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J Moscovici

Publications and source records attributed to J Moscovici.

At least 19 recordsLinked to original sources
PubMed2006

Quality of life and continence in patients with spina bifida.

PURPOSE: Spina bifida (SB) is the most common congenital cause of incontinence in childhood. This study attempts to determine the relationships between urinary/faecal incontinence, methods of management, and Health Related Quality of Life (HRQoL) in people with SB. PATIENTS AND METHOD: A total of 460 patients (300 adults and 160 adolescents) from six centres in France have taken part in this cross-sectional study. Clinical outcome measures included walking ability, urinary/faecal continence, and medical management. HRQoL was assessed using the SF36 in adults and the VSP in adolescents and their parents. Univariate and multivariate analysis was used to determine the relationships between clinical parameters and HRQoL. RESULTS: HRQoL were significantly lower than in the general population. Adult women had significantly lower scores than men, and adolescent females had significantly lower scores for psychological well being. We did not found strong relationship between incontinence and HRQoL in this population. Moreover patients surgically managed for urinary/fecal incontinence did not show significantly higher scores of HRQoL. CONCLUSION: Using generic HRQoL measures, urinary/faecal incontinence and their medical management may not play a determinant role in HRQoL of persons with SB. However many other factors affect HRQoL in these patients. A longitudinal study design is recommended to assess whether incontinence management is associated with improved HRQoL.

Adolescent↗
PubMed2006

Apparent mismatch between extended x-ray absorption fine structure and diffraction structures of crystalline metastable WO3 phases.

The local structure of monoclinic, monohydrate, hexagonal, and pyrochlore WO3 phases was investigated by the extended x-ray absorption fine structure spectroscopy as preliminary studies of model compounds of amorphous and thin film WO3 based electrochromic species. In the four cases, we found a large W-O distribution of distances ranging from 1.70 to 2.35 A. The apparent discrepancy of these results and previously published crystal structures are discussed and interpreted as the detection of vacancies and local distortion disorder.

Journal Article↗
PubMed2006

A multicenter evaluation of urinary incontinence management and outcome in spina bifida.

PURPOSE: We describe urinary continence management and outcome in patients with spina bifida to identify the procedures that are most successful. MATERIALS AND METHODS: In a multicenter retrospective cohort study medical charts were studied. At the same time in a cross-sectional survey sociodemographic characteristics, orthopedic features and urinary continence were described based on the frequency of leakage from the viewpoint of patients or close relatives using a Likert scale of 5 items, namely 1-leakage permanent to 5-leakage never. RESULTS: A total of 421 patients were included, of whom 191 (45%) had been medically treated with a normal voiding pattern according to the patient viewpoint in 21%, clean intermittent catheterization in 61% and no specific bladder emptying method in 18%. The mean leakage score +/- SD was 2.74 +/- 1.55. On the other hand, 230 patients (55%) were surgically treated. Except for 23 patients who underwent noncontinent urinary diversion 207 were considered for treatment and continence description. The mean leakage score was 3.45 +/- 1.60. An artificial urinary sphincter in male and females, and a sling or Kropp technique in females were satisfactory when bladder enlargement was not required. In cases of bladder augmentation without continent diversion an artificial urinary sphincter in males and a bladder neck sling or cinch, Kropp and Young-Dees procedures in females have provided the best results. In cases of bladder enlargement with continent urinary diversion bladder neck closure or a wrap have provided the best results whatever the patient sex. CONCLUSIONS: Many factors may influence the choice of a technique, such as patient sex, bladder characteristics or orthopedic conditions. However, since to our knowledge no randomized, controlled study has been yet performed, definitive conclusions on the best way to achieve urinary continence in patients with spina bifida cannot be established.

Adolescent↗
PubMed2006

A multicentre study of the management of disorders of defecation in patients with spina bifida.

Patients with spinal dysraphism may have severe constipation and faecal incontinence. The impact of antegrade colonic enema (ACE) in the management of patients with spina bifida (SB) is analysed. In a multicentre cross-sectional study, constipation, faecal incontinence and faecal management were described. Cases surgically treated were identified. Data were collected from 423 patients, of whom 230 did not use any manoeuvre or laxatives to assist evacuation. Conventional treatment was used in 193 patients, including digital extraction in 39%, retrograde enema in 21% and oral laxatives in 52%. For intractable constipation and overflow of faecal incontinence, 47 patients were treated with ACE, of whom 41 used the method at a mean time of interview of 4.1 +/- 1.9 years after ACE operation; six abandoned ACE for conventional management. With ACE, faecal continence was significantly improved compared with conventional management, and neither retrograde rectal enema nor digital extraction were required. The conduit was fashioned to the right colon in 32 cases and to the left colon in nine cases. This study provides information on a multicentre experience in bowel management in SB patients. Whatever the technique used, ACE has improved faecal status compared with conventional therapy.

