Author: "Nicolas, Belhomme" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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1. Efficacy of valaciclovir in preventing herpes zoster in patients receiving anifrolumab

Author: Zahir Amoura, Nathalie Costedoat-Chalumeau, Christophe Richez, Alexis Mathian, Didier Bessis, Marc André, Perrine Smets, Stanislas Faguer, Laurent Sailler, Bruno Pereira, François Chasset, Marc Scherlinger, Marie Jachiet, Estibaliz Lazaro, Julien Henry, Kevin Chevalier, Gaelle Richard-Colmant, Noemie Abisror, Jean-David Bouaziz, Nicole Ferreira-Maldent, Aurélia Lanteri, Ludovic Trefond, Claire Cazalets, Pierre-Yves Jeandel, Jerome Hadjadj, Nassim Ait Abdallah, Nicolas Belhomme, Alexandra Audemard, Thomas Moulinet, Julien Campagne, Thomas Barba, Sarah Lechtman, Cristina Livideanu, Sandrine Roque, Ruben Monteiro, Jeanne de La Rochefoucauld, Cecile Lesort, Diane Kottler, Cecile Saint-Pastou Terrier, and Chloé Grolleau
Subjects: Medicine
Published: 2025
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2. Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome in the intensive care unit: a case report

Author: Félicie Belicard, Nicolas Belhomme, Simon Bouzy, Clémence Saillard, Fabienne Nedelec, Jean-Baptiste Mear, Samuel Ardois, Cedric Pastoret, Florian Reizine, Christophe Camus, and Benoit Painvin
Subjects: VEXAS syndrome, Vacuoles, Autoinflammatory disease, Cardiac arrest, ICU, Sweet’s syndrome, Medicine
Abstract: Abstract Background Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome is a newly discovered inflammatory disease affecting male subjects, for which few data exist in the literature. Here, we describe the case of a patient with known Sweet’s syndrome admitted to the intensive care unit and for whom a vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome was diagnosed, allowing for appropriate treatment and the patient’s discharge and recovery. Case presentation A 70-year-old male White patient was hospitalized in the intensive care unit following an intrahospital cardiac arrest. History started a year before with repeated deep vein thrombosis and episodes of skin eruption compatible with Sweet’s syndrome. After a course of oral steroids, fever and inflammatory syndrome relapsed with onset of polychondritis, episcleritis along with neurological symptoms and pulmonary infiltrates. Intrahospital hypoxic cardiac arrest happened during patient’s new investigations, and he was admitted in a critical state. During the intensive care unit stay, he presented with livedoid skin lesions on both feet. Vasculitis was not proven; however, cryoglobulinemia screening came back positive. Onset of pancytopenia was explored with a myelogram aspirate. It showed signs of dysmyelopoiesis and vacuoles in erythroid and myeloid precursors. Of note, new deep vein thrombosis developed, despite being treated with heparin leading to the diagnosis of heparin-induced thrombocytopenia. The course of symptoms were overlapping multiple entities, and so a multidisciplinary team discussion was implemented. Screening for UBA1-mutation in the blood came back positive, confirming the vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome. Corticosteroids and anti-IL1 infusion were started with satisfactory results supporting patient’s discharge from intensive care unit to the internal medicine ward. Conclusions Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome should be suspected in male patients presenting with inflammatory symptoms, such as fever, skin eruption, chondritis, venous thromboembolism, and vacuoles in bone marrow precursors. Patients with undiagnosed vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome may present with organ failure requiring hospitalization in intensive care unit, where screening for UBA1 mutation should be performed when medical history is evocative. Multidisciplinary team involvement is highly recommended for patient management, notably to start appropriate immunosuppressive treatments.
Published: 2023
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3. History of pre-eclampsia does not appear to be a risk factor for vascular phenotype in women with systemic sclerosis

