontété que très peuétudiées, et il n'existe aucun appareil clinique capable de renseigner sur sonélasticité ou son architecture. Dans ce contexte, nous proposons uneétude ex vivo de la dispersion de la vitesse des ondes de cisaillement (Cs) dans le placenta. La méthode d'Elastographie Transitoire (TE) proposée consisteà suivre la propagation d'une onde plane de cisaillement générée par une plaque reliéeà un actionneur basse fréquenceélectromagnétique. A l'aide d'unéchographe ultrarapide (Aixplorer) programméà une cadence d'images de 5kHz, il est possible de suivre la vitesse particulaire, calculée par une méthode d'autocorrélation. La courbe de dispersion de Cs(ω) est obtenue sur l'intervalle [20 60]Hz. Après validation sur fantômes d'élasticité calibrés, cette méthode aété appliquée sur 8 placentas sains (<12h après livraison). Les mesures ontété réalisées 3 fois avec repositionnement puis comparées aux mêmes mesures réalisées avec la méthode ShearWaveElastography (SWE). Enfin, un dispositif basé sur ce système, permettant la mesure in vivo, aété développé et caractérisé. Les mesures ex vivo réaliséesà une fréquence fixe de 50 Hz (TE/SWE) montrent de faibles variations inter-observateur. Dans la région périphérique du placenta, le Cs mesuré est de 1.83±0.18 m/s (SWE) contre 1.80±0.24 m/s (TE). La méthode TE démontre une forte reproductibilité des mesures. Un modèle classique de Voigt ainsi qu'un modèle rhéologique fractionnaire (G*(iω)=Ge+K.
Véritable outil pour la pratique quotidienne des médecins, des sages-femmes et des étudiants en m... more Véritable outil pour la pratique quotidienne des médecins, des sages-femmes et des étudiants en médecine, ce livre rassemble 120 questions/réponses et conduites à tenir, adaptées à chaque problématique de gynécologie-obstétrique. Présentée sous forme de fiche, chaque question suit le même plan : demande de la patiente, première consultation avec l'interrogatoire et l'examen du généraliste ou de la sage-femme, et prescription des examens complémentaires initiaux, puis réponse du spécialiste avec ce qu'il faut connaître du diagnostic, les bilans, le traitement et le suivi de chaque pathologie. L'ouvrage aborde chaque sujet avec des conduites à tenir précises, des arbres décisionnels sur tous les aspects de la gynécologie médicale et chirurgicale, d'obstétrique et de grossesse pathologique, de cancérologie et de médecine de la reproduction. Sont présentées les questions de diagnostic anténatal, d'interruption volontaire de grossesse, de demande de certificat, ma...
Background: Obstetric pathologies associated with placental dysfunction correspond to an importan... more Background: Obstetric pathologies associated with placental dysfunction correspond to an important public health issue. Indeed, this pathology is responsible for pre-eclampsia and intrauterine growth retardation (IUGR). For clinicians, the ultrasound (US) assessment of placental function is limited to the observation of indirect parameters such as the amount of amniotic fluid, fetal growth or fetal-placental Doppler. In the case of IUGR, significant changes in the villous architecture are observed [1], most likely changing the elasticity of IUGR placentas compared to normal placentas.
Background: Brain elastography has been recognized as being a promising diagnostic tool. A diseas... more Background: Brain elastography has been recognized as being a promising diagnostic tool. A disease like Alzheimer's slowly replaces normal brain tissue with plaques and neurofibrillary tangles which affect the mechanical properties of cerebral tissue .
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, Jan 25, 2014
Journal de mycologie médicale, 2014
The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laborat... more The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.
