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1. Maturation cervicale : y a-t-il un avantage à utiliser un double ballonnet pour le déclenchement du travail ?

Author

Philippe Deruelle, E. Clouqueur, C. Boyon, and N. Monsarrat

Subjects
Reproductive Medicine, Obstetrics and Gynecology, General Medicine
Abstract

Resume Objectif Comparer l’efficacite d’un double ballonnet aux prostaglandines vaginales pour le declenchement du travail chez des patientes avec col defavorable. Patientes et methodes Cinquante patientes declenchees par double ballonnet etaient comparees a 50 patientes recevant des prostaglandines vaginales appariees sur l’âge, la parite, l’antecedent d’uterus cicatriciel, le terme et le score de Bishop. Le critere de jugement principal etait le taux d’echec de declenchement. Les criteres secondaires incluaient les modifications du score de Bishop, le delai pose-accouchement, le taux de cesarienne ainsi que la morbidite maternelle et neonatale. Resultats Le taux d’echec de declenchement (16 % dans le groupe double ballonnet vs 14 % dans le groupe prostaglandines) et le taux de cesarienne (28 % vs 36 %) etaient similaires dans les deux groupes. Le taux de col favorable et le delai d’obtention d’un col favorable etaient identiques avec les deux methodes. Le score de douleur maximale pendant la maturation cervicale etait significativement inferieur dans le groupe double ballonnet (p Discussion et conclusion Dans notre etude, le double ballonnet avait une efficacite identique aux prostaglandines. Le delai pose-accouchement n’etait pas allonge par rapport aux prostaglandines. L’avantage principal pourrait etre une meilleure tolerance favorisant la satisfaction des patientes.

Published
2014
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2. Actualité sur la chirurgie robotique du cancer du rectum

Author

A. Adenis, L. Boulanger, N. Monsarrat, M. Jafari, L. Vanseymortier, and Fabrice Narducci

Subjects
Oncology
Abstract

L’utilisation de robots dans la chirurgie du cancer du rectum est assez recente. Plusieurse quipes ont rapportedes resultats initiaux encourageants. Nous avons fait une revue de ces principaux travaux et rapportons notre experience preliminaire.

Published
2009
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3. Échographie et Doppler fœtaux dans le bloc auriculoventriculaire congénital d’origine immunologique

Author

D. Launay, Philippe Deruelle, A. Richard, P.-Y. Hatron, V. Houfflin-Debarge, N. Monsarrat, Damien Subtil, and M. Lambert

Subjects
Reproductive Medicine, Cardiac pacing, Fetal hydrops, Philosophy, Obstetrics and Gynecology, General Medicine, Myocardial disease, Humanities, Fluorinated steroids, Congenital heart block
Abstract

Resume Les blocs auriculoventriculaires congenitaux d’origine immunologique sont lies au passage transplacentaire d’anticorps anti-SS-A/Ro et/ou anti-SS-B/La maternels pouvant s’integrer dans le cadre d’une connectivite. L’echographie avec Doppler est essentielle pour le depistage de ces blocs auriculoventriculaires au cours des grossesses a risque. Elle permet le diagnostic des blocs du premier ou deuxieme degre qui constituent probablement des etapes preliminaires dans l’atteinte des voies de conduction. Un traitement maternel par corticoides peut dans cette situation etre propose au couple, en raison d’un possible effet de cette therapeutique sur les blocs du premier ou deuxieme degre. En tant que signes precoces d’une lesion nodale, ils peuvent toutefois manquer : certains fœtus developpent un bloc complet sans qu’aucun bloc de degre inferieur n’ait ete identifie prealablement. De meme, la valeur semiologique du bloc du premier degre n’est pas totalement claire puisqu’il semble pouvoir etre spontanement reversible. D’autres marqueurs de lesion nodale seraient donc precieux. En cas de bloc complet, l’echographie est utile pour identifier des signes de decompensation cardiaque et guider la conduite obstetricale et l’extraction fœtale sur la base de signes pronostiques defavorables.

