The Hôtel-Dieu Saint-Jacques of Toulouse: Oldest Dental Site still in Activity?

The Hôtel-Dieu Saint-Jacques of Toulouse (in Southwest France) is an ancient hospital officially existing since the 16th century and initially dedicated to the treatment of the poor and the destitute. In the 18th century, it became a hospital in the "modern" sense of the word, by maintaining health and trying to cure diseases. The first official traces of professional dental care in the Hôtel-Dieu Saint-Jacques by a dental surgeon date from 1780. From this period, the Hôtel-Dieu Saint-Jacques had a dentist to treat "paupers" in the early years. The first "officially" recorded dentist was named Pierre Delga, known for having treated the French Queen Marie-Antoinette for a difficult extraction. Delga also provided dental care to the famous French writer and philosopher Voltaire. The aim of this article is to relate the history of this hospital along with French dentistry, and to advance the hypothesis that the Hôtel-Dieu Saint-Jacques, now a hospital site of the Toulouse University Hospital, is probably the oldest building in Europe still in activity and still hosting a dentistry department.

Predictive Factors of Early Postoperative Complications After Robot-Assisted Radical Cystectomy for Urothelial Bladder Carcinoma.

Purpose: To identify protective and risk factors of early postoperative complications after robot-assisted radical cystectomy (RARC) for urothelial bladder carcinoma. Methods: Data of all robot-assisted cystectomies performed in six French centers between February 2010 and December 2019 were retrospectively reviewed. All RARCs for bladder cancer (muscle-invasive and high-risk or Bacillus Calmette-Guerin-resistant nonmuscle-invasive bladder cancer) were included. Perioperative outcomes and early postoperative complications (in the first 30 days) were collected. Multivariable analysis was performed to identify factors associated with early postoperative complications. Results: Two hundred seventy patients were included. The overall incidence of early postoperative complications after RARC was 52.2% (27% of major complications). Most frequent complications were infectious complications (24.4%) and paralytic ileus (15.6%). Anticoagulant therapy (odds ratio [OR] = 2.909, 95% confidence interval [CI]: 1.003-8.432) and ureteroenteric anastomosis-type Wallace II (OR = 4.4, 95% CI: 1.435-13.489) were associated with a higher rate of overall complications. Complete intracorporeal diversion was a protective factor (OR = 0.399, 95% CI: 0.222-0.718). Tobacco consumption, anticoagulant therapy, and ureteroenteric anastomosis-type Wallace II were associated with a higher rate of minor complications (OR = 2.01, 95% CI: 1.079-3.744; OR = 2.495, 95% CI: 1.022-6.089; OR = 3.836, 95% CI: 1.384-10.63, respectively). Opioid-free analgesia (OFA) was associated with a lower rate of infectious complications (OR = 0.148, 95% CI: 0.034-0.644). Conclusion: Early postoperative complication rate after RARC for urothelial bladder carcinoma is high. Encouraging complete intracorporeal diversion and promoting OFA seem to reduce postoperative complications in the first 30 days. Prospective studies are needed to provide a high level of evidence.

Robot-Assisted Cystectomy and Ileal Conduit for Neurogenic Bladder: Comparison of Extracorporeal vs Intracorporeal Urinary Diversion.

Objectives: The aim of the present study was to compare the perioperative outcomes of extracorporeal (EXTRA) vs intracorporeal (INTRA) urinary diversion in patients undergoing robotic cystectomy and ileal conduit for neurogenic bladder. Methods: All consecutive patients who underwent robot-assisted cystectomy and ileal conduit for neurogenic bladder in six centers between 2011 and 2020 were included in a retrospective study. Four centers performed exclusively INTRA urinary diversion all over the study period, one center performed exclusively EXTRA urinary diversion, and the last center performed EXTRA urinary diversion during a first period and INTRA during the subsequent period. Results: Ninety-seven patients were included: 66 in the EXTRA group and 31 in the INTRA group. There were 11 major (Clavien grade ≥3) postoperative complications in the overall population (11.3%) with no statistically significant difference between both groups (EXTRA = 12.1% vs INTRA = 9.7%; p = 0.99). The mean length of stay did not differ significantly between INTRA and EXTRA (13.1 vs 14.1 days; p = 0.44). The mean times to oral feeding and to return of bowel function were similar in the two groups (3.9 vs 3.5 days; p = 0.28 and 4.1 vs 4.1 days; p = 0.51, respectively). There was no incisional hernia in the INTRA group vs five in the EXTRA group (0% vs 7.6%; p = 0.17). Conclusion: The perioperative morbidity of robotic cystectomy and ileal conduit for neurogenic bladder appears to be relatively limited compared with the historical open series. Possibly due to the relatively small sample size, no difference was found between INTRA and EXTRA urinary diversion in terms of perioperative outcomes.

[The Briochés: a family of marionette operators]. / Une famille d'opérateurs-marionnettistes les brioché.

In the 17th and 18th centuries, empiries were travelling in Europe, coming, in majority from actual Italy. To attract the crowds, they put up boards on the street and play some pantomimes, parades or improvised scenes. In the 17th century this street show, little or none at all printed, was in a normal way in the day life. In the 18th century this street show is still alive and whole families as the Brioché, the Contugi, the Toscano, the Ricci, the Borsari have transmitted the art of the stage and the empiric practice. A few individuals of these families moved from empirics to be graduate dentists. In other families of dentists as the Talma or Fauchard it is the stage which brought some.

Dental practitioners in France at the end of the eighteenth century.

This chapter serves as a reminder of the political and social conditions in France over a period that embraces the Ancient Regime, the Revolution and the post-Revolutionary years. Contemporary legislation relating to the practice of medicine and dentistry in particular is outlined.

Dental practice in selected areas of France.

This is an exploration of the great diversity to be found among those offering treatment of the teeth and determines what impact, if any, the change of regime had upon the practice of dentistry. The study is not restricted to the 'expert dentists' (already much studied by traditional histories of dentistry in France) but attempts to describe dental practice as it really was. In an attempt to paint as broad a picture as possible, it draws on material from such diverse communities as Lyons, Rennes, Sens, Dijon,Toulouse, Aix en Provence and Nancy. A description of the sources used is to be found in Appendix 1.

Dental practice in Paris.

This describes dental practice and the availability of dental patent remedies in Paris. Accounts of legal disputes, from original sources, illustrate the status and social history of some of the most wealthy dental practitioners in Paris during the Revolution.

France: discussion.

An attempt is made here to answer the question 'What is a dentist?'. Is he (or she) a successful pillar of society, wealthy and respected, or a lying charlatan, claiming all sorts of unbelievable cures and treatments. Were they specialists or was dentistry a sideline for some other trade or profession? This chapter discusses the evidence from France.

[The Leroy de la Faudignére, a family of dentists of the 18th century]. / Une famille de dentistes au XVIIIème siècle: les Leroy de la Faudignère.

François Leroy de la Faudignére was the founder of the family. Although he was not an expert in dentistry, he acquired a good reputation of dentist in the second half of the 18th century. He published some books between 1766 and 1780. He lived in Paris and set up in 1780 at the Pavillon Royal, Plave Royale no1 (Place des Vosges nowadays). He was mainly busy with selling an approved analgesic elixir of his own. Out of his 5 children, 2 have been experts in dentistry and one of his daughters, Marie Marianne Françoise, married Jacques René Duval, Maître en Chirurgie. François died six weeks after his daughter's marriage but her brothers sued her about the elixir their father had bequeathed to her. She won her case and carried on selling the elixir with Duval. Her daughter married Jean Nicolas Marjolin, a famous surgeon. Their son René Nicolas became a surgeon too.