![Research paper thumbnail of [Off-label use of calcium channel blockers for tocolysis - Methods and organization]](https://attachments.academia-assets.com/42803410/thumbnails/1.jpg)
](Journal de gynécologie, obstétrique et biologie de la reproduction, 2015
Pour citer cet article : Simon EG, Perrotin F. L'usage hors AMM des inhibiteurs calciques en toco... more Pour citer cet article : Simon EG, Perrotin F. L'usage hors AMM des inhibiteurs calciques en tocolyse -méthodes et organisation. J Gynecol Obstet Biol Reprod (Paris) (2015), http://dx.
Ultrasound in Obstetrics & Gynecology, 2013
1st day (65 cases in lower segment and 8 cases in upper segment) with mean diameter of 4.15cm. Th... more 1st day (65 cases in lower segment and 8 cases in upper segment) with mean diameter of 4.15cm. The clinical characteristics such as parity, gestational age at delivery, birthweight, and use of oxytocin was not different between patients with intrauterine hematoma and those without hematoma. Moreover the need for transfusion and the hemoglobin difference between before and after delivery was not different between the two groups, either. Conclusions: The intrauterine hematoma was common in immediate postpartum period, and the presence of intrauterine hematoma was not associated with adverse clinical outcome.
Ultrasound in Obstetrics & Gynecology, 2013
from a continuous-wave Doppler ultrasound technique. The aim of this study was to investigate the... more from a continuous-wave Doppler ultrasound technique. The aim of this study was to investigate these two novel cardiovascular parameters in pregnancies complicated by hypertensive disorders compared to uncomplicated pregnancies. Methods: This was a prospective case-control study including a group of women presenting with hypertension in the second half of the pregnancy and a group of uncomplicated pregnancies recruited after 20 weeks' gestation. Cardiovascular parameters were assessed using a continuous-wave Doppler ultrasound technique (USCOM ). Pregnancies were followed up and the outcome ascertained. Mann-Whitney test and regression analysis were used for statistical analysis. Results: We recruited 94 women with hypertensive disorders in pregnancy and 106 controls. Compared to normotensive controls, the cases had significantly higher SMII (median 1.96 W/m2, IQR 1.64-2.40 vs 1.75 W/m2, IQR 1.47-2.03, p < 0.001), higher PKR (median 26.27, IQR 19.0-37.07 vs 20.94, IQR 15.69-27.73, p < 0.001), higher systemic vascular resistance index (median 2622dynes-sec/cm5/m2, IQR 2170-3023 vs 1877dynes-sec/cm5/m2, IQR 1561-2233, p < 0.001), but significantly lower cardiac index (median 3.34 L/min/m2, IQR 2.97-4.0 vs 3.72 L/min/m2, IQR 3.17-4.40, p = 0.003). Conclusions: Women presenting with hypertensive disorders in pregnancy demonstrate significant changes in cardiac contractility and dynamic arterial impedance. It remains to be established whether these indices may be used prospectively for the individualized triage and management of these pregnancies.
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, Jan 18, 2015
The aim of this study was to analyze the anatomical relation between the symphysis and the ischia... more The aim of this study was to analyze the anatomical relation between the symphysis and the ischial spines to obtain reliable landmarks for the assessment by Intrapartum Translabial Uultrasound (ITU) of fetal head descent. All Computed Tomography (CT) scans performed for breech presentations and for twin deliveries from 2006 to 2014 in a tertiary university hospital were collected for measurement and analysis by two operators. The Symphysis-left Ischial spine Angle (SIA) and the Symphysis-left Ischial spine Distance (SID) were measured on 3D reconstructions from a CT volume dataset. We calculated intra- and interobserver agreement for SIA and SID with 95% prediction intervals, created Bland-Altman plots created with 95% limits of agreement, and estimated the Intraclass Correlation Coefficient (ICC). A sagittal plane projection from the SIA allowed calculating a sagittal angle, corresponding to the Angle of Progression (AoP) for ITU. SIA and SID were obtained from CT images from 458 w...
