PubMed Health⌕ Search

Biomedical subjects

Jean-François Chateil

Publications and source records attributed to Jean-François Chateil.

11 recordsLinked to original sources
PubMed2005

Cost-minimization analysis of a wide-area teleradiology network in a French region.

OBJECTIVE: The objective of our study was to perform a cost-minimization analysis of a wide-area teleradiology network. DESIGN: A prospective analysis of all transmissions over 1 year (data transmitted at the time of the remote consultation, and health outcomes of patients from medical record). INTERVENTION: The inter-hospital teleradiology network of the Aquitaine area (RIHRA) is a telemedicine system enabling the management of remote emergencies and elective radiology consultations. MAIN OUTCOME MEASURE: A cost-minimization study enabled a comparison of care procedures following the use of the network with those which would have been implemented without the network. The outcome measures of effectiveness were the transfers, hospitalizations, and consultations avoided or added. Fixed and variable costs were estimated. RESULTS: Among the 664 transmissions included in the study, 562 (85%) were performed in emergency and 102 (15%) for elective (non-emergency) cases. In emergency, 48% of transfers were avoided. For elective teleconsultations, a transfer was avoided for 37% of the patients and hospitalization for 12%. An extra consultation occurred after remote consultation for 2% of the patients. Annual saving can be estimated at 102,779 EUR for the Aquitaine area. CONCLUSIONS: This study underlines the efficiency of an inter-hospital teleradiology network. A qualitative evaluation of the impact of the use of the system should be carried out to improve technical and organizational operations.

Cost Control↗
PubMed2005

Chemical shift imaging and localised magnetic resonance spectroscopy in full-term asphyxiated neonates.

BACKGROUND: Diagnosis of brain lesions after birth anoxia-ischemia is essential for appropriate management. Clinical evaluation is not sufficient. MRI has been proven to provide useful information. OBJECTIVE: To compare abnormalities observed with MRI, including diffusion-weighted imaging (DWI), localised magnetic resonance spectroscopy (MRS) and chemical shift imaging (CSI) and correlate these findings with the clinical outcome. MATERIALS AND METHODS: Fourteen full-term neonates with birth asphyxia were studied. MRI, MRS and CSI were performed within the first 4 days of life. RESULTS: Lesions observed with DWI were correlated with outcome, but the apparent diffusion coefficient (ADC) did improve diagnostic confidence. The mean value of Lac/Cr for the neonates with a favourable outcome was statically lower than for those who died (0.22 vs 1.04; P = 0.01). The same results were observed for the Lac/NAA ratio (0.21 vs 1.23; P = 0.01). Data obtained with localised MRS and CSI were correlated for the ratio N-acetyl-aspartate/choline, but not for the other metabolites. No correlation was found between the ADC values and the metabolite ratios. CONCLUSIONS: Combination of these techniques could be helpful in our understanding of the physiopathological events occurring in neonates with asphyxia.

Apgar Score↗
PubMed2005

Evaluation of the benefits for the patient arising from an inter-hospital teleradiology network in a French administrative area.

We conducted a prospective study of the teleradiology network which connects 15 hospitals in the Aquitaine area. All transmissions sent over a one-year period were examined (data transmitted at the time of the remote consultation and health outcomes of patients from their medical records). For emergency cases, the main outcome measure of effectiveness was the proportion of avoided transfers. For non-emergency cases, the main outcome measure of effectiveness was the proportion of transfers, hospitalizations and consultations avoided. There were 737 transmissions, of which 664 (90%) met the inclusion criteria. Of these, 562 (85%) were for emergency care and 102 (15%) for non-emergency care. In emergency care, the pathologies most often associated with a remote consultation were cerebral pathologies (88%) and traumatic spinal pathologies (8%); the proportion of avoided transfers was 48%. In non-emergency care, the specialties most often concerned with remote consultations were neurology/neurosurgery (36%), cardiology and pulmonary diseases (17%) and gastroenterology (14%). Transfer was avoided for 37% of the patients and hospitalization for 12%. An additional consultation occurred after remote consultation for 2% of the patients. The results confirm the effectiveness of an inter-hospital teleradiology network.

Adolescent↗
PubMed2004

Oculo-ectodermal syndrome: a new tumour predisposition syndrome.

