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Research paper thumbnail of Characteristics of the Neuropathy Induced by Thoracotomy A 4-month Follow-up Study With Psychophysical Examination

Clinical Journal of Pain, 2011

To explore the role of neuropathy in persistent pain after thoracotomy, combining a clinical foll... more To explore the role of neuropathy in persistent pain after thoracotomy, combining a clinical follow-up and a psychophysical examination of the operated area. Seventy-three patients were followed and examined at their discharge from hospital, 6 weeks and 4 months after pneumonectomy under thoracotomy. Spontaneous and evoked pain was assessed by clinical examination, a 7-day pain score, and the Neuropathic Pain Symptom Inventory. At the fourth month follow-up, pain and tolerance thresholds to pinprick, heat, and warm sensation threshold were measured on both sides of the thorax. The rate of spontaneous pain was 40% at discharge and went up to 59% at the sixth week follow-up. Evoked pain was rare at discharge (11%), most cases appearing at the sixth week follow-up (47%). The evolution profiles of pain between the sixth week and the fourth month follow-up were heterogeneous with a tendency to decrease. Young age, female sex, and spontaneous pain observed at discharge from hospital were identified as early predictive factors of spontaneous pain persisting at the fourth month follow-up. On the side of operation, thresholds tended to increase for warm and hot stimuli, and to decrease for mechanical stimuli. At the fourth month follow-up, spontaneous pain and evoked pain were associated to static hyperalgesia, persisting hypoesthesia, low mechanical thresholds, altered sensation of heat, and impaired quality of life. Peripheral neuropathy is common after thoracotomy, with variant characteristics, ranging from subclinical disturbances to severe pain. The process seems to develop between the discharge from hospital and the sixth week after thoracotomy.

Research paper thumbnail of tude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints de schizophrénie

Annales Medico-psychologiques, 2004

Étude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints ... more Étude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints de schizophrénie Study of weight gain at schizophrenic patients treated by risperidone, olanzapine, amisulpride

Research paper thumbnail of Efficiency of TachoSil® to prevent postsurgical adhesion development on laparoscopic rat model

Gynecological Surgery, 2009

The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemos... more The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemostatic sponge (TachoSil®) in the prevention of postsurgical adhesions in a laparoscopic rat model and its histological effects on uterine and peritoneal parenchyma. Design was a prospective randomized blinded study. Setting was in International Laparoscopic Surgery Centre, Clermont-Ferrand, France. There were 100 sexually mature female Sprague–Dawley rats weighing 240 to 300 g and aged 6–8 weeks. A standardized severe surgical injury induced by scissors and 40-W bipolar coagulation in the rat uterine horn, corpus, and peritoneum was performed to induce adhesion formation. After trauma, group 1 (n = 50) received no treatment and group 2 rats (n = 50) received TachoSil® applied on injured areas. Twelve weeks after the procedure, repeat laparoscopy was performed and adhesions were scored according to their extent and severity. A hysterectomy and a peritoneal biopsy in the injured area were achieved by laparotomy in order to investigate on a possible earlier effect of TachoSil® on the uterine and peritoneal parenchyma in 49 rats of each group. TachoSil® group adhesion scores showed a significant decrease on the three injured areas: peritoneum (12.96 vs. 21.66), uterine horn (7.22 vs. 15.20), and uterine corpus (5.88 vs. 34.52). TachoSil® group also demonstrated a major decline of uterine fibrosis and inflammation. This study revealed that TachoSil®, an absorbable biomaterial, can reduce postoperative adhesions after laparoscopic surgery on a rat model. TachoSil® also prevents thermo-induced injuries on uterine parenchyma (less fibrosis and less inflammation).

