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49 results on '"MESH : Retrospective Studies"'

1. Impact of body composition on outcome in patients with early breast cancer

Author: Elise Deluche, Julie Usseglio, Sophie Leobon, Nicole Tubiana-Mathieu, Laurence Venat-Bouvet, Jean Claude Desport, Grelier, Elisabeth, Service d'Oncologie médicale [CHU Limoges], CHU Limoges, and Service d'Hépato-Gastro-Entérologie et Nutrition [CHU Limoges]
Subjects: Sarcopenia, Multivariate analysis, MESH : Retrospective Studies, MESH : Aged, Adipose tissue, MESH : Breast Neoplasms, Body composition, 0302 clinical medicine, MESH : Female, 030212 general & internal medicine, Early breast cancer, Aged, 80 and over, MESH : Prognosis, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, Middle Aged, Prognosis, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, MESH : Disease-Free Survival, Female, Original Article, Adult, medicine.medical_specialty, MESH : Body Composition, Urology, MESH : Young Adult, Breast Neoplasms, Disease-Free Survival, 03 medical and health sciences, Young Adult, Breast cancer, medicine, Humans, In patient, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, Retrospective Studies, business.industry, MESH : Humans, Skeletal muscle, Retrospective cohort study, medicine.disease, Surgery, MESH : Sarcopenia, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; PURPOSE:We investigated the impact of body composition on outcomes of patients with early breast cancer. Skeletal muscle mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and muscle fat infiltration or inter-muscular adipose tissue areas (IMAT), obtained by computed tomography (CT), were assessed.METHODS:A total of 119 female patients who had breast cancer were included in this retrospective study. The total skeletal muscle and fat tissue areas were evaluated in two adjacent axial slices obtained at the third lumbar vertebra by CT used for disease staging. The women were assigned to either a sarcopenia or non-sarcopenia group based on their skeletal muscle index (cut-off 41.0 cm2/m2). They also were classified into high and low VAT/SAT ratio groups and assigned to either the high or low IMAT index group. The association of the body composition parameters and prognosis was statistically analyzed.RESULTS:Among the 119 evaluable patients, 58 were sarcopenic (48.8%), 55 (46.2%) had a high VAT/SAT ratio, and 62 (52.1%) had a high IMAT index. Median follow-up was 52.4 months. Multivariate analysis revealed sarcopenia and IMAT index as independent prognostic factors for disease-free survival (p = 0.02 and p = 0.04, respectively) and overall survival (p = 0.05 and p = 0.02, respectively). BMI was not significantly associated with disease-free survival, but a trend was observed (p = 0.09).CONCLUSIONS:Sarcopenia and IMAT index are independent prognostic factors in early breast cancer; therefore, assessing body composition could be a simple and useful approach to integrate into patient management.
Published: 2017
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2. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

Author: Hos , Andrew J, Allignol , Arthur, Beyersmann , Jan, Graves , Nicholas, Schumacher , Martin, Hos , Rodolphe, Hos , Evelina, Hos , Giulia, Hos , Claudio, Hos , Fabio, Bertrand , Xavier, Gbaguidi-Haore , Houssein, Edgeworth , Jonathan, Tosas , Olga, Hos , Jose A, Hos , M Pilar, Pan , Angelo, Zoncada , Alessia, Hos , Charis A, Hos , Dilip, Seifert , Harald, Hos , Nina, Hagel , Stefan, Pletz , Mathias, Harbarth , Stephan, Meyer , Rodolphe, Tacconelli , Evelina, De Angelis , Giulia, Farina , Claudio, Pezzoli , Fabio, Martinez , Jose A, Ayala-Blanco , M Pilar, Marwick , Charis A, Nathwani , Dilip, Freiburg Center for Data Analysis and Modeling, University of Freiburg [Freiburg], Laboratoire de Biologie Moléculaire et Cellulaire du Cancer, Hôpital Kirchberg, Fondation de Recherche Cancer et Sang - Hôpital Kirchberg, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Divisione di Malattie Infettive, Istituti Ospitalieri di Cremona, Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nuremberg, Feinberg School of Medicine, Northwestern University, Department of Pulmonary Medicine, Hannover Medical School [Hannover] ( MHH ), Infection Control Programme and WHO Collaborating Centre on Patient Safety, Department of Infectious Diseases, Università Cattolica del Sacro Cuore, INFN Laboratori Nazionali di Legnaro, Unità di Microbiologia, AO 'Ospedale San Carlo Borromeo', Hospital Papa Giovanni XXIII ( Hosp P Giovanni XXIII ), Groupe d'histoire et diffusion des sciences d'Orsay ( GHDSO ), Université Paris-Sud - Paris 11 ( UP11 ), Laboratoire Interdisciplinaire de Recherche en Didactique, Éducation et Formation ( LIRDEF ), and Université Paul-Valéry - Montpellier 3 ( UM3 ) -Université de Montpellier ( UM )
Subjects: Staphylococcus aureus, MESH : Retrospective Studies, MESH : Male, MESH : Europe, MESH : Aged, bloodstream infection, MESH : Treatment Outcome, Antimicrobial resistance, MESH : Hospital Mortality, multidrug resistance, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Enterobacteriaceae Infections, Escherichia coli, MESH : Methicillin-Resistant Staphylococcus aureus, MESH : Female, MESH : Middle Aged, MESH : Anti-Bacterial Agents, MESH : Cephalosporin Resistance, MESH : Staphylococcus aureus, MESH : Humans, MESH : Enterobacteriaceae, MESH : Proportional Hazards Models, MESH : Hospitals, MESH : Length of Stay, bacterial infections, MESH : Staphylococcal Infections, Meticillin-resistant Staphylococcus aureus (MRSA) in humans, MESH : Health Care Costs
Abstract: International audience; We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.
Published: 2016

3. Mycobacterial disease in patients with chronic granulomatous disease: A retrospective analysis of 71 cases

Author: Capucine Picard, Anastasia Bondarenko, Marjorie Hubeau, Lorena Regairaz, Caroline Deswarte, Imen Ben-Mustapha, Antoine Guérin, Joseph Hertecant, Guillaume Vogt, Rose-Marie Herbigneaux, Fatima Ailal, Davood Mansouri, Guzide Aksu, Antonio Condino-Neto, Laurent Abel, Carolina Prando, Ambre Czarna, Lizbeth Blancas Galicia, Saul Oswaldo Lugo-Reyes, Isil Barlan, Mussaret B. Zaidi, Liliana Bezrodnik, Daniela Di Giovanni, Laura Perez, Laila Ait Baba, Sigifredo Pedraza-Sánchez, Miguel Galicchio, Gehad ElGhazali, Aminata Diabate, Sara Espinosa, Matías Oleastro, Francesca Conti, Necil Kutukculer, Edgar Oliveira, Héctor Eduardo Guidos Morales, Edith Gonzalez Serrano, Fatma Nur Öz, Ahmed Aziz Bousfiha, Jalel Chemli, Özden Anal, Peter Ciznar, Nizar Mahlaoui, Francisco J. Espinosa-Rosales, Silvia Danielian, Gloria G. Guerrero, Saleh Al-Muhsen, Marco Antonio Yamazaki Nakashimada, Nadia Kechout, Ridha Barbouche, Maria Claudia Ortega, Susana Soto Lavin, Liudmyla Chernyshova, Ghassan Dbaibo, Melike Emiroglu, Stéphane Blanche, Jacinta Bustamante, Mélanie Migaud, Jean-Laurent Casanova, Maylis de Suremain, Barik Konte, Neslihan Edeer Karaca, Jianxin He, Stéphanie Ndaga, Nestor Proenza Pérez, Stéphanie Boisson-Dupuis, Eman Al-Idrissi, Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Public Health and Cellular Biology [Rome], Università degli Studi di Roma Tor Vergata [Roma], Génétique Humaine des Maladies Infectieuses (Inserm U980), Immunodeficiencies Research Unit [Mexico city], National Institute of Pediatrics, Mexico, Beijing Childrens Hospital, Department of Pediatrics [Izmir], Ege University, Institute of Biomedical Sciences - Department of Immunology [Sao Paulo], University of São Paulo (USP), Laboratory of Biology and Health UARC34–Metabolic and Immunologic Pathology Research Team, Faculté des Sciences Ben M'sik [Casablanca], Université Hassan II [Casablanca] (UH2MC)-Université Hassan II [Casablanca] (UH2MC), Bioinformatics Laboratory [Curitiba], Pelé Pequeno Principe Research Institute, Curitiba, Department of Pediatric Infectious Diseases [Konya], Necmettin Erbakan University, Meram Medical Faculty, Pediatric Infectious Diseases Department [Ankara], Dr Sami Ulus Matern & Childrens Res & Training Ho, Department of Immunology [Mexico City], Natl Inst Pediat, Immunodeficiencies Res Unit, Mexico City, DF, Mexico, Marmara University [Kadıköy - İstanbul], Childrens Hosp Super Sor Maria Ludovica, Allergy and Immunology Unit [San Salvador], Natl Childrens Hosp Benjamin Bloom San Salvador, Immunology Unit [Buenos Aires], Childrens Hosp Ricardo Gutierrez Buenos Aires, Department of Pediatrics [Beirut], American University of Beirut [Beyrouth] (AUB), Clinical Immunology Unit, Casablanca Children's Hospital, Ibn Rochd Hospital King Hassan II University-Aïn Chok, Childrens Hosp Victor J Vilela Rosario, Department of Immunology [Buenos Aires], 'Juan Pedro Garrahan' National Hospital of Pediatrics, Buenos Aires, Department of Pediatrics [Sousse], Sahloul Hospital, Childrens Hosp San Jose Colombia, Concepcion Regional Hospital [Concepción], Department of Pediatrics [Abu Dhabi], Tawam Hospital, Al Ain, Dokuz Eylül Üniversitesi = Dokuz Eylül University [Izmir] (DEÜ), Institut Pasteur d'Algérie, Réseau International des Instituts Pasteur (RIIP), Department of Pediatrics [Riyadh], King Fahad Medical City, Department of Pediatrics Infectious Diseases and Clinical Immunology [Kiev], Department of Pediatrics, Comenius University Medical School [Bratislava], University Children's Hospital, Bratislava, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unit of Biochemistry [Tlalpan], Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], Microbiology Research Laboratory, Hospital General O'Horan and Infectious Diseases Research Unit [Merida], Hosp Reg Alta Especialidad Peninsula Yucatan, Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur de Tunis, Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Shahid Beheshti University, St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller University [New York], French Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of Pediatrics, Prince Naif Center for Immunology Research, College of Medicine, King Saud University [Riyadh] (KSU), F.C. was supported by the Department of Public Health and Cellular Biology, University of Rome Tor Vergata. A.G. was supported by the French National Research Agency (ANR). The Laboratory of Human Genetics of Infectious Diseases is supported by institutional grants from INSERM, University Paris Descartes, the Rockefeller University, and the St Giles Foundation and grants from the French National Research Agency (ANR) under the 'Investments for the Future' program (grant no. ANR-10-IAHU-01) and grant IFNGPHOX (no. ANR13-ISV3-0001-01). E.B.d.O. and A.C.-N. are supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP grants 2012/11757-2, 2010/51814-0, and 2012/51094-2) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ grant 303809/2010-8). S.P.-S. is supported by Consejo Nacional de Ciencia y Tecnología (CONACYT, grant 182817)., Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Rome Tor Vergata, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Dokuz Eylul University, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Shahid Beheshti University of Medical Sciences, St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, rockefeller university, Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Génétique Humaine des Maladies Infectieuses ( Inserm U980 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), University of São Paulo ( USP ), Faculty of Science of Ben M'sik, King Hassan II University–Mohammedia, Casablanca, American University of Beirut [Beyrouth], Faculty of Medicine, Dokuz Eylül University, Izmir, Institut Pasteur d'Algérie-Réseau International des Instituts Pasteur ( RIIP ), Centre Hospitalier Universitaire de La Réunion ( CHU La Réunion ), Natl Inst Med Sci & Nutr Salvador Zubiran, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur de Tunis-Réseau International des Instituts Pasteur ( RIIP ), and King Saud University [Riyadh] ( KSU )
Subjects: 0301 basic medicine, Male, MESH : Retrospective Studies, [SDV]Life Sciences [q-bio], Disease, MESH : Child, Preschool, chronic granulomatous disease, Granulomatous Disease, Chronic, 0302 clinical medicine, Chronic granulomatous disease, MESH : Child, MESH: Granulomatous Disease, Chronic, MESH: Child, Immunology and Allergy, Disseminated disease, MESH : Female, BCG, MESH: Tuberculosis, MESH : BCG Vaccine, Child, biology, MESH: Patient Outcome Assessment, MESH : Infant, Bacterial Infections, MESH : Tuberculosis, MESH: Infant, MESH : Patient Outcome Assessment, 3. Good health, Vaccination, MESH : Bacterial Infections, MESH: BCG Vaccine, tuberculosis, Mycobacterium ulcerans, Child, Preschool, BCG Vaccine, Female, Tuberculosis, MESH: Bacterial Infections, MESH : Male, Immunology, primary immunodeficiency, 03 medical and health sciences, MESH: Mycoses, medicine, Humans, MESH: Mycobacterium Infections, Retrospective Studies, MESH : Mycoses, Mycobacterium Infections, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, MESH: Child, Preschool, Infant, Mycobacteria, MESH: Retrospective Studies, medicine.disease, biology.organism_classification, MESH: Male, Patient Outcome Assessment, 030104 developmental biology, Mycoses, MESH : Mycobacterium Infections, Primary immunodeficiency, MESH : Granulomatous Disease, Chronic, business, BCG vaccine, MESH: Female, 030215 immunology
Abstract: International audience; Background : Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by inborn errors of the phagocyte nicotinamide adenine dinucleotide phosphate oxidase complex. From the first year of life onward, most affected patients display multiple, severe, and recurrent infections caused by bacteria and fungi. Mycobacterial infections have also been reported in some patients.Objective : Our objective was to assess the effect of mycobacterial disease in patients with CGD.Methods : We analyzed retrospectively the clinical features of mycobacterial disease in 71 patients with CGD. Tuberculosis and BCG disease were diagnosed on the basis of microbiological, pathological, and/or clinical criteria.Results : Thirty-one (44%) patients had tuberculosis, and 53 (75%) presented with adverse effects of BCG vaccination; 13 (18%) had both tuberculosis and BCG infections. None of these patients displayed clinical disease caused by environmental mycobacteria, Mycobacterium leprae, or Mycobacterium ulcerans. Most patients (76%) also had other pyogenic and fungal infections, but 24% presented solely with mycobacterial disease. Most patients presented a single localized episode of mycobacterial disease (37%), but recurrence (18%), disseminated disease (27%), and even death (18%) were also observed. One common feature in these patients was an early age at presentation for BCG disease. Mycobacterial disease was the first clinical manifestation of CGD in 60% of these patients.Conclusion : Mycobacterial disease is relatively common in patients with CGD living in countries in which tuberculosis is endemic, BCG vaccine is mandatory, or both. Adverse reactions to BCG and severe forms of tuberculosis should lead to a suspicion of CGD. BCG vaccine is contraindicated in patients with CGD.
Published: 2016
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4. Clinical similarities and differences of patients with X-linked lymphoproliferative syndrome type 1 (XLP-1/SAP deficiency) versus type 2 (XLP-2/XIAP deficiency)

Author: Pierre Bordigoni, Danielle Canioni, Michèle Milili, Nathalie Lambert, Claire Galambrun, Marie Ouachée-Chardin, Filomeen Haerynck, Françoise Le Deist, Despina Moshous, Christelle Lenoir, Stephanie Rigaud, Lionel Galicier, Fabien Touzot, Capucine Picard, Mohamed Hamidou, Hirokazu Kanegane, Ester Mejstrikova, Helen Chapel, Eduardo López-Granados, Stéphane Blanche, Alain Dabadie, Jana Pachlopnik Schmid, Pierre-Simon Rohrlich, Fabian Hauck, Geneviève de Saint Basile, Claudin Schiff, Jean-Louis Stephan, Alain Fischer, Isabelle Pellier, Nizar Mahlaoui, Sylvain Latour, Alain Fourmaintraux, Vincent Barlogis, IFR Necker-Enfants Malades (IRNEM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Developpement Normal et Pathologique du Système Immunitaire, Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'anatomie pathologique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Graduate School of Medicine, University of Toyama, Department of pediatrics, University of Oxford [Oxford], Teaching Hospital Motol and 2nd Medical School, Charles University, Department of Pediatric Hematology and Oncology, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'immuno-hématologie pédiatrique [CHU Necker], Service d'Hématologie pédiatrique, Hôpital de la Timone, Marseille, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'hématologie pédiatrique, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Groupe Hospitalier Sud Réunion (GHSR), Centre Hospitalier Universitaire [Rennes], Centre de Référence Déficits Immunitaires Héréditaires (CEREDIH), Department of Paediatric Pulmonology, Ghent University Hospital, Service d'hématologie et immunologie pédiatrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Département de pédiatrie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Saint-Etienne, Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Génétique Humaine des Maladies Infectieuses (Inserm U980), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'étude des Déficits Immunitaires, Assistance Publique-Hôpitaux de Paris, Service d'Immunologie et d'Hématologie Pédiatrique, Chaire Médecine expérimentale (A. Fischer), Collège de France (CdF (institution)), University of Oxford, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Collège de France - Chaire Médecine expérimentale (A. Fischer), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), IFR Necker-Enfants Malades ( IRNEM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Groupe Hospitalier Sud Réunion ( GHSR ), Centre de Référence Déficits Immunitaires Héréditaires ( CEREDIH ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 ( UPD7 ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Centre d'Immunologie de Marseille - Luminy ( CIML ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Génétique Humaine des Maladies Infectieuses ( Inserm U980 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), and Assistance publique - Hôpitaux de Paris (AP-HP)
Subjects: Male, MESH : Retrospective Studies, MESH: X-Linked Inhibitor of Apoptosis Protein, MESH : Aged, MESH : Child, Preschool, Biochemistry, Cohort Studies, Immunoenzyme Techniques, Hypogammaglobulinemia, MESH: Lymphoproliferative Disorders, 0302 clinical medicine, MESH : Child, MESH: Child, hemic and lymphatic diseases, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH : Female, XIAP Deficiency, Signaling Lymphocytic Activation Molecule Associated Protein, X-Linked Lymphoproliferative Syndrome, Child, MESH: Cohort Studies, MESH: Aged, 0303 health sciences, MESH: Middle Aged, MESH : Lymphoproliferative Disorders, Intracellular Signaling Peptides and Proteins, MESH : Infant, Hematology, MESH : Adult, Middle Aged, MESH : Survival Rate, MESH: Infant, 3. Good health, Survival Rate, MESH : Phenotype, Phenotype, MESH: Young Adult, Child, Preschool, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, MESH : Mutation, Adult, medicine.medical_specialty, MESH: Mutation, Adolescent, MESH: Survival Rate, MESH : Male, Immunology, MESH : Young Adult, MESH : Cohort Studies, X-Linked Inhibitor of Apoptosis Protein, Biology, MESH: Phenotype, Virus, Young Adult, 03 medical and health sciences, MESH : Intracellular Signaling Peptides and Proteins, MESH : Immunoenzyme Techniques, MESH : Adolescent, MESH: Intracellular Signaling Peptides and Proteins, medicine, Humans, MESH : Middle Aged, MESH: Immunoenzyme Techniques, Aged, Retrospective Studies, 030304 developmental biology, MESH: Adolescent, Hemophagocytic lymphohistiocytosis, Cytopenia, MESH: Humans, MESH : Humans, MESH: Child, Preschool, Infant, X-linked lymphoproliferative disease, MESH: Adult, MESH: Retrospective Studies, Cell Biology, medicine.disease, Lymphoproliferative Disorders, MESH: Male, MESH : X-Linked Inhibitor of Apoptosis Protein, Mutation, Histopathology, MESH: Female, 030215 immunology
Abstract: X-linked lymphoproliferative syndromes (XLP) are primary immunodeficiencies characterized by a particular vulnerability toward Epstein-Barr virus infection, frequently resulting in hemophagocytic lymphohistiocytosis (HLH). XLP type 1 (XLP-1) is caused by mutations in the gene SH2D1A (also named SAP), whereas mutations in the gene XIAP underlie XLP type 2 (XLP-2). Here, a comparison of the clinical phenotypes associated with XLP-1 and XLP-2 was performed in cohorts of 33 and 30 patients, respectively. HLH (XLP-1, 55%; XLP-2, 76%) and hypogammaglobulinemia (XLP-1, 67%; XLP-2, 33%) occurred in both groups. Epstein-Barr virus infection in XLP-1 and XLP-2 was the common trigger of HLH (XLP-1, 92%; XLP-2, 83%). Survival rates and mean ages at the first HLH episode did not differ for both groups, but HLH was more severe with lethal outcome in XLP-1 (XLP-1, 61%; XLP-2, 23%). Although only XLP-1 patients developed lymphomas (30%), XLP-2 patients (17%) had chronic hemorrhagic colitis as documented by histopathology. Recurrent splenomegaly often associated with cytopenia and fever was preferentially observed in XLP-2 (XLP-1, 7%; XLP-2, 87%) and probably represents minimal forms of HLH as documented by histopathology. This first phenotypic comparison of XLP subtypes should help to improve the diagnosis and the care of patients with XLP conditions.
Published: 2011
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5. Antithymocyte globulins and chronic graft-vs-host disease after myeloablative allogeneic stem cell transplantation from HLA-matched unrelated donors: a report from the Sociéte Française de Greffe de Moelle et de Thérapie Cellulaire

Author: Colette Raffoux, Mohamad Mohty, R. Tabrizi, J.Y. Cahn, Ibrahim Yakoub-Agha, J. H. Bourhis, Yosr Hicheri, Norbert Ifrah, Mauricette Michallet, Agnès Buzyn, Nathalie Dhedin, Myriam Labopin, Marie-Lorraine Balere, Didier Blaise, Gérard Socié, Helene Esperou, Noel Milpied, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier universitaire de Nantes (CHU Nantes), Université Bordeaux Segalen - Bordeaux 2, Service des maladies du sang, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Groupe Hospitalier Sud, Centre Léon Bérard [Lyon], Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Institut Gustave Roussy (IGR), Service greffe de moelle osseuse, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ) -Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers, Centre hospitalier universitaire de Nantes ( CHU Nantes ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Institut Gustave Roussy ( IGR ), and Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
Subjects: Male, MESH: Tissue Donors, Cancer Research, MESH : Retrospective Studies, MESH : Aged, MESH: Rabbits, Graft vs Host Disease, Gastroenterology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, MESH : HLA Antigens, MESH: Antilymphocyte Serum, HLA Antigens, MESH : Precursor Cell Lymphoblastic Leukemia-Lymphoma, MESH : Female, MESH: Animals, Cumulative incidence, MESH: Incidence, MESH: HLA Antigens, MESH : Tissue Donors, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Hematology, Histocompatibility Testing, Incidence, Incidence (epidemiology), MESH : Graft vs Host Disease, MESH : Histocompatibility Testing, MESH : Adult, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma, MESH : Incidence, Tissue Donors, 3. Good health, Leukemia, Myeloid, Acute, Leukemia, Treatment Outcome, surgical procedures, operative, Oncology, 030220 oncology & carcinogenesis, Female, Rabbits, MESH: Stem Cell Transplantation, MESH: Leukemia, Myeloid, Acute, MESH: Myelodysplastic Syndromes, Adult, endocrine system, medicine.medical_specialty, Adolescent, MESH : Transplantation, Homologous, MESH : Male, MESH : Leukemia, Myeloid, Acute, MESH : Antilymphocyte Serum, MESH: Graft vs Host Disease, MESH : Myelodysplastic Syndromes, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, MESH: Histocompatibility Testing, MESH : Stem Cell Transplantation, 03 medical and health sciences, MESH : Adolescent, Internal medicine, MESH: Transplantation, Homologous, medicine, Animals, Humans, Transplantation, Homologous, MESH : Middle Aged, MESH : Rabbits, Aged, Antilymphocyte Serum, Retrospective Studies, MESH: Adolescent, MESH: Precursor Cell Lymphoblastic Leukemia-Lymphoma, MESH: Humans, business.industry, Myelodysplastic syndromes, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Male, Histocompatibility, Transplantation, Graft-versus-host disease, Myelodysplastic Syndromes, Immunology, MESH : Animals, business, MESH: Female, Stem Cell Transplantation, 030215 immunology
Abstract: International audience; This retrospective report assessed the impact of rabbit antithymocyte globulins (ATG), incorporated within a standard myeloablative conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT) using human leukocyte antigen-matched unrelated donors (HLA-MUD), on the incidence of acute and chronic graft-vs-host disease (GVHD). In this series of leukemia patients, 120 patients (70%) did not receive ATG ('no-ATG' group), whereas 51 patients received ATG ('ATG' group). With a median follow-up of 30.3 months, the cumulative incidence of grade 3-4 acute GVHD was 36% in the no-ATG group and 20% in the ATG group (P = 0.11). The cumulative incidence of extensive chronic GVHD was significantly lower in the ATG group as compared to the no-ATG group (4 vs 32%, respectively; P = 0.0017). In multivariate analysis, the absence of use of ATG was the strongest parameter associated with an increased risk of extensive chronic GVHD (relative risk) = 7.14, 95% CI: 1.7-33.3, P = 0.008). At 2 years, the probability of nonrelapse mortality, relapse, overall and leukemia-free survivals was not significantly different between the no-ATG and ATG groups. We conclude that the addition of ATG to GVHD prophylaxis resulted in decreased incidence of extensive chronic GVHD without an increase in relapse or nonrelapse mortality, and without compromising survival after myeloablative allo-SCT from HLA-MUD.
Published: 2010
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6. Comparative Effectiveness of First Antiretroviral Regimens in Clinical Practice Using a Causal Approach