Adolescent↗
PubMed2001

EXAFS and thermodynamics of Fe(II) spin transition polymeric compounds.

We have studied the temperature variations of the EXAFS spectra of three Fe(II)/triazole-based spin transition polymeric compounds compared to a monomer belonging to the same family. These compounds have various temperatures of transition and hysteresis loop widths. In the three polymers, the Fe-Fe-Fe alignment, detected by a multiple scattering signal at the double Fe-Fe distance, is preserved through the spin transition. For the four compounds, we have studied the variations versus temperature of the Debye-Waller factors for both FeN6 (first shell) and Fe-Fe-Fe (multiple scattering path, only for the polymers). We report a strong increase of (sigma2(FeN6) through the spin transition for the monomer and two of the polymeric species. For the polymers an increase of sigma2(Fe-Fe-Fe) is also observed. These observations confirm the results available in the literature, and we confirm the interpretation as an increase of the vibrational part of the DW. For one particular polymer, we observe an unexpected behaviour: no significant increase of the Debye-Waller factor from low spin to high spin states. The EXAFS study of these non mono-crystalline species is the only way to discuss the local structure-thermodynamics properties relationships, and particularly the so-called cooperative effect in the spin transition process.

Journal Article↗
PubMed2001

Unexpected Fe local order in iron oxide coated nanocrystalline magnesium oxides with exceptional reactivities against environmental toxins.

Mg oxide nanoparticles are very reactive materials used to mitigate atmospheric pollution and to sequester polluting molecules. Using Fe K-edge XAFS, we have studied the structure of iron oxide-coated MgO nanoparticles before and after reaction with CCl4. Before reaction, the local structure around Fe is totally different from that in iron oxide coatings on SrO and CaO nanoparticles, although these coated materials were prepared in the same way. In SrO and CaO, the iron oxide coating has been shown to be well separated from the bulk of the nanoparticle, whereas in MgO, Fe was found to mix with MgO. After reaction with CCl4, Fe-Cl bonds can be detected when the coated nanoparticle is saturated. Such Fe-Cl EXAFS signals have not been observed in previously studied nanoparticles.

Air Pollutants↗
PubMed2000

Synthesis, crystal structure, EXAFS, and magnetic properties of catena [mu-tris(1,2-bis(tetrazol-1-yl)propane-N1,N1')iron(II)] bis(perchlorate). First crystal structure of an iron(II) spin-crossover chain compound.

[Fe(btzp)3](ClO4)2 (btzp = 1,2-bis(tetrazol-1-yl)propane) represents the first structurally characterized Fe(II) linear chain compound exhibiting thermal spin crossover. It shows a very gradual spin transition (T1/2 = 130 K) which has been followed by magnetic susceptibility measurements and 57Fe Mössbauer spectroscopy. The structure has been solved at 200 and 100 K by single-crystal X-ray analysis. It crystallizes in the trigonal space group P3c1 with Z = 2 Fe(II) units at both temperatures. The molecular structure consists of chains running along the c axis in which the Fe(II) ions are linked by three N4,N4' coordinating bis(tetrazole) ligands. The main difference between the two forms appears to be in the Fe-N bond lengths, which are 2.164(4) A at 200 K and 2.038(4) A at 100 K. The Fe-Fe separations are 7.422(1) A at 200 K and 7.273(1) A at 100 K. The EXAFS results are consistent with the crystal structure. In both spin states, the FeN6 octahedron is almost regular within the EXAFS resolution. The Fe-N distance is found as 2.16(2) A at 300 K and 2.00(2) A at 40 K. The absence of the "7 A peak" in the EXAFS spectra of [Fe(btzp)3](ClO4)2, in contrast with what has been observed for the [Fe(4-R-1,2,4-triazole)3]-(anion)2 chain compounds, confirms that this peak can be used as the signature of a metal alignment only when it involves a strongly enhanced multiple scattering M-M-M path, with M-M spacing less than 4 A. Irradiation with green light at 5 K has led to the population of the metastable high-spin state for the iron(II) ion. The nature of the spin-crossover behavior has been discussed on the basis of the structural features.