Research paper thumbnail of Dosage de l’homocystéine plasmatique, comparaison de deux méthodes : CLHP versus immunonéphélémétrie

Immuno-analyse & Biologie Specialisee, 2009

Homocysteine (Hcy) is a thiol containing amino acid related to methionine demethylation. Increase... more Homocysteine (Hcy) is a thiol containing amino acid related to methionine demethylation. Increased Hcy concentration is considered as a risk factor for cardiovascular diseases. In clinical laboratories, Hcy measurement can be performed using diverse methods such as chromatography, immunonephelemetry, immunochimiluminescence or enzymatic colorimetry. The goal of this work was to correlate two methods: high-pressure liquid chromatography (HPLC) versus immunonephelemetry. We studied 196 plasmatic samples collected in two hospitals, according to established protocols. The statistical analysis showed strong correlation and concordance between the two techniques. Hcy measurements using immunonephelemetry are underestimated by 25% compared to HPLC, leading to normality and cut-off changes for immunonephelemetry to 12 M compared to 15 M for HPLC. Using this value, sensibility of the measurement is 82% and specificity is 94.5%. In these conditions, Hcy measurements in immunonephelemetry on BN ProSpec (Siemens ® ) are as dependable as those of HPLC and applicable, as it is currently the case in CHU of Saint-Étienne.

Research paper thumbnail of Déficit cognitif et mesure de la qualité de vie dans la sclérose en plaques

Revue Neurologique, 2006

Parmi les atteintes de la sclérose en plaques, l’existence d’une atteinte cognitive peut modifier... more Parmi les atteintes de la sclérose en plaques, l’existence d’une atteinte cognitive peut modifier la perception qu’ont les patients de leur qualité de vie.Cent dix-sept patients atteints de SEP et ayant un Mini Mental State > 24, ont été soumis à des tests neuropsychologiques (vocabulaire, Stroop, Grober et Buschke, WCST, similitudes, fluence, échelle de dépression de Hamilton) et à l’auto-questionnaire de qualité de vie SEP-59, pour évaluer le lien entre dégradation cognitive et qualité de vie.La structure des données entre qualité de vie et tests neuropsychologiques, étudiée par analyse en composantes principales et analyse des corrélations, révèle une influence de l’atteinte cognitive sur la perception de la qualité de vie, une meilleure qualité de vie étant déclarée lorsque l’atteinte cognitive augmente. L’analyse en seuil montre que la partition de notre cohorte en deux groupes, (l’un atteint déficitaire, l’autre non, à partir des 8 tests neuropsychologiques combinés entre eux) permet de confirmer que la présence d’un déficit cognitif entraîne une surestimation de la qualité de vie et une sous-estimation du handicap.Il convient de considérer avec prudence le niveau cognitif des patients dès lors qu’ils doivent être évalués sur des dimensions mettant en jeu leur propre perception.Cognitive disorders may bias perception of quality-of-life in patients with multiple sclerosis (MS).Neuropsychological tests (WAIS-vocabulary, Gröber and Buschke, Stroop, WCST, WAIS-similitude, fluency, Hamilton's depression scale) along with a French health-related quality of life self questionnaire for MS patients (the SEP59) were performed by 117 MS patients with a minor cognitive impairment (Mini Mental State over 24) in order to explore the links between quality of life perception and cognitive functioning.Main Component Analysis and correlation analysis showed that cognitive impairment produced an overrating of the self perception of quality of life. Threshold analysis, splitting patients between the most and the less cognitively impaired, confirmed this relationship.The level of cognitive functioning must be considered with caution when analyzing health-related quality of MS patients.

Research paper thumbnail of Elderly suicide attempters: characteristics and outcome

International Journal of Geriatric Psychiatry, 2006

PurposeWe made a descriptive survey to assess the outcome of elderly patients discharged from a h... more PurposeWe made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics.We made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics.MethodsFifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files.Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files.ResultsElderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression.Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression.ConclusionElderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect. Copyright © 2006 John Wiley & Sons, Ltd.Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect. Copyright © 2006 John Wiley & Sons, Ltd.