Published
2009
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4. Assistance robotisée en chirurgie gynécologique : état des lieux

Author

Pierre Collinet, Denis Vinatier, Eric Leblanc, N. Monsarrat, and Fabrice Narducci

Subjects
Laparoscopic surgery, medicine.medical_specialty, Hysterectomy, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Obstetrics and Gynecology, General Medicine, Endoscopy, Surgery, Robotic systems, Reproductive Medicine, Laparotomy, Medicine, Lymphadenectomy, business, Laparoscopy, Robotic arm
Abstract

From the Automated Endoscopic System for Optimal Positioning (AESOP), a robotic arm which operates the laparoscope, to the robots Zeus and da Vinci, robotic assistance in gynaecological endoscopic surgery has continuously evolved for the last fifteen years or so. It has brought about new technical advancements: the last generation robots offer a steady three-dimensional image, improved instrument dexterity and precision, higher ergonomics and comfort for the surgeon. The da Vinci robotic system has been used without evincing any specific morbidity in various cases, notably for tubal reanastomosis, myomectomy, hysterectomy, pelvic and para-aortic lymphadenectomy or sacrocolpopexy amongst others. Robotic assistance in gynaecology is thus feasible. Like conventional laparoscopic surgery, it allows decreased blood loss and morbidity as well as shorter hospital stay, as compared to laparotomy. It might indeed allow many surgical teams to perform minimally invasive surgical procedures which they were not used to performing by laparoscopy. Randomized prospective studies are needed to define its indications more precisely. Besides, its medico-financial impact should be evaluated too.

Published
2009
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5. [Robotic assistance in gynaecological surgery: State-of-the-art]

Author

N, Monsarrat, P, Collinet, F, Narducci, E, Leblanc, and D, Vinatier

Subjects
Automation, Laparotomy, Gynecologic Surgical Procedures, Postoperative Complications, Costs and Cost Analysis, Humans, Minimally Invasive Surgical Procedures, Female, Laparoscopy, France, Robotics, Length of Stay
Abstract

From the Automated Endoscopic System for Optimal Positioning (AESOP), a robotic arm which operates the laparoscope, to the robots Zeus and da Vinci, robotic assistance in gynaecological endoscopic surgery has continuously evolved for the last fifteen years or so. It has brought about new technical advancements: the last generation robots offer a steady three-dimensional image, improved instrument dexterity and precision, higher ergonomics and comfort for the surgeon. The da Vinci robotic system has been used without evincing any specific morbidity in various cases, notably for tubal reanastomosis, myomectomy, hysterectomy, pelvic and para-aortic lymphadenectomy or sacrocolpopexy amongst others. Robotic assistance in gynaecology is thus feasible. Like conventional laparoscopic surgery, it allows decreased blood loss and morbidity as well as shorter hospital stay, as compared to laparotomy. It might indeed allow many surgical teams to perform minimally invasive surgical procedures which they were not used to performing by laparoscopy. Randomized prospective studies are needed to define its indications more precisely. Besides, its medico-financial impact should be evaluated too.

Published
2008

6. [Fetal ultrasonography and Doppler in isolated congenital heart block]

Author

N, Monsarrat, V, Houfflin-Debarge, A, Richard, D, Launay, M, Lambert, P-Y, Hatron, D, Subtil, and P, Deruelle

Subjects
Myocarditis, Heart Block, Pregnancy, Antibodies, Antinuclear, Hydrops Fetalis, Pregnancy Outcome, Humans, Female, Ultrasonography, Doppler, Prognosis, Ultrasonography, Prenatal
Abstract

Isolated congenital heart block is linked to transplacental passage of maternal anti-SSA/Ro and/or anti-SSB/La antibodies that may be related to a connective tissue disease. Ultrasonography and Doppler are essential to screen fetus at risk. They allow the diagnosis of first- and second-degree blocks which are probably preliminary stages in conducting tissue's injury. In these situations, a maternal treatment by fluorinated steroids can be proposed because of its possible effect on partial blocks. However, these early signs of nodal injury can be lacking: some fetus present a complete heart block without previously detected less advanced block. Moreover, the significance of first-degree block is unclear since it could reverse spontaneously. Other markers of nodal injury would be valuable. In case of complete congenital heart block, ultrasonography is useful to detect congestive heart failure and help the obstetrical management when unfavorable prognostic signs occur.