Journal Article↗
PubMed2000

Post-traumatic arterial priapism in the child: a study of four cases.

The authors report four cases of arterial priapism in the child, a rare condition since only 13 cases are described in the literature. High-flow priapism follows perineal or penile injury with damage to a cavernosal artery and formation of an arteriosinusoidal fistula. The onset may be immediate but more often occurs after a few days. Arterial priapism is painless, as the corpora cavernosa are less tumescent in the anterior third of the penis. The clinical appearance and circumstances of onset suggest the diagnosis. Doppler ultrasound is the complementary investigation of choice, confirming and localising the fistula. Various methods of treatment have been proposed. Injections of alphastimulant seem ineffective in most cases and are not without danger. Surgery, which is potentially damaging, has been used only in the adult. Most authors propose embolising with resorbable material the artery which feeds the fistula. However, priapism may resolve spontaneously in less than three weeks, as occurred in our cases, without recurrence or subsequent erectile dysfunction. We thus consider the condition may initially be managed by observation alone, with recourse to embolisation if priapism does not resolve after a period of time which however remains to be defined.

Arteries↗
PubMed2000

[Diabetes and urination disorders].

Diabetic neuropathy of can induce multi-organ dysfunction. The diabetes simultaneously has profound repercussions on gastrointestinal, sexual and erectile functions. One of the main sequelae of diabetic neuropathy is autonomic neuropathy affecting the vesicosphincteric control. The objective of this study was to review the epidemiological, clinical, laboratory and therapeutic data concerning voiding disorders observed in diabetes. Although the therapeutic management of an isolated voiding disorder in diabetics still remains symptomatic, it raises aetiological problems due to the comorbidity, particularly prostatic obstructive syndromes in men, pelvic dysfunction in women and ageing. Diabetic patients in renal failure also present specific vesicosphincteric disorders which are reviewed. Diabetic patients should be more systematically screened for the development of diabetic bladder disease, especially for associated factors which participate in its clinical expression. This implies extreme caution in the management of benign prostatic hyperplasia in the case of comorbidity, to avoid deteriorating a sometimes fragile detrusor-sphincter equilibrium. Diabetic detrusor hyperactivity must be better known in order to be more effectively detected. Pharmacological treatment of this condition raises problems related to detrusor hypocontractility also related to diabetic bladder disease. Clinical examination should be able to select those patients requiring further urodynamic studies in order to assess the individual detrusor-sphincter equilibrium. These investigations are required when surgical treatment of an associated urological or gynaecological disorder is considered.

Diabetes Complications↗
PubMed2000

[Trauma of the renal pedicle in children. Report of 2 cases of late revascularization with endovascular prosthesis].

OBJECTIVE: The diagnosis of renal pedicle rupture in children is difficult and often delayed. Ultrasound alone is insufficient in the assessment of all cases of renal contusion. This often leads to nephrectomy, due to the uncertain results of a late surgical revascularization procedure. A minimally invasive endovascular approach is therefore sometimes useful. CASE REPORTS: 1st case: a 6-year-old boy was admitted to the emergency department with contusion of the right flank caused by a road accident. The immediate test for haematuria was negative. Twenty-four hours after trauma, renal duplex ultrasound was performed due to the appearance of microscopic haematuria and it demonstrated trunkal thrombosis of the right renal artery, while the initial ultrasound was normal. 2nd case: a 15-year-old girl who jumped out of a window. 48 hours after the trauma, IVU was performed because of persistent microscopic haematuria and revealed a silent kidney, while the initial ultrasound was normal. Renal arteriography showed complete dissection of the right renal artery in both cases. Stenting was performed. The postoperative course was uneventful. In the first case, follow-up duplex ultrasound revealed a modification of the echostructure of the superior pole (absence of blood supply) while the lower pole had a normal interlobular blood supply. CT scan at the 2nd month confirmed normal excretion from the lower pole. In the first case, revascularization was satisfactory on the follow-up duplex ultrasound. After 20 months of follow-up, the kidney presented a normal functional and morphological appearance. CONCLUSION: The diagnosis of renal pedicle lesions remains difficult and is based on emergency CT angiography. Treatment by vascular stenting can be performed in children. In some cases of renal artery dissection, it can constitute an alternative to surgery. However, it raises the question of the medium- and long-term repercussions of renal artery stenosis on the child's growth.

