9 results on '"Jean-Philippe Lanoix"'
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2. One Hundred Explicit Definitions of Potentially Inappropriate Prescriptions of Antibiotics in Hospitalized Older Patients: The Results of an Expert Consensus Study
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Nicolas Baclet, Emmanuel Forestier, Gaëtan Gavazzi, Claire Roubaud-Baudron, Vincent Hiernard, Rozenn Hequette-Ruz, Serge Alfandari, Hugues Aumaître, Elisabeth Botelho-Nevers, Pauline Caraux-Paz, Alexandre Charmillon, Sylvain Diamantis, Thibaut Fraisse, Pierre Gazeau, Maxime Hentzien, Jean-Philippe Lanoix, Marc Paccalin, Alain Putot, Yvon Ruch, Eric Senneville, and Jean-Baptiste Beuscart
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antimicrobial resistance ,elderly ,inappropriate prescription ,antibiotic stewardship ,hospital setting ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: In geriatrics, explicit criteria for potentially inappropriate prescriptions (PIPs) are useful for optimizing drug use. Objective: To produce an expert consensus on explicit definitions of antibiotic-PIPs for hospitalized older patients. Methods: We conducted a Delphi survey involving French experts on antibiotic stewardship in hospital settings. During the survey’s rounds, the experts gave their opinion on each explicit definition, and could suggest new definitions. Definitions with a 1-to-9 Likert score of between 7 and 9 from at least 75% of the participants were adopted. The results were discussed during consensus meetings after each round. Results: Of the 155 invited experts, 128 (82.6%) participated in the whole survey: 59 (46%) infectious diseases specialists, 45 (35%) geriatricians, and 24 (19%) other specialists. In Round 1, 65 explicit definitions were adopted and 21 new definitions were suggested. In Round 2, 35 other explicit definitions were adopted. The results were validated during consensus meetings (with 44 participants after Round 1, and 54 after Round 2). Conclusions: The present study is the first to have provided a list of explicit definitions of potentially inappropriate antibiotic prescriptions for hospitalized older patients. It might help to disseminate key messages to prescribers and reduce inappropriate prescriptions of antibiotics.
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- 2024
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3. Number of initial symptoms is more related to long COVID-19 than acute severity of infection: a prospective cohort of hospitalized patients
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Adrien Chan Sui Ko, Alexandre Candellier, Marie Mercier, Cédric Joseph, Jean-Luc Schmit, Jean-Philippe Lanoix, and Claire Andrejak
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COVID-19 ,Persistent symptoms ,Long COVID ,Risk factor ,Severity ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objectives: Post–COVID-19 symptoms experienced by many survivors have a further devastating effect. This study aimed to analyze the risk factors associated with long COVID-19 in a prospective cohort of hospitalized patients including those requiring intensive care unit (ICU) transfer, taking into account objective measures of COVID-19 severity. Methods: Hospitalized patients with confirmed COVID-19 were enrolled. A structured follow-up visit was performed 4 months after hospital admission. Multivariable adjusted regression models were used to analyse the association between parameters at the acute phase and persistent symptoms. Results: A follow-up visit was performed in 316 patients including 115 (36.4%) discharged from the ICU. Mean age was 64.1 years, and 201 patients (58.3%) were men. Female sex (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.17-3.22; P =.01), hypertension (OR, 2.01; 95% CI, 1.22-3.31; P
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- 2022
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4. Plasma Markers of Neutrophil Extracellular Trap Are Linked to Survival but Not to Pulmonary Embolism in COVID-19-Related ARDS Patients
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Renaud Prével, Annabelle Dupont, Sylvie Labrouche-Colomer, Geoffrey Garcia, Antoine Dewitte, Antoine Rauch, Julien Goutay, Morgan Caplan, Elsa Jozefowicz, Jean-Philippe Lanoix, Julien Poissy, Etienne Rivière, Arthur Orieux, Denis Malvy, Didier Gruson, Loic Garçon, Sophie Susen, and Chloé James
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neutrophil extracellular trap ,acute respiratory distress syndrome ,COVID-19 ,immunothrombosis ,pulmonary embolism ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionCoronavirus disease 2019 (COVID-19) can cause life-threatening acute respiratory distress syndrome (ARDS). Recent data suggest a role for neutrophil extracellular traps (NETs) in COVID-19-related lung damage partly due to microthrombus formation. Besides, pulmonary embolism (PE) is frequent in severe COVID-19 patients, suggesting that immunothrombosis could also be responsible for increased PE occurrence in these patients. Here, we evaluate whether plasma levels of NET markers measured shorty after admission of hospitalized COVID-19 patients are associated with clinical outcomes in terms of clinical worsening, survival, and PE occurrence.Patients and MethodsNinety-six hospitalized COVID-19 patients were included, 50 with ARDS (severe disease) and 46 with moderate disease. We collected plasma early after admission and measured 3 NET markers: total DNA, myeloperoxidase (MPO)–DNA complexes, and citrullinated histone H3. Comparisons between survivors and non-survivors and patients developing PE and those not developing PE were assessed by Mann–Whitney test.ResultsAnalysis in the whole population of hospitalized COVID-19 patients revealed increased circulating biomarkers of NETs in patients who will die from COVID-19 and in patients who will subsequently develop PE. Restriction of our analysis in the most severe patients, i.e., the ones who enter the hospital for COVID-19-related ARDS, confirmed the link between NET biomarker levels and survival but not PE occurrence.ConclusionOur results strongly reinforce the hypothesis that NETosis is an attractive therapeutic target to prevent COVID-19 progression but that it does not seem to be linked to PE occurrence in patients hospitalized with COVID-19.