Author: Catherine Chirouze, Christine Katlama, Laurent Cotte, Lise Cuzin, Pascal Pugliese, Antoine Cheret, Clotilde Allavena, Philippe Flandre, David Rey, Firouzé Bani-Sadr, André Cabié, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Maladies Infectieuses [Nice], Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Infectious and Tropical Diseases Unit, Fort-de-France University Hospital, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Infectious Diseases Department, Université Montpellier 1 (UM1), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Nantes ( UN ) -Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Universitaire de La Réunion ( CHU La Réunion ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre d'Investigation Clinique Antilles-Guyane ( CIC - Antilles Guyane ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], School of Aerospace and Mechanical Engineering University of Oklahoma, Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Université Montpellier 1 ( UM1 ), Cholley, Pascal, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), and Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE)
Subjects: Male, Time Factors, MESH : Retrospective Studies, MESH: Treatment Failure, HIV Infections, MESH : Viral Load, MESH: Logistic Models, Cohort Studies, chemistry.chemical_compound, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Female, Treatment Failure, Prospective cohort study, MESH: Cohort Studies, MESH: Middle Aged, General Medicine, MESH: HIV Infections, Middle Aged, Viral Load, MESH : Adult, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Anti-Retroviral Agents, Tolerability, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Female, France, MESH: Viral Load, Research Article, medicine.drug, Cohort study, MESH : Time Factors, Adult, medicine.medical_specialty, Efavirenz, MESH : Male, Observational Study, MESH : Cohort Studies, MESH: Anti-Retroviral Agents, MESH : Treatment Failure, Internal medicine, medicine, MESH : HIV Infections, Humans, MESH : Anti-Retroviral Agents, MESH : Middle Aged, MESH : France, Darunavir, Retrospective Studies, MESH: Humans, business.industry, MESH : Drug Therapy, Combination, MESH : Humans, MESH: Time Factors, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, MESH: Male, Surgery, Atazanavir, MESH: France, MESH: Drug Therapy, Combination, Logistic Models, chemistry, Propensity score matching, business, MESH: Female, MESH : Logistic Models
Abstract: International audience; The objective of this study was to estimate the cumulative incidences of failure by months 12 (M12) and 24 (M24) for the most prescribed first-line anti-retroviral regimens (ART). It is retrospective analysis of a prospectively collected database. All patients who initiated their first ART with the most prescribed regimens between 1st January 2004 and 30th June 2013 in 12 large HIV reference centers in France were included. The outcome was treatment failure--defined by any treatment modification for virological or tolerability reasons--and comparisons between regimens were carried out at M12 and M24. Adjusted and weighted methods via the propensity score (PS) were used to compare the effectiveness of the first antiretroviral regimens. Potential confounders of the treatment-outcome association were used to estimate PS with multinomial logistic regression. Overall, 3128 and 2690 patients were included in the M12 and M24 analyses, respectively. Patients received 5 different regimens (ABC/3TC with ATV/r or DRV/r, TDF/FTC with ATV/r, DRV/r, or EFV). Failure was reported in 25% and 42% at M12 and M24, respectively. Patients who received TDF/FTC/EFV had a significantly higher proportion of failure at M12 by comparison with TDF/FTC with DRV/r (reference), but not at M24. Patients in the 3 other groups had a trend toward a higher proportion of failure at M12 although not statistically significant. No difference was found at M24. Using data from a large prospective cohort, we found that boosted atazanavir and darunavir had comparable effectiveness, whatever the associated NRTIs, whereas efavirenz-based regimens were relatively less performing on the short term.
Published: 2015
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7. Water vole (Arvicola terrestris scherman) density as risk factor for human alveolar echinococcosis

Author: V. Abrial, Patrick Giraudoux, Jean-François Viel, Solange Bresson-Hadni, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté ( UFC ), Laboratoire de chrono-écologie - CNRS (UMR6565) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Franche-Comté (UFC), Giraudoux, Patrick, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)
Subjects: Veterinary medicine, MESH : Retrospective Studies, Rodent, MESH : Poisson Distribution, Climate, MESH : Prospective Studies, MESH: Echinococcus, MESH: Regression Analysis, Disease Outbreaks, 030308 mycology & parasitology, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH : Regression Analysis, MESH : Echinococcus, MESH: Animals, Poisson Distribution, Prospective Studies, MESH: Incidence, MESH: Disease Outbreaks, 0303 health sciences, Arvicolinae, Altitude, Incidence, MESH: Echinococcosis, Hepatic, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Climate, MESH : Risk Factors, MESH : Incidence, Infectious Diseases, symbols, Regression Analysis, France, Seasons, Echinococcosis, Hepatic, MESH: Population Density, 030231 tropical medicine, Cestoda, Biology, Echinococcus multilocularis, MESH: Poisson Distribution, 03 medical and health sciences, symbols.namesake, Virology, biology.animal, Animals, Humans, MESH : Disease Outbreaks, MESH : Population Density, Poisson regression, Water vole, Risk factor, MESH : France, Retrospective Studies, Population Density, [ SDE.BE ] Environmental Sciences/Biodiversity and Ecology, MESH: Humans, MESH : Seasons, MESH : Humans, MESH: Retrospective Studies, MESH : Climate, MESH: Arvicolinae, 15. Life on land, MESH: Altitude, biology.organism_classification, MESH: Prospective Studies, Echinococcus, [SDE.BE] Environmental Sciences/Biodiversity and Ecology, MESH: France, MESH : Arvicolinae, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Relative risk, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Parasitology, Vole, MESH : Animals, [SDE.BE]Environmental Sciences/Biodiversity and Ecology, MESH : Echinococcosis, Hepatic, MESH: Seasons, MESH : Altitude
Abstract: International audience; Concern is growing in Europe about alveolar echinococcosis (AE) with the increase in grassland rodent and red fox populations, intermediate and definitive hosts for Echinococcus multilocularis, respectively. The objective of this study was to assess the influence of rodent densities on human AE distribution. Spatial Poisson regression analyses were performed with geomorphologic features, landscape composition, climatic characteristics, and water vole density as independent variables. The outcome consisted of AE cases diagnosed over the period 1980-1992. High vole density yielded a 10-fold risk (relative risk [RR] = 10.34, 95% confidence interval [CI] = 2.78-38.39), and the first plateau (400-700 m altitude) compared with the plain (200-400 m) was associated with a large increase in risk (RR = 7.10, 95% CI = 1.30-38.63). These results confirm that human AE is strongly influenced by the densities of arvicolid species. Foxes feeding almost exclusively on grassland rodents when the latter expand could mediate this relation.
Published: 1999
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8. In newly diagnosed diffuse large B-cell lymphoma, determination of bone marrow involvement with 18F-FDG PET/CT provides better diagnostic performance and prognostic stratification than does biopsy

Author: Olivier Humbert, Alexandre Cochet, Salim Kanoun, Caroline Legouge, François Brunotte, Olivier Casasnovas, Inna Dygai-Cochet, Alina Berriolo-Riedinger, Michel Toubeau, Louis Berthet, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Nucléaire, UNICANCER-UNICANCER, Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -Centre National de la Recherche Scientifique ( CNRS ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon )
Subjects: MESH : Bone Marrow, Male, MESH : Retrospective Studies, Biopsy, MESH : Aged, Iliac crest, MESH : Lymphoma, Large B-Cell, Diffuse, Multimodal Imaging, 030218 nuclear medicine & medical imaging, [ SDV.IB.MN ] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, MESH: Biopsy, 0302 clinical medicine, International Prognostic Index, MESH: Aged, 80 and over, MESH: Fluorodeoxyglucose F18, Bone Marrow, MESH : Tomography, X-Ray Computed, MESH : Neoplasm Staging, MESH : Female, MESH: Aged, Aged, 80 and over, MESH : Prognosis, MESH: Middle Aged, medicine.diagnostic_test, MESH: Multimodal Imaging, MESH: Neoplasm Staging, MESH : Adult, Middle Aged, Prognosis, MESH: Positron-Emission Tomography, 3. Good health, medicine.anatomical_structure, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Survival Analysis, MESH: Bone Marrow, Female, Radiology, Lymphoma, Large B-Cell, Diffuse, MESH: Tomography, X-Ray Computed, Adult, medicine.medical_specialty, Adolescent, MESH : Male, MESH : Multimodal Imaging, MESH : Young Adult, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, MESH: Prognosis, 03 medical and health sciences, Young Adult, Fluorodeoxyglucose F18, MESH : Adolescent, medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, Neoplasm Staging, Retrospective Studies, MESH: Adolescent, PET-CT, MESH: Humans, business.industry, MESH : Humans, MESH : Positron-Emission Tomography, MESH: Adult, MESH: Retrospective Studies, MESH : Fluorodeoxyglucose F18, medicine.disease, Survival Analysis, MESH: Male, Lymphoma, Concomitant, MESH : Biopsy, Positron-Emission Tomography, MESH: Lymphoma, Large B-Cell, Diffuse, Bone marrow, MESH : Survival Analysis, business, Nuclear medicine, Tomography, X-Ray Computed, Diffuse large B-cell lymphoma, MESH: Female
Abstract: International audience; UNLABELLED: In newly diagnosed diffuse large B-cell lymphoma (DLBCL), the sensitivity of bone marrow biopsy (BMB) for the detection of bone marrow involvement (BMI) can be low because of sampling error if the BMI is focal and not diffuse. Although (18)F-FDG PET/CT is now recommended for initial staging of DLBCL, its role regarding BMI is not well defined. This study evaluated whether (18)F-FDG PET/CT, in comparison with BMB, is useful for the detection of BMI and predictive of outcome. METHODS: From the 142 patients who were referred to our institution for newly diagnosed DLBCL from June 2006 to October 2011, 133 were retrospectively enrolled in our study. All patients underwent whole-body (18)F-FDG PET/CT and a BMB from the iliac crest before any treatment. (18)F-FDG PET/CT was considered positive for BMI in cases of uni- or multifocal bone marrow (18)F-FDG uptake that could not be explained by benign findings on the underlying CT image or history. A final diagnosis of BMI was considered if the BMB was positive or if the positive (18)F-FDG PET/CT was confirmed by guided biopsy or targeted MR imaging or in cases of disappearance of focal bone marrow uptake concomitant with the disappearance of uptake in other lymphoma lesions on (18)F-FDG PET/CT monitoring. Progression-free survival and overall survival were analyzed using the Cox proportional hazards regression model. RESULTS: Thirty-three patients were considered to have BMI. Of these, 8 were positive according to the BMB and 32 were positive according to (18)F-FDG PET/CT. (18)F-FDG PET/CT was more sensitive (94% vs. 24%; P < 0.001), showed a higher negative predictive value (98% vs. 80%), and was more accurate (98% vs. 81%) than BMB. Median follow-up was 24 mo (range, 1-67 mo). Twenty-nine patients (22%) experienced recurrence or disease progression during follow-up, and 20 patients died (15%). In multivariate analysis, only the International Prognostic Index and the (18)F-FDG PET/CT bone marrow status were independent predictors of progression-free survival (P = 0.005 and 0.02, respectively), whereas only the International Prognostic Index remained an independent predictor of overall survival (P = 0.004). CONCLUSION: Assessment of BMI with (18)F-FDG PET/CT provides better diagnostic performance and prognostic stratification in newly diagnosed DLBCL than does BMB.
Published: 2013
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9. Populations at risk for alveolar echinococcosis, France

Author: Piarroux, Martine, Piarroux, Renaud, Knapp, Jenny, Bardonnet, Karine, Dumortier, Jérôme, Watelet, Jérôme, Gerard, Alain, Beytout, Jean, Abergel, Armand, Bresson-Hadni, Solange, Gaudart, Jean, Surveillance Network, Francechino, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infections Parasitaires : Transmission, Physiopathologie et Thérapeutiques (IP-TPT), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Service de Santé des Armées, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut de Mécanique et d'Ingénierie de Bordeaux (I2M), Institut National de la Recherche Agronomique (INRA)-Université de Bordeaux (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses et Tropicales [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service d'hépatologie, CHU Etaing, Service de Santé des Armées-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut de Recherche pour le Développement (IRD), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Service des Maladies Infectieuses et Tropicales, Hôpital Gabriel Montpied, Clermont-Ferrand, France, Service des Maladies Infectieuses et Tropicales, Hopital Gabriel Montpied, Clermont-Ferrand, France, Laboratoire Chrono-environnement (UMR 6249) (LCE), 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)-Arts et Métiers Sciences et Technologies, 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)-Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique (CNRS), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Infections Parasitaires : Transmission, Physiopathologie et Thérapeutiques ( IP-TPT ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Service de Santé des Armées-Université de Montpellier ( UM ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Institut de Mécanique et d'Ingénierie de Bordeaux ( I2M ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bordeaux ( UB ) -Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Université (AMU) - ORS PACA - Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Chrono-environnement (LCE), Centre National de la Recherche Scientifique (CNRS) - Université de Franche-Comté (UFC), Hospices Civiles de Lyon - Hôpital Edouard Heriault, Service d'Hépatogastroentérologie, CHU de Nancy-Brabois, Université Sciences et Technologies - Bordeaux 1 - Arts et Métiers ParisTech - Institut Polytechnique de Bordeaux - Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastro-Entérologie, CHU de Clermont-Ferrand - Hôpital d'Estaing, and Aix Marseille Université (AMU)
Subjects: Male, Rural Population, [MATH.MATH-PR] Mathematics [math]/Probability [math.PR], Veterinary medicine, communicable disease prevention and control, MESH : Retrospective Studies, MESH : Anthelmintics, Alveolar echinococcosis, 0302 clinical medicine, [STAT.AP] Statistics [stat]/Applications [stat.AP], MESH: Rural Population, [SDV.SPEE] Life Sciences [q-bio]/Public Health and Epidemiology, Medicine, MESH: Animals, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Anthelmintics, 0303 health sciences, MESH: Middle Aged, MESH: Echinococcosis, Hepatic, 3. Good health, MESH: Anthelmintics, agricultural workers diseases, alveolar echinococcosis, MESH : Endemic Diseases, Microbiology (medical), MESH : Albendazole, medicine.medical_specialty, Echinococcus multilocularis. epidemiology, Echinococcus multilocularis, Albendazole, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, Humans, MESH : Middle Aged, Risk factor, MESH : Mebendazole, Retrospective Studies, MESH : Foxes, MESH: Echinococcus multilocularis, MESH: Humans, 030306 microbiology, MESH : Humans, lcsh:R, MESH: Adult, MESH: Retrospective Studies, Odds ratio, zoonoses, Relative risk, [SDE.ES] Environmental Sciences/Environmental and Society, MESH: Female, Demography, MESH: Liver, Endemic Diseases, MESH: Registries, Foxes, lcsh:Medicine, MESH : Echinococcus multilocularis, Risk Factors, MESH: Risk Factors, Epidemiology, MESH : Socioeconomic Factors, MESH : Female, Registries, rural health, [MATH.MATH-ST] Mathematics [math]/Statistics [math.ST], [STAT.ME] Statistics [stat]/Methodology [stat.ME], biology, Rural health, MESH : Adult, Middle Aged, MESH : Risk Factors, Mebendazole, Infectious Diseases, Liver, MESH: Endemic Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, epidemiology, France, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Adult, [ SDV.MP.PAR ] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Echinococcosis, Hepatic, MESH: Socioeconomic Factors, MESH : Male, 030231 tropical medicine, [MATH.MATH-DS] Mathematics [math]/Dynamical Systems [math.DS], parasites, MESH: Mebendazole, Echinococcosis, MESH: Albendazole, Animals, lcsh:RC109-216, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, MESH : France, MESH: Foxes, business.industry, Research, MESH : Liver, Retrospective cohort study, biology.organism_classification, MESH: Male, MESH : Rural Population, MESH: France, Socioeconomic Factors, MESH : Animals, business, MESH : Echinococcosis, Hepatic, MESH : Registries
Abstract: International audience; During 1982-2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls. We found that almost all AE patients lived in 22 départements in eastern and central France (relative risk 78.63, 95% CI 52.84-117.02). Classification and regression tree analysis showed that the main risk factor was living in AE-endemic areas. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21-464.51 for farmers and OR 6.98, 95% CI 2.88-18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82-10.91). These findings can help sensitization campaigns focus on specific groups.
Published: 2013
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10. Parental electrocardiographic screening identifies a high degree of inheritance for congenital and childhood nonimmune isolated atrioventricular block

Author: Hervé Le Marec, Caroline Bonnet, Jean-René Lusson, Raphaël P. Martins, Jean-Jacques Schott, Francis Rouault, Alban-Elouen Baruteau, Jean-Benoit Thambo, Christian Dina, Elisabeth Villain, François Godart, Philippe Mabo, Vincent Probst, Alain Fraisse, François Marçon, Albin Behaghel, Véronique Gournay, Sophie Guillaumont, Yves Dulac, Jean-Marc Schleich, Stéphanie Chatel, Swanny Fouchard, Alain Chantepie, Béatrice Delasalle, Jean-Claude Daubert, unité de recherche de l'institut du thorax UMR1087 UMR6291 ( ITX ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Department de Chirurgie cardiaque des cardiopathies congénitales, Centre chirurgical Marie Lannelongue, Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire de génie des procédés - environnement - agroalimentaire ( GEPEA ), Mines Nantes ( Mines Nantes ) -Université de Nantes ( UN ) -Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique ( ONIRIS ) -Centre National de la Recherche Scientifique ( CNRS ), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service cardiologie pédiatrique [Bordeaux], CHU Bordeaux [Bordeaux], Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de cardiologie pédiatrique [Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Cabinet de Cardiologie pédiatrique, Service de cardiologie pédiatrique [Tours], CHU Tours, Service de cardiologie Pédiatrique [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Service de cardiologie Pédiatrique [Lille], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de cardiologie pédiatrique et congénitale adulte [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de cardiologie Pédiatrique [Marseille], Hôpital de la Timone [CHU - APHM] ( TIMONE ), Service de cardiologie [Clermont-Ferrand], CHU Clermont-Ferrand, Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de génie des procédés - environnement - agroalimentaire (GEPEA), Mines Nantes (Mines Nantes)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Chirurgical Marie Lannelongue (CCML), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes (UN)-Université de Nantes (UN)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Le Corre, Morgane, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Parents, MESH : Retrospective Studies, Heart malformation, MESH : NAV1.5 Voltage-Gated Sodium Channel, MESH : Prevalence, MESH : Aged, Electrocardiography, 0302 clinical medicine, MESH: Pregnancy, MESH : Child, Pregnancy, Prenatal Diagnosis, MESH: Child, Medicine, Sinus rhythm, genetics, Child, 0303 health sciences, MESH: Middle Aged, MESH: Genetic Testing, MESH : Infant, MESH: Infant, 3. Good health, MESH : Phenotype, MESH: Young Adult, MESH : Electrocardiography, Child, Preschool, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, conduction, MESH : Young Adult, Prenatal diagnosis, MESH: Phenotype, Sudden death, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), MESH : Adolescent, MESH : Genetic Testing, Humans, MESH : Middle Aged, Genetic Testing, MESH: Prenatal Diagnosis, MESH : Prenatal Diagnosis, MESH: Prevalence, Aged, Retrospective Studies, [SDV.IB] Life Sciences [q-bio]/Bioengineering, MESH: Adolescent, MESH: Parents, MESH: Humans, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Pregnancy, MESH : Genetic Predisposition to Disease, Atrioventricular block, MESH: Female, Pediatrics, ECG screening, 030204 cardiovascular system & hematology, MESH : Child, Preschool, NAV1.5 Voltage-Gated Sodium Channel, atrioventricular block, Prevalence, Mass Screening, MESH : Female, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Family history, MESH : Parents, MESH: Aged, MESH: Infant, Newborn, MESH: Genetic Predisposition to Disease, Middle Aged, MESH : Adult, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Atrioventricular Block, Phenotype, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Adult, Adolescent, pediatrics, MESH : Male, MESH : Infant, Newborn, Asymptomatic, Young Adult, MESH: Atrioventricular Block, Genetic Predisposition to Disease, MESH: Mass Screening, PR interval, 030304 developmental biology, MESH : Mass Screening, business.industry, Infant, Newborn, MESH: NAV1.5 Voltage-Gated Sodium Channel, MESH: Male, MESH: Electrocardiography, business
Abstract: Background— The origin of congenital or childhood nonimmune isolated atrioventricular (AV) block remains unknown. We hypothesized that this conduction abnormality in the young may be a heritable disease. Methods and Results— A multicenter retrospective study (13 French referral centers, from 1980–2009) included 141 children with AV block diagnosed in utero, at birth, or before 15 years of age without structural heart abnormalities and without maternal antibodies. Parents and matched control subjects were investigated for family history and for ECG screening. In parents, a family history of sudden death or progressive cardiac conduction defect was found in 1.4% and 11.1%, respectively. Screening ECGs from 130 parents (mean age 42.0±6.8 years, 57 couples) were compared with those of 130 matched healthy control subjects. All parents were asymptomatic and in sinus rhythm, except for 1 with undetected complete AV block. Conduction abnormalities were more frequent in parents than in control subjects, found in 50.8% versus 4.6%, respectively ( P P P P SCN5A mutation screening identified 2 mutations in 2 patients among 97 children. Conclusions— ECG screening in parents of children affected by idiopathic AV block revealed a high prevalence of conduction abnormalities. These results support the hypothesis of an inheritable trait in congenital and childhood nonimmune isolated AV block.
Published: 2012
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11. Oral involvement in sarcoidosis: report of 12 cases

Author: C. Chapelon-Abric, Pascal Sève, J. Le Scanff, Dominique Valeyre, S. Khenifer, L. Varron, A. Bouaziz, A. Gleizal, M.-H. Bentz, A. Barthel, Laboratoire de Bactériologie de l'Hôpital de la Croix-Rousse, Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Croix-Rousse [CHU - HCL], Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Unite de Microbiologie Alimentaire et Previsionnelle, Ecole Nationale Vétérinaire de Lyon (ENVL), Hopital General de Montbelliard, Departement de médecine interne, Institut Pasteur de Nouvelle-Calédonie, Réseau International des Instituts Pasteur (RIIP), Stabilité génétique, Cellules Souches et Radiations (SCSR (U_967)), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon ( HCL ), CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Ecole Nationale Vétérinaire de Lyon ( ENVL ), Institut Pasteur of New-Caledonia, Cellules Souches et Radiations ( SCSR - U 967 ), Université Paris-Sud - Paris 11 ( UP11 ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)
Subjects: Male, MESH : Retrospective Studies, MESH : Recurrence, MESH : Aged, Disease, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 030207 dermatology & venereal diseases, 0302 clinical medicine, Adrenal Cortex Hormones, Recurrence, MESH : Female, Oral mucosa, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, General Medicine, MESH : Adult, Middle Aged, MESH: Case-Control Studies, 3. Good health, Treatment Outcome, medicine.anatomical_structure, MESH : Mouth Diseases, MESH: Young Adult, Female, Sarcoidosis, medicine.symptom, medicine.drug, Adult, MESH: Sarcoidosis, MESH : Case-Control Studies, medicine.medical_specialty, MESH : Male, MESH : Young Adult, MESH : Sarcoidosis, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Asymptomatic, MESH : Adrenal Cortex Hormones, MESH: Adrenal Cortex Hormones, Young Adult, 03 medical and health sciences, Tongue, Internal medicine, medicine, Humans, MESH : Middle Aged, Aged, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, Retrospective cohort study, Hydroxychloroquine, MESH: Adult, MESH: Retrospective Studies, 030206 dentistry, medicine.disease, MESH: Male, Surgery, MESH: Recurrence, Case-Control Studies, Methotrexate, MESH: Mouth Diseases, Mouth Diseases, business, MESH: Female
Abstract: Aim: To assess the clinical features, treatment and outcome of oral sarcoidosis and to determine whether oral involvement is associated with a particular clinical phenotype of sarcoidosis. Design: Multicentric retrospective study. Methods: Retrospective chart review. Each patient was matched with four controls. Results: Twelve patients (9 women, 3 men) were identified. Their median age at sarcoidosis diagnosis was 38 years. Oral involvement was the first clinical evidence of sarcoidosis in seven cases and was a relapse symptom in five cases. Clinical presentations were nodules ( n = 7) or ulcers ( n = 5) and were mostly solitary. The tongue was the commonest site affected ( n = 4), followed by lips ( n = 3), oral mucosa ( n = 2), palate ( n = 2) and gingiva ( n = 1). Patients with oral sarcoidosis were significantly younger and had more frequent lacrimal or salivary glands and upper airway tract clinical involvement than the controls; increased angiotensin-converting enzyme was less frequent in oral sarcoidosis. Multiple treatments of oral sarcoidosis were used: no treatment ( n = 3), surgery ( n = 2), corticosteroids ( n = 7), hydroxychloroquine ( n = 3), methotrexate ( n = 2), doxycycline ( n = 1). Methotrexate was efficient in one patient, hydroxychloroquine showed benefit in only 1 out of 3 patients. Three patients presented oral relapses. After a mean follow-up of 6 years, 10 patients experienced a complete ( n = 7) or partial ( n = 3) remission of oral sarcoidosis; stability was observed in the remaining two cases. Conclusion: Although oral manifestations of sarcoidosis are unusual, physicians should be aware that this specific localization is frequently the first manifestation of the disease. Treatment modalities range from observation in asymptomatic patients to immunosuppressants for severe involvement.
Published: 2012
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12. Management of noninfectious mixed cryoglobulinemia vasculitis: data from 242 cases included in the CryoVas survey