Research paper thumbnail of Characteristics of the Neuropathy Induced by Thoracotomy A 4-month Follow-up Study With Psychophysical Examination

Clinical Journal of Pain, 2011

To explore the role of neuropathy in persistent pain after thoracotomy, combining a clinical foll... more To explore the role of neuropathy in persistent pain after thoracotomy, combining a clinical follow-up and a psychophysical examination of the operated area. Seventy-three patients were followed and examined at their discharge from hospital, 6 weeks and 4 months after pneumonectomy under thoracotomy. Spontaneous and evoked pain was assessed by clinical examination, a 7-day pain score, and the Neuropathic Pain Symptom Inventory. At the fourth month follow-up, pain and tolerance thresholds to pinprick, heat, and warm sensation threshold were measured on both sides of the thorax. The rate of spontaneous pain was 40% at discharge and went up to 59% at the sixth week follow-up. Evoked pain was rare at discharge (11%), most cases appearing at the sixth week follow-up (47%). The evolution profiles of pain between the sixth week and the fourth month follow-up were heterogeneous with a tendency to decrease. Young age, female sex, and spontaneous pain observed at discharge from hospital were identified as early predictive factors of spontaneous pain persisting at the fourth month follow-up. On the side of operation, thresholds tended to increase for warm and hot stimuli, and to decrease for mechanical stimuli. At the fourth month follow-up, spontaneous pain and evoked pain were associated to static hyperalgesia, persisting hypoesthesia, low mechanical thresholds, altered sensation of heat, and impaired quality of life. Peripheral neuropathy is common after thoracotomy, with variant characteristics, ranging from subclinical disturbances to severe pain. The process seems to develop between the discharge from hospital and the sixth week after thoracotomy.

Research paper thumbnail of tude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints de schizophrénie

Annales Medico-psychologiques, 2004

Étude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints ... more Étude de la prise de poids sous rispéridone, olanzapine, amisulpride, chez des patients atteints de schizophrénie Study of weight gain at schizophrenic patients treated by risperidone, olanzapine, amisulpride

Research paper thumbnail of Efficiency of TachoSil® to prevent postsurgical adhesion development on laparoscopic rat model

Gynecological Surgery, 2009

The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemos... more The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemostatic sponge (TachoSil®) in the prevention of postsurgical adhesions in a laparoscopic rat model and its histological effects on uterine and peritoneal parenchyma. Design was a prospective randomized blinded study. Setting was in International Laparoscopic Surgery Centre, Clermont-Ferrand, France. There were 100 sexually mature female Sprague–Dawley rats weighing 240 to 300 g and aged 6–8 weeks. A standardized severe surgical injury induced by scissors and 40-W bipolar coagulation in the rat uterine horn, corpus, and peritoneum was performed to induce adhesion formation. After trauma, group 1 (n = 50) received no treatment and group 2 rats (n = 50) received TachoSil® applied on injured areas. Twelve weeks after the procedure, repeat laparoscopy was performed and adhesions were scored according to their extent and severity. A hysterectomy and a peritoneal biopsy in the injured area were achieved by laparotomy in order to investigate on a possible earlier effect of TachoSil® on the uterine and peritoneal parenchyma in 49 rats of each group. TachoSil® group adhesion scores showed a significant decrease on the three injured areas: peritoneum (12.96 vs. 21.66), uterine horn (7.22 vs. 15.20), and uterine corpus (5.88 vs. 34.52). TachoSil® group also demonstrated a major decline of uterine fibrosis and inflammation. This study revealed that TachoSil®, an absorbable biomaterial, can reduce postoperative adhesions after laparoscopic surgery on a rat model. TachoSil® also prevents thermo-induced injuries on uterine parenchyma (less fibrosis and less inflammation).

