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3. Leukocyte cell population data in patients with cardiac surgery and cardiopulmonary bypass: A potential readily available tool to monitor immunity.

Author

Nguyen, Maxime, Stiel, Laure, Guilloteau, Adrien, Bahr, Pierre-Alain, Masson, David, Thomas, Charles, Blot, Mathieu, Guy, Julien, Fontaine, Cécile, Durand, Bastien, Bouhemad, Belaid, and Guinot, Pierre-Grégoire

Subjects
CARDIAC surgery, CELL populations, CARDIOPULMONARY bypass, CARDIAC patients, LEUCOCYTES, SURGICAL complications
Abstract

Purpose: Cardiac surgery with cardiopulmonary bypass triggers sterile inflammation that is responsible for post-operative morbidity. Automated flow cytometry devices used for leucocyte count provide cell population data (CPD) regarding fluorescence intensity, size and granularity of leukocytes that have never been studied in the context of sterile inflammation. Our objective was to explore leukocyte cell population data in patients undergoing cardiac surgery with cardiopulmonary bypass in order to determine whether CPD could be used to monitor immune cell activation. Methods: This is an ancillary study of a cohort of patients undergoing cardiac surgery with cardiopulmonary bypass. Cell population data (CPD) extracted from a routine automated flow cytometer were analyzed (Fluorescence targeted to nucleic acids). The time points of interest were: pre-operative, postoperative and 5 days after surgery. The variations in those parameters were studied. Data were then compared between patients according to the occurrence of a composite criteria (supra-ventricular arrythmia, stroke, acute renal failure, and/or death). Results: Data from 1453 patients were analyzed. The neutrophil count, fluorescence granularity (NE-SCC), intensity (NE-SFL) and size (NE-FSC) increased with surgery. Heterogeneity of neutrophils decreased in terms of fluorescence granularity (NE-WX) and size (NE-WZ) but increased in terms of intensity (NE-WY). The lymphocyte count decreased with surgery. While fluorescence granularity (LY-X) and size increased (LY-Z), Lymphocyte intensity decreased (LY-Y). Lymphocytes were less heterogeneous in terms of their granularity, size and intensity after surgery (LY-WX, LY-WY, LY-WZ). Patients who developed the composite complication criteria had a higher pre-operative neutrophil count (5.08 [3.89;6.95] vs 4.76 [3.60;6.13], p = 0.02; AUC = 0.56 [0.51;0.60]), and more heterogeneous neutrophils in terms of fluorescence granularity (NE-WX, AUC = 0.57 [0.52;0.62]) and intensity (NE-WY, AUC 0.61 [0.56;0.65]). Those patients also had lower pre-operative lymphocyte count (1.49 [1.10;1.14] vs 1.81 [1.39;2.39], p<0.01, AUC = 0.61 [0.57;0.66]) and fluorescence granularity (LY-X, AUC = 0.57 [0.53;0.62]). NE-WX, NE-WY and LYX were associated with post-operative complications after adjustment on the EuroSCORE 2 (adjusted odd ratio of 1.01 [1.00;1.02]; 1.01 [1.00;1.01] and 1.08 [1.02;1.15] respectively). Conclusion: Cardiac surgery with cardiopulmonary bypass was associated with substantial alterations of CPD probably reflecting leukocytes activation in sterile inflammation. Pre-operative NE-WX, NE-WY and LY-X biomarkers levels were associated with post-operative complications, independently of the EuroSCORE 2. Such routine, unexploited and low cost parameters might represent useful tools likely to monitor immune function and predict outcomes for patients undergoing cardiac surgery. Our findings requires validation on a larger external cohort. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Neurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study