Author: Antoine Huart, Estibaliz Lazaro, P. Belenotti, Olivier Hermine, David Launay, Guillaume Le Guenno, Thierry Zenone, Adeline Lacraz, Patrice Cacoub, Evguenia Krastinova, Franck Bridoux, Patricia Senet, P. Rullier, Elisabeth Diot, Xavier Mariette, Luc de Saint-Martin, Thomas Quemeneur, Isabelle Marie, Emmanuelle Plaisier, Benjamin Terrier, Fabrice Carrat, Fabrice Bonnet, Olivier Hinschberger, Jean-Emmanuel Kahn, Jean-Marc Léger, Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne [Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Néphrologie-Transplantation-Dialyse, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service de Médecine Interne (MARSEILLE - Med Int), Assistance Publique - Hôpitaux de Marseille (APHM), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Département de Médecine Interne (VALENCIENNES - Med Int), CH Valenciennes, Service de Néphrologie et Immunopathologie Clinique, Centre Hospitalier Universitaire de Toulouse, PRES Université de Toulouse, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire Estaing, CHU Estaing, Laboratoire d'Immunologie (EA 2686), Université de Lille, Droit et Santé, Service de Médecine Interne B, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Médecine Interne, Hôpital Bretonneau, Service de médecine interne et maladies tropicales, CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Contrôle de la Réponse Immune B et des Lymphoproliférations (CRIBL), Centre National de la Recherche Scientifique (CNRS)-Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Service de néphrologie - hémodialyse et transplantation rénale, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Médecine Interne (VALENCE - Med Int), Centre hospitalier de Valence, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cytokines, hématopoïèse et réponse immune (CHRI), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie 1 [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Dermatologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Remodelage et Reparation du Tissu Renal, Service de médecine interne [CHU Pitié-Salpétrière], Biologie et thérapeutique des pathologies immunitaires (BTPI), Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC), Immunologie - Immunopathologie - Immunothérapeutique ( I3 ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Médecine Interne ( MARSEILLE - Med Int ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Département de Médecine Interne ( VALENCIENNES - Med Int ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire d'Immunologie ( EA 2686 ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Contrôle de la Réponse Immune B et des Lymphoproliférations ( CRIBL ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Limoges ( UNILIM ) -Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ), Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Médecine Interne ( VALENCE - Med Int ), Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Cytokines, hématopoïèse et réponse immune ( CHRI ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Biologie et thérapeutique des pathologies immunitaires ( BTPI ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Université de Brest (UBO)-Université de Brest (UBO), CHU Clermont-Ferrand, Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Médecine interne et immunopathologie clinique [CHU Toulouse], Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)
Subjects: Male, MESH: Combined Modality Therapy, MESH : Retrospective Studies, [SDV]Life Sciences [q-bio], MESH : Aged, Arthritis, 030204 cardiovascular system & hematology, Biochemistry, Gastroenterology, MESH: Antibodies, Monoclonal, Cohort Studies, Antibodies, Monoclonal, Murine-Derived, 0302 clinical medicine, Prednisone, Adrenal Cortex Hormones, MESH : Female, MESH: Data Collection, MESH: Cohort Studies, MESH : Algorithms, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Data Collection, MESH: Vasculitis, Antibodies, Monoclonal, Hematology, Middle Aged, Connective tissue disease, Combined Modality Therapy, 3. Good health, MESH : Vasculitis, MESH : Infection, Treatment Outcome, Cryoglobulinemia, MESH : Antibodies, Monoclonal, Rituximab, Female, medicine.symptom, MESH : Data Collection, Vasculitis, MESH: Infection, Algorithms, medicine.drug, medicine.medical_specialty, MESH: Cryoglobulinemia, MESH : Male, Immunology, MESH : Cohort Studies, MESH: Algorithms, MESH : Treatment Outcome, Infections, MESH : Adrenal Cortex Hormones, MESH: Adrenal Cortex Hormones, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, Aged, Retrospective Studies, 030203 arthritis & rheumatology, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, MESH: Retrospective Studies, Cell Biology, Skin ulcer, medicine.disease, MESH : Cryoglobulinemia, MESH: Male, MESH : Antibodies, Monoclonal, Murine-Derived, Regimen, Peripheral neuropathy, MESH: Antibodies, Monoclonal, Murine-Derived, business, MESH : Combined Modality Therapy, MESH: Female
Abstract: Data on the clinical spectrum and therapeutic management of noninfectious mixed cryoglobulinemia vasculitis (CryoVas) in the era of hepatitis C virus screening are lacking. We analyzed data from 242 patients with noninfectious mixed CryoVas included in the French multicenter CryoVas survey. Baseline manifestations were purpura (75%), peripheral neuropathy (52%), arthralgia or arthritis (44%), glomerulonephritis (35%), cutaneous ulcers (16%), and cutaneous necrosis (14%). A connective tissue disease was diagnosed in 30% and B-cell non-Hodgkin lymphoma in 22%, whereas the CryoVas was considered to be essential in 48%. With the use of Cox-marginal structural models, rituximab plus corticosteroids showed the greater therapeutic efficacy compared with corticosteroids alone and alkylating agents plus corticosteroids to achieve complete clinical, renal, and immunologic responses and a prednisone dosage < 10 mg/d at 6 months. However, this regimen was also associated with severe infections, particularly when high doses of corticosteroids were used, whereas death rates did not differ between the therapeutic regimens. The role of each of these strategies remains to be defined in well-designed randomized controlled trials.
Published: 2012
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13. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys

Author: Duval, Xavier, Delahaye, François, Alla, François, Tattevin, Pierre, Obadia, Jean-François, Le Moing, Vincent, Doco-Lecompte, Thanh, Celard, Marie, Poyart, Claire, Strady, Christophe, Chirouze, Catherine, Bes, Michelle, Cambau, Emmanuelle, Iung, Bernard, Selton-Suty, Christine, Hoen, Bruno, Renseigné, Non, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Service des maladies infectieuses et réanimation médicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Bactériologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), services de maladies infectieuses, CHU J Minjoz, Besançon, Ministère de la santé, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Epidémiologie Clinique (CIC-EC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Epidémiologie Clinique ( CIC-EC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Cochin-Saint Vincent de Paul, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), and Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC )
Subjects: MESH : Retrospective Studies, MESH : Male, [SDV]Life Sciences [q-bio], MESH : Age Distribution, MESH : Young Adult, MESH: Staphylococcal Infections, [SDU.STU.PE]Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH: Prognosis, MESH : Guideline Adherence, MESH: Population Surveillance, MESH: Practice Guidelines as Topic, MESH: Risk Factors, MESH: Antibiotic Prophylaxis, MESH : Population Surveillance, MESH: Staphylococcus aureus, MESH : Middle Aged, MESH : Female, MESH: Endocarditis, Bacterial, MESH: Incidence, MESH : Endocarditis, Bacterial, MESH : Antibiotic Prophylaxis, MESH : France, MESH : Sex Distribution, MESH: Age Distribution, [ SDU.STU.PE ] Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH : Prognosis, MESH: Middle Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], MESH : Staphylococcus aureus, MESH : Humans, MESH: Sex Distribution, MESH : Follow-Up Studies, MESH: Adult, MESH: Retrospective Studies, MESH: Follow-Up Studies, MESH : Adult, MESH : Risk Factors, MESH : Incidence, MESH: Male, MESH: France, MESH : Practice Guidelines as Topic, MESH: Young Adult, MESH: Guideline Adherence, MESH : Staphylococcal Infections, MESH: Female
Abstract: International audience; OBJECTIVES: The goal of this study was to evaluate temporal trends in infective endocarditis (IE) incidence and clinical characteristics after 2002 French IE prophylaxis guideline modifications. BACKGROUND: There are limited data on changes in the epidemiology of IE since recent guidelines recommended restricting the indications of antibiotic prophylaxis of IE. METHODS: Three 1-year population-based surveys were conducted in 1991, 1999, and 2008 in 3 French regions totaling 11 million inhabitants age ≥20 years. We prospectively collected IE cases from all medical centers and analyzed age- and sex-standardized IE annual incidence trends. RESULTS: Overall, 993 expert-validated IE cases were analyzed (323 in 1991; 331 in 1999; and 339 in 2008). IE incidence remained stable over time (95% confidence intervals given in parentheses/brackets): 35 (31 to 39), 33 (30 to 37), and 32 (28 to 35) cases per million in 1991, 1999, and 2008, respectively. Oral streptococci IE incidence did not increase either in the whole patient population (8.1 [6.4 to 10.1], 6.3 [4.8 to 8.1], and 6.3 [4.9 to 8.0] in 1991, 1999, and 2008, respectively) or in patients with pre-existing native valve disease. The increased incidence of Staphylococcus aureus IE (5.2 [3.9 to 6.8], 6.8 [5.3 to 8.6], and 8.2 [6.6 to 10.2]) was not significant in the whole patient population (p = 0.228) but was significant in the subgroup of patients without previously known native valve disease (1.6 [0.9 to 2.7], 3.7 [2.6 to 5.1], and 4.1 [3.0 to 5.6]; p = 0.012). CONCLUSIONS: Scaling down antibiotic prophylaxis indications was not associated with an increased incidence of oral streptococcal IE. A focus on avoidance of S. aureus bacteremia in all patients, including those with no previously known valve disease, will be required to improve IE prevention.
Published: 2012
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14. Markers of recurrence and long-term morbidity in craniopharyngioma: a systematic analysis of 171 patients

Author: Fabrice Bonnet, A. Gautier, Ariane Godbout, Mathieu Coudert, Gilles Brassier, Catherine Grosheny, Laurent Riffaud, Philippe Touraine, Christian Sainte-Rose, Marc de Kerdanet, Carine Courtillot, Christel Jublanc, Elisabeth Thibaud, Isabelle Tejedor, Jean-Yves Poirier, Remy Van Effenterre, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'endocrinologie diabétologie et nutrition [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Endocrinology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM)-Department of Medicine, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Modeling in Clinical Research, Université Pierre et Marie Curie - Paris 6 (UPMC)-EA 3974, Service de Pédiatrie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Service de neurochirurgie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Craniopharyngioma Study Group, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Centre de recherche du Centre Hospitalier de l'Université de Montréal ( CRCHUM ) -Department of Medicine, Department of Endocrinology and Reproductive Medicine, CHU Pitié-Salpêtrière [APHP]-Centre de Référence des Maladies Endocriniennes rares de la croissance et des maladies gynécologiques rares, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -EA 3974, Department of Biostatistics and Medical Informatics, CHU Pitié-Salpêtrière [APHP], Department of Endocrinology and Metabolism, Service de neurochirurgie [Rennes], Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Department of Neurosurgery, and Le Corre, Morgane
Subjects: Male, Pediatrics, MESH : Retrospective Studies, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, MESH : Child, Preschool, Biochemistry, MESH: Craniopharyngioma, Cohort Studies, Craniopharyngioma, 0302 clinical medicine, Endocrinology, MESH : Child, Quality of life, MESH: Child, MESH : Female, MESH : Craniotomy, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Age of Onset, Child, MESH: Cohort Studies, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, MESH : Prognosis, MESH: Middle Aged, MESH : Neoplasm Recurrence, Local, MESH: Follow-Up Studies, MESH : Adult, [ SDV.MHEP.EM ] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Prognosis, MESH : Age of Onset, 3. Good health, 030220 oncology & carcinogenesis, Child, Preschool, MESH: Survival Analysis, MESH : Social Adjustment, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Social Adjustment, MESH: Neoplasm Recurrence, Local, Craniotomy, Cohort study, MESH: Intracranial Hypertension, Adult, medicine.medical_specialty, Adolescent, MESH : Male, MESH: Age of Onset, MESH: Craniotomy, MESH : Cohort Studies, Context (language use), MESH: Prognosis, 03 medical and health sciences, MESH : Intracranial Hypertension, MESH : Adolescent, Internal medicine, MESH : Craniopharyngioma, medicine, Humans, MESH : Middle Aged, MESH : France, Survival rate, Survival analysis, Retrospective Studies, [SDV.IB] Life Sciences [q-bio]/Bioengineering, MESH: Adolescent, MESH: Humans, business.industry, MESH : Humans, Biochemistry (medical), MESH: Child, Preschool, MESH: Quality of Life, MESH : Follow-Up Studies, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, MESH : Quality of Life, medicine.disease, Survival Analysis, MESH: Social Adjustment, MESH: Male, Surgery, MESH: France, Quality of Life, MESH : Survival Analysis, Age of onset, Intracranial Hypertension, Neoplasm Recurrence, Local, business, MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: International audience; CONTEXT: Craniopharyngiomas are often associated with an unfavorable prognosis, but data on their long-term consequences are sparse. OBJECTIVE: The aim of the study was to identify markers of recurrence and factors associated with compromised social rehabilitation and altered quality of life in a large cohort of patients with either childhood-onset (CO) or adult-onset craniopharyngioma. METHODS: Retrospective analysis was performed for 171 patients treated for craniopharyngioma in two academic centers in France between 1972 and 2009. For each subject, data were collected concerning clinical presentation, imaging features, visual sequelae, endocrine and metabolic impact, treatment modalities (surgery, radiotherapy), recurrence-free survival rate, and social insertion, as well as answers to the WHO-QOL BREF questionnaire. RESULTS: A total of 65 CO and 106 adult-onset patients were reviewed. If CO was diagnosed before the age of 10 yr, this was associated with a higher incidence of obesity, blindness, and panhypopituitarism, and only 40.7% of subjects had adequate work or school attendance compared to 72.4% of patients with later disease onset. Initial symptoms of intracranial hypertension (SIHT), pterional surgery, and multiple surgery were associated with obesity and poorer social insertion. No determinant of quality of life was identified. In the subgroup of patients treated in the 1990s and later, the progression rate was 59.4% in patients with residual tumor on magnetic resonance imaging compared with a 19.8% recurrence rate in the group with apparently complete resection. Recurrence/progression correlates significantly with male gender, early onset (before 10 yr), and SIHT, but only SIHT at presentation remained a significant predictor with multivariate analysis. CONCLUSIONS: Craniopharyngioma continues to be associated with severe outcomes. Higher morbidity rates are found in patients with early-onset disease (before 10 yr), initial SIHT, or in whom pterional surgery was required. Markers of recurrence are difficult to identify, with SIHT being the most powerful predictor.
Published: 2012
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15. Characteristics and long-term outcome of non-immune isolated atrioventricular block diagnosed in utero or early childhood: a multicentre study

Author: François Marçon, Caroline Bonnet, Sophie Guillaumont, Elisabeth Villain, Véronique Gournay, François Godart, Albin Behaghel, Yves Dulac, Jean-Benoit Thambo, Swanny Fouchard, Vincent Probst, Jean-Jacques Schott, Jean-Marc Schleich, Alain Chantepie, Francis Rouault, Christophe Leclercq, Alban-Elouen Baruteau, Alain Fraisse, Hervé Le Marec, Jean-Claude Daubert, Jean-René Lusson, Philippe Mabo, Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut du thorax, Université de Nantes ( UN ) -IFR26-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), unité de recherche de l'institut du thorax UMR1087 UMR6291 ( ITX ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service cardiologie pédiatrique [Bordeaux], CHU Bordeaux [Bordeaux], Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de cardiologie pédiatrique [Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Cabinet de Cardiologie pédiatrique, Service de cardiologie pédiatrique [Tours], CHU Tours, Service de cardiologie Pédiatrique [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Service de cardiologie Pédiatrique [Lille], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de cardiologie pédiatrique et congénitale adulte [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de cardiologie Pédiatrique [Marseille], Hôpital de la Timone [CHU - APHM] ( TIMONE ), Service de cardiologie [Clermont-Ferrand], CHU Clermont-Ferrand, Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, 'Protocole Hospitalier de Recherche Clinique' 2001 R20/03 and 2004 R20/07 from the University Medical Center of Nantes, France, the 2009 Philippe Coumel Research Grant from the French Society of Cardiology, grant no 05 CVD 01 (Preventing Sudden Death) from the Foundation Leducq Trans-Atlantic Network of Excellence, 'Agence Nationale de la Recherche' grant 05-MRAR-028., Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Pacemaker, Artificial, Heart disease, MESH : Retrospective Studies, law.invention, Electrocardiography, 0302 clinical medicine, MESH: Pregnancy, MESH : Child, Pregnancy, Prenatal Diagnosis, MESH: Child, Age of Onset, Child, MESH: Treatment Outcome, MESH: Bundle-Branch Block, Clinical outcome, Cardiac Pacing, Artificial, MESH : Infant, MESH: Infant, 3. Good health, MESH : Age of Onset, Pacemaker, MESH: Young Adult, MESH : Electrocardiography, Child, Preschool, Disease Progression, MESH: Pacemaker, Artificial, MESH: Disease Progression, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, MESH : Bundle-Branch Block, MESH: Age of Onset, MESH : Young Adult, MESH: Cardiac Pacing, Artificial, Disease-Free Survival, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Adolescent, Humans, MESH: Prenatal Diagnosis, MESH : Prenatal Diagnosis, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, MESH : Disease Progression, medicine.disease, MESH : Pregnancy, MESH: Disease-Free Survival, Atrioventricular block, MESH: Female, Pediatrics, Paediatric electrocardiology, 030204 cardiovascular system & hematology, MESH : Child, Preschool, Risk Factors, law, MESH: Risk Factors, MESH : Female, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, medicine.diagnostic_test, Dilated cardiomyopathy, MESH : Adult, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, MESH : Atrioventricular Block, Treatment Outcome, MESH : Disease-Free Survival, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Adult, Adolescent, MESH : Male, Bundle-Branch Block, MESH : Treatment Outcome, Asymptomatic, Young Adult, MESH: Atrioventricular Block, 030225 pediatrics, medicine, business.industry, MESH : Pacemaker, Artificial, Retrospective cohort study, MESH: Male, Surgery, MESH: Electrocardiography, MESH : Cardiac Pacing, Artificial, Artificial cardiac pacemaker, Age of onset, business
Abstract: International audience; AIMS: The natural history of congenital or childhood non-immune, isolated atrioventricular (AV) block is poorly defined. METHODS AND RESULTS: We retrospectively studied 141 children with isolated, non-immune AV block diagnosed in utero, or up to 15 years of age, at 13 French medical centres, between 1980 and 2009. Patients with structural heart disease or maternal antibodies were excluded. Atrioventricular block was asymptomatic in 119 (84.4%) and complete in 100 (70.9%) patients. There was progression to complete AV block in 29/41 (70.7%) patients with incomplete AV block over 2.8 ± 3.4 years (1-155 months), but all patients with incomplete AV block may not have been included in the study. Narrow QRS complex was present in 18 of 26 patients (69.2%) with congenital, and 106 of 115 (92.2%) with childhood AV block. Pacemakers were implanted in 112 children (79.4%), during the first year of life in 18 (16.1%) and before 10 years of age in 90 (80.4%). The mean interval between diagnosis of AV block and pacemaker implants was 2.6 ± 3.9 years (0-300 months). The pacing indication was prophylactic in 70 children (62.5%). During a mean follow-up of 11.6 ± 6.7 years (1-32 years), no patient died or developed dilated cardiomyopathy (DCM). The long-term follow-up was uncomplicated in 127 children (90.1%). CONCLUSION: In this large multicentre study, the long-term outcome of congenital or childhood non-immune, isolated AV block was favourable, regardless of the patient's age at the time of diagnosis. No patient died or developed DCM, and pacemaker-related complications were few.
Published: 2012
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16. Reduced-intensity conditioning before allogeneic hematopoietic stem cell transplantation in patients over 60 years: a report from the SFGM-TC

Author: Sylvie François, Agnes Buzyn, Mauricette Michallet, Nicole Gratecos, Didier Blaise, François Guilhot, Richard Szydlo, Reza Tabrizi, Mohamad Mohty, Gérard Socié, Nathalie Contentin, Madalina Uzunov, Nathalie Fegueux, Jacques-Olivier Bay, Patrice Chevallier, Anne Huynh, Simona Lapusan, Jean-Yves Cahn, Ibrahim Yakoub-Agha, Sébastien Maury, Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'hématologie et oncologie médicale, Hôpital Lapeyronie-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-Institut de Chimie du CNRS (INC), Service Hématologie, Centre Hospitalier Universitaire de Nice (CHU Nice), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Hematology, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, Service d'hématologie greffe [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), UAM Allogreffes de CSH, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Unité de transplantation médullaire et laboratoire d'oncologie moléculaire, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER-UNICANCER, Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Chimie des Milieux et Matériaux de Poitiers ( IC2MP ), Université de Poitiers-Centre National de la Recherche Scientifique ( CNRS ), CHU Nice, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Hematology, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-CHU Grenoble, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Université Toulouse III - Paul Sabatier ( UPS ), CRLCC Jean Perrin, Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ) -Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers, Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Hematology, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), and PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes
Subjects: Male, MESH: Tissue Donors, Multivariate analysis, Transplantation Conditioning, MESH : Retrospective Studies, MESH : Transplantation Conditioning, medicine.medical_treatment, MESH : Aged, Hematopoietic stem cell transplantation, Disease, Allo-HSCT, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Medicine, MESH : Female, MESH : Tissue Donors, MESH: Transplantation Conditioning, MESH: Aged, MESH: Middle Aged, Age Factors, Hematopoietic Stem Cell Transplantation, Hematology, MESH: Follow-Up Studies, Middle Aged, SFGM-TC, MESH : Survival Rate, MESH : Risk Factors, Tissue Donors, 3. Good health, Survival Rate, 030220 oncology & carcinogenesis, Reduced Intensity Conditioning, Hematologic Neoplasms, MESH : Disease-Free Survival, Female, MESH : Hematologic Neoplasms, medicine.medical_specialty, MESH: Survival Rate, MESH : Transplantation, Homologous, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease-Free Survival, 03 medical and health sciences, Age, MESH : Hematopoietic Stem Cell Transplantation, Internal medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, MESH : Middle Aged, In patient, MESH: Hematopoietic Stem Cell Transplantation, Aged, Retrospective Studies, MESH: Age Factors, Transplantation, MESH: Humans, business.industry, MESH : Humans, RIC, Complete remission, MESH : Follow-Up Studies, MESH: Retrospective Studies, Confidence interval, MESH: Male, Surgery, Elderly patients, Relative risk, MESH: Disease-Free Survival, MESH : Age Factors, business, MESH: Female, 030215 immunology, Follow-Up Studies, MESH: Hematologic Neoplasms
Abstract: International audience; This retrospective multicenter report assessed the outcome of 600 patients with hematologic diseases older than 60 years who received reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT), with the specific aim to compare outcomes of patients between 60 and 65 years old (N = 493) with those older than 65 years (N = 107). Except for donor age, there were no significant differences between the groups regarding patients, diseases, and allo-HSCT characteristics. At time of RIC allo-HSCT, 276 patients (46%) were in complete remission. With a median follow-up of 22.8 and 23.7 months in the younger and the older groups, respectively, 2-year relapse, nonrelapse mortality, disease-free survival, and overall survival rates were similar in both groups (29.6% vs. 20.4%; 29.9% vs. 34.6%; 40.6% vs. 46.7%; 49.2% vs. 50.2%, respectively; P = NS for all comparisons). In a Cox multivariate analysis, after adjustment for disease and transplant factors, age per se was not an adverse factor for survival (relative risk = 1.08; 95% confidence interval, 0.81-1.44, P = .62). We conclude that in selected patients, RIC allo-HSCT could be offered to patients over 65 years old.
Published: 2012
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17. Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children

Author: Laurent Bonnemains, Younes Boudjemline, Bertrand Stos, Freddy Odille, Thibaud Vaugrenard, Pierre-Yves Marie, Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Chirurgical Marie Lannelongue (CCML), Centre chirurgical Marie Lannelongue, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle imagerie, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Bonnemains, Laurent, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre Chirurgical Marie Lannelongue ( CCML ), Imagerie Adaptative Diagnostique et Interventionnelle ( IADI ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: Male, MESH : Retrospective Studies, MESH: Myocardial Contraction, Ventricular Dysfunction, Right, MESH : Ventricular Dysfunction, Right, 030204 cardiovascular system & hematology, MESH: Stroke Volume, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, MESH : Child, MESH: Child, MESH : Stroke Volume, MESH : Female, Child, MESH : Myocardial Contraction, MESH: Ventricular Dysfunction, Right, Tetralogy of Fallot, education.field_of_study, Ejection fraction, medicine.diagnostic_test, General Medicine, Stroke volume, MESH : Adult, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Magnetic Resonance Imaging, MESH: Predictive Value of Tests, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, medicine.anatomical_structure, MESH: Young Adult, Echocardiography, Predictive value of tests, Cardiology, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Adolescent, MESH : Male, Heart Ventricles, Population, MESH : Young Adult, MESH: Tetralogy of Fallot, 03 medical and health sciences, Young Adult, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, MESH : Adolescent, MESH : Magnetic Resonance Imaging, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Predictive Value of Tests, Systole, education, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH : Tetralogy of Fallot, MESH : Echocardiography, business.industry, MESH : Humans, Magnetic resonance imaging, MESH: Adult, MESH: Retrospective Studies, Stroke Volume, medicine.disease, Myocardial Contraction, MESH: Male, Ventricle, MESH : Heart Ventricles, MESH: Echocardiography, Right ventricle functio, MESH: Heart Ventricles, business, MESH: Female
Abstract: International audience; AIMS: To examine in a population of post-operative tetralogy of Fallot patients, the correlation between right ventricle (RV) ejection fractions (EF) computed from magnetic resonance imaging (MRI) and three echocardiographic indices of RV function: TAPSE, longitudinal strain and strain rate. Indeed, these patients present a pulmonary regurgitation which is responsible for progressive dilatation of the RV. An echocardiographic assessment of the RV function would be very useful in determining the timing of pulmonary revalvulation for Fallot patients. However, these indices are generally based on the ventricle contraction in the long axis direction which is impaired in this population and does not seem to correlate with the EF. METHODS AND RESULTS: Thirty-five post-operative tetralogy of Fallot patients and 20 patients with normal RVs were included. In both groups, RVEF, assessed by MRI, was compared with the three echocardiographic indices. Longitudinal strain and strain rates were computed both on the free wall and on the whole RV. No correlation was found between the echocardiographic indices and the MRI EF in our Fallot population. The accuracy of those indices as a diagnostic test of an altered RV was low with Younden's indices varying from -0.18 to 0.5 and areas under the Receiver Operating Characterictic (ROC) curves equal to 0.54 for tricuspid annulus plane systolic excursion, 0.59-0.62 for strain and 0.57-0.63 for strain rate. CONCLUSION: Three conventional echocardiographic indices based on RV longitudinal contraction failed to assess the EF in our population of post-operative tetralogy of Fallot patients.
Published: 2011
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18. Clinical features and evolution of alveolar echinococcosis in France from 1982 to 2007: results of a survey in 387 patients