We report a new case of oculo-ectodermal syndrome who developed giant cell granulomas of the jaw, similar to the patient previously described by Toriello et al. (1999). We review reported cases to better delineate the clinical spectrum of this rare condition. Giant cell granulomas developing in childhood seem to be part of the oculo-ectodermal syndrome. This condition appears to be a new tumour predisposition syndrome.

Alopecia↗
PubMed2003

Costello syndrome and neurological abnormalities.

Costello syndrome is a rare but increasingly recognized syndrome of unknown etiology. Neurological abnormalities are not rare in this syndrome and consist of structural and electrophysiological disorders. Ventricular dilatation is observed in more than 40% of cases. Other reported cerebral anomalies are brain atrophy, Chiari malformation and syringomyelia. Although there is insufficient data to propose strict guidelines, it seams reasonnable to have a low threshold for neuroimaging, in general, and particularly when neurologic signs or symptoms are present. Screening including cerebral MRI and EEG should be proposed after a diagnosis of Costello syndrome. The frequency of testing in such children should be guided by neurological follow-up.

Abnormalities, Multiple↗
PubMed2002

Water excitation as an alternative to fat saturation in MR imaging: preliminary results in musculoskeletal imaging.

PURPOSE: To compare fat suppression methods by using spectrally selective fat saturation and section-selective water excitation in standard magnetic resonance (MR) imaging sequences used in day-to-day musculoskeletal practice. MATERIALS AND METHODS: Eighty-three patients underwent MR examination with a 1.5-T system. The two methods were compared by using three common sequences: T1-weighted spin-echo (SE) imaging performed after contrast material injection (n = 24), intermediate-weighted fast SE (n = 36) imaging, and T2-weighted fast SE (n = 36) imaging. Acquisition times of the sequences and signal-to-noise and contrast-to-noise ratios of bone, muscle, fat, and water for the two methods were compared quantitatively. Images were then qualitatively reviewed by two radiologists who were blinded to the type of fat suppression used. Image quality was scored according to four criteria (homogeneity of fat suppression, susceptibility and foldover artifacts, conspicuousness of lesion, and overall image quality) by using a five-point scale (0, bad; 1, poor; 2, fair; 3, good; and 4, excellent). A paired Student t test was used to compare the quantitative data, and a nonparametric paired-data Wilcoxon signed rank test was used for qualitative analysis. RESULTS: Water excitation allowed a substantial decrease in acquisition time (by up to 50%) for T1-weighted sequences. Quantitative measurements revealed a greater signal-to-noise ratio (P <.01) with water excitation for all three sequences, whereas the contrast-to-noise ratio was greater with water excitation only in intermediate-weighted sequences (P <.01). Qualitatively, water excitation proved statistically better than or equal to fat saturation for all criteria in all imaging sequences (P <.05). Mean scores of overall image quality ranged between 2.5 and 3.0 for fat saturation and 3.4 and 3.7 for water excitation, respectively (P <.05). CONCLUSION: Section-selective water excitation is faster than conventional fat saturation and produces images of better quality.

Adolescent↗
PubMed2002

Gaucher's disease and fatal hepatic fibrosis despite prolonged enzyme replacement therapy.

We report on the case of a girl with type 1 Gaucher's disease, treated from age 9 to 15 with high-dose enzyme replacement therapy. This treatment did not avert the development of an extensive mutilating hepatic fibrosis warranting a liver transplantation, which was followed by death. In some cases of Gaucher's disease, alternative strategies such as fractionated or further increased ERT, gene therapy, or glucosyltransferase inhibitor should be explored.

Adolescent↗
PubMedDate not supplied

A patient with hydranencephaly and PEHO-like dysmorphic features.

Progressive encephalopathy with Edema, Hypsarrhythmia, and Optic atrophy (PEHO syndrome) is a rare recessive autosomal neurodegenerative condition essentially described in Finland. The term PEHO-like syndrome has been proposed for patients who share clinical features of PEHO syndrome but lack the cerebellar atrophy, one of its major diagnostic criteria. We describe a patient presenting with hypoxic-ischaemic encephalopathy and PEHO-like syndrome features.

Brain↗