O. Hamel

Hotel Dieu Hospital, Kingston, Ontario, Canada

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Publications (142)102.67 Total impact

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    ABSTRACT: Background: Aneurysmal subarachnoid haemorrhage (ASH) with intracerebral hematoma (ICH) has a poor prognosis. The treatment is to secure the aneurysm and do an ICH evacuation. Objective: The aim of the study was to determine if aneurysm coiling followed by ICH evacuation is a viable alternative treatment compared to exclusive surgery, regardless of the clinical or paraclinical presentations. Methods: A retrospective study was conducted between 2004 and 2014, which included 44 patients. The patients were divided up in four groups. Two were principal groups: The clipped group (aneurysm clipping with ICH evacuation) and the coiled group (aneurysm coiling, followed by ICH evacuation); and two were subgroups of the latter: Aneurysm coiling with ICH evacuation after 24 hours and ICH evacuation followed by aneurysm coiling. We studied the demographic and radiologic characteristics, and the 3-month outcome. Results: We included 17 patients in the coiled group: The outcome was better for the patients with World Federation of Neurosurgery (WFNS) scores of 1, 2 and 3; compared to the patients with WFNS scores 4 and 5. We included 16 patients in the clipped group: The outcome was better, compared the coiled group, for those patients with WFNS scores 4 and 5. Six patients were treated with aneurysm coiling, followed by ICH evacuation after 24 hours: 33% had a good outcome. Five patients were treated by ICH evacuation, followed by aneurysm coiling: None had a good outcome. Conclusions: It was necessary to realise a prospective study to compare the outcomes of patients with WFNS scores of 1, 2 or 3; between those with aneurysm coiling followed by ICH evacuation and aneurysm clipping with ICH evacuation, to determine the potential of using the coiling first, for these patients.
    No preview · Article · Dec 2015 · Interventional Neuroradiology

  • No preview · Article · Sep 2015
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    ABSTRACT: The surgical assumption of responsibility of the pancreatic pain requires either a truncular coelioscopic or radicular neurectomy of greater splanchnic nerves (gsn). The goal of our work is to describe the way and relations of the right gsn which are variable and rarely described. This constitutes an undeniable peroperational hemorrhagic risk during splanchnicectomy. After a double side thoracotomy and a bilateral sterno-clavicular desarticulation on 15 adult cadaveric subjects preserved by method of Winckler we removed the sterno-costal drill plate as well as the ventral rib arch and proceeded to a mediastinal evisceration of the thorax. Then we respected only the thoracic aorta and the oesophagus, the azygos venous system, the thoracic duct and the thoracic sympathetic chain. In some of the subjects, the azygos vein was injected (after catheterization of its stick) using gelatine coloured with blue paint. We studied the way and vascular relations of the right gsn. We measured the transverse distances between the origin of the gsn on one hand and the longitudinal axes of the azygos vein and the thoracic duct on the other hand. The relations of the right gsn trunk during its way related to the azygos vein in particular its constitutive origin and its affluents: ascending lumbar vein and twelfth intercostal vein. Sometimes the thoracic duct even a lymphatic node was near the gsn in the posterior infra-mediastinal space. A classification of the way and vascular relations of the right gsn in the thorax identified 3 anatomical types. The average distances separating the right gsn on one hand from the azygos vein and the thoracic duct on the other hand were respectively 5,7mm and 11,2mm. The vascular relations of the right gsn are very variable from one subject to another but primarily venous, sometimes lymphatic. They concerned the great thoracic vessels whose respect is essential in particular at the time of mini-invasive access procedure for a cœlioscopic splanchnicectomy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Jul 2015 · Morphologie

