M. Rodière

University of Grenoble, Grenoble, Rhône-Alpes, France

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Publications (161)110.24 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectifs Évaluer l’efficacité et les évènements secondaires survenant lors de la prise en charge des traumatismes spléniques par embolisation proximale, distale et combinée. Matériels et méthodes Étude rétrospective monocentrique entre 2005 et 2010. Les patients présentant des traumatismes spléniques embolisés ont été répartis en trois groupes selon la technique d’embolisation utilisée : proximale (P), distale (D) ou combinée (C). Les échecs de l’embolisation (splénectomie) et l’ensemble des évènements survenant au cours du suivi ont été recensés. Les résultats ont été comparés en fonction des groupes et du matériel utilisé. Résultats Cinquante patients ont été traités (P [n = 18], 36 % ; D [n = 22], 44 % ; C [n = 8], 16 %) avec un Injury Severity Score (ISS) moyen à 20. Le succès technique était de 98 %. Le succès en termes de sauvetage de rate était de 92 % (4 splénectomies : P [n = 1], D [n = 3], C [n = 0]). Le succès en termes d’hémostase était de 92 % (4 resaignements : P [n = 2], D [n = 2], C [n = 0]). Les différents matériels utilisés ont présenté la même efficacité. Des évènements secondaires sont survenus chez 65 % des patients dans les suites du polytraumatisme. Quatre pour cent des patients ont présenté des complications majeures et 56 % des complications mineures imputables à l’embolisation, sans différence significative entre les groupes. Conclusion L’embolisation splénique est un traitement efficace des traumatismes spléniques avec la survenue d’évènements secondaires dans 65 % des cas quelle que soit la technique d’embolisation employée. L’embolisation proximale préventive semble protéger les traumatismes spléniques de haut grade.
    Journal de Radiologie Diagnostique et Interventionnelle. 09/2014;
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    ABSTRACT: Venous thromboembolism disease (VTE) is rare in children (5.3 of 10,000 hospitalized children). However, morbidity and mortality are high, especially when the child is already suffering from severe sepsis. We report an analytical study of 24 cases of deep venous thrombosis occurring in children during infection, recorded at the Montpellier University Hospital between 1999 and 2009. Many parameters were studied in each population (age, sex, familial and personal history of thrombosis, history of thrombophilia, the presence of a venous catheter, a causative organism, time to onset of thrombus, topography of lesions, acquired abnormalities of hemostasis, and thrombosis prophylaxis). The children were aged from 1day of life to 16years. Thromboses occurred in two clinical contexts: "contact" thrombosis (which appeared near the infection) and disseminated thrombosis. This is an early complication because in most of the cases, it appeared in the first 10days of sepsis. Infection and coagulation appear to be closely related and the states of latent or decompensated disseminated intravascular coagulation are common. Nevertheless, it is not possible to predict the occurence of a thrombotic event. The presence of risk factors (venous catheters, acquired thrombophilia, or constitutional thrombophilia) may increase the thrombogenic potential of the infection. VTE should always be suspected and sought in case of an unfavorable clinical course, and routine prophylaxis of thrombosis during sepsis should be discussed.
    Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 06/2014;
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    ABSTRACT: To assess clinical outcomes of blunt splenic injuries (BSI) managed with proximal versus distal versus combined splenic artery embolization (SAE). All consecutive patients with BSI admitted to our trauma centre from 2005 to 2010 and managed with SAE were reviewed. Outcomes were compared between proximal (P), distal (D) or combined (C) embolization. We focused on embolization failure (splenectomy), every adverse events occurring during follow up and material used for embolization. Fifty patients were reviewed (P n=18, 36%; D n=22, 44%; C n=8, 16%). Mean injury severity score was 20. The technical success rate was 98%. Four patients required splenectomy (P n=1, D n=3, C n=0). Clinical success rate for haemostasis was 92% (4 re-bleeds: P n=2, D n=2, C n=0). Outcomes were not statistically different between the materials used. Adverse events occurred in 65% of the patients during follow up. Four percent of the patients developed major complications and 56% developed minor complications attributable to embolization. There was no significant difference between the 3 groups. SAE had an excellent success rate with adverse events occurring in 65% of the patients and no significant differences found between the embolization techniques used. Proximal preventive embolization appears to protect in high-grade traumatic injuries.
    Diagnostic and interventional imaging. 04/2014;