Author: Alain Gerard, Jérôme Watelet, Jenny Knapp, Roch Giorgi, Armand Abergel, Bertrand Sudre, Martine Piarroux, Karine Bardonnet, Jérôme Dumortier, Georges Mantion, Jean Beytout, Dominique A. Vuitton, Renaud Piarroux, Solange Bresson-Hadni, Théoriser et modéliser pour aménager (UMR 6049) (ThéMA), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de la Méditerranée - Aix-Marseille 2, Laboratoire d'Enseignement et de Recherche sur le Traitement de l'Information Médicale (LERTIM), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Institut de Mécanique et d'Ingénierie de Bordeaux (I2M), École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Institut Polytechnique de Bordeaux-Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), HESAM Université (HESAM)-HESAM Université (HESAM)-Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB)-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement (UMR 6249) (LCE), Institut National de la Recherche Agronomique (INRA)-Université de Bordeaux (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), 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)-Arts et Métiers Sciences et Technologies, 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)-Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique (CNRS), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Théoriser et modéliser pour aménager ( ThéMA ), Université de Bourgogne ( UB ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire d'Enseignement et de Recherche sur le Traitement de l'Information Médicale ( LERTIM ), Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Institut de Mécanique et d'Ingénierie de Bordeaux ( I2M ), Institut Polytechnique de Bordeaux-Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Recherche Agronomique ( INRA ) -Université de Bordeaux ( UB ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )
Subjects: Male, Pediatrics, MESH : Retrospective Studies, MESH : Anthelmintics, MESH : Prospective Studies, MESH : Aged, MESH : Echinococcus multilocularis, Severity of Illness Index, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, MESH: Aged, 80 and over, Surveys and Questionnaires, MESH : Female, MESH: Animals, Prospective Studies, MESH: Incidence, Young adult, Prospective cohort study, Aged, 80 and over, Anthelmintics, MESH: Aged, education.field_of_study, MESH : Prognosis, MESH: Middle Aged, biology, Incidence, Hazard ratio, MESH: Echinococcosis, Hepatic, MESH : Questionnaires, Middle Aged, MESH : Adult, Prognosis, Echinococcosis, MESH : Incidence, 3. Good health, MESH: Anthelmintics, MESH : Benzimidazoles, MESH: Young Adult, 030211 gastroenterology & hepatology, Female, MESH : Severity of Illness Index, France, Adult, medicine.medical_specialty, Echinococcosis, Hepatic, MESH: Liver Transplantation, Adolescent, MESH : Male, 030231 tropical medicine, Population, MESH : Young Adult, [SDV.CAN]Life Sciences [q-bio]/Cancer, Echinococcus multilocularis, MESH: Prognosis, 03 medical and health sciences, Young Adult, MESH : Adolescent, MESH: Severity of Illness Index, medicine, Animals, Humans, MESH : Middle Aged, education, MESH : France, MESH : Aged, 80 and over, Aged, Retrospective Studies, MESH: Adolescent, MESH: Echinococcus multilocularis, MESH: Humans, Hepatology, business.industry, MESH: Questionnaires, MESH : Humans, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, biology.organism_classification, medicine.disease, MESH: Male, MESH: Prospective Studies, Surgery, Liver Transplantation, MESH: France, Benzimidazoles, MESH : Animals, MESH : Liver Transplantation, business, MESH : Echinococcosis, Hepatic, MESH: Benzimidazoles, MESH: Female, Rare disease
Abstract: International audience; BACKGROUND & AIMS: Alveolar echinococcosis (AE) is a rare disease in humans, caused by the larval stage of the fox tapeworm Echinococcus multilocularis. METHODS: We present here 387 detailed AE cases diagnosed in France from 1982 to 2007 actively identified by a retrospective survey performed in 1997-1998 and prospectively thereafter. RESULTS: Male:female ratio was 1.03 and mean age 57.8 years at time of diagnosis. Among the 362 complete files (including 347 non dead-out and 15 dead-out lesions), 73% of the patients were symptomatic at first admittance. Among them, 83% presented with clinical patterns evocative either of a digestive or a hepatic disorder. Other symptomatic patients presented with erratic clinical pictures, generally due to metastasis or extra-hepatic location of the parasite. Except for a few patients with particularly severe AE who died shortly after the diagnosis, most patients were treated using benzimidazoles. Their mortality tends to merge with that of the general French population, matched by sex, age, and calendar year. This study also highlights an unexpectedly high frequency of blood-tied family cases (13% of patients submitted to a specific questionnaire). CONCLUSIONS: Even though the broad set of clinical features provoked by E. multilocularis makes AE a potential diagnostic trap for many physicians, our study revealed an improvement of its prognosis. However, as shown by our findings about the frequency of family cases, there is still a need for studies aimed at better describing this uncommon parasitic disease.
Published: 2011
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19. Imported acquired immunodeficiency syndrome-related histoplasmosis in metropolitan France: a comparison of pre-highly active anti-retroviral therapy and highly active anti-retroviral therapy eras

Author: Nicolas Dupin, Stéphane Bretagne, Jean-michel Molina, Willy Rozenbaum, Eric Dannaoui, Anne-Lise Bienvenu, Sophie Matheron, Cedric Arvieux, Stéphane Ranque, Service de réanimation médicale [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire ( CNRMA ), Institut Pasteur [Paris], Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service de Médecine Interne, GH Bichat-Claude Bernard, Paris, Centre de Référence Déficits Immunitaires Héréditaires ( CEREDIH ), Centre d'infectiologie Necker-Pasteur [CHU Necker], Thérapeutique Recombinante Expérimentale ( TIMC-IMAG-THEREX ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Référence Déficits Immunitaires Héréditaires (CEREDIH), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Thérapeutique Recombinante Expérimentale (TIMC-IMAG-TheREx), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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 Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), and Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP]
Subjects: Male, Antifungal Agents, MESH : Retrospective Studies, MESH : Immune Reconstitution Inflammatory Syndrome, MESH: Antiretroviral Therapy, Highly Active, 0302 clinical medicine, Immune Reconstitution Inflammatory Syndrome, immune system diseases, Antiretroviral Therapy, Highly Active, MESH: Histoplasmosis, MESH : Female, 030212 general & internal medicine, Young adult, MESH: Anti-HIV Agents, Histoplasmosis, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, 0303 health sciences, MESH : AIDS-Related Opportunistic Infections, MESH: Middle Aged, MESH : Prognosis, MESH: AIDS-Related Opportunistic Infections, Mortality rate, MESH : Acquired Immunodeficiency Syndrome, Highly active anti-retroviral therapy, virus diseases, Articles, Middle Aged, MESH : Adult, Prognosis, 3. Good health, Infectious Diseases, MESH: Young Adult, MESH: Immune Reconstitution Inflammatory Syndrome, Female, France, Adult, medicine.medical_specialty, Anti-HIV Agents, AIDS-Related Opportunistic Infections, MESH : Male, MESH : Antifungal Agents, MESH : Young Adult, MESH: Prognosis, 03 medical and health sciences, Young Adult, Immune reconstitution inflammatory syndrome, Acquired immunodeficiency syndrome (AIDS), MESH : Histoplasmosis, Virology, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : France, Retrospective Studies, MESH: Acquired Immunodeficiency Syndrome, Acquired Immunodeficiency Syndrome, MESH: Humans, 030306 microbiology, business.industry, MESH : Anti-HIV Agents, MESH : Humans, Retrospective cohort study, MESH: Retrospective Studies, MESH: Adult, medicine.disease, MESH: Antifungal Agents, MESH : Antiretroviral Therapy, Highly Active, MESH: Male, MESH: France, Immunology, Parasitology, business, MESH: Female
Abstract: International audience; Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diagnosis was established a mean of 62 days after onset of symptoms. One-year overall mortality rates decreased from 53% (pre-HAART era) to 22% (HAART era). Diagnosis during the pre-HAART era and an older age were the only independent factors associated with death. Histoplasmosis is a rare invasive fungal infection outside disease-endemic areas. Its prognosis improved significantly during the HAART era.
Published: 2011
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20. Occurrence of and risk factors for electroencephalogram burst suppression during propofol-remifentanil anaesthesia

Author: Mariette Mercier, Nathalie Boichut, E. Samain, C. Pericard, Ngai Liu, Guillaume Besch, S. Pili-Floury, T. Chazot, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Male, MESH : Retrospective Studies, MESH : Piperidines, MESH : Aged, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Piperidines, MESH: Risk Factors, 030202 anesthesiology, Risk Factors, Odds Ratio, MESH : Female, General anaesthesia, Propofol, MESH: Aged, MESH: Middle Aged, MESH : Hemodynamics, MESH: Anesthesia, General, Age Factors, Electroencephalography, MESH : Adult, Middle Aged, MESH : Risk Factors, Anesthetics, Combined, 3. Good health, Burst suppression, MESH: Piperidines, MESH: Propofol, Anesthesia, Bispectral index, Female, MESH : Anesthetics, Combined, MESH: Anesthetics, Intravenous, Anesthetics, Intravenous, medicine.drug, MESH : Anesthetics, Intravenous, Adult, MESH: Hemodynamics, MESH : Male, MESH : Sex Factors, MESH: Monitoring, Intraoperative, Remifentanil, [SDV.CAN]Life Sciences [q-bio]/Cancer, Anesthesia, General, 03 medical and health sciences, Sex Factors, MESH: Sex Factors, Monitoring, Intraoperative, MESH: Electroencephalography, Post-hoc analysis, medicine, Humans, MESH : Middle Aged, MESH : Propofol, MESH : Electroencephalography, MESH : Anesthesia, General, Aged, Retrospective Studies, MESH: Age Factors, MESH: Humans, business.industry, MESH : Humans, Hemodynamics, MESH: Adult, MESH: Retrospective Studies, Odds ratio, MESH: Male, MESH: Odds Ratio, Confidence interval, Anesthesiology and Pain Medicine, MESH : Monitoring, Intraoperative, MESH : Odds Ratio, MESH : Age Factors, MESH: Anesthetics, Combined, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; BACKGROUND: Suppression ratio (SR) derived from bispectral index (BIS) monitoring is correlated to EEG burst suppression. It may occur during deep anaesthesia, but also in the case of metabolic or haemodynamic brain injury. The goal of the study was to describe the occurrence of SR and to determine factors associated with SR during propofol-remifentanil general anaesthesia maintenance. METHODS: We conducted a post hoc analysis of BIS recordings in consecutive patients included in two multi-centre trials, undergoing non-cardiac surgery using a dual closed-loop BIS controller allowing automated propofol-remifentanil administration. The percentage of time spent with a BIS value between 40 and 60 (T(BIS 40-60)) was measured. Two groups of patients were defined: the SR group, including patients with at least one episode of SR value >10% lasting more than 1 min, and the control group. Factors associated with SR were analysed using a stepwise multivariate analysis. RESULTS: A total of 1494 patients [age=57 (17) yr; T(BIS 40-60)=76 (17%)] were analysed and 131 (8.7%) patients constituted the SR group. The main independent factors associated with SR were advanced age [odds ratio (95% confidence interval)=4.80 (1.85-12.43) (P=0.027), 10.59 (3.76-29.81) (P80 yr, respectively], history of coronary artery disease (CAD) [2.53 (1.47-4.37) (P=0.001)] and male gender [1.57 (1.03-2.40) (P=0.03)]. CONCLUSIONS: The occurrence of SR during BIS-controlled propofol and remifentanil anaesthesia is mainly observed in elderly male patients or in patients with a history of CAD. The mechanisms underlying SR and the potential consequences for the patient's postoperative outcome remain unsolved.
Published: 2011
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21. Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants

Author: Jacques Izopet, Pascal Lebray, Marie Essig, Robert N. Santella, Anne Marie Roque-Afonso, Valérie Garrigue, Nada Kanaan, Amelie Cannesson, Nassim Kamar, Elisabeth Cassuto-Viguier, Lionel Rostaing, Elizabeth B. Haagsma, Filomena Conti, Cyril Garrouste, Sven Pischke, Christiane Mousson, Sylvie Radenne, Harry R. Dalton, Jérôme Dumortier, Cecile Chauvet, Eric Thervet, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées, Service de virologie, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Department of Gastroenterology and Hepatology, University Medical Center Groningen [Groningen] (UMCG), Service de Pédiatrie spécialisée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School [Hannover] (MHH), Département de néphrologie et transplantation, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, service de néphrologie et transplantation, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépatologie [Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), European Centre for Environment and Human Health, Royal Cornwall Hospital-Universities of Exeter and Plymouth, North Central Kidney Institute, Avera Mckennan Hospital-University Health Center, Service de néphrologie, Saint-Luc Hospital, Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'hépatologie, Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Laboratoire de Virologie [Purpan], CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Physiopathologie Toulouse Purpan (ex IFR 30 et IFR 150), Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR30-IFR150-Institut National de la Santé et de la Recherche Médicale ( INSERM ), University Medical Center Groningen, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Hannover Medical School [Hannover] ( MHH ), Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ), CHU Nice, CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Hospices Civils de Lyon ( HCL ) -Hôpital de la Croix-Rousse [CHU - HCL], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse, Marquet, Pierre, Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'hépatologie [CHU Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Royal Cornwall Hospital-Plymouth University
Subjects: Male, MESH : Retrospective Studies, CYCLOSPORINE-A, medicine.medical_treatment, MESH : Aged, Liver transplantation, medicine.disease_cause, Polymerase Chain Reaction, MESH : Hepatitis E virus, THERAPY, Organ transplantation, MESH : Organ Transplantation, Liver disease, 0302 clinical medicine, Hepatitis E virus, Cyclosporin a, MESH : Female, MESH: Incidence, MESH : Polymerase Chain Reaction, Hepatitis, Chronic, MESH: Aged, 0303 health sciences, MESH: Middle Aged, Incidence, Liver Disease, Gastroenterology, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, LIVER-TRANSPLANTATION, MESH : Incidence, 3. Good health, Hepatitis E, Virus, PREVALENCE, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Europe, MESH: Young Adult, BLOOD-DONORS, MESH: RNA, Viral, RNA, Viral, 030211 gastroenterology & hepatology, Female, Adult, MESH: Hepatitis E virus, medicine.medical_specialty, MESH : United States, MESH : Male, MESH: Hepatitis, Chronic, MESH : Europe, MESH : Young Adult, FRANCE, MESH: Organ Transplantation, 03 medical and health sciences, Young Adult, medicine, MESH: United States, Humans, MESH : RNA, Viral, MESH : Hepatitis, Chronic, MESH : Middle Aged, KIDNEY-TRANSPLANT, 030304 developmental biology, Aged, Retrospective Studies, Hepatitis, Transplantation, MESH: Humans, Hepatology, business.industry, MESH : Humans, MESH: Hepatitis E, MESH : Follow-Up Studies, MESH: Adult, MESH: Polymerase Chain Reaction, MESH: Retrospective Studies, Organ Transplantation, medicine.disease, Fibrosis, Tacrolimus, United States, MESH: Male, Chronic infection, RECIPIENTS, [ SDV.SP ] Life Sciences [q-bio]/Pharmaceutical sciences, MESH : Hepatitis E, Immunology, REPLICATION, PEGYLATED INTERFERON-ALPHA, MESH: Europe, business, MESH: Female, Follow-Up Studies
Abstract: International audience; BACKGROUND & AIMS: Hepatitis E virus (HEV) infection can cause chronic hepatitis in recipients of solid organ transplants. However, the factors that contribute to chronic infection and the outcomes of these patients are incompletely understood. We performed a retrospective analysis of data from 17 centers from Europe and the United States that described the progression, outcomes, and factors associated with development of chronic HEV infection in recipients of transplanted solid organs. METHODS: We studied data from 85 recipients of solid organ transplants who were infected with HEV. Chronic HEV infection was defined by the persistent increases in levels of liver enzymes and polymerase chain reaction evidence of HEV in the serum and/or stool for at least 6 months. RESULTS: Fifty-six patients (65.9%) developed chronic hepatitis. Univariate analysis associated liver transplant, shorter times since transplant, lower levels of liver enzymes and serum creatinine, lower platelet counts, and tacrolimus-based immunosuppressive therapy (rather than cyclosporin A) with chronic hepatitis. On multivariate analysis, the independent predictive factors associated with chronic HEV infection were the use of tacrolimus rather than cyclosporin A (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.49-1.97; P = .004) and a low platelet count at the time of diagnosis with HEV infection (OR, 1.02; 95% CI, 1.001-1.1; P = .04). Of patients with chronic hepatitis, 18 (32.1%) achieved viral clearance after the dose of immunosuppressive therapy was reduced. No HEV reactivation was observed after HEV clearance. CONCLUSIONS: HEV infection causes chronic hepatitis in more than 60% of recipients of solid organ transplants. Tacrolimus therapy is the main predictive factor for chronic hepatitis. Dose reductions of immunosuppressive therapy resulted in viral clearance in more than 30% of patients.
Published: 2011
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22. Incidence of stroke and socioeconomic neighborhood characteristics: an ecological analysis of Dijon stroke registry

Author: Olivier Grimaud, Yannick Béjot, Zoe Heritage, Julie Vallée, Jerôme Durier, Emmanuelle Cadot, Maurice Giroud, Pierre Chauvin, École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Chauvin, Pierre, École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins ( DS3 ), and Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Male, Stroke registry, MESH : Stroke, MESH : Retrospective Studies, MESH: Registries, MESH : Poisson Distribution, MESH : Aged, 0302 clinical medicine, MESH: Aged, 80 and over, Residence Characteristics, Epidemiology, MESH : Socioeconomic Factors, MESH : Female, Poisson Distribution, Registries, 030212 general & internal medicine, MESH: Incidence, MESH: Residence Characteristics, Ecological analysis, Stroke, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Incidence (epidemiology), Age Factors, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, cerebrovascular disorders, Middle Aged, MESH : Adult, MESH : Incidence, MESH : Residence Characteristics, Income, Female, epidemiology, France, Cardiology and Cardiovascular Medicine, Stroke incidence, Adult, medicine.medical_specialty, MESH: Socioeconomic Factors, MESH : Sex Factors, MESH : Male, socioeconomic factors, MESH: Stroke, MESH: Poisson Distribution, 03 medical and health sciences, Sex Factors, MESH: Sex Factors, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : France, Socioeconomic status, Aged, Retrospective Studies, Advanced and Specialized Nursing, MESH: Age Factors, MESH: Humans, business.industry, MESH : Humans, MESH : Income, MESH: Adult, MESH: Retrospective Studies, MESH: Income, medicine.disease, MESH: Male, Surgery, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, incidence, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), MESH : Age Factors, business, MESH: Female, 030217 neurology & neurosurgery, MESH : Registries, Demography
Abstract: Background and Purpose— Studies have shown higher stroke incidence in areas with higher levels of deprivation. We aimed to determine the pattern of association between various area socioeconomic status (SES) indicators and stroke incidence in specific sex and age groups. Methods— Data are from the Dijon stroke registry for the period 1995 to 2003. The analyses included 1255 cases aged older than 40 (median age, 76.8). Poisson regression was used to model stroke incidence according to the SES level of 61 small areas. Results— Among women, stroke incidence was higher in neighborhoods with large income inequality (incidence rate ratio, 1.34; P =0.003), higher proportions of unemployed (1.24; P =0.02), of non-French nationals (1.21, P =0.02), and of rented housing (1.31; P =0.03). Areas with a higher proportion of people aged older than 60 were associated with lower stroke incidence (incidence rate ratio, 0.72; P =0.01). Analysis by specific age-groups showed stronger effects among the 60- to 74-year-olds. Among men, no associations between SES and stroke incidence were identified overall but analysis by age groups showed significant effect among the 40- to 59-year-olds. In this age group, incidence rate ratios were 1.47 for unemployment ( P =0.01), 1.86 for no car ownership ( P =0.02), and 1.56 for income inequality ( P =0.01). Among stroke cases, no trend in vascular risk factors prevalence according to area SES was identified. Conclusions— Variations of stroke incidence were more marked for the SES indicators of wealth and of income inequality. They were apparent at an earlier age in men and showed a stronger gradient among women.
Published: 2011
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23. Spectrum of mutations in Gitelman syndrome

Author: Annabelle Venisse, Diana Kahila, Claire Rigothier, Bernard Grisart, Bruno Moulin, Marie-Christine Vantyghem, Ivan Tack, Anne-Paule Gimenez-Roqueplo, Franck Bridoux, Jean-Philippe Haymann, Olivier Devuyst, Hubert Nivet, Rosa Vargas-Poussou, Laurence Dubourg, Eva Riveira-Munoz, Anne Blanchard, Karin Dahan, Michel Godin, Pascal Houillier, Huguette Debaix, Bertrand Dussol, Robert J. Unwin, Xavier Jeunemaitre, Service de néphrologie - hémodialyse et transplantation rénale, Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Contrôle de la Réponse Immune B et des Lymphoproliférations ( CRIBL ), Université de Limoges ( UNILIM ) -Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ) -Centre National de la Recherche Scientifique ( CNRS ), Institute of Physiology, University of Zürich [Zürich] ( UZH ) -Zurich Center for Integrative Human Physiology, Klinik für Nephrologie, UniversitätsSpital, Division of Nephrology, UCL Medical School, Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Contrôle de la Réponse Immune B et des Lymphoproliférations (CRIBL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), University of Zürich [Zürich] (UZH)-Zurich Center for Integrative Human Physiology, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Universität Zürich [Zürich] = University of Zurich (UZH)-Zurich Center for Integrative Human Physiology, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Male, MESH : Molecular Sequence Data, MESH : Retrospective Studies, Receptors, Drug, Gene Dosage, 030232 urology & nephrology, MESH: Base Sequence, MESH : Child, Preschool, medicine.disease_cause, MESH: Gitelman Syndrome, MESH: Gene Dosage, MESH : Chloride Channels, 0302 clinical medicine, MESH : Child, MESH: Child, Missense mutation, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Solute Carrier Family 12, Member 3, MESH : Female, MESH : Gene Dosage, Child, Gene Rearrangement, Genetics, 0303 health sciences, Mutation, MESH: Middle Aged, Symporters, MESH: Genetic Testing, MESH: Genetic Predisposition to Disease, General Medicine, Middle Aged, MESH : Adult, 3. Good health, Nephrology, MESH: Young Adult, Child, Preschool, MESH : Symporters, MESH: Solute Carrier Family 12, Member 3, MESH : Gitelman Syndrome, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, MESH : Mutation, MESH : Sensitivity and Specificity, Gitelman Syndrome, Adult, MESH: Symporters, MESH: Mutation, Adolescent, MESH: Gene Rearrangement, MESH : Male, Molecular Sequence Data, Non-allelic homologous recombination, MESH : Young Adult, MESH : Solute Carrier Family 12, Member 3, Biology, Sensitivity and Specificity, Gene dosage, Young Adult, 03 medical and health sciences, Chloride Channels, MESH: Receptors, Drug, MESH : Adolescent, MESH : Genetic Testing, medicine, Humans, Genetic Predisposition to Disease, MESH : Middle Aged, Genetic Testing, Multiplex ligation-dependent probe amplification, Allele, Alleles, Retrospective Studies, 030304 developmental biology, MESH: Adolescent, MESH: Humans, MESH: Molecular Sequence Data, Base Sequence, MESH : Receptors, Drug, MESH: Alleles, MESH: Child, Preschool, MESH: Chloride Channels, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, Gene rearrangement, MESH : Gene Rearrangement, Gitelman syndrome, medicine.disease, MESH: Male, MESH: Sensitivity and Specificity, Basic Research, MESH : Genetic Predisposition to Disease, MESH : Base Sequence, MESH : Alleles, MESH: Female
Abstract: International audience; Gitelman's syndrome (GS) is a rare, autosomal recessive, salt-losing tubulopathy caused by mutations in the SLC12A3 gene, which encodes the thiazide-sensitive NaCl cotransporter (NCC). Because 18 to 40% of suspected GS patients carry only one SLC12A3 mutant allele, large genomic rearrangements may account for unidentified mutations. Here, we directly sequenced genomic DNA from a large cohort of 448 unrelated patients suspected of having GS. We found 172 distinct mutations, of which 100 were unreported previously. In 315 patients (70%), we identified two mutations; in 81 patients (18%), we identified one; and in 52 patients (12%), we did not detect a mutation. In 88 patients, we performed a search for large rearrangements by multiplex ligation-dependent probe amplification (MLPA) and found nine deletions and two duplications in 24 of the 51 heterozygous patients. A second technique confirmed each rearrangement. Based on the breakpoints of seven deletions, nonallelic homologous recombination by Alu sequences and nonhomologous end-joining probably favor these intragenic deletions. In summary, missense mutations account for approximately 59% of the mutations in Gitelman's syndrome, and there is a predisposition to large rearrangements (6% of our cases) caused by the presence of repeated sequences within the SLC12A3 gene.
Published: 2011
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24. Confocal laser endomicroscopy is a new imaging modality for recognition of intramucosal bacteria in inflammatory bowel disease in vivo