Author: Arsène Mekinian, Eric Hachulla, Alain Lescoat, Elisabeth Pasquier, Christian Agard, Sabine Berthier, Perrine Smets, Grégory Pugnet, Emmanuel Chatelus, Marie-Elise Truchetet, Viviane Queyrel, Nathalie Tieulie, Bénédicte Rouvière, Claire de Moreuil, Emilie Brenaut, Valérie Devauchelle-Pensec, Olivier Lidove, Jérémy Keraen, Benjamin Subran, Nicolas Belhomme, Elizabeth Diot, Mathieu Delplanque, Sandy Lucier, and Emmanuelle Courtois-Communier
Subjects: Medicine
Abstract: Background Vascular phenotype is associated with a poor prognosis in systemic sclerosis (SSc). The identification of its risk factors could facilitate its early detection.Objectives To explore risk factors for a vascular phenotype of SSc, among them a history of pre-eclampsia.Methods This observational multicentre case–control study enrolled adult women fulfilling European Alliance of Associations for Rheumatology 2013 diagnosis criteria for SSc and having a pregnancy history≥6 months before SSc diagnosis in 14 French hospital-based recruiting centres from July 2020 to July 2022. Cases had specific vascular complications of SSc defined as history of digital ischaemic ulcers, pulmonary arterial hypertension, specific cardiac involvement or renal crisis. Women with SSc were included during their annual follow-up visit and filled in a self-administered questionnaire about pregnancy. A case report form was completed by their physician, reporting data on medical history, physical examination, clinical investigations and current medication. The main outcome was the presence/absence of a personal history of pre-eclampsia before SSc diagnosis, according to the validated pre-eclampsia questionnaire.Results 378 women were included: 129 cases with a vascular phenotype and 249 matched controls. A history of pre-eclampsia was reported in 5 (3.9%) cases and 12 (4.8%) controls and was not associated with a vascular phenotype (OR=0.96, 95% CI 0.28 to 3.34, p=0.9). Besides, Rodnan skin score and disease duration≥5 years were risk factors for vascular phenotype.Conclusions In women with SSc and a pregnancy history≥6 months before SSc, a history of pre-eclampsia is not associated with a vascular phenotype.
Published: 2024
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4. Role of serum immunoglobulins for predicting sarcoidosis outcome: A cohort study.

Author: Nicolas Belhomme, Stéphane Jouneau, Guillaume Bouzillé, Olivier Decaux, Mathieu Lederlin, Stéphanie Guillot, Antoinette Perlat, and Patrick Jégo
Subjects: Medicine, Science
Abstract: Sarcoidosis is a systemic granulomatous disease which carries variable outcomes. Serum protein electrophoresis is an easily accessible and routinely performed examination at diagnosis, in order to search for hypergammaglobulinemia, which is frequently found, and to rule out other granulomatous diseases such as common variable immunodeficiency. We aimed to assess the impact of baseline immunoglobulin level on the outcome of sarcoidosis.We conducted a retrospective cohort-study, at Rennes University Hospital, in which all newly diagnosed patients for whom a serum protein electrophoresis had been performed at baseline were enrolled, from 2006 to 2014. The main outcome was the need for corticosteroid treatment within 2 years from diagnosis, the secondary outcome was the occurrence of relapse among treated patients.Eighty patients were included in the study, and 41.25% of them exhibited an elevated globulins rate. In univariate analysis, an elevated ACE level >70 U/l, Afro-Caribbean origin, and extra-pulmonary involvement, were associated with the need for corticosteroid treatment. In multivariate analysis, only ACE elevation (OR = 1.03, IC95% 1.01-1.05, p = 0.009) and extra-pulmonary involvement (OR = 5.8, IC95% 1.4-24, p = 0.015) were significant. Immunoglobulin level was not associated with the main outcome. Regarding the secondary outcome, none of the studied features were predictive of relapse among the 34 treated patients followed for two years.There was no relation between the immunoglobulin level at diagnosis and the evolution of sarcoidosis. An elevated ACE level and the presence of initial extra-pulmonary involvement were both associated with a more severe course of the disease necessitating a corticosteroid treatment.
Published: 2018
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5. Libman-Sacks endocarditis under apixaban in a patient with a high-risk profile venous antiphospholipid syndrome