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- 2022
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5. Mortality risk and antibiotic use for COVID-19 in hospitalized patients over 80
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Andreea Rosca, Thibaut Balcaen, Audrey Michaud, Jean-Philippe Lanoix, Julien Moyet, Ingrid Marcq, Jean-Luc Schmit, Frederic Bloch, and Guillaume Deschasse
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COVID-19 ,Mortality ,Hospitalisation ,Elderly ,Antibiotics use ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Introduction: Patients over 80 years of age are more prone to develop severe symptoms and die from COVID-19. Antibiotics were massively prescribed in the first days of the pandemic without evidence of super infection. Antibiotics may increase the risk of mortality in cases of viral pneumonia. With age and antibiotic use, the microbiota becomes altered and less protective effect against lethal viral pneumonia. Thus we assessed whether it is safe to prescribe antibiotics for COVID-19 pneumonia to patients over 80 years of age. Method: We conducted a retrospective monocentric study in a 1240-bed university hospital. Our inclusion criteria were patients aged ≥ 80 years, hospitalized in a COVID-19 unit, with either a positive SARS-CoV-2 RT-PCR from a nasopharyngeal swab or a CT scan within 72 h after or prior to hospitalization in the unit suggestive of infection. Results: We included 101 patients who received antibiotics and 48 who did not. The demographics in the two groups were similar. Overall mortality was higher for the group that received antibiotics than for the other group (36.6% vs 14.6%,). According to univariate COX analysis, the risk of mortality was higher (HR = 1.98 [0.926; 4.23]) but non-significantly for the antibiotic group. In multivariate analysis, independent risk factors of mortality were an increased leukocyte count and decreased oxygen saturation (HR = 1.097 [1.022; 1.178] and HR = 0.927 [0.891; 0.964], respectively). Conclusion: This study raises questions about the interest of antibiotic therapy, its efficacy, and its effect on COVID-19 and encourages further research.
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- 2022
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6. Cytomegalovirus-Associated Gianotti-Crosti Syndrome in 28-Year-Old Immunocompetent Patient
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Florence Dupont, Aurélien Aubry, Jean-Philippe Lanoix, and Baptiste Demey
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Cytomegalovirus ,Gianotti-Crosti ,acrodermatitis ,CMV ,Medicine - Abstract
Gianotti-Crosti syndrome is a cutaneous eruption that occurs rarely in adults. It mostly concerns pediatric population and immunocompromised patients. Cytomegalovirus has already been described as one etiology of Gianotti-Crosti acrodermatitis in children and bone-marrow transplanted patients. Here, we present a Cytomegalovirus-associated Gianotti-Crosti syndrome in a 28-year-old immunocompetent female patient diagnosed in CHU Amiens-Picardie (Amiens, France). This type of case has never been shared in literature before. This rare complication of Cytomegalovirus infection indirectly led to disruption of anticoagulant treatment and thromboembolic incident that could have been fatal.