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    ABSTRACT: Patients with a contra-indication for anticoagulation can benefit from temporary vena caval filters for protection against pulmonary embolism or recurrence. The filter can be removed secondarily, once the contra-indication is overcome, enabling better long-term outcome by reducing the risk of thrombotic and mechanic complications inherent in these devices. However, it has been shown in several studies that effective withdrawal rates were low and could be improved by the establishment of protocols and registries. We report a retrospective study of withdrawal in 72 patients in whom an ALN(®) vena caval filter was implanted at the Grenoble University Hospital over a period of three years with an intention for secondary retrieval. Seventy percent of the indications were related to the coexistence of thrombotic and hemorrhagic conditions. Fifty-five percent of filters were removed, the remaining 45% shared involved patients who died before retrieval (11%), those lost to follow-up (4%), technical failure of retrieval (6%), withdrawal technically unfeasible (3%), retrieval refused by patients (6%) and medical indications for continuing filtration (15%). Despite an effective follow-up of these patients and 91% success rate of withdrawal, nearly one out of two filters remains in place. A long-term follow-up of these patients is needed to learn more about the outcome of these filters.
    Journal des Maladies Vasculaires 09/2013; · 0.24 Impact Factor
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    ABSTRACT: The source for late-onset neonatal infections (LONI) due to group B Streptococcus (GBS) has not been fully explored. We reviewed GBS LONI cases associated with contaminated breast milk to determine whether breast milk was a possible route for neonatal infection. A PubMed search from January 1977 to March 2013 was performed with MeSH words "Streptococcus agalactiae", "group B Streptococcus", "infection", "milk", "human", "late-onset infection" and/or "neonate"; relevant cross references were also reviewed. Forty-eight documented cases of GBS LONI matched our search criteria and were retrieved from the literature. When performed, molecular typing identified clonal isolates in the neonate and milk samples taken after LONI in all cases, with the hypervirulent sequence type 17 (ST-17) clone identified in two of these cases. Caesarean delivery combined with the absence of GBS recovery from maternal samples other than milk was noted for four cases. The rate of recurrent infections was high (35%) and, together with the data reviewed, points to a potential role of breast milk in GBS LONI. The cases reviewed here, together with the evidence of breast milk transmission for other pathogens, suggest that breast milk, which would account for repeated GBS transmission to the neonate, may favour gut translocation and subsequent LONI. Further investigations are nevertheless needed to study the relative importance of this contamination route compared with persistent postnatal gut colonisation and the dynamics of milk and neonatal gut colonisation.
    Archives of Disease in Childhood - Fetal and Neonatal Edition 08/2013; · 3.45 Impact Factor
  • Clinical Pediatrics 03/2013; · 1.27 Impact Factor
  • Source
    Journal des Maladies Vasculaires 03/2013; 38(2):81. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):82-3. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):82–83. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):81. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):81. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):81. · 0.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients with a contra-indication for anticoagulation can benefit from temporary vena caval filters for protection against pulmonary embolism or recurrence. The filter can be removed secondarily, once the contra-indication is overcome, enabling better long-term outcome by reducing the risk of thrombotic and mechanic complications inherent in these devices. However, it has been shown in several studies that effective withdrawal rates were low and could be improved by the establishment of protocols and registries. We report a retrospective study of withdrawal in 72 patients in whom an ALN® vena caval filter was implanted at the Grenoble University Hospital over a period of three years with an intention for secondary retrieval. Seventy percent of the indications were related to the coexistence of thrombotic and hemorrhagic conditions. Fifty-five percent of filters were removed, the remaining 45% shared involved patients who died before retrieval (11%), those lost to follow-up (4%), technical failure of retrieval (6%), withdrawal technically unfeasible (3%), retrieval refused by patients (6%) and medical indications for continuing filtration (15%). Despite an effective follow-up of these patients and 91% success rate of withdrawal, nearly one out of two filters remains in place. A long-term follow-up of these patients is needed to learn more about the outcome of these filters.
    Journal des Maladies Vasculaires 01/2013; 38(6):335–340. · 0.24 Impact Factor
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    ABSTRACT: Neonatal late-onset infections (NLOI) are defined as infections occurring between seven days and three months of life. Their incidence in industrialized countries is stable (1). A recent review reported an average incidence of NLOI due to Streptococcus agalactiae, so-called Group B Streptococcus (GBS), of 0.24/1,000 live births and a case fatality ratio of 6.8% (2). The pathophysiology of GBS NLOI is still not fully understood despite recent advances in the pathogenesis knowledge of invasive infections due to serotype III GBS (S3GBS) and the identification of the hypervirulent clone of sequence type-17 (S3GBS ST-17) (3). © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
    Acta Paediatrica 09/2012; · 1.97 Impact Factor