Author: Marcus Kerner, Bernard Flourié, Stephan Biesterfeld, Peter R. Galle, Martin Goetz, Barry J. Campbell, Jean-Christophe Saurin, Driffa Moussata, Alastair J.M. Watson, Annabel Gloeckner, Arthur Hoffman, Ralf Kiesslich, Markus F. Neurath, Hepato-Gastroenterology, Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), university of mainz, Johannes Gutenberg - University of Mainz ( JGU ), Univeristy of mainz, University of Liverpool, Equipe 8, Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Hôpital Edouard Herriot [CHU - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Johannes Gutenberg - Universität Mainz (JGU), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Edouard Herriot [CHU - HCL]
Subjects: Pathology, MESH : Escherichia coli, fluorescein, MESH : Retrospective Studies, Colorectal cancer, MESH : Prospective Studies, Gastroenterology, Inflammatory bowel disease, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Intestinal mucosa, MESH: Microscopy, Confocal, MESH: Animals, MESH : Colonoscopy, MESH: In Situ Hybridization, Fluorescence, intramucosal bacteria, 0303 health sciences, Crohn's disease, MESH: Escherichia coli, MESH : Enterobacteriaceae, MESH : Colitis, Ulcerative, Ulcerative colitis, enteric bacterial microflora, 3. Good health, MESH : In Situ Hybridization, Fluorescence, MESH: Colonoscopy, confocal laser endomicroscopy, MESH: Intestinal Mucosa, MESH : Inflammatory Bowel Diseases, 030211 gastroenterology & hepatology, medicine.medical_specialty, MESH : Male, MESH: Colitis, Ulcerative, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Mice, Inbred C57BL, Biology, MESH : Intestinal Mucosa, MESH : Crohn Disease, 03 medical and health sciences, MESH: Enterobacteriaceae, FISH, fluorescence endoscopy, In vivo, MESH: Mice, Inbred C57BL, Internal medicine, MESH : Mice, medicine, Endomicroscopy, MESH: Colon, MESH : Microscopy, Confocal, MESH: Mice, ulcerative colitis, 030304 developmental biology, MESH : Ileum, MESH: Humans, Bacteria, MESH: Crohn Disease, infectious colitis, MESH : Humans, Endoscopy, MESH: Retrospective Studies, medicine.disease, MESH: Inflammatory Bowel Diseases, MESH : Colon, MESH: Male, MESH: Prospective Studies, MESH: Ileum, MESH : Animals, Ex vivo
Abstract: International audience; BACKGROUND AND OBJECTIVES: Interaction of bacteria with the immune system within the intestinal mucosa plays a key role in the pathogenesis of inflammatory bowel disease (IBD). The aim of the current study was to develop a fluorescein-aided confocal laser endomicroscopy (CLE) method to visualise intramucosal enteric bacteria in vivo and to determine the involved mucosal area in the colon and ileum in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS: Initially, E coli strains expressing enhanced green fluorescent protein (pEGFP) were endomicroscopically imaged in mice. In addition, ex vivo and in vivo imaging of fluorescent human enteric bacteria was performed to specify the distinct endomicroscopic appearance of enteral bacteria. Targeted mucosal biopsies towards endomicroscopic identifiable intramucosal bacteria and negative mucosal areas were prospectively obtained during colonoscopy and correlated with bench-top fluorescence microscopy (FISH) to prove the endomicroscopic visualisation of intramucosal bacteria. Finally, a retrospective analysis as well as a prospective study was performed in patients with UC and CD to confirm the presence and distribution of intramucosal bacteria within the gut. RESULTS: Confocal endomicroscopy was able to identify intramucosal pEGFP E coli in mice and strains of enteric microflora in the mucosa of humans. Using FISH as the gold standard, evaluation of 21 patients showed that CLE had a sensitivity of 89% and specificity of 100% to identify intramucosal bacteria. In a retrospective study, 113 patients with CD and UC had intramucosal bacteria significantly more often than 50 control patients (66% vs 60% vs 14%, p
Published: 2011
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25. International retrospective analysis of 73 cases of invasive fusariosis treated with voriconazole

Author: Pinaki Biswas, Raoul Herbrecht, Issam I Raad, Karine Sitbon, Elisabeth Chachaty, Peter F. Troke, Denis Caillot, Anne-Lise Bienvenu, Frédéric Grenouillet, Muriel Cornet, Claire Lacroix, John H. Greene, Gaelle Obenga, Olivier Lortholary, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris], CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Département de biologie et pathologie médicales [Gustave Roussy], Institut Gustave Roussy (IGR), Centre National de Référence des Borrelia (CNR), Microbiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), Service d'Hématologie, CHU Strasbourg, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire ( CNRMA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Institut Gustave Roussy ( IGR ), Centre National de Référence des Borrelia ( CNR ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), and Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC )
Subjects: Male, Antifungal Agents, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Pyrimidines, MESH : Aged, MESH : Child, Preschool, Gastroenterology, 0302 clinical medicine, Fusarium, MESH : Child, MESH: Child, MESH : Female, Pharmacology (medical), 030212 general & internal medicine, Child, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Treatment Outcome, MESH: Aged, 0303 health sciences, MESH: Fusarium, MESH: Middle Aged, Immunosuppression, Middle Aged, MESH : Adult, 3. Good health, Treatment Outcome, Infectious Diseases, MESH: Young Adult, Child, Preschool, Female, medicine.drug, Adult, Fusariosis, medicine.medical_specialty, Adolescent, Combination therapy, MESH : Male, MESH : Antifungal Agents, MESH : Young Adult, MESH : Treatment Outcome, Clinical Therapeutics, Neutropenia, Young Adult, 03 medical and health sciences, Pharmacotherapy, MESH: Mycoses, MESH : Adolescent, Internal medicine, MESH : Triazoles, medicine, Humans, MESH : Fusarium, MESH : Middle Aged, Aged, Retrospective Studies, MESH : Mycoses, Pharmacology, Voriconazole, MESH: Adolescent, MESH: Humans, 030306 microbiology, business.industry, MESH : Humans, MESH: Child, Preschool, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, Triazoles, medicine.disease, MESH: Antifungal Agents, MESH: Male, Surgery, Transplantation, Pyrimidines, Mycoses, MESH: Triazoles, MESH: Pyrimidines, business, MESH: Female
Abstract: The outcomes for 73 invasive fusariosis patients treated with voriconazole were investigated. Patients with proven ( n = 67) or probable ( n = 6) infections were identified from the voriconazole clinical database ( n = 39) and the French National Reference Center for Mycoses and Antifungals database ( n = 34). Investigator-determined success was a complete or partial response. Survival was determined from day 1 of voriconazole therapy to the last day known alive. Patients were 2 to 79 years old (median, 43 years), and 66% were male. Identified Fusarium species (62%) were F. solani , F. moniliforme , F. proliferatum , and F. oxysporum . Underlying conditions analyzed included hematopoietic stem cell transplant (HSCT; 18%), hematologic malignancy (HM; 60%), chronic immunosuppression (CI; 12%), or other condition (OC; 10%). Infection sites were brain (5%), disseminated excluding brain (67%), lungs/sinus (15%), and other (12%). Most patients (64%) were or had recently been neutropenic (3 ). Therapy duration was 1 to 480 days (median, 57 days), with a 47% success rate. Baseline neutropenia impacted success adversely ( P ≤ 0.03). Success varied by underlying condition (HSCT, 38%; HM, 45%; CI, 44%; OC, 71%) and infection site (brain, 0%; disseminated, 45%; other, 56%; lung/sinus, 64%) ( P > 0.05). Combination therapy (13 patients) was no better than treatment with voriconazole alone. Overall, 59% of the patients died (49% died of fusariosis), and 90-day survival was 42%. Site of infection influenced survival ( P = 0.02). Median survival (in days) by species was as follows: F. solani , 213; F. oxysporum , 112; Fusarium spp., 101; F. proliferatum , 84; F. moniliforme , 76. We conclude that voriconazole is a therapeutic option for invasive fusariosis.
Published: 2010
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26. Antibiotic use in 530 French hospitals: results from a surveillance network at hospital and ward levels in 2007

Author: Anne Carbonne, Ludivine Lacavé, Pacôme Angora, Anne-Marie Rogues, Florence Nguyen, Pascal Jarno, Muriel Péfau, Sandrine Boussat, A Savey, Xavier Bertrand, François L'Hériteau, Karine Saby, C. Dumartin, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Léon Bérard [Lyon], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-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), Laboratoire Chrono-environnement (UMR 6249) (LCE), Laboratoire Chrono-environnement ( LCE ), and Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC )
Subjects: Pediatrics, MESH : Retrospective Studies, Antibiotics, Administration, Oral, MESH : Drug Utilization, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Medicine, Pharmacology (medical), 030212 general & internal medicine, MESH : Anti-Bacterial Agents, MESH: Drug Utilization, Infusions, Intravenous, Antibacterial agent, 0303 health sciences, MESH : Infusions, Intravenous, MESH: Hospitals, Hospitals, 3. Good health, Anti-Bacterial Agents, MESH : Hospitals, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Administration, Oral, France, medicine.drug, Microbiology (medical), medicine.medical_specialty, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], medicine.drug_class, MEDLINE, 03 medical and health sciences, Intensive care, MESH: Anti-Bacterial Agents, Humans, Medical prescription, MESH : France, MESH: Infusions, Intravenous, Beta-Lactamase Inhibitors, Retrospective Studies, Pharmacology, MESH : Administration, Oral, MESH: Humans, 030306 microbiology, business.industry, MESH : Humans, Retrospective cohort study, MESH: Retrospective Studies, equipment and supplies, Drug Utilization, MESH: France, Emergency medicine, business, Rifampicin
Abstract: International audience; OBJECTIVES: Antibiotic use in French hospitals is among the highest in Europe. A study was carried out to describe antibiotic consumption for inpatients at hospital and at ward levels. METHODS: Data were voluntarily collected retrospectively by 530 hospitals accounting for approximately 40 million patient-days (PD) on the following: antibacterials for systemic use [J01 class of the WHO Anatomical Therapeutic Chemical (ATC) classification, defined daily doses (DDD) system, 2007], rifampicin and oral imidazole derivatives, expressed in number of DDD and number of PD in 2007. Consumption was expressed in DDD/1000 PD. RESULTS: Median antibiotic use ranged from 60 DDD/1000 PD in long-term care (LTC) and psychiatric hospitals to 633 DDD/1000 PD in teaching hospitals. Penicillins and beta-lactamase inhibitors combinations were the most frequently used antibiotics, accounting for 26% of total use in cancer hospitals to 40% in LTC/psychiatric hospitals. Glycopeptides and carbapenems were mostly used in cancer and teaching hospitals. Level of consumption and pattern of use differed according to clinical ward from 60 DDD/1000 PD in psychiatric wards up to 1466 DDD/1000 PD in intensive care units (ICUs). In medicine, surgery, ICU and rehabilitation wards, fluoroquinolones accounted for 13%-19% of the total use. CONCLUSIONS: This multicentre survey provided detailed information on antibiotic use in a large sample of hospitals and wards, allowing relevant comparisons and benchmarking. Analysis of consumption at the ward level should help hospitals to target practice audits to improve antibiotic use.
Published: 2010
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27. Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene mutations

Author: Marion Sallée, Marie Essig, David Ribes, Marie-Agnès Dragon-Durey, Sophie Caillard, Eric Rondeau, Véronique Frémeaux-Bacchi, Fadi Fakhouri, Lionel Couzi, Lubka T. Roumenina, Franck Bridoux, François Provôt, Service de néphrologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de néphrologie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Composantes innées de la réponse immunitaire et différenciation (CIRID), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Université Bordeaux Segalen - Bordeaux 2, ifr 66, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Laboratoire d'Immunologie Biologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), CHU Necker - Enfants Malades [AP-HP] - Assistance publique - Hôpitaux de Paris (AP-HP), Université Bordeaux Segalen - Bordeaux 2 - Centre National de la Recherche Scientifique (CNRS), Université de Limoges (UNILIM) - CHU Limoges - Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503) - Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Européen Georges Pompidou [APHP] (HEGP), and Université de Limoges (UNILIM) - Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503) - Centre National de la Recherche Scientifique (CNRS)
Subjects: Hemolytic anemia, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Hemolytic-Uremic Syndrome, MESH: Pregnancy Complications, Hematologic, 030204 cardiovascular system & hematology, Gene mutation, urologic and male genital diseases, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, hemic and lymphatic diseases, MESH : Female, MESH : Pregnancy Outcome, Pregnancy Outcome, General Medicine, MESH : Adult, 3. Good health, Nephrology, MESH: Hemolytic-Uremic Syndrome, MESH: Young Adult, MESH : Complement C3 Convertase, Alternative Pathway, Gestation, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Thrombotic thrombocytopenic purpura, MESH : Young Adult, Preeclampsia, 03 medical and health sciences, Young Adult, MESH : Pregnancy Complications, Hematologic, Clinical Research, Internal medicine, Atypical hemolytic uremic syndrome, medicine, Humans, Retrospective Studies, Complement C3 Convertase, Alternative Pathway, MESH: Humans, business.industry, MESH : Humans, Pregnancy Complications, Hematologic, MESH: Complement C3 Convertase, Alternative Pathway, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Pregnancy Outcome, MESH : Pregnancy, Immunology, Hemolytic-Uremic Syndrome, business, MESH: Female, Kidney disease
Abstract: International audience; In contrast to pregnancy-associated thrombotic thrombocytopenic purpura, the pathogenesis and presentation of pregnancy-associated atypical hemolytic uremic syndrome (P-aHUS) remain ill-defined. We conducted a retrospective study to assess the presentation and outcomes of patients presenting with P-aHUS and the prevalence of alternative C3 convertase dysregulation. P-aHUS occurred in 21 of the 100 adult female patients with atypical HUS, with 79% presenting postpartum. We detected complement abnormalities in 18 of the 21 patients. The outcomes were poor: 62% reached ESRD by 1 month and 76% by last follow-up. The risk for P-aHUS was highest during a second pregnancy. Thirty-five women, 26 (74%) of whom had complement abnormalities, had at least one pregnancy before the onset of a non-pregnancy-related aHUS. Outcomes did not differ between patients with pregnancy-related and non-pregnancy-related aHUS. Mutations in the SCR19-20 domains of factor H were less frequent in P-aHUS patients compared with non-pregnancy-related aHUS. Pregnancies in female patients with complement abnormalities (n = 44) were complicated by fetal loss and preeclampsia in 4.8% and 7.7%, respectively. Better understanding of complement dysregulation in pregnancy complications is essential, especially to guide development of pharmacologic agents to modulate this system.
Published: 2010
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28. The role of circumstances of diagnosis and access to dermatological care in early diagnosis of cutaneous melanoma: a population-based study in France

Author: Dan Lipsker, Catherine Michel, Florence Granel-Brocard, Arlette Danzon, François Truchetet, Stéphane Dalle, Philippe Bernard, G. Reuter, G. Hedelin, Fabien Vitry, Frédérique Durbec, Beatrice Domissy-Baury, Marie-Laure Batard, Jean-Michel Halna, François Aubin, Florent Grange, Sophie Dalac, Christian Delvincourt, Jean Luc Schmutz, Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), Unité de recherche clinique [Reims], Centre Hospitalier Universitaire de Reims ( CHU Reims ) -Hôpital Maison Blanche, Service de Dermatologie et Allergologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Département de dermatologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Registre des cancers du Bas-Rhin, CRLCC Paul Strauss, Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Direction de la recherche, Société des accumulateurs fixes et de traction ( SAFT ), Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Maison Blanche, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de l'Hôtel Dieu [CHU-HCL], Hospices Civils de Lyon (HCL), and Société des accumulateurs fixes et de traction (SAFT)
Subjects: Male, Skin Neoplasms, Time Factors, MESH : Retrospective Studies, MESH : Aged, Health Services Accessibility, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 030207 dermatology & venereal diseases, 0302 clinical medicine, MESH : Health Services Accessibility, MESH: Risk Factors, Risk Factors, Surveys and Questionnaires, Medicine, MESH : Neoplasm Staging, MESH : Female, MESH: Incidence, skin and connective tissue diseases, Melanoma, ComputingMilieux_MISCELLANEOUS, MESH: Aged, education.field_of_study, MESH: Health Services Accessibility, MESH: Middle Aged, Incidence (epidemiology), Incidence, MESH : Questionnaires, General Medicine, MESH: Neoplasm Staging, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, MESH : Risk Factors, MESH : Incidence, 3. Good health, 030220 oncology & carcinogenesis, MESH : Dermatology, Female, MESH: Clinical Competence, Clinical Competence, France, MESH : Time Factors, Adult, medicine.medical_specialty, MESH: Melanoma, MESH : Male, Population, MESH : Melanoma, MESH: Dermatology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, Breslow Thickness, 03 medical and health sciences, Nevus, Humans, MESH : Middle Aged, Lentigo maligna melanoma, education, MESH : France, Aged, Neoplasm Staging, Retrospective Studies, MESH: Humans, business.industry, MESH: Questionnaires, MESH: Skin Neoplasms, MESH: Time Factors, MESH : Skin Neoplasms, MESH : Humans, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, MESH : Follow-Up Studies, medicine.disease, MESH : Clinical Competence, MESH: Male, Superficial spreading melanoma, MESH: France, Cutaneous melanoma, business, MESH: Female, Follow-Up Studies
Abstract: International audience; OBJECTIVES: To describe circumstances of the diagnosis and access to dermatological care for patients with cutaneous melanoma (CM) and to investigate factors associated with early detection. DESIGN: Retrospective population-based study of incident cases of invasive CM in 2004, using questionnaires to physicians and a survey of cancer registries and pathology laboratories. SETTING: Five regions in northeastern France. PATIENTS: Six hundred fifty-two patients who were referred to dermatologists by general practitioners (group 1) or by other specialists (group 2), who directly consulted a dermatologist for CM (group 3), or who were diagnosed as having CM during a prospective follow-up of nevi (group 4) or when consulting a dermatologist for other diseases (group 5). MAIN OUTCOME MEASURES: Characteristics of patients, tumors, and patients' residence in each group, including the geographical concentration of dermatologists. We performed multivariate analysis of these factors to determine association with Breslow thickness. RESULTS: Age, tumor location, Breslow thickness, ulceration, histological type, and geographical concentration of dermatologists significantly differed among groups. Patients consulting dermatologists directly formed the largest group (45.1%). Those referred by general practitioners (26.1%) were the oldest and had the highest frequency of thick (>3 mm), nodular, and/or ulcerated CM. Patients from groups 4 (8.4%) and 5 (14.1%) had the thinnest CMs. Ulcerated and/or thick tumors were absent in group 4. In multivariate analysis, histological types superficial spreading melanoma and lentigo maligna melanoma, younger age, high concentration of dermatologists, and detection by dermatologists were significantly associated with thinner CMs. CONCLUSION: Easy access of patients to dermatologists, information campaigns targeting elderly people, and education of general practitioners are complementary approaches to improving early detection.
Published: 2010
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29. Severe imported falciparum malaria: a cohort study in 400 critically ill adults

Author: Fabrice, Bruneel, Florence, Tubach, Philippe, Corne, Bruno, Megarbane, Jean-Paul, Mira, Eric, Peytel, Christophe, Camus, Frederique, Schortgen, Elie, Azoulay, Yves, Cohen, Hugues, Georges, Agnes, Meybeck, Herve, Hyvernat, Jean-Louis, Trouillet, Eric, Frenoy, Laurent, Nicolet, Carine, Roy, Remy, Durand, Jacques, Le Bras, Michel, Wolff, G, Galeazzi, Service de réanimation [CH Versailles], Centre Hospitalier de Versailles André Mignot (CHV), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychopharmacologie des addictions. Vulnérabilité et variabilité expérimentale et clinique (NAVVEC - UM 81 (UMR 8206/ U705)), Université Paris Diderot - Paris 7 (UPD7)-Institut des sciences du Médicament -Toxicologie - Chimie - Environnement (IFR71), Institut de Recherche pour le Développement (IRD)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de médecine d'urgence [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital d'Instruction des Armées Laveran, Hôpital d'instruction des armées Laveran, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Outcomerea Organization, Outcomerea, Unité de Soins Intensifs [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'anesthésie-réanimation [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Service de Réanimation polyvalente et des Maladies infectieuses, Centre Hospitalier Gustave Dron, Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Laboratoire de Parasitologie-Mycologie, Centre National de Référence du Paludisme, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-PRES Sorbonne Paris Cité, Unité de Soins Intensifs et de Maladies Infectieuses, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Institut des sciences du Médicament -Toxicologie - Chimie - Environnement (IFR71), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Diderot - Paris 7 (UPD7), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), réanimation chirurgicale, CH Versailles, Ministère de la santé, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Gui de Chauliac, Neuropsychopharmacologie des addictions. Vulnérabilité et variabilité expérimentale et clinique ( NAVVEC (UM 81) ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut des sciences du Médicament -Toxicologie - Chimie - Environnement ( IFR71 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-PRES Sorbonne Paris Cité-APHP, Neuroépidémiologie Tropicale et Comparée ( NETEC ), Université de Limoges ( UNILIM ) -Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Avicenne, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], PRES Sorbonne Paris Cité-APHP-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Neuroépidémiologie Tropicale et Comparée (NETEC), and Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)
Subjects: Male, Pediatrics, Critical Care and Emergency Medicine, MESH : Retrospective Studies, MESH : Aged, MESH : Critical Illness, Severity of Illness Index, MESH : Malaria, Falciparum, law.invention, Cohort Studies, 0302 clinical medicine, law, Epidemiology, Medicine, MESH : Female, Microbiology/Parasitology, 030212 general & internal medicine, Malaria, Falciparum, MESH: Cohort Studies, MESH: Aged, Multidisciplinary, MESH: Middle Aged, Mortality rate, MESH: Malaria, Falciparum, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, Middle Aged, Intensive care unit, 3. Good health, Infectious Diseases, MESH: Critical Illness, MESH : Severity of Illness Index, Female, Research Article, Cohort study, Adult, medicine.medical_specialty, Science, MESH : Male, Critical Illness, 030231 tropical medicine, MESH : Cohort Studies, Antimalarials, 03 medical and health sciences, Intensive care, MESH: Severity of Illness Index, Humans, MESH : Middle Aged, Aged, Retrospective Studies, Neurological Disorders/Infectious Diseases of the Nervous System, MESH: Humans, business.industry, MESH : Humans, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, Odds ratio, medicine.disease, MESH: Antimalarials, MESH: Male, MESH : Antimalarials, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Malaria
Abstract: International audience; BACKGROUND: Large studies on severe imported malaria in non-endemic industrialized countries are lacking. We sought to describe the clinical spectrum of severe imported malaria in French adults and to identify risk factors for mortality at admission to the intensive care unit. METHODOLOGY AND PRINCIPAL FINDINGS: Retrospective review of severe Plasmodium falciparum malaria episodes according to the 2000 World Health Organization definition and requiring admission to the intensive care unit. Data were collected from medical charts using standardised case-report forms, in 45 French intensive care units in 2000-2006. Risk factors for in-hospital mortality were identified by univariate and multivariate analyses. Data from 400 adults admitted to the intensive care unit were analysed, representing the largest series of severe imported malaria to date. Median age was 45 years; 60% of patients were white, 96% acquired the disease in sub-Saharan Africa, and 65% had not taken antimalarial chemoprophylaxis. Curative quinine treatment was used in 97% of patients. Intensive care unit mortality was 10.5% (42 deaths). By multivariate analysis, three variables at intensive care unit admission were independently associated with hospital death: older age (per 10-year increment, odds ratio [OR], 1.72; 95% confidence interval [95%CI], 1.28-2.32; P = 0.0004), Glasgow Coma Scale score (per 1-point decrease, OR, 1.32; 95%CI, 1.20-1.45; P
Published: 2010
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30. Ocular syphilis and HIV infection

Author: Michèle Grappin, S. Mahy, Pascal Chavanet, Lionel Piroth, Michel Duong, Marielle Buisson, Damien Biotti, Catherine Creuzot-Garcher, Samuel Bidot, Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'Ophtalmologie (CHU de Dijon), Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre des Sciences du Goût et de l'Alimentation [Dijon] ( CSGA ), and Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS )
Subjects: Sexually transmitted disease, Male, Pediatrics, MESH : Retrospective Studies, Eye Diseases, MESH : Eye Diseases, HIV Infections, MESH: Comorbidity, Comorbidity, Neurosyphilis, Immunopathology, MESH : Syphilis, Sida, MESH: Eye Diseases, MESH: Middle Aged, biology, MESH: HIV Infections, MESH : Adult, Middle Aged, MESH: Neurosyphilis, Infectious Diseases, MESH : Comorbidity, Viral disease, France, Treponematosis, Microbiology (medical), Adult, medicine.medical_specialty, MESH : Male, MESH : Neurosyphilis, Dermatology, Acquired immunodeficiency syndrome (AIDS), [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, medicine, MESH : HIV Infections, Humans, MESH : Middle Aged, Syphilis, MESH : France, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, Public Health, Environmental and Occupational Health, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, biology.organism_classification, medicine.disease, MESH: Male, MESH: France, MESH: Syphilis, Immunology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Syphilitic ocular involvement is thought to be rare in HIV infected patients. During a 5-year study in 509 HIV-positive patients, syphilis was diagnosed in 3.9%, and the eye was involved in one-fifth of these. The high risk for sequelae emphasizes the need for prevention and for early diagnosis.
Published: 2010
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31. 17q21 variants modify the association between early respiratory infections and asthma