  • No preview · Article · May 2015
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    ABSTRACT: Thirty percent of patients with pudendal neuralgia due to pudendal nerve entrapment obtain little or no relief from nerve decompression surgery. The objective was to describe the efficacy of spinal cord stimulation of the conus medullaris in patients with refractory pudendal neuralgia. This prospective study, conducted by two centers in the same university city, described the results obtained on perineal pain and functional disability in all patients with an implanted conus medullaris stimulation electrode for the treatment of refractory pudendal neuralgia. Twenty-seven consecutive patients were included by a multidisciplinary pelvis and perineal pain clinic between May 2011 and July 2012. Mean follow-up was 15 months. The intervention was an insertion of a stimulation electrode was followed by a test period (lasting an average of 13 days) before deciding on permanent electrode implantation. Maximum and average perineal pain scores and the pain-free sitting time were initially compared during the test and in the long-term (paired t-test). The estimated percent improvement (EPI) was evaluated in the long-term. Twenty of the 27 patients were considered to be responders to spinal cord stimulation and 100% of implanted patients remained long-term responders (mean tripling of sitting time, and mean EPI of 55.5%). Spinal cord stimulation of the conus medullaris is a safe and effective technique for long-term treatment of refractory pudendal neuralgia. Routine use of this technique, which has never been previously reported in the literature in this type of patient, must now be validated by a larger scale study. Neurourol. Urodynam. © 2013 Wiley Periodicals, Inc.
    No preview · Article · Feb 2015 · Neurourology and Urodynamics
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    ABSTRACT: Introduction: The last decade has seen the emergence of minimally invasive spine surgery. However, there is still no consensus on whether percutaneous osteosynthesis (PO) or open surgery (OS) is more cost-effective in treatment of traumatic fractures and degenerative lesions. The objective of this study is to compare the clinical results and hospitalization costs of OS and PO for degenerative lesions and thoraco-lumbar fractures. Methods: This cost-minimization study was performed in patients undergoing OS or PO on a 36-month period. Patient data, surgical and clinical results, as well as cost data were collected and analyzed. The financial costs were calculated based on diagnosis related group reimbursement and the French national cost scale, enabling the evaluation of charges for each hospital stay. Results: 46 patients were included in this cost analysis, 24 patients underwent OS and 22 underwent PO. No significant difference was found between surgical groups in terms of patient's clinical features and outcomes during the patient hospitalization. The use of PO was significantly associated with a decrease in Length Of Stay (LOS). The cost-minimization revealed that PO is associated with decreased hospital charges and shorten LOS for patients, with similar clinical outcomes and medical device cost to OS. Conclusions: This medico-economic study has leaded to choose preferentially the use of minimally invasive surgery techniques. This study also illustrates the discrepancy between the national health system reimbursement and real hospital charges. The medico-economic is becoming critical in the current context of sustainable health resource allocation.
    No preview · Article · Jan 2015 · International Journal of Surgery

  • No preview · Article · Jan 2015 · Annals of Physical and Rehabilitation Medicine
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    ABSTRACT: Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid. Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery. After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability. This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.
    No preview · Article · Jan 2015 · Journal of Neurosurgery Spine

  • No preview · Article · Dec 2014 · Revue de Chirurgie Orthopédique et Traumatologique
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    ABSTRACT: A large proportion of low back pain may be explained by intervertebral disc (IVD) degeneration. Currently, the process leading to IVD degeneration highlights the pivotal role of IVD cells. The number of these cells drastically decreases and does not support a spontaneous repair of the tissue. In order to counteract IVD degeneration, regenerative medicine, based on a cell supplementation of the damaged tissue is considered as a promising approach. After a description of IVD physiopathology, we will develop the different strategies based on cell therapy and tissue engineering and currently under investigation to improve altered IVD degeneration. Finally, results from the current pre-clinical and clinical studies will be discussed. © 2014 médecine/sciences – Inserm.
    No preview · Article · Dec 2014 · Medecine sciences: M/S
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    ABSTRACT: Minor head trauma is a common cause for pediatric emergency department visits. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) published a clinical prediction rule for identifying children at very low risk of clinically important traumatic brain injuries (ciTBI) and for reducing CT use because of malignancy induced by ionizing radiation. The prediction rule for ciTBI was derived and validated on 42,412 children in a prospective cohort study. The Société Française de Médecine d’Urgence (French Emergency Medicine Society) and the Groupe Francophone de Réanimation et Urgences Pédiatriques (French-Language Pediatric Emergency Care Group) recommend this algorithm for the management of children after minor head trauma. Based on clinical variables (history, symptoms, and physical examination findings), the algorithm assists in medical decision-making: CT scan, hospitalization for observation or discharge, according to three levels of ciTBI risk (high, intermediate, or low risk). The prediction rule sensitivity for children younger than 2 years is 100 % [86.3–100] and for those aged 2 years and older it is 96.8 % [89–99.6]. Our aim is to present these new recommendations for the management of children after minor head trauma.
    No preview · Article · Nov 2014 · Journal Europeen des Urgences et de Reanimation
  • M. Le Fort · O. Hamel · B. Perrouin-Verbe