Author: J.-S. Allain, Patrick Jego, Alice Ballerie, E. Paven, A. Le Bot, B. Henriot, Nicolas Belhomme, CHU Pontchaillou [Rennes], 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), CH de Saint-Malo [Broussais], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 )
Subjects: medicine.medical_specialty, Non-bacterial thrombotic endocarditis, Traitement anticoagulant, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Libman–Sacks endocarditis, 03 medical and health sciences, 0302 clinical medicine, Antiphospholipid syndrome, Internal Medicine, medicine, cardiovascular diseases, Anticoagulant therapy, 030203 arthritis & rheumatology, Gynecology, Endocardite thrombotique non bactérienne, Libman-Sacks endocarditis, business.industry, Gastroenterology, Endocardite de Libman-Sacks, medicine.disease, 3. Good health, business, Syndrome des antiphospholipides
Abstract: Resume Introduction L’endocardite de Libman-Sacks est une complication rare du syndrome des antiphospholipides. L’anticoagulation par anti-vitamine K est le traitement de reference, parfois associee a une chirurgie. Dans les dernieres recommandations EULAR, l’utilisation des anticoagulants oraux directs est deconseillee pour la prise en charge du syndrome des antiphospholipides, en particulier en cas de profil a haut risque. Observation Nous rapportons le cas d’une patiente de 63 ans atteinte de sclerose en plaque et d’un syndrome des antiphospholipides ayant presente une endocardite mitrale de Libman-Sacks compliquee d’accidents vasculaires ischemiques apres deux annees d’apixaban. La reintroduction de tinzaparine puis de warfarine au long cours et deux mois d’hydroxychloroquine ont permis une amelioration des lesions valvulaires. Conclusion A notre connaissance, il s’agit du premier cas d’endocardite de Libman-Sacks survenue sous apixaban pour le traitement d’un syndrome des antiphospholipides. Cette atteinte grave conforte l’idee que les anticoagulants oraux directs ne sont pas a utiliser dans la prevention des evenements thrombotiques au cours du syndrome des antiphospholipides.
Published: 2021
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6. Ultrasound classification of finger pulp blood flow in patients with systemic sclerosis: A pilot study

Author: Thomas Le Gallou, François Robin, Guillaume Coiffier, Nicolas Belhomme, Claire Cazalets, Jean-David Albert, Alice Ballerie, Martine Sebillot, Jego Patrick, Aleth Perdriger, Alain Lescoat, Marine de Saint Riquier, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre hospitalier Rene Pleven de Dinan, Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Chard-Hutchinson, Xavier
Subjects: medicine.medical_specialty, systemic sclerosis, [SDV]Life Sciences [q-bio], Gastroenterology, 03 medical and health sciences, Basal (phylogenetics), 0302 clinical medicine, Rheumatology, Internal medicine, medicine.artery, Occlusion, medicine, In patient, scleroderma, 030212 general & internal medicine, Pathological, Ultra-sound, Ulnar artery, 030203 arthritis & rheumatology, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, business.industry, Ultrasound, Doppler, Blood flow, 3. Good health, [SDV] Life Sciences [q-bio], [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, digital ulcers, Pulp (tooth), business, finger pulp
Abstract: International audience; Objective - To define a semiquantitative classification of finger pulp blood flow (FPBF) and to evaluate whether this classification could be used to assess FPBF in healthy controls and in systemic sclerosis (SSc) patients. Methods - Thirty controls and 86 SSc patients were consecutively included. A classification of FPBF including 5 grades (from grade 0 [no signal] to 4 [signal detected on the entire finger pulp, including the subepidermal vascular network]) was evaluated. This classification was explored in basal conditions and after hand baths in hot and cold water in controls. Its relevance was also assessed at room temperature in SSc patients. Results - In controls, power Doppler ultrasonography (PDUS) of FPBF was improved after hot challenge (P = 0.024), whereas cold challenge decreased FPBF (P = 0.001). FPBF correlated with the vasodilation status assessed by the resistivity index of radial arteries (Spearman's correlation coefficient = -0.50, P = 0.0049). Grade 0 was more frequent in SSc patients than in controls (22.1% versus 3.3%; P
Published: 2021
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7. Impact of Three Different Algorithms for the Screening of SSc-PAH and Comparison with the Decisions of a Multidisciplinary Team