Published
2008

8. Quebec Bridge (2nd bridge)

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017613%5DLS017613, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017613/LS017613/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1913

9. Quebec Bridge (2nd bridge); Condition of the north anchor arm at the close of the season of 1914

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017611%5DLS017611, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017611/LS017611/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1914

10. Quebec Bridge (2nd bridge); End elevation of the traveller showing the four tracks on which it was carried and the temporary outside girders to support the outside tracks

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017610%5DLS017610, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017610/LS017610/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1913

11. Quebec Bridge (present bridge)

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017628%5DLS017628, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017628/LS017628/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1917

12. Quebec Bridge

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017629%5DLS017629, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017629/LS017629/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1913

13. Quebec Bridge (2nd bridge)

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017641%5DLS017641, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017641/LS017641/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1915

14. Quebec Bridge (present bridge); Elevation, to the same scale, of the Quebec and other great cantilever bridges (Forth Br., Blackwells Island, N.Y.)

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017605%5DLS017605, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017605/LS017605/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1917

15. Quebec Bridge (present bridge); Diagram showing principal dimensions of present Quebec Bridge

Author

Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider, and Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider

Abstract

Design: St. Lawrence Bridge Co.; Engineers: Henri Vautelet, Maurice Fitzmaurice, Ralph Modjeski, Charles MacDonald, Charles N. Monsarrat, and C.C. Schneider; After the collapse of the 1st bridge the Canadian government took over the project and appointed a board of engineers which included Henri Vautelet, Maurice Fitzmurice, and Ralph Modjeski. However, by the time of the bridge's completion Ralph Modjeski was the only original board member still involved with the project. A new design was chosen for the bridge by the St. Lawrence Bridge Co. which involved building the two sides of the bridge then floating the center span into place and lifting it up from the river with the use of jacks. The first attempt to lift the center ended with its collapse on Sept. 11, 1916, due to a steel casting failure. A new span was quickly created and the bearings re-designed so that the 2nd attempt was successful and the bridge was completed in 1917. At 1800 ft the Quebec Bridge has the longest cantilever span in the world. For more information see: William D. Middleton, The Bridge at Quebec (Bloomington: Indiana Univ. Press, 2001), http://name.umdl.umich.edu/IC-UMMU2IC-X-LS017604%5DLS017604, https://quod.lib.umich.edu/cgi/i/image/api/thumb/ummu2ic/LS017604/LS017604/!250,250, https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1917

16. [Syncopes and brief spells of feeling faint: value of Holter monitoring?]

Author

X, André-Fouet, N, Monsarrat, B, Wintzer, S, Benflis, J F, Thizy, K, Allouache, M T, Chatelain, J J, Sarda, S, Guillaume, and A M, Cosseron

Subjects
Adult, Male, Electrocardiography, Adolescent, Heart Function Tests, Humans, Arrhythmias, Cardiac, Female, Middle Aged, Dizziness, Syncope, Aged, Retrospective Studies
Abstract

A retrospective study of Holter monitoring of 250 patients referred for syncope and short spells of dizziness suspected of being cardiac in origin was undertaken to assess the diagnostic value of the investigation. The arrhythmias observed were classified in 3 groups, significant, suspect and physiological with respect to their true or potential severity and to previously reported results of Holter monitoring in healthy subjects. The following arrhythmias were classified as significant: supraventricular tachycardia with a ventricular rate greater than or equal to 200 bpm; sustained ventricular tachycardia (greater than 30 s and greater than or equal to 150 bpm), bradycardia (less than bpm), sinus arrest (waking greater than 2 s sleeping greater than or equal to 6 s), complete AV block with wide QRS complexes and pacemaker dysfunction. The following arrhythmias were classified as suspect: paroxysmal supraventricular tachycardia with a ventricular rate less than 200 bpm, salvos of ventricular tachycardia (120 greater than 150 bpm); R/T phenomenon and doublets (greater than or equal to 50/24 hours), sinus arrest of 2 to 6 seconds during sleep, complete AV block with narrow QRS complexes or second degree Mobitz II block. This classification led to a diagnosis of certitude in 20 patients (5.7%) with significant arrhythmias concomitant with syncope or a minor form in only 5 cases, supraventricular tachycardia (4 cases), ventricular tachycardia (4 cases), AV block (5 cases), sinus arrest (3 cases), pacemaker dysfunction (4 cases); a diagnosis of presumption in 74 patients (21.1%) with suspect arrhythmias in the absence of syncope or minor equivalent.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1985

17. Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.