Author

Pierrat, Véronique, Marchand-Martin, Laetitia, Marret, Stéphane, Arnaud, Catherine, Benhammou, Valérie, Cambonie, Gilles, Debillon, Thierry, Dufourg, Marie-Noëlle, Gire, Catherine, Goffinet, François, Kaminski, Monique, Lapillonne, Alexandre, Morgan, Andrei Scott, Rozé, Jean-Christophe, Twilhaar, Sabrina, Charles, Marie-Aline, Ancel, Pierre-Yves, Langer, Bruno, Matis, Jacqueline, Kuhn, Pierre, Rebola, Muriel, Renesme, Laurent, Joly, Laurent, Lecomte, Benedicte, Datin-Dorriere, Valerie, Guillois, Bernard, Burguet, Antoine, Semama, Denis, Roué, Jean-Michel, Bretaudeau, Gilles, Rouget, Florence, Saliba, Elie, Favaris, Géraldine, Bednarek, Nathalie, Loron, Gauthier, Thiriez, Gerard, Chadie, Alexandra, de la Villéon, Gaëlle, Durrmeyer, Xavier, Granier, Michèle, Boileau, Pascal, Kayem, Gilles, Jarreau, Pierre-Henri, Foix-L’Hélias, Laurence, Boulot, Pierre, Daudé, Hubert, Bédu, Antoine, Mons, Fabienne, Deforge, Hélène, Fresson, Jeanne, Vayssière, Christophe, Breinig, Sophie, Truffert, Patrick, Nuytten, Alexandra, Charkaluk, Marie Laure, Brevaut, Veronique, Zahed, Meriem, Garcia, Patricia, Fayol, Laurence, Flamant, Cyril, Muller, Jean-Baptiste, Gascoin, Géraldine, Leke, André, Fontaine, Cécile, Claris, Olivier, Picaud, Jean-Charles, Ego, Anne, Patural, Hughes, Poulichet, Anne, Abrial, Aude, Favre, Anne, Fléchelles, Olivier, Ramful, Duksha, Carbonnier, Magali, Simeon, Thierry, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University College of London [London] (UCL), CHU Rouen, Normandie Université (NU), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Paris (UP), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), French Institute of Public Health Research/Institute of Public HealthFrench Health MinistryPREMUP FoundationFondation de France11779Foundation for Medical ResearchSPF20160936356hospital clinical research programme EpinutriDGOS13-040Institut National de la Sante et de la Recherche Medicale (Inserm)National Institute of CancerNational Solidarity Fund for Autonomy (CNSA), ANR-11-EQPX-0038,RE-CO-NAI,Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance(2011), Paris Diderot, Equipe HAL, Equipements d'excellence - Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance - - RE-CO-NAI2011 - ANR-11-EQPX-0038 - EQPX - VALID, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier], Modélisation et Évaluation des données complexes en Santé Publique (TIMC-MESP), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Paris Cité (UPCité), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)

Subjects
Male, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Research, [SDV]Life Sciences [q-bio], Age Factors, Infant, Newborn, Gestational Age, Infant, Premature, Diseases, Cohort Studies, [SDV] Life Sciences [q-bio], Child Development, Neurodevelopmental Disorders, Case-Control Studies, Child, Preschool, Humans, Female, France, Infant, Premature, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Abstract Objectives To describe neurodevelopment at age 5 among children born preterm. Design Population based cohort study, EPIPAGE-2. Setting France, 2011. Participants 4441 children aged 5½ born at 24-26, 27-31, and 32-34 weeks Main outcome measures Severe/moderate neurodevelopmental disabilities, defined as severe/moderate cerebral palsy (Gross Motor Function Classification System (GMFCS) ≥2), or unilateral or bilateral blindness or deafness, or full scale intelligence quotient less than minus two standard deviations (Wechsler Preschool and Primary Scale of Intelligence, 4th edition). Mild neurodevelopmental disabilities, defined as mild cerebral palsy (GMFCS-1), or visual disability ≥3.2/10 and

Published
2021

5. HOME MOVIE.

Author

FONTAINE, CÉCILE

Subjects
FILMSTRIPS, 16MM film, SILENT films
Published
2018

6. In a tertiary maternity hospital, when should a paediatrician be present in the delivery room?

Author

Tourneux, Pierre, Pascard, Loriane, Daune, Pascale, Gondry, Jean, and Fontaine, Cécile