2015 IEEE International Ultrasonics Symposium (IUS), 2015
Gynécologie Obstétrique & Fertilité
Gastroentérologie Clinique et Biologique
Gynécologie Obstétrique & Fertilité
Cette étude rétrospective, portant sur 517 patientes ayant un cancer infiltrant du sein classé pT... more Cette étude rétrospective, portant sur 517 patientes ayant un cancer infiltrant du sein classé pT1, évalue la pertinence de la scintigraphie osseuse dans le dépistage des métastases au moment du bilan initial de la maladie, ainsi que les coûts engendrés par un tel dépistage. La réalisation systématique d'une scintigraphie en postopératoire n'a pas permis de dépister les deux seuls cas de métastases osseuses synchrones de cette population. Aucune métastase osseuse n'a été dépistée dans les sous-groupes ayant le plus grand risque métastatique (rentabilité faible pour l'ensemble des pT1). Le taux de faux-positif de la scintigraphie est élevé (17 %). Le surcoût global est évalué à 110 770 euros, soit 215 euros par patiente (208 à 232 euros dans les groupes à risque). ß 2008 Elsevier Masson SAS. Tous droits réservés.
Fetal diagnosis and therapy, Jan 23, 2015
Ultrasound in Obstetrics & Gynecology, 2014
Objectives: To assess the prevalence and timing of prenatal detection of anencephaly in the Nethe... more Objectives: To assess the prevalence and timing of prenatal detection of anencephaly in the Netherlands during a five year period. Methods: A retrospective cohort study was undertaken in the Northwest and the Northeast of the Netherlands. A case-list of all pre-and postnatally diagnosed cases of anencephaly, with or without additional anomalies, was compiled. Cases were included if the estimated due date was between August 1, 2008 and July 31, 2013. Results: During the study period 110 cases of anencephaly were diagnosed. Overall prevalence of anencephaly was 5.4 per 10.000 pregnancies. The majority of the cases (60%) was detected before 14 weeks gestation. The detection rate before 14 weeks of pregnancy was significantly higher in the Northwest compared to the Northeast. (p = .003). During the study period, gestational age at the time of detection did not change significantly (p = .579). The percentage of cases with reported additional (chromosomal) anomalies was 24.5%. Conclusions: The majority of the anencephaly cases in this study was diagnosed prior to the mid-trimester scan. Early detection requires that scans are performed by sonographers trained and experienced in recognizing fetal anomalies in the first trimester. Pregnant women should be informed that an ultrasound scan in early pregnancy can reveal serious anomalies like anencephaly.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
The purpose of this study was to assess the feasibility of using a contrast agent for the sonogra... more The purpose of this study was to assess the feasibility of using a contrast agent for the sonographic examination of adnexal tumors and identify discriminating parameters in the preoperative diagnosis of malignant tumors. We conducted a prospective descriptive monocenter study that analyzed validated echographic criteria and parameters of the enhancement curve obtained by sonographic contrast agent injection. Patients included were referred for a second opinion after the discovery of a suspicious ovarian image. The final diagnosis was reached after surgery and an anatomopathologic examination. Fifty-two tumors were analyzed. Morphologic and Doppler criteria analyses were conducted as described in the literature. The significant parameters of the enhancement curve were the time-intensity curve total area and the duration of activity of the contrast agent during the first phase of decay (P < .002). The performance of the contrast agent was lower than that of the examiner's subj...