Author

Veyre F, Poulain-Veyre C, Esparcieux A, Monsarrat N, Aouifi A, Lapeze J, and Chatelard P

Subjects
Anticoagulants therapeutic use, Arterial Occlusive Diseases therapy, Betacoronavirus, COVID-19, Combined Modality Therapy, Diagnosis, Differential, Humans, Male, Pandemics, Platelet Aggregation Inhibitors therapeutic use, SARS-CoV-2, Thrombectomy, Thrombosis drug therapy, Young Adult, Arterial Occlusive Diseases virology, Coronavirus Infections complications, Femoral Artery, Pneumonia, Viral complications, Thrombosis virology
Abstract

Introduction: Few cases of arterial thromboembolisms have been reported after novel coronavirus disease 2019 (COVID-19) in case of severe infection or in elderly patients. We report a case of femoral arterial thrombosis in a young patient after nonsevere infection., Case Description: A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal artery thrombosis was diagnosed in a 24-year-old man complaining of right lower limb pain for one month. The evolution was good after anticoagulation and antiaggregant treatments and thrombectomy. Etiologic assessment was negative except for nonsevere COVID-19., Discussion: COVID-19 accesses host cells via angiotensin-converting enzyme 2 protein, abundant in the lungs, which is also expressed by endothelial cells and is associated with important inflammatory syndrome and coagulopathy, leading to vascular lesions. Thrombosis prevalence is not fully established and seems to be higher in case of major inflammation and in the intensive care unit (ICU). Arterial thromboembolisms are described in many vascular territories, each time in elderly patients, or in case of severe infection. We described a femoral arterial thrombosis in a young patient with negative etiological assessment except nonsevere COVID-19. Treatment consists in anticoagulation and antiaggregant drugs and thrombectomy. Preventing venous thromboembolism treatment is recommended in case of severe infection or in the ICU, but there is no clear recommendation for arterial thromboembolism prevention. This case should lead us to be very careful of the arterial event risk even if the infection is nonsevere and the patient is young., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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18. [Cervical ripening: is there an advantage for a double-balloon device in labor induction?].

Author

Boyon C, Monsarrat N, Clouqueur E, and Deruelle P

Subjects
Administration, Intravaginal, Adult, Cesarean Section statistics & numerical data, Female, Gestational Age, Humans, Pain Measurement, Patient Satisfaction, Pregnancy, Prostaglandins administration & dosage, Treatment Outcome, Cervical Ripening physiology, Labor, Induced instrumentation, Labor, Induced methods
Abstract

Objectives: To compare efficiency of a double-balloon to vaginal prostaglandins for cervical ripening in patients with unfavourable cervix., Patients and Methods: Fifty patients induced with a double-balloon were compared to 50 patients receiving vaginal prostaglandins. Matching criteria were age, parity, history of uterine scar, gestational age and Bishop score. The primary outcome was failure induction. Secondary outcomes included improvement in Bishop score, ripening-to-delivery interval, caesarean section rate, maternal and neonatal morbidity., Results: Risk of failed induction (16% in the double-balloon group vs. 14% in the prostaglandins group) and caesarean section rate (28% vs. 36%) were similar in the two groups. The proportion of favourable cervix and the time to obtain a better Bishop score were similar with the two methods. Maximal pain score during cervical ripening was significantly lower in the double-balloon group (P<0.001). Ripening-to-delivery interval (30.4 h ± 15.6h vs. 28.9 h ± 20.5h) was not different between the two groups. There was no difference about maternal and neonatal outcomes., Discussion and Conclusion: The double-balloon was as efficient as vaginal prostaglandins. The ripening-to-delivery interval was not different between the two groups. The main advantage of this device could be a better tolerance favourishing patient satisfaction., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Published
2014
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19. [Fetal ultrasonography and Doppler in isolated congenital heart block].

Author

Monsarrat N, Houfflin-Debarge V, Richard A, Launay D, Lambert M, Hatron PY, Subtil D, and Deruelle P

Subjects
Antibodies, Antinuclear blood, Female, Humans, Hydrops Fetalis diagnostic imaging, Myocarditis congenital, Myocarditis diagnostic imaging, Pregnancy, Pregnancy Outcome, Prognosis, Heart Block congenital, Heart Block diagnostic imaging, Ultrasonography, Doppler, Ultrasonography, Prenatal
Abstract

Isolated congenital heart block is linked to transplacental passage of maternal anti-SSA/Ro and/or anti-SSB/La antibodies that may be related to a connective tissue disease. Ultrasonography and Doppler are essential to screen fetus at risk. They allow the diagnosis of first- and second-degree blocks which are probably preliminary stages in conducting tissue's injury. In these situations, a maternal treatment by fluorinated steroids can be proposed because of its possible effect on partial blocks. However, these early signs of nodal injury can be lacking: some fetus present a complete heart block without previously detected less advanced block. Moreover, the significance of first-degree block is unclear since it could reverse spontaneously. Other markers of nodal injury would be valuable. In case of complete congenital heart block, ultrasonography is useful to detect congestive heart failure and help the obstetrical management when unfavorable prognostic signs occur.