Author: Smit, L.A., Bouzigon, E., Pin, V., Siroux, V., Monier, F., Aschard, H., Bousquet, J., Gormand, F., Just, J., le Moual, N., Nadif, R., Scheinmann, P., Vervloet, D., Lathrop, M., Demenais, F., Kauffmann, F., Risk Assessment of Toxic and Immunomodulatory Agents, Dep IRAS, Faraldo, Beatrice, Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID, Division of Environmental Epidemiology, Utrecht University [Utrecht]-Institute of Risk Assessment Sciences, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Etude du Polymorphisme Humain (CEPH), Université Paris Diderot - Paris 7 (UPD7)-Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Fondation Jean Dausset, Variabilité Génétique et Maladies Humaines, Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de pédiatrie, CHU Grenoble-Hôpital Michallon, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumo-Allergologie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre National de Génotypage (CNG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Supported by the French Ministry of Higher Education and Research, University Paris Diderot-Paris 7, grants from the French Agency for Environmental and Occupational Health Safety (grant AFSSET-APR-SE-2004), the French National Agency for Research (grants ANR 05-SEST-020-02/05-9-97 and ANR 06-CEBS), Merck Sharp & Dohme (MSD), Hospital program of clinical research (PHRC)-Paris, and GABRIEL, a multidisciplinary study to identify the genetic and environmental causes of asthma in the European Community (contract n° 01896 under the Integrated Programme LSH-2004-1.2.5-1 Post genomic approaches to understand the molecular bias of asthma aiming at a preventive or therapeutic control). Lidwien Smit is supported by a European Academy of Allergology and Clinical Immunology- Global Allergy and Asthma European Network (EAACI-GA2LEN) exchange fellowship award., ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Etude du Polymorphisme Humain ( CEPH ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut Universitaire d'Hématologie ( IUH ), Université Paris Diderot - Paris 7 ( UPD7 ) -Fondation Jean Dausset, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Centre de l'asthme et de l'allergologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Centre National de Génotypage ( CNG ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), ANR-06-CEBS,ANR-06-CEBS, Risk Assessment of Toxic and Immunomodulatory Agents, and Dep IRAS
Subjects: Male, MESH: Neoplasm Proteins, MESH : Retrospective Studies, MESH: Asthma, MESH : Respiratory Tract Infections, 0302 clinical medicine, MESH : Child, Risk Factors, immune system diseases, respiratory infection, MESH: Risk Factors, MESH: Child, Epidemiology, MESH : Female, Age of Onset, Young adult, Child, Respiratory Tract Infections, MESH: Genetic Association Studies, 0303 health sciences, MESH: Polymorphism, Single Nucleotide, MESH : Polymorphism, Single Nucleotide, Respiratory disease, ORMDL3, MESH: Genetic Predisposition to Disease, Respiratory infection, MESH : Chromosomes, Human, Pair 17, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Follow-Up Studies, MESH : Risk Factors, Neoplasm Proteins, MESH : Age of Onset, 3. Good health, MESH: Tobacco Smoke Pollution, Female, epidemiology, MESH: Membrane Proteins, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, MESH : Male, MESH : Sex Factors, MESH: Age of Onset, Single-nucleotide polymorphism, MESH : Asthma, Polymorphism, Single Nucleotide, MESH : Tobacco Smoke Pollution, 03 medical and health sciences, Sex Factors, MESH : Neoplasm Proteins, MESH: Sex Factors, MESH : Adolescent, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, Genetic Association Studies, Retrospective Studies, 030304 developmental biology, Asthma, Genetic association, MESH: Adolescent, MESH: Humans, business.industry, MESH : Humans, environmental tobacco smoke exposure, Membrane Proteins, MESH : Follow-Up Studies, MESH: Retrospective Studies, MESH : Genetic Association Studies, Odds ratio, medicine.disease, MESH: Male, respiratory tract diseases, gene-environment interaction, 030228 respiratory system, GSDML, MESH : Membrane Proteins, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, MESH: Respiratory Tract Infections, Tobacco Smoke Pollution, MESH : Genetic Predisposition to Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Chromosomes, Human, Pair 17, MESH: Female, Chromosomes, Human, Pair 17, Follow-Up Studies
Abstract: Single nucleotide polymorphisms (SNPs) at chromosome 17q21 confer an increased risk of early-onset asthma. The objective was to study whether 17q21 SNPs modify associations between early respiratory infections and asthma. Association analysis was conducted in 499 children (268 with asthma, median age 11 yrs) from the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). The 12-yr follow-up data were used to assess persistent or remittent asthma in young adulthood. Respiratory infection before 2 yrs of age was assessed retrospectively. For the 12 17q21 SNPs studied, the odds ratios (OR) for association between infection and early-onset asthma (age at onsetor=4 yrs) were higher in carriers of risk genotypes (OR 3.42-6.36) than in noncarriers (OR 1.84-2.44; p-value for interaction 0.02-0.04 for five SNPs). Risk genotypes also increased the association between infection and childhood asthma that remits in adulthood (OR 4.84-7.16 in carriers and 1.74-2.25 in noncarriers; p-value for interaction 0.008-0.05 for 10 SNPs). In children with 17q21 risk genotypes and early-life environmental tobacco smoke (ETS) exposure, associations between infection and asthma were further enhanced. 17q21 genetic variants and early ETS exposure enhance the association between early respiratory infections and early-onset asthma and childhood asthma that remits in adulthood.
Published: 2010
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32. An ANOCEF genomic and transcriptomic microarray study of the response to radiotherapy or to alkylating first-line chemotherapy in glioblastoma patients

Author: François M. Vallette, Olivier Chinot, Carole Colin, Yannick Marie, Ahmed Idbaih, Michel Wager, Aurélien de Reyniès, François Ducray, Dominique Figarella-Branger, Marc Sanson, Emilie Thomas, Jérôme Honnorat, Jean-Yves Delattre, Lucie Karayan-Tapon, David S. Rickman, François Berger, Hervé Chneiweiss, Neuro-oncologie et neuro-inflammation, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie des Interactions Neurones / Glie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Association des Neuro-Oncologues d'Expression Française (ANOCEF), Hôpital de la Timone [CHU - APHM] (TIMONE)-CHU Marseille, (le programme) Cartes d'identité des tumeurs (CIT), Ligue Nationales Contre le Cancer (LNCC), Neuro-Oncologie [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Aix Marseille Université (AMU), Cellules souches leucémiques et thérapeuthiques, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work is part of the national program Cartes d'Identité des Tumeurs (CIT) funded and developed by the Ligue Nationale Contre le Cancer., Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Psychiatrie et Neurosciences (U894), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Association des Neuro-Oncologues d'Expression Française ( ANOCEF ), Hôpital de la Timone [CHU - APHM] ( TIMONE ) -CHU Marseille, Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre le Cancer, Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Centre de Recherches en Oncologie biologique et Oncopharmacologie ( CRO2 ), Aix Marseille Université ( AMU ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Centre de Psychiatrie et Neurosciences ( CPN - U894 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Grenoble Institut des Neurosciences ( GIN ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Institut National de la Santé et de la Recherche Médicale ( INSERM ), and BMC, Ed.
Subjects: Cancer Research, Microarray, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Immunohistochemistry, MESH : Promoter Regions, Genetic, MESH: Antineoplastic Agents, Alkylating, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Transcriptome, 0302 clinical medicine, MESH: DNA Methylation, Gene expression, Promoter Regions, Genetic, Oligonucleotide Array Sequence Analysis, 0303 health sciences, CD68, MESH: Glioblastoma, MESH : Cyclin-Dependent Kinase Inhibitor p16, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Immunohistochemistry, 3. Good health, MESH : Oligonucleotide Array Sequence Analysis, Oncology, [ SDV.BBM.GTP ] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], 030220 oncology & carcinogenesis, MESH: Cyclin-Dependent Kinase Inhibitor p16, DNA methylation, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Molecular Medicine, MESH : Antineoplastic Agents, Alkylating, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, In Vitro Techniques, lcsh:RC254-282, MESH : Glioblastoma, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], MESH: Promoter Regions, Genetic, medicine, Humans, Antineoplastic Agents, Alkylating, Cyclin-Dependent Kinase Inhibitor p16, 030304 developmental biology, Retrospective Studies, Chemotherapy, MESH: Humans, Research, MESH : Humans, MESH: Immunohistochemistry, MESH: Retrospective Studies, DNA Methylation, Radiation therapy, MESH: Oligonucleotide Array Sequence Analysis, Cancer research, Glioblastoma, MESH : DNA Methylation
Abstract: Background The molecular characteristics associated with the response to treatment in glioblastomas (GBMs) remain largely unknown. We performed a retrospective study to assess the genomic characteristics associated with the response of GBMs to either first-line chemotherapy or radiation therapy. The gene expression (n = 56) and genomic profiles (n = 67) of responders and non-responders to first-line chemotherapy or radiation therapy alone were compared on Affymetrix Plus 2 gene expression arrays and BAC CGH arrays. Results According to Verhaak et al.'s classification system, mesenchymal GBMs were more likely to respond to radiotherapy than to first-line chemotherapy, whereas classical GBMs were more likely to respond to first-line chemotherapy than to radiotherapy. In patients treated with radiation therapy alone, the response was associated with differential expression of microenvironment-associated genes; the expression of hypoxia-related genes was associated with short-term progression-free survival (< 5 months), whereas the expression of immune genes was associated with prolonged progression-free survival (> 10 months). Consistently, infiltration of the tumor by both CD3 and CD68 cells was significantly more frequent in responders to radiotherapy than in non-responders. In patients treated with first-line chemotherapy, the expression of stem-cell genes was associated with resistance to chemotherapy, and there was a significant association between response to treatment and p16 locus deletions. Consistently, in an independent data set of patients treated with either radiotherapy alone or with both radiotherapy and adjuvant chemotherapy, we found that patients with the p16 deletion benefited from adjuvant chemotherapy regardless of their MGMT promoter methylation status, whereas in patients without the p16 deletion, this benefit was only observed in patients with a methylated MGMT promoter. Conclusion Differential expression of microenvironment genes and p16 locus deletion are associated with responses to radiation therapy and to first-line chemotherapy, respectively, in GBM. Recently identified transcriptomic subgroups of GBMs seem to respond differently to radiotherapy and to first-line chemotherapy.
Published: 2010
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33. Impact of Chikungunya Virus Infection on Health Status and Quality of Life: A Retrospective Cohort Study

Author: Antoine Flahault, François Favier, J. Perrau, Man-Koumba Soumahoro, Adrian Fianu, Pierre-Yves Boëlle, Jacques Pouchot, Patrick Gérardin, Denis Malvy, Thomas Hanslik, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC régional épidémiologie clinique/essais cliniques - Ile de la Réunion (CIC-EC), Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Médecine Interne [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, Service de médecine interne et maladies tropicales, CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, École des Hautes Études en Santé Publique [EHESP] (EHESP), Service de médecine interne (APHP), Hôpital Ambroise Paré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, Hôpital Ambroise Paré, Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique Regional Epidemiologie Clinique/essais Cliniques - Ile de la Reunion, Institut National de la Santé et de la Recherche Médicale ( INSERM ), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Centre de référence des syndromes drépanocytaires majeurs, École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Service de médecine interne ( APHP ), and Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ )
Subjects: myalgia, Male, MESH : Retrospective Studies, MESH : Aged, lcsh:Medicine, MESH : Child, Preschool, Cohort Studies, 0302 clinical medicine, MESH: Aged, 80 and over, MESH : Child, Quality of life, MESH: Risk Factors, MESH : Insect Vectors, MESH: Child, MESH : Female, MESH: Animals, MESH : Indian Ocean Islands, 030212 general & internal medicine, MESH : Climate Change, lcsh:Science, MESH: Alphavirus Infections, Child, MESH: Travel, MESH: Cohort Studies, Depression (differential diagnoses), MESH: Aged, Aged, 80 and over, Multidisciplinary, MESH: Middle Aged, MESH: Climate Change, Chikungunya virus/*metabolism, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Aedes, MESH : Adult, Middle Aged, MESH : Risk Factors, 3. Good health, Infectious Diseases, Alphavirus Infections/*diagnosis/physiopathology/*psychology, Child, Preschool, Female, medicine.symptom, Chikungunya virus, Cohort study, Research Article, Infectious Diseases/Tropical and Travel-Associated Diseases, Adult, medicine.medical_specialty, Adolescent, MESH : Male, 030231 tropical medicine, MESH : Cohort Studies, MESH: Insect Vectors, MESH : Chikungunya virus, 03 medical and health sciences, Indian Ocean Islands, MESH : Adolescent, Internal medicine, Infectious Diseases/Viral Infections, medicine, Humans, MESH : Middle Aged, Alphavirus infection, MESH : Aged, 80 and over, MESH : Alphavirus Infections, MESH: Indian Ocean Islands, MESH : Aedes, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, business.industry, Alphavirus Infections, MESH : Humans, lcsh:R, MESH: Child, Preschool, MESH: Quality of Life, Retrospective cohort study, MESH: Retrospective Studies, MESH: Chikungunya virus, MESH: Adult, MESH : Quality of Life, medicine.disease, MESH: Male, MESH : Travel, Relative risk, Immunology, Quality of Life, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Animals, Unexposed Population, business, MESH: Female, Rheumatology/Musculoskeletal Pain and Analgesia
Abstract: International audience; BACKGROUND: Persistent symptoms, mainly joint and muscular pain and depression, have been reported several months after Chikungunya virus (CHIKV) infection. Their frequency and their impact on quality of life have not been compared with those of an unexposed population. In the present study, we aimed to describe the frequency of prolonged clinical manifestations of CHIKV infection and to measure the impact on quality of life and health care consumption in comparison with that of an unexposed population, more than one year after infection. METHODOLOGY/PRINCIPAL FINDINGS: In a retrospective cohort study, 199 subjects who had serologically confirmed CHIKV infection (CHIK+) were compared with 199 sero-negative subjects (CHIK-) matched for age, gender and area of residence in La Réunion Island. Following an average time of 17 months from the acute phase of infection, participants were interviewed by telephone about current symptoms, medical consumption during the last 12 months and quality of life assessed by the 12-items Short-Form Health Survey (SF-12) scale. At the time of study, 112 (56%) CHIK+ persons reported they were fully recovered. CHIK+ complained more frequently than CHIK- of arthralgia (relative risk = 1.9; 95% confidence interval: 1.6-2.2), myalgia (1.9; 1.5-2.3), fatigue (2.3; 1.8-3), depression (2.5; 1.5-4.1) and hair loss (3.8; 1.9-7.6). There was no significant difference between CHIK+ and CHIK- subjects regarding medical consumption in the past year. The mean (SD) score of the SF-12 Physical Component Summary was 46.4 (10.8) in CHIK+ versus 49.1 (9.3) in CHIK- (p = 0.04). There was no significant difference between the two groups for the Mental Component Summary. CONCLUSIONS/SIGNIFICANCE: More than one year following the acute phase of infection, CHIK+ subjects reported more disabilities than those who were CHIK-. These persistent disabilities, however, have no significant influence on medical consumption, and the impact on quality of life is moderate.
Published: 2009
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34. Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital

Author: Daniel Talon, Xavier Bertrand, Houssein Gbaguidi-Haore, Michelle Thouverez, Gérard Couetdic, Pascal Cholley, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH : Leukocidins, Male, MESH : Retrospective Studies, MESH : Aged, MESH: Leukocidins, Hospitals, University, 0302 clinical medicine, MESH : Child, MESH: Superantigens, MESH: Child, MESH : Superantigens, Child, Aged, 80 and over, 0303 health sciences, Cross Infection, MESH: Middle Aged, Superantigens, MESH : Genes, Bacterial, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Staphylococcal Infections, Antimicrobial, MESH: Infant, 3. Good health, Electrophoresis, Gel, Pulsed-Field, MESH : Phenotype, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Staphylococcus aureus, MESH: Young Adult, Child, Preschool, MESH : Cross Infection, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, Fusidic acid, MESH : Molecular Epidemiology, MESH: Staphylococcal Infections, MESH : Young Adult, Exotoxins, MESH: Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, MESH: Phenotype, Microbiology, 03 medical and health sciences, Antibiotic resistance, MESH : Adolescent, MESH: Molecular Epidemiology, MESH : Methicillin-Resistant Staphylococcus aureus, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : Hospitals, University, MESH : Electrophoresis, Gel, Pulsed-Field, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH: Methicillin Resistance, 030306 microbiology, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Virology, MESH : Methicillin Resistance, MESH : Exotoxins, MESH : Staphylococcal Infections, MESH: Female, Meticillin, Drug resistance, MESH : Child, Preschool, medicine.disease_cause, Enterotoxins, MESH: Aged, 80 and over, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Leukocidins, MESH: Enterotoxins, MESH : Female, 030212 general & internal medicine, MESH : Enterotoxins, MESH: Aged, MESH: Microbial Sensitivity Tests, Molecular Epidemiology, MESH: Infant, Newborn, MESH : Adult, Middle Aged, Phenotype, Female, France, MESH: Genes, Bacterial, medicine.drug, Adult, Adolescent, MESH : Male, Bacterial Toxins, MESH : Infant, Newborn, Young Adult, medicine, MESH : France, MESH: Hospitals, University, business.industry, Infant, Newborn, MESH: Cross Infection, MESH: Exotoxins, MESH: Male, Multiple drug resistance, MESH: France, MESH: Bacterial Toxins, Genes, Bacterial, MESH : Bacterial Toxins, Multilocus sequence typing, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Methicillin Resistance, MESH : Microbial Sensitivity Tests, business
Abstract: Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton–Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing. Demographic and clinical data were collected from all patients. For PVL-positive MRSA, the typical antimicrobial resistance pattern (susceptible to fluoroquinolones, non-susceptible to fusidic acid, kanamycin resistant and susceptible to gentamicin and tobramycin) had a sensitivity of 77.8 % and a positive predictive value (PPV) of 100 %. For tst-positive MRSA, the antimicrobial resistance pattern (susceptible to fluoroquinolones and non-susceptible to fusidic acid) had a sensitivity of 100 % and a PPV of 72.4 %. These results suggest that phenotypic rules based on antimicrobial resistance patterns are potentially useful for the detection of PVL- and tst-positive MRSA isolates.
Published: 2009
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35. Evidence that graft-site candidiasis after kidney transplantation is acquired during organ recovery: a multicenter study in France

Author: Albano , Laetitia, Bretagne , Stéphane, Mamzer-Bruneel , Marie-France, Kacso , Irina, Desnos-Ollivier , Marie, Guerrini , Patrice, Le Luong , Thanh, Cassuto , Elisabeth, Dromer , Françoise, Lortholary , Olivier, Gangneux , Jean-Pierre, Service de néphrologie, Hôpital Pasteur [Nice] ( CHU ), Service de parasitologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Service de néphrologie adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Agence de la biomédecine [Saint-Denis la Plaine], Service de transplantation, Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ), Centre d'infectiologie Necker-Pasteur [CHU Necker], Signalisation et Réponses aux Agents Infectieux et Chimiques ( SeRAIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140, Service de Parasitologie-Mycologie [Rennes], Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Hôpital Pasteur [Nice] (CHU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Signalisation et Réponses aux Agents Infectieux et Chimiques (SeRAIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Université de Rennes (UR), and Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Aged, MESH : Genotype, 030230 surgery, MESH: Kidney Transplantation, MESH: Genotype, MESH : Candidiasis, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Female, MESH: Incidence, Abscess, Candida albicans, Kidney transplantation, MESH: Treatment Outcome, Candida, MESH: Aged, 0303 health sciences, Kidney, MESH: Middle Aged, biology, Incidence, Candidiasis, Middle Aged, MESH : Adult, MESH : Risk Factors, MESH: Candidiasis, Urinoma, Nephrectomy, MESH : Incidence, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Treatment Outcome, Infectious Diseases, medicine.anatomical_structure, surgical procedures, operative, Female, France, Adult, Microbiology (medical), medicine.medical_specialty, Genotype, MESH : Male, MESH : Treatment Outcome, 03 medical and health sciences, MESH: Candida, medicine, Humans, MESH : Middle Aged, Arteritis, MESH : France, Aged, Retrospective Studies, MESH: Humans, 030306 microbiology, business.industry, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, biology.organism_classification, Kidney Transplantation, MESH: Male, Surgery, MESH: France, Transplantation, MESH : Kidney Transplantation, business, MESH: Female, MESH : Candida
Abstract: International audience; BACKGROUND: Infections of renal grafts with Candida species can induce life-threatening complications in the recipient. METHODS: A 9-year retrospective study involving all of the transplant centers in France was designed to determine the incidence, origin, characteristics, and outcome of graft-site candidiasis that occurred after kidney transplantation. Yeasts cultured from preservation or drainage solutions and graft specimens were recorded. RESULTS: Among 18,617 kidney grafts, 18 recipients corresponding to 12 donors developed culture-confirmed graft-site candidiasis (incidence, 1 case per 1000 grafts) a median of 25 days after the graft procedure. Clinical presentations included 14 cases of renal arteritis (13 were complicated by aneurysm), 1 urinoma, 2 graft site abscesses, and 1 surgical site infection. Candida albicans was involved in 13 cases. A unique C. albicans genotype or a single rare Candida species was involved in each episode. Together with the clinical history, these findings demonstrate that organ contamination followed by transmission to the recipient occurred during recovery. Therapeutic management varied from simple monitoring in 1 case to a combination of surgery (nephrectomy in 9 cases and arterial bypass in 9 cases) and antifungal therapy (14 cases). Overall, 3 of 18 kidney transplant recipients died, and 9 had their graft surgically removed. CONCLUSION: Graft-transmitted candidiasis that ends most often in fungal arteritis is associated with high morbidity and mortality after kidney transplantation and is related to organ contamination during recovery in the donor.
Published: 2009
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36. L-asparaginase-based treatment of 15 western patients with extranodal NK/T-cell lymphoma and leukemia and a review of the literature

Author: Dominique Bordessoule, Benoît Marin, Claire Larroche, Alain Devidas, Arnaud Jaccard, Barbara Petit, Nathalie Gachard, Catherine Thieblemont, Felipe Suarez, P. Gaulard, V. Coiteux, Stephane Girault, Jean-Marc Zini, Olivier Hermine, Remy Gressin, Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Université de Limoges (UNILIM), Laboratoire SUBATECH Nantes (SUBATECH), Mines Nantes (Mines Nantes)-Université de Nantes (UN)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Groupe d'Étude sur les Géomatériaux et Environnements Naturels, Anthropiques et Archéologiques - EA 3795 (GEGENAA), SFR Condorcet, Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)-Université de Reims Champagne-Ardenne (URCA), Service d'Hématologie biologique [CHU Limoges], CHU Limoges, Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], Cytokines, hématopoïèse et réponse immune (CHRI), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université de Nantes (UN)-Mines Nantes (Mines Nantes), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations ( PMRIL ), Université de Limoges ( UNILIM ) -Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Limoges ( UNILIM ), Laboratoire SUBATECH Nantes ( SUBATECH ), Mines Nantes ( Mines Nantes ) -Université de Nantes ( UN ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Groupe d'Étude sur les Géomatériaux et Environnements Naturels, Anthropiques et Archéologiques - EA 3795 ( GEGENAA ), Université de Reims Champagne-Ardenne ( URCA ) -Institut national de recherches archéologiques préventives ( Inrap ) -SFR Condorcet, Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Centre National de la Recherche Scientifique ( CNRS ), Cytokines, hématopoïèse et réponse immune ( CHRI ), and Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS )
Subjects: Oncology, Male, MESH : Retrospective Studies, MESH : Recurrence, MESH : Antineoplastic Combined Chemotherapy Protocols, MESH : Aged, MESH: Western World, Extranodal Disease, chemistry.chemical_compound, 0302 clinical medicine, MESH: Aged, 80 and over, Aggressive NK-cell leukemia, Recurrence, MESH : Western World, Antineoplastic Combined Chemotherapy Protocols, T-cell lymphoma, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH: Asparaginase, Disseminated disease, MESH : Female, MESH: Lymphoma, Extranodal NK-T-Cell, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, 0303 health sciences, Leukemia, MESH: Middle Aged, MESH : Lymphoma, Extranodal NK-T-Cell, Hematology, MESH : Adult, Middle Aged, MESH: Drug Resistance, Neoplasm, 3. Good health, Lymphoma, Extranodal NK-T-Cell, MESH: Antineoplastic Combined Chemotherapy Protocols, MESH : Drug Resistance, Neoplasm, Treatment Outcome, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Adult, medicine.medical_specialty, Asparaginase, MESH : Male, MESH : Treatment Outcome, 03 medical and health sciences, Internal medicine, MESH : Asparaginase, MESH: Leukemia, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, 030304 developmental biology, Aged, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, MESH : Leukemia, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Male, Lymphoma, MESH: Recurrence, Regimen, chemistry, Drug Resistance, Neoplasm, Immunology, Western World, business, MESH: Female
Abstract: International audience; BACKGROUND: Extranodal natural killer (NK)/T-cell lymphoma, nasal type, and aggressive NK-cell leukemia are highly aggressive diseases with a poor outcome. PATIENTS AND METHODS: We report a multicentric French retrospective study of 15 patients with relapsed, refractory, or disseminated disease, treated with L-asparaginase-containing regimens in seven French centers. Thirteen patients were in relapse and/or refractory and 10 patients were at stage IV. RESULTS: All but two of the patients had an objective response to L-asparaginase-based treatment. Seven patients reached complete remission and only two relapsed. CONCLUSION: These data, although retrospective, confirm the excellent activity of L-asparaginase-containing regimens in refractory extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia. Therefore, L-asparaginase-based regimen should be considered as a salvage treatment, especially for patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia should be tested in prospective trials.
Published: 2009
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37. Impact of previous sepsis on the accuracy of procalcitonin for the early diagnosis of blood stream infection in critically ill patients

Author: André Pechinot, Aurélie Snauwaert, Jean-Pierre Quenot, Jean-Marc Doise, Sébastien Prin, Niels-Olivier Olsson, Serge Aho, Sylvain Ladoire, Pierre Emmanuel Charles, Bernard Blettery, Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Laboratoire de Microbiologie Médicale et Moléculaire, Université de Bourgogne (UB), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), and Université de Bourgogne ( UB )
Subjects: Male, MESH: Protein Precursors, MESH : Retrospective Studies, MESH : Aged, [ SDV.MP.BAC ] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH : Critical Illness, MESH : Early Diagnosis, Procalcitonin, law.invention, Leukocyte Count, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Early Diagnosis, law, MESH : Female, 030212 general & internal medicine, MESH : Protein Precursors, MESH: Sepsis, Aged, 80 and over, MESH: Aged, First episode, MESH: Middle Aged, Middle Aged, MESH : Leukocyte Count, Intensive care unit, MESH: Predictive Value of Tests, 3. Good health, C-Reactive Protein, Infectious Diseases, Predictive value of tests, MESH: Critical Illness, Female, MESH : Sepsis, SOFA score, Research Article, Calcitonin, medicine.medical_specialty, Calcitonin Gene-Related Peptide, Critical Illness, MESH : Male, MESH: Multivariate Analysis, lcsh:Infectious and parasitic diseases, Sepsis, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Intensive care, MESH: C-Reactive Protein, medicine, Humans, MESH : Middle Aged, lcsh:RC109-216, MESH : Predictive Value of Tests, Protein Precursors, MESH : Aged, 80 and over, Intensive care medicine, Aged, Retrospective Studies, MESH: Humans, MESH: Calcitonin, business.industry, MESH : Humans, MESH : Multivariate Analysis, MESH: Retrospective Studies, 030208 emergency & critical care medicine, MESH : C-Reactive Protein, medicine.disease, bacterial infections and mycoses, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Male, MESH : Calcitonin, Systemic inflammatory response syndrome, Early Diagnosis, MESH: Leukocyte Count, Multivariate Analysis, business, MESH: Female
Abstract: Background Blood stream infections (BSI) are life-threatening infections in intensive care units (ICU), and prognosis is highly dependent on early detection. Procalcitonin levels have been shown to accurately and quickly distinguish between BSI and noninfectious inflammatory states in critically ill patients. It is, however, unknown to what extent a recent history of sepsis (namely, secondary sepsis) can affect diagnosis of BSI using PCT. Methods review of the medical records of every patient with BSI in whom PCT dosage at the onset of sepsis was available between 1st September, 2006 and 31st July, 2007. Results 179 episodes of either primary (n = 117) or secondary (n = 62) sepsis were included. Procalcitonin levels were found to be markedly lower in patients with secondary sepsis than in those without (6.4 [9.5] vs. 55.6 [99.0] ng/mL, respectively; p < 0.001), whereas the SOFA score was similar in the two groups. Although patients in the former group were more likely to have received steroids and effective antibiotic therapy prior to the BSI episode, and despite a higher proportion of candidemia in this group, a low PCT value was found to be independently associated with secondary sepsis (Odd Ratio = 0.33, 95% Confidence Interval: 0.16–0.70; p = 0.004). Additional patients with suspected but unconfirmed sepsis were used as controls (n = 23). Thus, diagnostic accuracy of PCT as assessed by the area under the receiver-operating characteristic curves (AUROCC) measurement was decreased in the patients with secondary sepsis compared to those without (AUROCC = 0.805, 95% CI: 0.699–0.879, vs. 0.934, 95% CI: 0.881–0.970, respectively; p < 0.050). Conclusion In a critically ill patient with BSI, PCT elevation and diagnosis accuracy could be lower if sepsis is secondary than in those with a first episode of infection.
Published: 2008
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38. Survival in patients with uveal melanoma in Europe