Les pathologies obstétriques liéesà un dysfonctionnement placentaire constituent un enjeu de sant... more Les pathologies obstétriques liéesà un dysfonctionnement placentaire constituent un enjeu de santé publique important. Dans le cas du Retard de Croissance Intra-Utérin (RCIU), on constate une modification significative de l'architecture villositaire en comparaison d'un placenta sain, modifiant la valeur absolue du moduleélastique et vraisemblablement la loi de dépendance en fréquence de ce paramètre. A ce jour, les propriétés biomécaniques du placenta n'ontété que très peuétudiées, et il n'existe aucun appareil clinique capable de renseigner sur sonélasticité ou son architecture. Dans ce contexte, nous proposons uneétude ex vivo de la dispersion de la vitesse des ondes de cisaillement (Cs) dans le placenta. La méthode d'Elastographie Transitoire (TE) proposée consisteà suivre la propagation d'une onde plane de cisaillement générée par une plaque reliéeà un actionneur basse fréquenceélectromagnétique. A l'aide d'unéchographe ultrarapide (Aixplorer) programméà une cadence d'images de 5kHz, il est possible de suivre la vitesse particulaire, calculée par une méthode d'autocorrélation. La courbe de dispersion de Cs(ω) est obtenue sur l'intervalle [20 60]Hz. Après validation sur fantômes d'élasticité calibrés, cette méthode aété appliquée sur 8 placentas sains (<12h après livraison). Les mesures ontété réalisées 3 fois avec repositionnement puis comparées aux mêmes mesures réalisées avec la méthode ShearWaveElastography (SWE). Enfin, un dispositif basé sur ce système, permettant la mesure in vivo, aété développé et caractérisé. Les mesures ex vivo réaliséesà une fréquence fixe de 50 Hz (TE/SWE) montrent de faibles variations inter-observateur. Dans la région périphérique du placenta, le Cs mesuré est de 1.83±0.18 m/s (SWE) contre 1.80±0.24 m/s (TE). La méthode TE démontre une forte reproductibilité des mesures. Un modèle classique de Voigt ainsi qu'un modèle rhéologique fractionnaire (G*(iω)=Ge+K.
Véritable outil pour la pratique quotidienne des médecins, des sages-femmes et des étudiants en m... more Véritable outil pour la pratique quotidienne des médecins, des sages-femmes et des étudiants en médecine, ce livre rassemble 120 questions/réponses et conduites à tenir, adaptées à chaque problématique de gynécologie-obstétrique. Présentée sous forme de fiche, chaque question suit le même plan : demande de la patiente, première consultation avec l'interrogatoire et l'examen du généraliste ou de la sage-femme, et prescription des examens complémentaires initiaux, puis réponse du spécialiste avec ce qu'il faut connaître du diagnostic, les bilans, le traitement et le suivi de chaque pathologie. L'ouvrage aborde chaque sujet avec des conduites à tenir précises, des arbres décisionnels sur tous les aspects de la gynécologie médicale et chirurgicale, d'obstétrique et de grossesse pathologique, de cancérologie et de médecine de la reproduction. Sont présentées les questions de diagnostic anténatal, d'interruption volontaire de grossesse, de demande de certificat, ma...
Background: Obstetric pathologies associated with placental dysfunction correspond to an importan... more Background: Obstetric pathologies associated with placental dysfunction correspond to an important public health issue. Indeed, this pathology is responsible for pre-eclampsia and intrauterine growth retardation (IUGR). For clinicians, the ultrasound (US) assessment of placental function is limited to the observation of indirect parameters such as the amount of amniotic fluid, fetal growth or fetal-placental Doppler. In the case of IUGR, significant changes in the villous architecture are observed [1], most likely changing the elasticity of IUGR placentas compared to normal placentas.
Background: Brain elastography has been recognized as being a promising diagnostic tool. A diseas... more Background: Brain elastography has been recognized as being a promising diagnostic tool. A disease like Alzheimer's slowly replaces normal brain tissue with plaques and neurofibrillary tangles which affect the mechanical properties of cerebral tissue .
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, Jan 25, 2014
Journal de mycologie médicale, 2014
The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laborat... more The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2015
Pour citer cet article : Simon EG, Perrotin F. L'usage hors AMM des inhibiteurs calciques en toco... more Pour citer cet article : Simon EG, Perrotin F. L'usage hors AMM des inhibiteurs calciques en tocolyse -méthodes et organisation. J Gynecol Obstet Biol Reprod (Paris) (2015), http://dx.