Author: Vincent Sobanski, Stéphane Jouneau, Nicolas Belhomme, Eric Hachulla, A. Lescoat, Patrick Jego, Claire Cazalets, Alice Ballerie, Valentin Coirier, Céline Chabanne, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, This research received no external funding., HAL UR1, Admin, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 )
Subjects: Right heart catheterization, Medicine (General), Longitudinal study, systemic sclerosis, [SDV]Life Sciences [q-bio], Clinical Biochemistry, 030204 cardiovascular system & hematology, Multidisciplinary team, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Article, 03 medical and health sciences, multidisciplinary team meeting, R5-920, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, pulmonary arterial hypertension, pulmonary hypertension, Medicine, [SDV.IB] Life Sciences [q-bio]/Bioengineering, 030203 arthritis & rheumatology, algorithm, business.industry, screening, Missing data, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, Algorithm
Abstract: International audience; Background: to compare three existing screening algorithms of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) with the results of a multidisciplinary team (MDT) meeting from a tertiary center. Methods: we conducted a monocentric longitudinal study from 2015 to 2018. All patients with SSc according to LeRoy’s classification were eligible. Patients were excluded in the case of missing data required by any of the three screening algorithms. The algorithms were applied for each patient at inclusion. Right heart catheterization (RHC) was performed based on the MDT decision. MDT members were all blinded from the results of the three algorithms regarding RHC recommendations. The RHC recommendations of each algorithm were compared with the MDT decision, and the impact on diagnosis and management was evaluated. Results: 117 SSc patients were consecutively included in the study, and 99 had follow-up data over the three-year duration of the study (10 deaths). Among the 117 patients, the MDT suggested RHC for 16 patients (14%), DETECT algorithm for 28 (24%), ASIG for 48 (41%) and ESC/ERS 2015 for 20 (17%). Among the 16 patients who had RHC, SSc-PAH was diagnosed in seven. Among patients with an initial recommendation of RHC based on at least one algorithm but not according to the MDT meeting, no SSc-PAH was diagnosed during the three-year follow-up. Results were unchanged when the new 2018 definition of PAH was applied instead of the previous definition. Conclusion: a MDT approach appears interesting for the screening of SSc-PAH, with a significant reduction of RHC performed in comparison with dedicated algorithms. The specific relevance of a MDT for the management and follow-up of patients with RHC recommended by existing algorithms but with no PAH warrants further studies.
Published: 2021
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8. Apixaban and rivaroxaban in obese patients treated for venous thromboembolism: Drug levels and clinical outcomes