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    ABSTRACT: Venous thromboembolism disease (VTE) is rare in children (5.3 of 10,000 hospitalized children). However, morbidity and mortality are high, especially when the child is already suffering from severe sepsis. We report an analytical study of 24 cases of deep venous thrombosis occurring in children during infection, recorded at the Montpellier University Hospital between 1999 and 2009. Many parameters were studied in each population (age, sex, familial and personal history of thrombosis, history of thrombophilia, the presence of a venous catheter, a causative organism, time to onset of thrombus, topography of lesions, acquired abnormalities of hemostasis, and thrombosis prophylaxis). The children were aged from 1 day of life to 16 years. Thromboses occurred in two clinical contexts: “contact” thrombosis (which appeared near the infection) and disseminated thrombosis. This is an early complication because in most of the cases, it appeared in the first 10 days of sepsis. Infection and coagulation appear to be closely related and the states of latent or decompensated disseminated intravascular coagulation are common. Nevertheless, it is not possible to predict the occurence of a thrombotic event. The presence of risk factors (venous catheters, acquired thrombophilia, or constitutional thrombophilia) may increase the thrombogenic potential of the infection. VTE should always be suspected and sought in case of an unfavorable clinical course, and routine prophylaxis of thrombosis during sepsis should be discussed.
    Journal des Maladies Vasculaires 09/2012; 37(5):261. · 0.24 Impact Factor
  • Source
    Pediatric Rheumatology 07/2012; 10(1). · 1.47 Impact Factor
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    ABSTRACT: Kawasaki disease is acute self-limited vasculitis of unknown etiology that mainly affects infants and young children. Many different clinical aspects can be encountered. A single dose of intravenous immunoglobulin and treatment by aspirin are the standard therapy. Cases of immunoglobulin therapy resistance pose a real problem. We report on the case of a 14-year-old boy with Kawasaki disease and hemophagocytic syndrome, resistant to the combination of two doses of immunoglobulins and three doses of corticosteroids. Recovery was obtained with one dose of infliximab. This observation highlights Kawasaki disease in adolescents and the therapeutic difficulties that may be encountered in cases of resistance to immunoglobulins. Association with macrophage activation syndrome is rare.
    Archives de Pédiatrie. 07/2012; 19(7):741–744.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Kawasaki disease is acute self-limited vasculitis of unknown etiology that mainly affects infants and young children. Many different clinical aspects can be encountered. A single dose of intravenous immunoglobulin and treatment by aspirin are the standard therapy. Cases of immunoglobulin therapy resistance pose a real problem. We report on the case of a 14-year-old boy with Kawasaki disease and hemophagocytic syndrome, resistant to the combination of two doses of immunoglobulins and three doses of corticosteroids. Recovery was obtained with one dose of infliximab. This observation highlights Kawasaki disease in adolescents and the therapeutic difficulties that may be encountered in cases of resistance to immunoglobulins. Association with macrophage activation syndrome is rare.
    Archives de Pédiatrie 05/2012; 19(7):741-4. · 0.36 Impact Factor
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    ABSTRACT: A rising incidence of invasive group A Streptococcus infections (IGASI) has been noted in children in the past three decades. The relative frequency of the infection types showed marked differences to IGASI in adults, and severity of the disease resulted in a mortality rate usually comprising between 3.6% and 8.3%. The emm1-type group A Streptococcus (GAS) subclone displaying a particular pattern of virulence factors was widely disseminated and prevalent in children with IGASI while the emm3-type GAS subclone appeared as a recent emerging genotype. However, the implication of these hypervirulent clones in the increase of IGASI in children is still controversial. Recent advances in our knowledge on pathogenesis of IGASI underlined that deregulation of virulence factor production, individual susceptibility, as well as exuberant cytokine response are important factors that may account for the severity of the disease in children. Future changes in IGASI epidemiology are awaited from current prospects for a safe and effective vaccine against GAS. IGASI are complex infections associating septic, toxic, and immunological disorders. Treatment has to be effective on both the etiologic agent and its toxins, due to the severity of the disease associated to the spread of highly virulent bacterial clones. More generally, emergence of virulent clones responsible for septic and toxic disease is a matter of concern in pediatric infectiology in the absence of vaccination strategy.
    European Journal of Pediatrics 02/2012; · 1.98 Impact Factor
  • Source
    Journal of Translational Medicine 11/2011; 9(2). · 3.46 Impact Factor

Publication Stats

525 Citations
110.24 Total Impact Points

Institutions

  • 2014
    • University of Grenoble
      Grenoble, Rhône-Alpes, France
  • 2005–2013
    • Centre Hospitalier Universitaire de Grenoble
      Grenoble, Rhône-Alpes, France
  • 2002–2010
    • Centre Hospitalier Universitaire de Montpellier
      Montpelhièr, Languedoc-Roussillon, France
  • 2009
    • French Polynesian Hospital Center
      Vaiete, Îles du Vent, French Polynesia