Author: Maria Cecilia Cercato, Pascale Grosclaude, Michel Coleman, Laura Ciccolallo, Mariano Santaquilani, Valerio Ramazzotti, Emanuele Crocetti, Stefano Ferretti, Gemma Gatta, Gianni Virgili, Laufey Tryggvadottir, Franco Berrino, Hans Storm, Paolo Baili, Evaluative Epidemiology Unit, Fondazione IRCCS, Department of Statistics 'G. Parenti', University of Florence and Biostatistics Unit ISPO (Institute for Cancer Prevention and Research), Registre Genevois des Tumeurs, CHU Genève, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Male, MESH : Retrospective Studies, MESH : Aged, MESH: Risk Assessment, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, 80 and over, MESH: Incidence, Melanoma, Cause of death, Aged, 80 and over, MESH: Middle Aged, Incidence, MESH: Sex Distribution, Prognosis, MESH : Incidence, MESH: International Classification of Diseases, 3. Good health, MESH : Uveal Neoplasms, 030220 oncology & carcinogenesis, Cohort study, medicine.medical_specialty, MESH: Melanoma, MESH: Probability, Survival - uveal melanoma - Europe, Socio-culturale, MESH : Cohort Studies, Risk Assessment, MESH: Prognosis, Disease-Free Survival, Europe/epidemiology, 03 medical and health sciences, Uveal Neoplasms/diagnosis/mortality/therapy, MESH : Adolescent, MESH : International Classification of Diseases, Humans, Melanoma/diagnosis/mortality/therapy, MESH : Middle Aged, MESH : Aged, 80 and over, MESH: Age Distribution, Survival analysis, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, Survival Analysis, Cancer registry, Ophthalmology, MESH: Disease-Free Survival, 030221 ophthalmology & optometry, MESH: Female, Uveal Neoplasms, MESH: Registries, MESH : Age Distribution, MESH : Analysis of Variance, MESH: Cause of Death, Cohort Studies, MESH: Aged, 80 and over, Cause of Death, MESH : Female, Registries, MESH : Risk Assessment, MESH: Cohort Studies, MESH : Sex Distribution, MESH: Aged, MESH : Prognosis, Relative survival, Incidence (epidemiology), Absolute risk reduction, Middle Aged, MESH : Adult, Europe, MESH: Survival Analysis, MESH : Disease-Free Survival, Female, Adult, Adolescent, MESH : Male, MESH : Probability, MESH : Europe, MESH : Melanoma, [SDV.CAN]Life Sciences [q-bio]/Cancer, Age Distribution, Analysis of Variance, International Classification of Diseases, Multivariate Analysis, Probability, Sex Distribution, MESH: Multivariate Analysis, MESH: Analysis of Variance, Internal medicine, medicine, ddc:613, MESH : Cause of Death, business.industry, MESH : Multivariate Analysis, Retrospective cohort study, MESH: Male, Surgery, MESH: Uveal Neoplasms, MESH: Europe, MESH : Survival Analysis, business, MESH : Registries
Abstract: International audience; OBJECTIVE: To estimate survival in patients in whom uveal melanoma was diagnosed between January 1, 1983, and December 31, 1994, in Europe. METHODS: Survival analysis of data from 32 cancer registries in 16 European countries adhering to the European Cancer Registry for 5788 patients with uveal melanoma diagnosed between January 1, 1983, and December 31, 1994, with follow-up to 1999. RESULTS: Five-year relative survival was 68.9% overall and remained stable with the period of diagnosis. Relative excess risk of death was 2.45 (95% confidence interval [CI], 2.10-2.86) in patients aged 75 years or older compared with patients aged 54 years or younger and was slightly higher in male patients (relative excess risk, 1.10; 95% CI, 1.02-1.19) than in female patients. Survival was similar in Nordic countries (relative excess risk, 1.03; 95% CI, 0.87-1.21) compared with the United Kingdom (reference country) and was lower in eastern and western European countries (1.26; 1.05-1.52, and 1.25; 0.90-1.60, respectively) compared with the reference country. CONCLUSIONS: In this large series of patients with uveal melanoma, 5-year relative survival remained stable with the introduction of conservative treatment in individuals in whom uveal melanoma was diagnosed between 1983 and 1994. We found differences in survival between sexes and in European areas that should be investigated in studies that consider tumor characteristics at the individual level.
Published: 2008
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39. Onset of psoriatic arthritis in patients treated with efalizumab for moderate to severe psoriasis

Author: Thomas Bardin, Franck Delesalle, M. Lahfa, Emmanuel Delaporte, Hervé Bachelez, Pascal Richette, François Aubin, Christophe Bedane, Marie-Aleth Richard-Lallemand, Manuelle Viguier, Marie Beylot-Barry, L. Dubertret, Bases Moleculaires de l'Homeostasie Cutanee : Inflammation, Reparation et Cancer, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Département de dermatologie, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )
Subjects: Male, MESH : Retrospective Studies, MESH : Psoriasis, Efalizumab, Arthritis, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Dactylitis, MESH: Antibodies, Monoclonal, Cohort Studies, 030207 dermatology & venereal diseases, 0302 clinical medicine, Immunology and Allergy, MESH: Arthritis, Psoriatic, MESH : Female, Pharmacology (medical), CD11a Antigen, MESH: Cohort Studies, MESH : Antigens, CD11a, MESH: Psoriasis, Oligoarthritis, MESH: Middle Aged, MESH: Immunologic Factors, Antibodies, Monoclonal, MESH : Adult, Middle Aged, 3. Good health, MESH : Antibodies, Monoclonal, Polyarthritis, Female, medicine.drug, Adult, medicine.medical_specialty, MESH : Male, Immunology, MESH : Cohort Studies, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antibodies, Monoclonal, Humanized, MESH : Immunologic Factors, 03 medical and health sciences, Psoriatic arthritis, Rheumatology, Psoriasis Area and Severity Index, Psoriasis, medicine, Humans, Immunologic Factors, MESH : Middle Aged, MESH : Arthritis, Psoriatic, Retrospective Studies, 030203 arthritis & rheumatology, MESH: Antigens, CD11a, MESH: Humans, business.industry, MESH : Humans, Arthritis, Psoriatic, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Dermatology, MESH: Male, business, MESH: Female
Abstract: Objective To investigate the nature of polyarthritis in patients with moderate to severe psoriasis undergoing treatment with efalizumab, a humanized anti-CD11a monoclonal antibody. Methods In a multicenter study, we retrospectively analyzed patients who developed arthritis during treatment with efalizumab. The relationship between joint manifestations and psoriatic disease was addressed by using different classification criteria for psoriatic arthritis (PsA). The course of arthritis and its response to treatment were also investigated. Results Sixteen patients developed de novo inflammatory rheumatic disease, with a mean delay of 15 weeks following the start of treatment, and with exclusive asymmetric peripheral monarthritis or oligoarthritis (8 patients), inflammatory spinal disease (1 patient), or both (7 patients), associated in some cases with enthesitis and dactylitis. All patients fulfilled at least 2 different sets of classification criteria for PsA. In most of them, an improvement in skin lesions was observed at the onset of PsA, as measured using the Psoriasis Area and Severity Index (mean score 24.88 before efalizumab versus 18.78 at the time of arthritis). Efalizumab treatment was stopped in 11 patients and was followed by the elimination of rheumatologic symptoms in 1 patient, while 8 patients required treatment with nonsteroidal antiinflammatory drugs with or without methotrexate, with 2 later being switched to tumor necrosis factor α inhibitors. Reintroduction of efalizumab (2 patients) was followed by a relapse of PsA. Conclusion This study questions the role of efalizumab in the induction of PsA. It also emphasizes the discrepancy between the courses of psoriatic skin and joint manifestations under treatment. Prospective case–control studies are needed to accurately investigate the impact of efalizumab on PsA.
Published: 2008
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40. Variations in management of stage I to stage III cutaneous melanoma: a population-based study of clinical practices in France

Author: G. Hedelin, Marie-Laure Batard, Jean-Michel Halna, Catherine Michel, Christian Delvincourt, G. Reuter, Florence Granel-Brocard, Sophie Dalac, Florent Grange, Arlette Danzon, François Truchetet, Jean Luc Schmutz, François Aubin, P. Bernard, Fabien Vitry, Béatrice Baury, Dan Lipsker, Stéphane Dalle, Unité de recherche clinique [Reims], Centre Hospitalier Universitaire de Reims ( CHU Reims ) -Hôpital Maison Blanche, Service de Dermatologie et Allergologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Département de dermatologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques-Université de Franche-Comté ( UFC ), Registre des cancers du Bas-Rhin, CRLCC Paul Strauss, Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Maison Blanche, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital de l'Hôtel Dieu [CHU-HCL], and Hospices Civils de Lyon (HCL)
Subjects: Male, Skin Neoplasms, Time Factors, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Aged, MESH : Dose-Response Relationship, Drug, MESH: Dose-Response Relationship, Drug, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 030207 dermatology & venereal diseases, 0302 clinical medicine, MESH: Aged, 80 and over, MESH : Interferons, MESH : Population Surveillance, MESH: Interferons, MESH : Neoplasm Staging, MESH : Female, Stage (cooking), Melanoma, ComputingMilieux_MISCELLANEOUS, MESH : Sentinel Lymph Node Biopsy, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH: Middle Aged, MESH : Chemotherapy, Adjuvant, General Medicine, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, 3. Good health, MESH : Antineoplastic Agents, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Population Surveillance, MESH : Dermatology, Female, Radiology, France, MESH : Time Factors, Adult, medicine.medical_specialty, Adolescent, MESH: Melanoma, MESH: Sentinel Lymph Node Biopsy, MESH : Male, Population, Sentinel lymph node, MESH : Melanoma, Antineoplastic Agents, MESH: Dermatology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, MESH: Population Surveillance, Breslow Thickness, 03 medical and health sciences, MESH : Adolescent, Adjuvant therapy, medicine, Humans, MESH : Middle Aged, education, MESH : Aged, 80 and over, MESH : France, Cancer staging, Aged, Neoplasm Staging, Retrospective Studies, MESH: Adolescent, MESH: Humans, Dose-Response Relationship, Drug, business.industry, Sentinel Lymph Node Biopsy, MESH: Skin Neoplasms, MESH: Time Factors, MESH : Humans, MESH : Skin Neoplasms, MESH: Adult, MESH: Retrospective Studies, MESH: Male, Surgery, MESH: France, Regimen, MESH: Antineoplastic Agents, Lymphadenectomy, Interferons, business, MESH: Female
Abstract: International audience; OBJECTIVE: To describe current management of cutaneous melanoma (CM) and identify factors accounting for disparities. DESIGN: Retrospective population-based study using survey of cancer registries and pathology laboratories, and questionnaires to physicians. SETTING: Five regions covering 19.2% of the French territory and including 8.2 million inhabitants. PATIENTS: Incident cases of patients with stage I to stage II (hereinafter, stage I-II) tumors staged according to the American Joint Committee on Cancer Staging guidelines and nodal stage III CM in 2004. MAIN OUTCOME MEASURES: Modalities of diagnosis and excision, surgical margins, sentinel lymph node biopsy, adjuvant therapies and surveillance procedures, and their variations according to age, sex, residence, location of primary CM, Breslow thickness, type of physicians, modalities of decisions, and health care patterns. RESULTS: Clinical stage I-II CMs (n = 710 cases) slightly predominated in females (53%), with a lower mean Breslow thickness (1.4 mm) than in males (1.9 mm). Initial excisions were most often performed by private dermatologists and wide excisions by surgeons. Narrow margins (8%) were associated with advanced age, higher Breslow thickness, and head location. Sentinel lymph node biopsy was performed in 34% of CMs thicker than 1.0 mm, depending on geographical regions, distance from reference centers, and health care patterns. Adjuvant therapies (mainly low-dose interferon) were proposed in 53% of thick CMs (>1.5 mm), depending on the patient's age and geographical region. In contrast with French recommendations, surveillance procedures frequently included systematic medical imaging. Stage III nodal CMs (n = 89 cases) predominated in males (62%). After lymphadenectomy, adjuvant therapies (including high-dose interferon in 32% of cases and chemotherapies in 24% of cases) were proposed in 68% of cases, depending on the patient's age and geographical region. A complete 1-year high-dose interferon regimen was administered in less than 10% of cases. CONCLUSION: Large disparities still exist in the management of CM in France, depending to a greater extent on medical and geographical environment than on the characteristics of either patients or tumors.
Published: 2008
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41. Adjuvant corticosteroid therapy for chronic disseminated candidiasis

Author: Olivier Lortholary, Erianna Bellaton, Bertrand Dupont, Marc Lecuit, Faezeh Legrand, Pierre-Simon Rohrlich, Michel Huerre, Service d'hématologie et immunologie pédiatrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service d'hématologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Microorganismes et Barrières de l'Hôte (Equipe avenir), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Histotechnologie et Pathologie, Institut Pasteur [Paris] (IP), Service d'hémato-onco-pédiatrie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Mycologie moléculaire, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], Institut Pasteur [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Saas, Philippe, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 ( UPD7 ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -hopital Jean Minjoz, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Equipe avenir Microorganismes et Barrières de l'Hôte, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) ( HOTE GREFFON ), Université de Franche-Comté ( UFC ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS )
Subjects: Male, Abdominal pain, MESH : Retrospective Studies, MESH: Spleen, medicine.medical_treatment, MESH : Aged, MESH : Immune Reconstitution Inflammatory Syndrome, MESH: Length of Stay, MESH : Child, Adrenal Cortex Hormones, MESH: Child, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Medicine, Child, 0303 health sciences, MESH: Middle Aged, Candidiasis, MESH : Chemotherapy, Adjuvant, 3. Good health, MESH : Length of Stay, C-Reactive Protein, Child, Preschool, MESH : Fever, Microbiology (medical), medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH : Abdominal Pain, Liver Abscess, MESH : Adrenal Cortex Hormones, MESH: Adrenal Cortex Hormones, 03 medical and health sciences, MESH : Adolescent, MESH: Fever, Humans, MESH : Middle Aged, Mycosis, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, 030306 microbiology, MESH : Humans, MESH : Leukemia, MESH : Liver Abscess, MESH: Child, Preschool, MESH: Retrospective Studies, MESH: Adult, Length of Stay, medicine.disease, MESH: Antifungal Agents, MESH: Abdominal Pain, MESH: Fibrinogen, MESH: Female, Antifungal Agents, Time Factors, MESH : Fibrinogen, MESH : Child, Preschool, MESH : Candidiasis, Prednisone, Immune Reconstitution Inflammatory Syndrome, MESH : Female, MESH: Aged, Acute leukemia, Leukemia, MESH : Adult, Middle Aged, MESH: Candidiasis, Infectious Diseases, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, MESH: Immune Reconstitution Inflammatory Syndrome, Corticosteroid, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, MESH : Time Factors, medicine.drug, MESH : Spleen, Adult, Adolescent, Fever, medicine.drug_class, MESH : Male, MESH : Antifungal Agents, MESH: Liver Abscess, Immune reconstitution inflammatory syndrome, Internal medicine, MESH: Leukemia, MESH: C-Reactive Protein, 030304 developmental biology, Chemotherapy, business.industry, MESH: Time Factors, Fibrinogen, Retrospective cohort study, MESH : C-Reactive Protein, MESH: Male, Surgery, Abdominal Pain, business, Spleen
Abstract: International audience; BACKGROUND: Chronic disseminated candidiasis (CDC) is typically observed during neutrophil recovery in patients with acute leukemia and requires protracted antifungal therapy. OBJECTIVE: Our objective was to document the efficacy and tolerance of corticosteroid therapy (CST) in patients with symptomatic CDC, including those who experienced fever and abdominal pain despite ongoing antifungal therapy. METHODS: We performed a retrospective, multicenter study involving 10 pediatric and adult patients who experienced ongoing symptomatic CDC despite receipt of appropriate antifungal therapy for whom adjuvant oral CST was initiated. RESULTS: All cases of CDC were proven or probable, as determined on the basis of the European Organization for Research and Treatment of Cancer-Mycosis Study Group definition criteria, and occurred in patients with leukemia. CDC-attributable clinical symptoms resolved with CST, which was started a mean of 33.8 days after antifungal therapy had been initiated. Fever and abdominal pain disappeared a median of 4-5 days, and serum fibrinogen and C-reactive protein levels returned to normal values within 14-30 days. The median duration of hospitalization after CST initiation was 8.8 days. Hepatosplenic microabscesses decreased or disappeared within a mean period of 107 days (range, 30-210 days). No relapses of CDC were observed during a median duration of follow-up of 6.5 years (range, 4-9 years). CONCLUSIONS: In children and adults who experience persistently symptomatic CDC despite ongoing receipt of antifungal therapy, CST involving a prednisone equivalent at a dosage of > or =0.5 mg/kg per day for at least 3 weeks is associated with a prompt resolution of symptoms and of inflammatory response. These findings support the pathophysiological hypothesis that CDC belongs to the spectrum of fungus-related immune reconstitution inflammatory syndrome.
Published: 2008
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42. The clinical spectrum of IgM-related amyloidosis: a French nationwide retrospective study of 72 patients

Author: Richard Delarue, Mathilde Hunault-Berger, Olivier Tournilhac, Arnaud Jaccard, Philippe Rodon, Pierre Morel, Marc Bernard, Arnaud Hot, Mohamed Hamidou, Benjamin Terrier, Fadi Fakhouri, Olivier Gisserot, Jean-Paul Fermand, Bernard Grosbois, Caroline Elie, Jacques Dantal, Véronique Leblond, Valérie Coiteux, Jean-Luc Harousseau, Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Service d'Hématologie biologique [CHU Limoges], CHU Limoges, Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Fédération des maladies infectieuses, CHU Clermont-Ferrand, Immunointervention dans les allo et xénotransplantations, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM)-ITUN, Institut de transplantation et de recherche en transplantation (ITERT), Laboratoire Hubert Curien [Saint Etienne] (LHC), Institut d'Optique Graduate School (IOGS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], CHU Pontchaillou [Rennes], Laboratoire de physique des milieux ionisés et applications (LPMIA), Université Henri Poincaré - Nancy 1 (UHP)-Centre National de la Recherche Scientifique (CNRS), Service d'immunologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service de néphrologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Service de médecine interne, Physique des milieux ionisés et applications (LPMIA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations ( PMRIL ), Université de Limoges ( UNILIM ) -Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Université de Nantes ( UN ) -IFR26-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -ITUN, Institut de transplantation et de recherche en transplantation ( ITERT ), Laboratoire Hubert Curien [Saint Etienne] ( LHC ), Institut d'Optique Graduate School ( IOGS ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), Physique des milieux ionisés et applications ( LPMIA ), Université Henri Poincaré - Nancy 1 ( UHP ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP)
Subjects: Male, Pathology, MESH: Remission Induction, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Aged, MESH : Alkylating Agents, MESH: Antigens, CD20, Hematopoietic stem cell transplantation, Gastroenterology, MESH: Antibodies, Monoclonal, 0302 clinical medicine, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH: Treatment Outcome, Aged, 80 and over, MESH: Middle Aged, MESH: Heart Diseases, Amyloidosis, MESH: Immunologic Factors, Remission Induction, Hematopoietic Stem Cell Transplantation, Antibodies, Monoclonal, General Medicine, MESH: Immunoglobulin M, 3. Good health, Survival Rate, 030220 oncology & carcinogenesis, MESH : Paraproteinemias, Rituximab, medicine.medical_specialty, Alkylating Agents, MESH: Serum Albumin, 03 medical and health sciences, MESH: Lymphatic Diseases, MESH : Antigens, CD20, MESH : Hematopoietic Stem Cell Transplantation, AL amyloidosis, Humans, Immunologic Factors, MESH : Middle Aged, MESH : Aged, 80 and over, Lymphatic Diseases, Aged, Retrospective Studies, MESH: Humans, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Amyloidosis, Complication, MESH: Female, Lung Diseases, Paraproteinemias, Antibodies, Monoclonal, Murine-Derived, MESH: Lung Diseases, MESH: Paraproteinemias, MESH: Aged, 80 and over, MESH : Purines, MESH : Female, Prospective cohort study, MESH: Aged, MESH : Lung Diseases, MESH : Lymphatic Diseases, MESH: Purines, Middle Aged, MESH : Adult, MESH : Survival Rate, Hematologic Response, MESH: Alkylating Agents, Treatment Outcome, MESH : Antibodies, Monoclonal, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, medicine.drug, Adult, Heart Diseases, MESH: Survival Rate, MESH : Immunoglobulin M, MESH : Male, MESH : Treatment Outcome, MESH : Immunologic Factors, MESH : Serum Albumin, Internal medicine, medicine, MESH: Amyloidosis, MESH : France, Serum Albumin, MESH: Hematopoietic Stem Cell Transplantation, MESH : Remission Induction, business.industry, Retrospective cohort study, MESH : Heart Diseases, Antigens, CD20, MESH: Male, MESH: France, Immunoglobulin M, Purines, business, 030215 immunology
Abstract: International audience; Immunoglobulin M (IgM)-related amyloidosis remains a rare and little-known complication of monoclonal IgM-associated disorders. We sought to determine the clinical and laboratory presentation, response to treatment, and outcome of patients with IgM-related amyloidosis in the era of new therapeutic approaches. We conducted a retrospective study in 29 French centers to identify patients with monoclonal IgM and biopsy-proven amyloidosis; we reviewed patients' records and collected relevant clinical and laboratory data. We identified 72 patients with IgM-related amyloidosis. Systemic primary amyloidosis (AL) was present in 64, peritumoral AL in 5, and systemic secondary amyloidosis (AA) in 3 patients. A peculiar pattern of relatively frequent lymph node (31%) and lung (17%) involvement was noted in patients with systemic AL amyloidosis. Response to alkylating agents was poor, with a hematologic response in 37%, a complete remission in 0%, and an organ response in 21%. Response to hematopoietic stem cell transplantation showed a hematologic response in 100% with complete remission in 75% and an organ response in 75%. Purine analogs and rituximab induced a hematologic response in 73% and 60%, respectively, with complete remission in 9% and 0% and an organ response in 55% and 0%, respectively. In multivariate analysis, prognostic factors for survival were serum albumin level < or =3.5 g/dL (p = 0.018) and heart involvement (p = 0.0034). Further prospective studies are needed in patients with IgM-related amyloidosis, with special emphasis on treatment options: hematopoietic stem cell transplantation and purine analogs could represent the most effective therapies. The identification of adverse prognostic factors of survival could be useful for those managing and making treatment decisions for these patients.
Published: 2008
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43. Negative impact of rurality on lung cancer survival in a population-based study

Author: Alexandre Pitard, Jean-Charles Dalphin, Patrick Arveux, Virginie Westeel, A. Depierre, Isabelle Thaon, Mael Martin, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Registre des Cancers du Sein et autres Cancers Gynécologiques de Côte d'Or - Breast and Gynaecologic Cancer Registry of Côte d’Or, Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Registre des tumeurs du Doubs, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Cancéropôle du Grand Est, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Registre des tumeurs du Doubs et du Territoire de Belfort [CHRU Besançon], Pôle cancérologie (CHRU Besançon), and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Male, Rural Population, Lung Neoplasms, Survival, MESH : Retrospective Studies, MESH : Aged, 0302 clinical medicine, Rurality, MESH: Aged, 80 and over, MESH: Rural Population, Risk Factors, MESH: Risk Factors, Medicine, Rural, MESH : Female, 030212 general & internal medicine, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH: Middle Aged, MESH : Prognosis, Relative survival, 1. No poverty, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Cancer registry, MESH : Adult, Prognosis, MESH : Survival Rate, MESH : Risk Factors, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Population study, Female, Medical emergency, France, Lung cancer, Adult, Pulmonary and Respiratory Medicine, MESH: Survival Rate, MESH : Male, Population, Prognostic factors, MESH: Prognosis, 03 medical and health sciences, Humans, MESH : Middle Aged, MESH : Lung Neoplasms, Risk factor, education, MESH : Aged, 80 and over, MESH : France, Aged, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, Cancer, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Male, MESH: Lung Neoplasms, MESH: France, MESH : Rural Population, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Rural area, business, MESH: Female, Demography
Abstract: International audience; INTRODUCTION: Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. METHODS: The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). RESULTS: The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. CONCLUSIONS: This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.
Published: 2007
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44. Does catheter-associated urinary tract infection increase mortality in critically ill patients?