Subjects
PRENATAL care, WOMEN'S hospitals, CRITICAL care medicine, MATERNAL health services, APGAR score, LONGITUDINAL method, PEDIATRICS, RESUSCITATION, SPECIALTY hospitals
Abstract

Objective: 10% of newborns require positive pressure ventilation (PPV) at birth. There are few data on prenatal or early postnatal factors that are predictive of the need for a paediatrician in the delivery room. The study analysed prenatal obstetric and early postnatal factors associated with the requirement for paediatrician assistance in this setting.Methods: Over a three-month period, all consecutive births in a tertiary hospital's maternity unit were prospectively evaluated with regard to the need for paediatrician assistance (requested either before or after the delivery), the requirement for resuscitation, and transfer to a neonatal intensive care unit (NICU).Results: For a total of 584 consecutive births, paediatrician assistance was requested before delivery in 170 cases (30.5%) and after in 78 cases (13.3%). 78% of the newborns requiring PPV, 95.8% of those requiring endotracheal intubation and 86.3% of those requiring transfer to the NICU matched recently published prenatal criteria for paediatrician assistance. Along with a low Apgar score and a cord blood pH <7.20, these criteria covered 95% of the prenatal and early postnatal requests for paediatrician assistance.Conclusions: These criteria for neonatal resuscitation in the delivery room would enable medical staff to anticipate the need for paediatrician assistance. [ABSTRACT FROM AUTHOR]

Published
2017
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7. Polyethylene bag wrapping to prevent hypothermia during percutaneous central venous catheter insertion in the preterm newborn under 32 weeks of gestation.

Author

Ghyselen, Laurent, Fontaine, Cécile, Dégrugilliers, Loïc, Degorre, Coralie, Lék, Andre, and Tourneux, Pierre

Subjects
*POLYOLEFINS, *THERMOPLASTIC elastomers, *POLYETHYLENE, *THERMOPLASTICS, *PREGNANCY
Abstract

Aim: In preterm neonates, during nursing procedures, body temperature decreases. This study evaluates the interest of polyethylene bag wrapping to prevent this decrease during percutaneous central venous catheter (PCVC) insertion procedure, in preterm neonates under 32 weeks of gestation nursed in closed incubators. Methods: This prospective observational study compared two periods: [May 2009-September 2009]: 'without polyethylene bag wrapping' and [October 2009-March 2010]: 'with polyethylene bag wrapping'. The main criterion was newborn skin temperature at the end of the procedure. Results: There was no difference between the two groups for skin temperature before the procedure (36.9 ± 0.3 °C versus 36.9 ± 0.3 °C; p = NS). The skin temperature at the end of the procedure was lower in the 'without bag wrapping' group (36.0 ± 0.5 °C) compared to the 'bag wrapping' group (36.4 C ± 0.5 °C; p = 0.01). Furthermore, no skin temperature at the end was higher than 37.4 °C in the bag wrapping group. Conclusion: The use of a polyethylene bag was effective in decreasing skin temperature fall during a PCVC insertion procedure in our population. No side effects were observed. The benefit of prolonged wrapping or for shorter procedure should be evaluated. [ABSTRACT FROM AUTHOR]

Published
2014
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8. The Military Programme Bill and the new French defense and security policy.

Author

Fontaine, Cécile and Debouzy, Olivier

Subjects
NATIONAL security, MILITARY readiness, MILITARY policy, ARMED Forces
Abstract

A wide-ranging reform of French defence has been in hand since 2007. The White Paper on defence and national security adopted in June 2008 included a redefinition of France's defence and security strategy in line with the new global risks and the creation of armed forces that meet the country's security needs at affordable cost. The Military Programme Bill adopted by the Council of Ministers on 29 October 2008 and due to come before Parliament shortly is a major step towards implementing the White Paper's guidelines. In parallel, reform of the organization of the MOD is currently in hand. Taken together, these measure will consolidate and modernise our defence for the coming decades. [ABSTRACT FROM AUTHOR]

Published
2009

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