    No preview · Article · Nov 2014 · Progrès en Urologie
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    ABSTRACT: Aims: The Brindley procedure, used since the 1980s, consists of implantation of a stimulator for sacral anterior root stimulation combined with a posterior sacral rhizotomy to enable micturition. Patients suitable for the procedure are patients with detrusor overactivity and a complete spinal cord lesion with intact sacral reflexes. S2 to S4 posterior sacral rhizotomy abolishes sacral hyperreflexia and may lead to decreased urethral closure pressure and loss of reflex adaptation of continence, leading to stress incontinence. Methods: In this retrospective study of 96 patients from Nantes or Le Mans, implanted with a Finetech-Brindley stimulator, we analyzed the incidence of stress incontinence one year after surgery and looked for predictive factors of stress incontinence one year after posterior sacral rhizotomy: age, gender, level of injury between T10 and L2 , previous urethral surgery, incompetent bladder neck, Maximum Urethral Closure Pressure before surgery less than 30 cmH2 O, compliance before surgery less than 30 ml/cmH2 0. Patients with persistent involuntary detrusor contractions with or without incontinence after surgery were excluded. Results: One year after surgery, 10.4% of the patients experienced stress incontinence. Urethral closure pressure was significantly decreased by 18% after posterior sacral rhizotomy (P = 0.002). This study highlights the only significant predictive factor of stress incontinence after rhizotomy: incompetent bladder neck (P = 0.002). Conclusions: As screening of patients undergoing the Brindley procedure is essential to achieve optimal postoperative results, on the basis of this study, we propose preoperative assessment to select the population of patients most likely to benefit from the Brindley procedure. Neurourol. Urodynam. © 2014 Wiley Periodicals, Inc.
    Full-text · Article · Nov 2014 · Neurourology and Urodynamics

  • No preview · Article · Sep 2014

  • No preview · Article · Sep 2014 · Morphologie

  • No preview · Article · Aug 2014 · Intensive Care Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Minor head trauma is a common cause for pediatric emergency department visits. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) published a clinical prediction rule for identifying children at very low risk of clinically important traumatic brain injuries (ciTBI) and for reducing CT use because of malignancy induced by ionizing radiation. The prediction rule for ciTBI was derived and validated on 42,412 children in a prospective cohort study. The Société Française de Médecine d'Urgence (French Emergency Medicine Society) and the Groupe Francophone de Réanimation et Urgences Pédiatriques (French-Language Pediatric Emergency Care Group) recommend this algorithm for the management of children after minor head trauma. Based on clinical variables (history, symptoms, and physical examination findings), the algorithm assists in medical decision-making: CT scan, hospitalization for observation or discharge, according to three levels of ciTBI risk (high, intermediate, or low risk). The prediction rule sensitivity for children younger than 2 years is 100 % [86.3-100] and for those aged 2 years and older it is 96.8 % [89-99.6]. Our aim is to present these new recommendations for the management of children after minor head trauma.
    No preview · Article · Jun 2014 · Archives de Pédiatrie
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    O. Hamel · B. Perrouin-Verbe

    Preview · Article · May 2014 · Annals of Physical and Rehabilitation Medicine
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    O. Hamel · B. Perrouin-Verbe

    Preview · Article · May 2014 · Annals of Physical and Rehabilitation Medicine
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    Full-text · Article · May 2014 · Annals of Physical and Rehabilitation Medicine

Publication Stats

424 Citations
102.67 Total Impact Points

Institutions

  • 2015
    • Hotel Dieu Hospital
      Kingston, Ontario, Canada
  • 2003-2015
    • Centre Hospitalier Universitaire de Nantes
      • Service de neurotraumatologie
      Naoned, Pays de la Loire, France
  • 2009-2014
    • University of Nantes
      • Faculté de Chirurgie Dentaire
      Naoned, Pays de la Loire, France
  • 2013
    • Centre Hospitalier Universitaire Rouen
      • Service d'Urologie
      Rouen, Upper Normandy, France
  • 2012
    • Centre Hospitalier Universitaire de Nancy
      Laxou, Lorraine, France
  • 2011
    • Centre Hospitalier de Gonesse
      Gonesse, Île-de-France, France
  • 2008
    • Hôtel-Dieu de Paris – Hôpitaux universitaires Paris Centre
      Lutetia Parisorum, Île-de-France, France
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 2005
    • Centre Catherine de Sienne
      Naoned, Pays de la Loire, France
  • 2004
    • Hospital Centre University of Fort de France
      Fort Royal, Martinique, Martinique