Published
2009
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20. [Robotic assistance in gynaecological surgery: State-of-the-art].

Author

Monsarrat N, Collinet P, Narducci F, Leblanc E, and Vinatier D

Subjects
Automation, Costs and Cost Analysis, Female, France, Gynecologic Surgical Procedures economics, Humans, Laparoscopy economics, Laparoscopy methods, Laparoscopy trends, Laparotomy methods, Length of Stay, Minimally Invasive Surgical Procedures economics, Minimally Invasive Surgical Procedures trends, Postoperative Complications prevention & control, Robotics economics, Gynecologic Surgical Procedures trends, Robotics trends
Abstract

From the Automated Endoscopic System for Optimal Positioning (AESOP), a robotic arm which operates the laparoscope, to the robots Zeus and da Vinci, robotic assistance in gynaecological endoscopic surgery has continuously evolved for the last fifteen years or so. It has brought about new technical advancements: the last generation robots offer a steady three-dimensional image, improved instrument dexterity and precision, higher ergonomics and comfort for the surgeon. The da Vinci robotic system has been used without evincing any specific morbidity in various cases, notably for tubal reanastomosis, myomectomy, hysterectomy, pelvic and para-aortic lymphadenectomy or sacrocolpopexy amongst others. Robotic assistance in gynaecology is thus feasible. Like conventional laparoscopic surgery, it allows decreased blood loss and morbidity as well as shorter hospital stay, as compared to laparotomy. It might indeed allow many surgical teams to perform minimally invasive surgical procedures which they were not used to performing by laparoscopy. Randomized prospective studies are needed to define its indications more precisely. Besides, its medico-financial impact should be evaluated too.

Published
2009
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21. [Syncopes and brief spells of feeling faint: value of Holter monitoring?].

Author

André-Fouet X, Monsarrat N, Wintzer B, Benflis S, Thizy JF, Allouache K, Chatelain MT, Sarda JJ, Guillaume S, and Cosseron AM

Subjects
Adolescent, Adult, Aged, Arrhythmias, Cardiac complications, Dizziness etiology, Female, Heart Function Tests, Humans, Male, Middle Aged, Retrospective Studies, Syncope etiology, Arrhythmias, Cardiac diagnosis, Dizziness diagnosis, Electrocardiography methods, Syncope diagnosis
Abstract

A retrospective study of Holter monitoring of 250 patients referred for syncope and short spells of dizziness suspected of being cardiac in origin was undertaken to assess the diagnostic value of the investigation. The arrhythmias observed were classified in 3 groups, significant, suspect and physiological with respect to their true or potential severity and to previously reported results of Holter monitoring in healthy subjects. The following arrhythmias were classified as significant: supraventricular tachycardia with a ventricular rate greater than or equal to 200 bpm; sustained ventricular tachycardia (greater than 30 s and greater than or equal to 150 bpm), bradycardia (less than bpm), sinus arrest (waking greater than 2 s sleeping greater than or equal to 6 s), complete AV block with wide QRS complexes and pacemaker dysfunction. The following arrhythmias were classified as suspect: paroxysmal supraventricular tachycardia with a ventricular rate less than 200 bpm, salvos of ventricular tachycardia (120 greater than 150 bpm); R/T phenomenon and doublets (greater than or equal to 50/24 hours), sinus arrest of 2 to 6 seconds during sleep, complete AV block with narrow QRS complexes or second degree Mobitz II block. This classification led to a diagnosis of certitude in 20 patients (5.7%) with significant arrhythmias concomitant with syncope or a minor form in only 5 cases, supraventricular tachycardia (4 cases), ventricular tachycardia (4 cases), AV block (5 cases), sinus arrest (3 cases), pacemaker dysfunction (4 cases); a diagnosis of presumption in 74 patients (21.1%) with suspect arrhythmias in the absence of syncope or minor equivalent.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1985

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