Adolescent↗
PubMed1999

Contribution to the study of the venous vasculature of the penis.

The penile veins are thought to be responsible for some erectile disorders. The aim of this study was to describe the anatomy and function of these veins. The venous systems of 25 cadaveric penises were studied by various anatomic and histologic techniques. The superficial veins arising from the tegumentary layers drain into the superficial dorsal vein which in three-quarters of cases empties into the left great saphenous vein. The veins of the deep internal system, running below the deep fascia of the penis, emerge from the erectile bodies and can be divided into two systems, one anterosuperior and the other posteroinferior. The anterosuperior system comprises the veins of the glans which will form the deep dorsal vein; the latter receives blood from the medial portion of the corpus spongiosum and from the free portion of the corpora cavernosum mainly via the circumflex veins. It ends in the pre-prostatic plexus. The posteroinferior system, issuing from the posterior portion of the erectile bodies, is composed of the bulbar, cavernous and crural veins which drain towards the pre-prostatic plexus and the internal pudendal veins. Anastomoses link the two networks, superficial and deep. Study of the structure of the veins of the deep system reveals the presence of muscular cushions, which we have shown to have adrenergic innervation. These findings are compared with those of the literature, which show variations which are mainly of number. The place of veins in the mechanism of erection is discussed.

Adult↗
PubMed1999

[Management of ureteroceles with pyelo-ureteral duplication in children. Report of 64 cases].

Sixty four cases of ureteroceles in a context of pyeloureteric duplication were reviewed. They were detected antenatally in 69% of cases. Upper pole nephroureterectomy was performed as first-line procedure in 32 cases. In 37.5% of cases, this procedure was followed by lower tract reconstruction, essentially because of symptomatic reflux in the inferior renal pelvis. Complete renal and vesical reconstruction was performed as the first-line procedure in 6 cases. An ureteropelvic anastomosis allowed preservation of the superior renal pelvis in 4 cases, including one case with secondary lower tract reconstruction. Intravesical reimplantation of the two ureters was performed in 8 cases. Primary endoscopic opening of the ureterocele was performed in 10 cases and complementary surgery was required in 7 cases. Other procedures were used more rarely: temporary ureterostomy, nephrostomy, resection of the protruding dome of a cecoureterocele. Current management is usually neonatal. The first step consists of prevention of infection. The therapeutic approach depends on the quality of the superior renal pelvis assessed by DMSA renal scintigraphy. Immediate complete reconstruction of the kidney and bladder is now rarely indicated. When the superior renal pelvis is not functional, resection should be considered with aspiration of the ureterocele. A complementary bladder procedure is required in some cases (40% in our series) to treat symptomatic reflux in the inferior renal pelvis. When the superior renal pelvis is functional, ureteropelvic anastomosis is a good solution, especially when the superior ureter is very large and poorly functional, but endoscopic opening of the ureterocele can also be proposed, which may need to be followed be intravesical reconstruction.

Child↗
PubMed1998

Endoscopic anatomy of the cerebellopontine angle: a study in cadaver brains.

The increasing trend toward performing minimally invasive neurosurgery may benefit from recent progress in using neuroendoscopic techniques to reduce trauma in patients who have undergone operations. Arterial and venous vessels, especially loops, may compress the central segment and cause hyperactive dysfunction of the nerves. Relationships of the anterior inferior cerebellar artery to the facial and vestibulocochlear nerves and the anterior inferior, and superior cerebellar arteries to the trigeminal nerve were studied. The authors report findings from an endoscopic study performed in cadaver heads via the retrosigmoid and retrolabyrinthine approaches. Arteries and veins were colored by injection of red and blue silicon rubber. The cerebellopontine angle (CPA) was examined using 2.7-mm and 4-mm-diameter rigid endoscopes at viewing angles of 0s degrees , 30s degrees , and 70s degrees . Well-known structures could be identified endoscopically without prior dissection, and the entire CPA could be explored. However, with a retrosigmoid or a retrolabyrinthine approach, the cerebellum had to be retracted to some extent to view the CPA. Moreover, wide dural exposure was required to maneuver the endoscope freely in the CPA. Use of the rigid fiberoptic endoscope is not yet superior to standard surgical techniques for approaching and exploring the CPA.

Journal Article↗