Research paper thumbnail of Dosage de l’homocystéine plasmatique, comparaison de deux méthodes : CLHP versus immunonéphélémétrie

Immuno-analyse & Biologie Specialisee, 2009

Homocysteine (Hcy) is a thiol containing amino acid related to methionine demethylation. Increase... more Homocysteine (Hcy) is a thiol containing amino acid related to methionine demethylation. Increased Hcy concentration is considered as a risk factor for cardiovascular diseases. In clinical laboratories, Hcy measurement can be performed using diverse methods such as chromatography, immunonephelemetry, immunochimiluminescence or enzymatic colorimetry. The goal of this work was to correlate two methods: high-pressure liquid chromatography (HPLC) versus immunonephelemetry. We studied 196 plasmatic samples collected in two hospitals, according to established protocols. The statistical analysis showed strong correlation and concordance between the two techniques. Hcy measurements using immunonephelemetry are underestimated by 25% compared to HPLC, leading to normality and cut-off changes for immunonephelemetry to 12 M compared to 15 M for HPLC. Using this value, sensibility of the measurement is 82% and specificity is 94.5%. In these conditions, Hcy measurements in immunonephelemetry on BN ProSpec (Siemens ® ) are as dependable as those of HPLC and applicable, as it is currently the case in CHU of Saint-Étienne.

Research paper thumbnail of Déficit cognitif et mesure de la qualité de vie dans la sclérose en plaques

Revue Neurologique, 2006

Parmi les atteintes de la sclérose en plaques, l’existence d’une atteinte cognitive peut modifier... more Parmi les atteintes de la sclérose en plaques, l’existence d’une atteinte cognitive peut modifier la perception qu’ont les patients de leur qualité de vie.Cent dix-sept patients atteints de SEP et ayant un Mini Mental State > 24, ont été soumis à des tests neuropsychologiques (vocabulaire, Stroop, Grober et Buschke, WCST, similitudes, fluence, échelle de dépression de Hamilton) et à l’auto-questionnaire de qualité de vie SEP-59, pour évaluer le lien entre dégradation cognitive et qualité de vie.La structure des données entre qualité de vie et tests neuropsychologiques, étudiée par analyse en composantes principales et analyse des corrélations, révèle une influence de l’atteinte cognitive sur la perception de la qualité de vie, une meilleure qualité de vie étant déclarée lorsque l’atteinte cognitive augmente. L’analyse en seuil montre que la partition de notre cohorte en deux groupes, (l’un atteint déficitaire, l’autre non, à partir des 8 tests neuropsychologiques combinés entre eux) permet de confirmer que la présence d’un déficit cognitif entraîne une surestimation de la qualité de vie et une sous-estimation du handicap.Il convient de considérer avec prudence le niveau cognitif des patients dès lors qu’ils doivent être évalués sur des dimensions mettant en jeu leur propre perception.Cognitive disorders may bias perception of quality-of-life in patients with multiple sclerosis (MS).Neuropsychological tests (WAIS-vocabulary, Gröber and Buschke, Stroop, WCST, WAIS-similitude, fluency, Hamilton's depression scale) along with a French health-related quality of life self questionnaire for MS patients (the SEP59) were performed by 117 MS patients with a minor cognitive impairment (Mini Mental State over 24) in order to explore the links between quality of life perception and cognitive functioning.Main Component Analysis and correlation analysis showed that cognitive impairment produced an overrating of the self perception of quality of life. Threshold analysis, splitting patients between the most and the less cognitively impaired, confirmed this relationship.The level of cognitive functioning must be considered with caution when analyzing health-related quality of MS patients.

Research paper thumbnail of Elderly suicide attempters: characteristics and outcome

International Journal of Geriatric Psychiatry, 2006

PurposeWe made a descriptive survey to assess the outcome of elderly patients discharged from a h... more PurposeWe made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics.We made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics.MethodsFifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files.Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files.ResultsElderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression.Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression.ConclusionElderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect. Copyright © 2006 John Wiley & Sons, Ltd.Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect. Copyright © 2006 John Wiley & Sons, Ltd.