Author: Patrick Jego, Francis Couturaud, Adeline Pontis, Isabelle Gouin-Thibault, Alain Lescoat, Fabienne Nedelec-Gac, Alice Ballerie, Chloé Rousseau, Karine Lacut, Hubert Galinat, Pierre Guéret, Rémi Nguyen Van, Nicolas Belhomme, Guillaume Mahé, Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pontchaillou [Rennes], Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, 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), Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), This research did not receive any specific grant from funding agencies in the public, commercial, ornot-for-profit sectors., Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-École normale supérieure - Rennes (ENS Rennes)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: medicine.medical_specialty, Multivariate analysis, Pyridones, [SDV]Life Sciences [q-bio], Hemorrhage, 030204 cardiovascular system & hematology, 030226 pharmacology & pharmacy, Drug levels, 03 medical and health sciences, 0302 clinical medicine, Rivaroxaban, Internal medicine, medicine, Humans, Apixaban, Obesity, Prospective Studies, Prospective cohort study, business.industry, Hematology, Venous Thromboembolism, Middle Aged, medicine.disease, Thrombosis, 3. Good health, Pharmaceutical Preparations, Pyrazoles, Observational study, business, Venous thromboembolism, medicine.drug
Abstract: International audience; BACKGROUND: Direct oral anticoagulants (DOAC) use remains challenging in obese patients treated for Venous-Thrombo-Embolism (VTE) due to the paucity of prospective and dedicated studies. OBJECTIVE: To assess rivaroxaban and apixaban concentrations at different time-points after intake, in obese patients followed at a thrombosis center and treated for VTE; to define factors associated with DOAC levels outside the on-therapy ranges; and to evaluate bleeding and thrombosis rates during follow-up. METHODS: Observational prospective study in two French University hospitals. Apixaban or rivaroxaban concentrations were measured after the first visit, regardless of last intake in obese patients receiving DOAC for VTE. Concentrations were compared to published reference values for non-obese patients. Demographic, clinical, biological and therapeutic data were collected. Univariate and multivariate analyses were performed to identify factors associated to DOAC concentrations outside the on-therapy ranges. RESULTS: Out of the 146 patients included, 22 (15%) had DOAC concentrations outside the on-therapy ranges, mainly in the rivaroxaban group (n = 17). Age ≤ 63 years, use of rivaroxaban and time since last intake ≤8 h were associated with DOAC concentrations outside the on-therapy ranges, in multivariable analysis. During the median follow-up of 16 months, two (1%) patients receiving apixaban had recurrent VTE. No patient had major bleeding, 11 (8%) patients had minor bleeding. CONCLUSION: In this specific prospective bi-centric study dedicated to VTE obese patients, use of DOACs at fixed doses led to concentrations similar to those of non-obese patients in a high proportion of patients, without any effect of the BMI, and with risk-benefit profile comparable to non-obese patients.
Published: 2021
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9. Bone mineral density and trabecular bone score assessment in systemic sclerosis: A cross-sectional study

Author: François Robin, Alain Lescoat, Marie Leroy, Pascal Guggenbuhl, Guillaume Coiffier, Claire Cazalets, Patrick Jego, Alice Ballerie, Nicolas Belhomme, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), This study did not receive any financial support., Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Jonchère, Laurent
Subjects: Trabecular bone score, Cross-sectional study, [SDV]Life Sciences [q-bio], Osteoporosis, Dentistry, 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Absorptiometry, Photon, Rheumatology, Bone Density, Vertebral fracture assessment, FRAX score, medicine, Bone mineral density, Humans, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Bone mineral, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Scleroderma, Systemic, business.industry, medicine.disease, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Cancellous Bone, Systemic sclerosis, business
Abstract: International audience
Published: 2021
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10. Sacroiliac joint in sarcoidosis on computed tomography: a monocentric retrospective study (SISTER)

Author: Stéphane Jouneau, Patrick Jego, Pascal Guggenbuhl, Aleth Perdriger, S. Cadiou, Raphaël Guillin, Guillaume Coiffier, Nicolas Belhomme, CHU Pontchaillou [Rennes], Centre hospitalier Rene Pleven de Dinan, Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UR), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Jonchère, Laurent, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA)
Subjects: Adult, Male, musculoskeletal diseases, medicine.medical_specialty, Sarcoidosis, Immunology, Osteoarthritis, Sacroiliac joint, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Pregnancy, Internal medicine, Spondylarthritis, Spondyloarthritis, medicine, Ankylosis, Prevalence, Immunology and Allergy, Humans, [SHS.INFO.AUTR]Humanities and Social Sciences/Library and information sciences/domain_shs.info.autr, Sacroiliitis, Computed tomography, [SHS.INFO.AUTR] Humanities and Social Sciences/Library and information sciences/domain_shs.info.autr, Diffuse Idiopathic Skeletal Hyperostosis, Aged, Retrospective Studies, 030203 arthritis & rheumatology, Aged, 80 and over, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, medicine.anatomical_structure, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Radiology, business, Tomography, X-Ray Computed
Abstract: International audience; Sacroiliitis and spondyloarthritis (SpA) have been associated to sarcoidosis. Sarcoidosis bone involvement of the sacral or iliac bones has been reported to mimic SpA. We aimed to evaluate the prevalence of structural sacroiliitis and structural changes of the sacroiliac joints (SIJ) in patients with sarcoidosis by abdominal-pelvic computed tomography (AP-CT). In this monocentric retrospective study, three blinded readers evaluated AP-CT that had already been performed on patients with sarcoidosis and classified them as normal, degenerative, or inflammatory. A consensus was reached for the divergent cases. Erosion, ankylosis, and sclerosis, classically associated with sacroiliitis, were noted. SpA was defined according to the ASAS 2009 classification criteria. We identified 217 patients with proven sarcoidosis who underwent AP-CT. Only three patients had sacroiliitis by CT and four had SpA, representing 1.38% and 1.85% of the patients, respectively. Degenerative SIJs represented 28.1% of patients and were significantly associated with age, at least one pregnancy, rural lifestyle, ankylosis, diffuse idiopathic skeletal hyperostosis, sclerosis, and the presence of osteophytes. Four patients had axial bone sarcoidosis. Sacroiliitis, SpA, and degenerative changes of the SIJ have been highlighted by AP-CT in patients with sarcoidosis. Osteoarthritis of the SIJ in sarcoidosis was associated with age, pregnancy, and rural lifestyle. Further studies are needed to assess the link between SpA and sarcoidosis.
Published: 2021
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11. Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study