Author: Jean-Philippe Fosse, Samir Jamali, Dany Toledano, Yves Cohen, Christophe Clec’h, Elie Azoulay, Adrien Français, Christophe Adrie, Jean-François Timsit, Adrien Descorps-Declere, Carole Schwebel, Maité Garrouste-Orgeas, Didier Nakache, Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Medical-Surgical ICU, Hôpital de Gonesse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Saint Joseph, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de réanimation chirurgicale [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Hôpital de Dourdan, Medical - Surgical ICU, CHU CLAMART, Centre d'enseignement Cnam Paris (CNAM Paris), Conservatoire National des Arts et Métiers [CNAM] (CNAM), INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], 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), Vesin, Aurélien, Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Albert Michallon, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Hôpital Saint Joseph, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Antoine Béclère, Conservatoire National des Arts et Métiers - Paris ( CNAM Paris ), Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Clinique de réanimation médicale, and Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Albert Michallon-Hôpital Albert Michallon
Subjects: Male, Pediatrics, MESH : Retrospective Studies, Epidemiology, MESH : Aged, MESH: Urinary Tract Infections, MESH : Critical Illness, Severity of Illness Index, law.invention, law, MESH : Urinary Tract Infections, MESH : Female, Hospital Mortality, Simplified Acute Physiology Score, MESH: Aged, education.field_of_study, Cross Infection, MESH: Middle Aged, Incidence (epidemiology), [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Intensive care unit, MESH: Case-Control Studies, 3. Good health, Intensive Care Units, Infectious Diseases, Cohort, MESH: Critical Illness, Urinary Tract Infections, MESH : Severity of Illness Index, Female, France, MESH : Intensive Care Units, MESH : Cross Infection, Microbiology (medical), MESH : Case-Control Studies, medicine.medical_specialty, MESH : Male, Critical Illness, Population, MESH : Hospital Mortality, MESH: Severity of Illness Index, Severity of illness, medicine, Humans, MESH : Middle Aged, MESH: Hospital Mortality, MESH : France, education, Aged, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, MESH: Cross Infection, Retrospective cohort study, MESH: Retrospective Studies, Odds ratio, MESH: Male, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Objective.To produce an accurate estimate of the association between catheter-associated urinary tract infection (UTI) and intensive care unit (ICU) and hospital mortality, controlling for major confounding factors.Design.Nested case-control study in a multicenter cohort (the OutcomeRea database).Setting.Twelve French medical or surgical ICUs.Methods.All patients admitted between January 1997 and August 2005 who required the insertion of an indwelling urinary catheter. Patients who developed catheter-associated UTI (ie, case patients) were matched to control patients on the basis of the following criteria: sex, age ( ± 10 years), SAPS (Simplified Acute Physiology Score) II score ( ± 10 points), duration of urinary tract catheterization, and presence or absence of diabetes mellitus. The association of catheter-associated UTI with ICU and hospital mortality was assessed by use of conditional logistic regression.Results.Of the 3,281 patients who had an indwelling urinary catheter, 298 (9%) developed at least 1 episode of catheter-associated UTI. The incidence density of catheter-associated UTI was 12.9 infections per 1,000 catheterization-days. Crude ICU mortality rates were higher among patients with catheter-associated UTI, compared with those without catheter-associated UTI (32% vs 25%, P = .02); the same was true for crude hospital mortality rates (43% vs 30%, P>.01). After matching and adjustment, catheter-associated UTI was no longer associated with increased mortality (ICU mortality: odds ratio [OR], 0.846 [95% confidence interval {CI}, 0.659-1.086]; P = .19 and hospital mortality: OR, 0.949 [95% CI, 0.763-1.181]; P = .64).Conclusion.After carefully controlling for confounding factors, catheter-associated UTI was not found to be associated with excess mortality among our population of critically ill patients in either the ICU or the hospital.
Published: 2007
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45. Economic impact of simplified de Gramont regimen in first-line therapy in metastatic colorectal cancer

Author: Christine Legat-Fagnoni, Samuel Limat, Claire-Hélène Bracco-Nolin, Bernard Huchet, Xavier Pivot, Ulrich Stein, Marie-Christine Woronoff-Lemsi, Loic Chaigneau, Département de pharmacie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Recherches épidémiologiques et cliniques en cancérologie digestive, Université de Bourgogne (UB)-IFR100 - Structure fédérative de recherche Santé-STIC-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Caisse régionale d'assurance maladie (CPAM), CPAM, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Université de Bourgogne ( UB ) -IFR100 - Structure fédérative de recherche Santé-STIC-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'oncologie Médicale, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Caisse régionale d'assurance maladie ( CPAM ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC)
Subjects: Male, Organoplatinum Compounds, MESH : Retrospective Studies, MESH : Antineoplastic Combined Chemotherapy Protocols, Colorectal cancer, medicine.medical_treatment, Economics, Econometrics and Finance (miscellaneous), Leucovorin, MESH : Aged, MESH : Camptothecin, MESH : Leucovorin, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH : Health Services, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, MESH : Female, Neoplasm Metastasis, health care economics and organizations, MESH: Aged, MESH: Middle Aged, MESH: Health Services, 030503 health policy & services, Health Policy, MESH: Organoplatinum Compounds, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Health Care Costs, Health Services, Middle Aged, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, 030220 oncology & carcinogenesis, MESH : Neoplasm Metastasis, MESH : Fluorouracil, MESH: Camptothecin, Female, Fluorouracil, MESH : Colorectal Neoplasms, Colorectal Neoplasms, 0305 other medical science, MESH : Health Care Costs, medicine.drug, medicine.medical_specialty, MESH : Male, MESH : Drug Administration Schedule, MESH: Health Care Costs, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Drug Administration Schedule, MESH : Organoplatinum Compounds, Drug Administration Schedule, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, FOLFIRI Regimen, Humans, MESH : Middle Aged, Intensive care medicine, Adverse effect, Aged, Retrospective Studies, Chemotherapy, MESH: Humans, business.industry, MESH : Humans, Retrospective cohort study, MESH: Retrospective Studies, medicine.disease, MESH: Neoplasm Metastasis, MESH: Male, Oxaliplatin, Irinotecan, Regimen, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Camptothecin, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Leucovorin, MESH: Female, MESH: Fluorouracil, MESH: Colorectal Neoplasms
Abstract: International audience; The cost of chemotherapy has dramatically increased in advanced colorectal cancer patients, and the schedule of fluorouracil administration appears to be a determining factor. This retrospective study compared direct medical costs related to two different de Gramont schedules (standard vs. simplified) given in first-line chemotherapy with oxaliplatin or irinotecan. This cost-minimization analysis was performed from the French Health System perspective. Consecutive unselected patients treated in first-line therapy by LV5FU2 de Gramont with oxaliplatin (Folfox regimen) or with irinotecan (Folfiri regimen) were enrolled. Hospital and outpatient resources related to chemotherapy and adverse events were collected from 1999 to 2004 in 87 patients. Overall cost was reduced in the simplified regimen. The major factor which explained cost saving was the lower need for admissions for chemotherapy. Amount of cost saving depended on the method for assessing hospital stay. In patients treated by the Folfox regimen the per diem and DRG methods found cost savings of Euro 1,997 and Euro 5,982 according to studied schedules; in patients treated by Folfiri regimen cost savings of Euro 4,773 and Euro 7,274 were observed, respectively. In addition, travel costs were also reduced by simplified regimens. The robustness of our results was showed by one-way sensitivity analyses. These findings demonstrate that the simplified de Gramont schedule reduces costs of current first-line chemotherapy in advanced colorectal cancer. Interestingly, our study showed several differences in costs between two costing approaches of hospital stay: average per diem and DRG costs. These results suggested that standard regimen may be considered a profitable strategy from the hospital perspective. The opposition between health system perspective and hospital perspective is worth examining and may affect daily practices. In conclusion, our study shows that the simplified de Gramont schedule in combination with oxaliplatin or irinotecan is an attractive option from the French Health System perspective. This safe and less costly regimen must compared to alternative options such as oral fluoropyrimidines.
Published: 2006
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46. A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000

Author: B. Ladeuil, Fabienne Bon, M. Cournot, Francis Mégraud, P. Le Cann, Anne Gallay, H de Valk, Jean-Claude Desenclos, C Castor, C. Hemery, De´partement Maladies Infectieuses, Unite´ Infections Ente´riques, Alimentaires et Zoonoses ( INVS ), Institut de Veille Sanitaire (INVS), Cellule Inter Régionale de l'Epidémiologie d'Intervention du Sud Ouest ( CIRE Sud Ouest ), Direction Départementale de l'Agriculture et de la Forêt du Lot, Laboratoire Interactions Muqueuses Agents Transmissibles ( LIMA ), Université de Bourgogne ( UB ), Centre National de Référence des Campylobacters et Hélicobacters ( CNR Campylobacters et Hélicobacters ), CHU Bordeaux [Bordeaux], Laboratoire de Microbiologie, IFREMER, Institut Français de Recherche pour l'Exploitation de la Mer ( IFREMER ), De´partement Maladies Infectieuses, Unite´ Infections Ente´riques, Alimentaires et Zoonoses (INVS), Cellule Inter Régionale de l'Epidémiologie d'Intervention du Sud Ouest (CIRE Sud Ouest), Laboratoire Interactions Muqueuses Agents Transmissibles (LIMA), Université de Bourgogne (UB), Centre National de Référence des Campylobacters et Hélicobacters (CNR Campylobacters et Hélicobacters), and Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)
Subjects: Rotavirus, MESH : Retrospective Studies, Epidemiology, MESH : Aged, Disease Outbreaks, Feces, 0302 clinical medicine, MESH : Child, Surveys and Questionnaires, MESH: Child, Campylobacter Infections, Medicine, Child, MESH: Water Supply, Caliciviridae Infections, 0303 health sciences, MESH: Middle Aged, MESH: Feces, General Medicine, MESH: Rotavirus, 3. Good health, MESH : Gastroenteritis, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Child, Preschool, gastroenteritis, Microbiology (medical), MESH: Norovirus, medicine.medical_specialty, MESH : Campylobacter Infections, norovirus, MESH : Cohort Studies, Microbiology, 03 medical and health sciences, Water Supply, MESH : Adolescent, Humans, MESH : Middle Aged, MESH : Disease Outbreaks, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, 030306 microbiology, MESH: Questionnaires, MESH : Water Microbiology, MESH: Child, Preschool, MESH : Humans, Outbreak, MESH: Adult, MESH: Retrospective Studies, MESH: Campylobacter coli, Waterborne outbreak, MESH: Gastroenteritis, MESH: Water Microbiology, MESH : Campylobacter coli, rotavirus, Campylobacter coli, MESH : Child, Preschool, medicine.disease_cause, Cohort Studies, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, waterborne outbreak, 030212 general & internal medicine, MESH: Disease Outbreaks, MESH: Cohort Studies, MESH: Caliciviridae Infections, MESH: Aged, biology, Campylobacter, MESH : Questionnaires, Middle Aged, MESH: Rotavirus Infections, MESH : Adult, Gastroenteritis, Infectious Diseases, epidemiology, France, MESH : Caliciviridae Infections, Water Microbiology, Adult, Adolescent, MESH : Rotavirus, Rotavirus Infections, MESH: Campylobacter Infections, MESH : Water Supply, Environmental health, MESH : Rotavirus Infections, MESH : France, business.industry, MESH : Norovirus, Norovirus, Retrospective cohort study, MESH : Feces, biology.organism_classification, MESH: France, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; A large waterborne outbreak of infection that occurred during August 2000 in a local community in France was investigated initially via a rapid survey of visits to local physicians. A retrospective cohort study was then conducted on a random cluster sample of residents. Of 709 residents interviewed, 202 (28.5%) were definite cases (at least three liquid stools/day or vomiting) and 62 (8.7%) were probable cases (less than three liquid stools/day or abdominal pain). Those who had drunk tap water had a three-fold increased risk for illness (95% CI 2.4-4.0). The risk increased with the amount of water consumed (chi-square trend: p < 0.0001). Bacteriological analyses of stools were performed for 35 patients and virological analyses for 24 patients. Campylobacter coli, group A rotavirus and norovirus were detected in 31.5%, 71.0% and 21% of samples, respectively. An extensive environmental investigation concluded that a groundwater source to this community had probably been contaminated by agricultural run-off, and a failure in the chlorination system was identified. This is the first documented waterborne outbreak of infection involving human C. coli infections. A better understanding of the factors influencing campylobacter transmission between hosts is required.
Published: 2006
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47. Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC

Author: Emmanuelle Jeannot, Charles Balabaud, Yannick Bacq, Jeanne Tran Van Nhieu, Emmanuelle Leteurtre, Paulette Bioulac-Sage, Dominique Wendum, Lucille Mellottee, Denis Castaing, Laurence Chiche, Jessica Zucman-Rossi, Christian Partensky, Elie Serge Zafrani, Sandra Rebouissou, Christophe Laurent, Monique Fabre, Valérie Paradis, Jean-Yves Scoazec, Sophie Michalak, Pierre Laurent-Puig, Catherine Guettier, Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Service de gastro-entérologie [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Hôpital Saint-André, Toxicologie Moleculaire (U490), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fibrose hépatique et cancer du foie, Université Bordeaux Segalen - Bordeaux 2-IFR66-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, The authors thank Leigh Pascoe for critical reading of the manuscript. We thank all the other participants to the GENTHEP (Groupe d'e´tude Ge´ne´tique des Tumeurs He´patiques) network: Michel Beaugrand, Jordi Bruix, Christine Bellanne´e-Chantelot, Jacques Belghiti, Jean Fre´de´ric Blanc, Pascal Bourlier, Paul Cale`s, Chen Liu, Marie Pierre Chenard-Neu, Daniel Cherqui, Vale´rie Costes, Thong Dao, Daniel Dhumeaux, Amar Paul Dhillon, Je´roˆme Dumortier, Olivier Ernst, Dominique Franco, Fre´de´ric Gauthier, Jean Gugenheim, Emmanuel Jacquemin, Daniel Jaeck, Brigitte Le Bail, Se´- bastien Lepreux, Anne de Muret, Fre´de´ric Oberti, Danielle Pariente, Franc¸ois Paye, Franc¸ois-Rene´ Pruvost, Alberto Quaglia, Pierre Rousselot, Antonio Sa Cunha, Marie Christine Saint-Paul, Jean Saric, Pierre Rousselot, Anne Rullier, Janick Selves, Nathalie Sturm. We thank the technicians from the CEPH, Fondation Jean Dausset for their help in sequencing and all the clinicians that referred the patients., Zucman-Rossi, Jessica, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Genomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -IFR105-Université Paris Diderot - Paris 7 ( UPD7 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse, Service de gastro-entérologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Beaujon, Centre Hospitalier Universitaire d'Angers ( CHU Angers ), PRES Université Nantes Angers Le Mans ( UNAM ), Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, CHU Bordeaux [Bordeaux]-Hôpital Saint -André, Toxicologie Moleculaire, Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Université Bordeaux Segalen - Bordeaux 2-IFR66-Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Male, Pathology, MESH : Liver Neoplasms, MESH : Retrospective Studies, MESH: beta Catenin, MESH : Aged, MESH : Genotype, Malignant transformation, MESH: Genotype, MESH: Adenoma, Liver Cell, 0302 clinical medicine, MESH: Liver Neoplasms, MESH : Female, Hepatocyte Nuclear Factor 1-alpha, MESH: Carcinoma, Hepatocellular, beta Catenin, MESH: Aged, MESH: Middle Aged, Liver Neoplasms, MESH : Adult, Middle Aged, 3. Good health, MESH : Phenotype, Phenotype, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, MESH : Hepatocyte Nuclear Factor 1-alpha, [ SDV.MHEP.HEG ] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Female, 030211 gastroenterology & hepatology, MESH : Mutation, MESH : Carcinoma, Hepatocellular, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, MESH: Mutation, Adolescent, Genotype, Adenoma, MESH : Male, Biology, MESH: Phenotype, Adenoma, Liver Cell, 03 medical and health sciences, MESH : Adenoma, Liver Cell, MESH : Adolescent, medicine, Carcinoma, Humans, MESH : Middle Aged, MESH: Hepatocyte Nuclear Factor 1-alpha, Pathological, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, Hepatology, MESH : Humans, MESH: Retrospective Studies, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatocellular adenoma, MESH : beta Catenin, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, digestive system diseases, MESH: Male, Mutation, Inflammatory Hepatocellular Adenoma, Steatosis, MESH: Female
Abstract: Hepatocellular adenomas are benign tumors that can be difficult to diagnose. To refine their classification, we performed a comprehensive analysis of their genetic, pathological, and clinical features. A multicentric series of 96 liver tumors with a firm or possible diagnosis of hepatocellular adenoma was reviewed by liver pathologists. In all cases, the genes coding for hepatocyte nuclear factor 1alpha (HNF1alpha) and beta-catenin were sequenced. No tumors were mutated in both HNF1alpha and beta-catenin enabling tumors to be classified into 3 groups, according to genotype. Tumors with HNF1alpha mutations formed the most important group of adenomas (44 cases). They were phenotypically characterized by marked steatosis (P < 10(-4)), lack of cytological abnormalities (P < 10(-6)), and no inflammatory infiltrates (P < 10(-4)). In contrast, the group of tumors defined by beta-catenin activation included 13 lesions with frequent cytological abnormalities and pseudo-glandular formation (P < 10(-5)). The third group of tumors without mutation was divided into two subgroups based on the presence of inflammatory infiltrates. The subgroup of tumors consisting of 17 inflammatory lesions, resembled telangiectatic focal nodular hyperplasias, with frequent cytological abnormalities (P = 10(-3)), ductular reaction (P < 10(-2)), and dystrophic vessels (P = .02). In this classification, hepatocellular carcinoma associated with adenoma or borderline lesions between carcinoma and adenoma is found in 46% of the beta-catenin-mutated tumors whereas they are never observed in inflammatory lesions and are rarely found in HNF1alpha mutated tumors (P = .004). In conclusion, the molecular and pathological classification of hepatocellular adenomas permits the identification of strong genotype-phenotype correlations and suggests that adenomas with beta-catenin activation have a higher risk of malignant transformation.
Published: 2006
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48. Primary lymphoma of the lacrimal sac: an EORTC ophthalmic oncology task force study

Author: Elisabeth Ralfkiaer, Birgitte R Juhl, Franck Bacin, Peter Meyer, Tero Kivelä, B. Kantelip, Claudia Auw-Haedrich, Steffen Heegaard, Nicolas Ducrey, Marta Carrera, Sarah E. Coupland, Jan Ulrik Prause, Nicolai Christian Sjö, Lene Dissing Sjö, Jean Louis Kemeny, Bernard Delbosc, Eye Pathology Institute, University of Copenhagen ( KU ), Department of Pathology, Rigshospitalet [Copenhagen], Department of Ophthalmology, Helsinki University Central Hospital, University Hospital in Freiburg, Service d'ophtalmologie [Clermont-Ferrand], CHU Clermont-Ferrand, Department of Ophthalmic Pathology, Hospital of Bellvitge-University of Barcelona, Department of Cellular and Molecular Pathology, University of Liverpool, Service d'ophtalmologie [Besançon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Jules Gonin Hospital, Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire de pathologie, University of Basle, European Organization for Research and Treatment of Cancer, University of Copenhagen = Københavns Universitet (KU), Copenhagen University Hospital-Copenhagen University Hospital, Service d'ophtalmologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Anatomie pathologique [CHRU Besançon], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), University of Copenhagen = Københavns Universitet (UCPH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), and Saas, Philippe
Subjects: Oncology, Pathology, MESH : Retrospective Studies, MESH : Aged, MESH: Antigens, Neoplasm, MESH : Lymphoma, Large B-Cell, Diffuse, MESH : Antigens, Neoplasm, MESH: Aged, 80 and over, MESH : Lymphoma, B-Cell, 0302 clinical medicine, immune system diseases, hemic and lymphatic diseases, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH : Female, MESH: Lymphoma, B-Cell, Marginal Zone, MESH: Antigens, CD, MESH: Aged, MESH: Middle Aged, MALT lymphoma, Sensory Systems, Lacrimal sac, 3. Good health, MESH : Lymphoma, B-Cell, Marginal Zone, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH : Male, MESH: Lacrimal Apparatus Diseases, Lacrimal gland, Ophthalmic pathology, 03 medical and health sciences, Cellular and Molecular Neuroscience, Internal medicine, MESH : Antigens, CD, medicine, MESH : Middle Aged, MESH : Aged, 80 and over, MESH: Lymphoma, B-Cell, MESH : Lacrimal Apparatus Diseases, MESH: Humans, business.industry, Clinical Science - Extended Report, MESH : Humans, Cancer, MESH: Retrospective Studies, medicine.disease, MESH: Male, Dacryocystitis, Lymphoma, Ophthalmology, 030221 ophthalmology & optometry, MESH: Lymphoma, Large B-Cell, Diffuse, Tears, business, MESH: Female, Diffuse large B-cell lymphoma, Mucosa-associated lymphoid tissue
Abstract: International audience; AIM: To define the clinical and histopathological characteristics of primary lacrimal sac lymphoma in a predominantly white population. METHODS: Specimens of lacrimal sac lymphoma and follow up data were solicited from members of the Ophthalmic Oncology Task Force of the European Organization for Research and Treatment of Cancer (EORTC) and the European Ophthalmic Pathology Society (EOPS). Specimens were stained with haematoxylin and eosin and an immunohistochemical panel against leucocyte antigens was applied. Diagnosis was reached by consensus of five experienced pathologists according to the World Health Organization classification system. The histopathological findings were correlated with the clinical data. RESULTS: Of 15 primary lacrimal sac lymphomas, five (33%) were diffuse large B cell lymphoma (DLBCL), five (33%) were extranodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT lymphoma), three were classified as "transitional MALT lymphoma," being in transition from MALT lymphoma to DLBCL, and two were unclassified B cell lymphomas. Nine of the patients were female, and the median age at the time of diagnosis was 71 years (range 45-95 years). The most frequent presenting symptoms were epiphora (85%), swelling in the region of the lacrimal sac (79%), and dacryocystitis (21%). All but one patient presented in stage I. Systemic spread occurred in three of nine patients (33%). The 5 year overall survival was 65%. CONCLUSIONS: DLBCL and MALT lymphoma are equally common in the lacrimal sac in contrast with the remaining periorbital and/or orbital region where MALT lymphoma predominates.
Published: 2006
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49. Acute respiratory failure in kidney transplant recipients: a multicenter study

Author: Georges Mourad, Jean-François Timsit, Benoît Schlemmer, Maryvonne Hourmant, David Osman, Denis Glotz, Bertrand Souweine, Anne-Elisabeth Heng, Antoine Durrbach, Christophe Guitton, Kada Klouche, Elie Azoulay, Christophe Legendre, Laurent Argaud, Jérôme Lambert, Eric Rondeau, Emmanuel Canet, Medical Intensive Care Unit and Biostatistics Departments, Saint-Louis Teaching Hospital, Service de Réanimation Médicale, Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Service de Pédiatrie spécialisée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service de néphrologie adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de néphrologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Medical ICU, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CHU Necker - Enfants Malades [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)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Bioenergétique fondamentale et appliquée ( LBFA ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de transplantation urologie-néphrologie ( ITUN ), Université de Nantes ( UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Laboratoire Microorganismes : Génome et Environnement ( LMGE ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ) -Université d'Auvergne - Clermont-Ferrand I ( UdA ), and Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
Subjects: Graft Rejection, Male, ARDS, MESH : Retrospective Studies, medicine.medical_treatment, MESH : Aged, 030230 surgery, Pneumocystis pneumonia, Critical Care and Intensive Care Medicine, law.invention, MESH: Kidney Transplantation, 0302 clinical medicine, law, MESH : Female, 030212 general & internal medicine, Hospital Mortality, Kidney transplantation, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Mortality rate, MESH : Acute Disease, MESH: Follow-Up Studies, Middle Aged, Intensive care unit, 3. Good health, Intensive Care Units, Treatment Outcome, Acute Disease, MESH: Acute Disease, Female, Respiratory Insufficiency, MESH : Intensive Care Units, medicine.medical_specialty, MESH : Male, MESH: Graft Rejection, MESH : Treatment Outcome, MESH : Hospital Mortality, 03 medical and health sciences, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Hospital Mortality, Dialysis, Aged, Retrospective Studies, MESH: Humans, business.industry, Research, MESH : Humans, Bacterial pneumonia, MESH : Graft Rejection, MESH : Follow-Up Studies, MESH: Retrospective Studies, MESH : Respiratory Insufficiency, medicine.disease, Kidney Transplantation, MESH: Male, Surgery, Transplantation, MESH : Kidney Transplantation, MESH: Intensive Care Units, business, MESH: Female, MESH: Respiratory Insufficiency, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; INTRODUCTION: Data on pulmonary complications in renal transplant recipients are scarce. The aim of this study was to evaluate acute respiratory failure (ARF) in renal transplant recipients. METHODS: We conducted a retrospective observational study in nine transplant centers of consecutive kidney transplant recipients admitted to the intensive care unit (ICU) for ARF from 2000 to 2008. RESULTS: Of 6,819 kidney transplant recipients, 452 (6.6%) required ICU admission, including 200 admitted for ARF. Fifteen (7.5%) of these patients had combined kidney-pancreas transplantations. The most common causes of ARF were bacterial pneumonia (35.5%), cardiogenic pulmonary edema (24.5%) and extrapulmonary acute respiratory distress syndrome (ARDS) (15.5%). Pneumocystis pneumonia occurred in 11.5% of patients. Mechanical ventilation was used in 93 patients (46.5%), vasopressors were used in 82 patients (41%) and dialysis was administered in 104 patients (52%). Both the in-hospital and 90-day mortality rates were 22.5%. Among the 155 day 90 survivors, 115 patients (74.2%) were dialysis-free, including 75 patients (65.2%) who recovered prior renal function. Factors independently associated with in-hospital mortality were shock at admission (odds ratio (OR) 8.70, 95% confidence interval (95% CI) 3.25 to 23.29), opportunistic fungal infection (OR 7.08, 95% CI 2.32 to 21.60) and bacterial infection (OR 2.53, 95% CI 1.07 to 5.96). Five factors were independently associated with day 90 dialysis-free survival: renal Sequential Organ Failure Assessment (SOFA) score on day 1 (OR 0.68/SOFA point, 95% CI 0.52 to 0.88), bacterial infection (OR 0.43, 95% CI 0.21 to 0.90), three or four quadrants involved on chest X-ray (OR 0.44, 95% CI 0.21 to 0.91), time from hospital to ICU admission (OR 0.98/day, 95% CI 0.95 to 0.99) and oxygen flow at admission (OR 0.93/liter, 95% CI 0.86 to 0.99). CONCLUSIONS: In kidney transplant recipients, ARF is associated with high mortality and graft loss rates. Increased Pneumocystis and bacterial prophylaxis might improve these outcomes. Early ICU admission might prevent graft loss.
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