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- 2022
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7. Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France
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Isabelle Bonnet, Elie Haddad, Lorenzo Guglielmetti, Pascale Bémer, Louis Bernard, Anne Bourgoin, Rachel Brault, Gaud Catho, Eric Caumes, Lélia Escaut, Eric Fourniols, Mathilde Fréchet-Jachym, Alice Gaudart, Hélène Guillot, Barthélémy Lafon-Desmurs, Jean-Philippe Lanoix, Philippe Lanotte, Adrien Lemaignen, Bénédicte Lemaire, Nadine Lemaitre, Christophe Michau, Philippe Morand, Faiza Mougari, Dhiba Marigot-Outtandy, Solène Patrat-Delon, Thomas Perpoint, Caroline Piau, Valérie Pourcher, Virginie Zarrouk, Valérie Zeller, Nicolas Veziris, Stéphane Jauréguiberry, and Alexandra Aubry
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MDR-TB ,XDR-TB ,bone ,spinal ,Biology (General) ,QH301-705.5 - Abstract
The optimal treatment for osteoarticular infection due to multidrug-resistant tuberculosis strains (MDR-OATB) remains unclear. This study aims to evaluate the diagnosis, management and outcome of MDR-OATB in France. We present a case series of MDR-OATB patients reviewed at the French National Reference Center for Mycobacteria between 2007 and 2018. Medical history and clinical, microbiological, treatment and outcome data were collected. Twenty-three MDR-OATB cases were reported, representing 3% of all concurrent MDR-TB cases in France. Overall, 17 were male, and the median age was 32 years. Six patients were previously treated for TB, including four with first-line drugs. The most frequently affected site was the spine (n = 16). Bone and joint surgery were required in 12 patients. Twenty-one patients (91%) successfully completed the treatment with a regimen containing a mean of four drugs (range, 2–6) for a mean duration of 20 months (range, 13–27). Overall, high rates of treatment success were achieved following WHO MDR-TB treatment guidelines and individualized patient management recommendations by the French National TB Consilium. However, the optimal combination of drugs, duration of treatment and role of surgery in the management of MDR-OATB remains to be determined.
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- 2022
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8. Therapeutic Options for Coronavirus Disease 2019 (COVID-19) - Modulation of Type I Interferon Response as a Promising Strategy?
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Aurélien Mary, Lucie Hénaut, Jean-Luc Schmit, Jean-Philippe Lanoix, and Michel Brazier
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COVID-19 ,SARS-CoV-2 ,type I interferon ,azithromycin ,hydroxychloroquine ,Public aspects of medicine ,RA1-1270 - Published
- 2020
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9. Heterogeneous disease progression and treatment response in a C3HeB/FeJ mouse model of tuberculosis
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Jean-Philippe Lanoix, Anne J. Lenaerts, and Eric L. Nuermberger
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Tuberculosis ,C3HeB/FeJ ,Heterogeneity ,pH ,Pyrazinamide ,Medicine ,Pathology ,RB1-214 - Abstract
Mice are the most commonly used species for non-clinical evaluations of drug efficacy against tuberculosis (TB). Unlike commonly used strains, C3HeB/FeJ mice develop caseous necrosis in the lung, which might alter the representation of drug efficacy in a way that is more like human TB. Because the development of such pathology requires time, we investigated the effect of infection incubation period on the activity of six drugs in C3HeB/FeJ and BALB/c mice. Mice were aerosol infected and held for 6, 10 or 14 weeks before receiving therapy with rifampin (RIF), rifapentine (RPT), pyrazinamide (PZA), linezolid (LZD), sutezolid (PNU) or metronidazole (MTZ) for 4-8 weeks. Outcomes included pathological assessments, pH measurements of liquefied caseum and assessment of colony-forming unit (CFU) counts from lung cultures. Remarkable heterogeneity in the timing and extent of disease progression was observed in C3HeB/FeJ mice, largely independent of incubation period. Likewise, drug efficacy in C3HeB/FeJ mice was not affected by incubation period. However, for PZA, LZD and PNU, dichotomous treatment effects correlating with the presence or absence of large caseous lesions were observed. In the case of PZA, its poor activity in the subset of C3HeB/FeJ mice with large caseous lesions might be explained by the pH of 7.36±0.09 measured in liquefied caseum. This study highlights the potential value of C3HeB/FeJ mice for non-clinical efficacy testing, especially for investigating the interaction of lesion pathology and drug effect. Careful use of this model could enhance the bridging of non-clinical results with clinical outcomes.
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- 2015
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