Author: Carlotta Cacciatore, Pierre Belnou, Sara Thietart, Carole Desthieux, Mathilde Versini, Noemie Abisror, Sébastien Ottaviani, Gregoire Cormier, Alban Deroux, Azeddine Dellal, Nicolas Belhomme, Nathalie Saidenberg Kermanac'H, Philippe Khafagy, Martin Michaud, Sylvain Lanot, Fabrice Carrat, Olivier Fain, Arsène Mékinian, Service de rhumatologie [CHU 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), Service de santé publique [CHU Saint-Antoine], 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), Centre Hospitalier Universitaire de Nice (CHU Nice), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Départemental Vendée, Centre Hospitalier Universitaire [Grenoble] (CHU), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, CHU Pontchaillou [Rennes], Groupe Hospitalier Avicenne-Jean Verdier-René Muret, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Joseph Ducuing, Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL-SU, Gestionnaire, Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Joseph Ducuing - Varsovie [Toulouse] (HJD), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, Arthritis, Sarcoid arthropathy, methotrexate, 03 medical and health sciences, 0302 clinical medicine, Synovitis, medicine, sarcoidosis, Original Research, 030203 arthritis & rheumatology, Erythema nodosum, lcsh:R5-920, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Hydroxychloroquine, sarcoid arthropathy, General Medicine, medicine.disease, Dermatology, Infliximab, 3. Good health, 030228 respiratory system, outcome, Medicine, Methotrexate, Sarcoidosis, business, infliximab, lcsh:Medicine (General), [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract: Introduction: We aimed to analyze patients with acute and chronic joint involvements in sarcoidosis.Methods: This is a retrospective multicenter analysis of patients with proven sarcoidosis, as defined by clinical, radiological, and histological criteria, with at least one clinical and/or ultrasonographic synovitis.Results: Thirty-nine patients with sarcoid arthropathy were included, and among them 19 had acute sarcoidosis (Lofgren's syndrome). Joint involvement and DAS44-CRP were not significantly different in acute and chronic sarcoid arthropathies. Acute forms were more frequent than chronic sarcoid arthropathy in Caucasians, without any difference of sex or age between these 2 forms. Joint involvement was frequently more symmetrical in acute than chronic forms (100 vs. 70%; p < 0.05), with a more frequent involvement in wrists and ankles in acute forms, whereas the tender and swollen joint counts and the DAS44-CRP were similar between the 2 groups. Skin lesions were significantly more frequent in patients with acute forms [17 (89%) vs. 5 (25%); p < 0.05] and were erythema nodosum in all patients with Löfgren's syndrome and sarcoid skin lesions in those with chronic sarcoidosis. Among 20 patients with chronic sarcoidosis, treatment was used in 17 (85%) cases, and consisted in NSAIDs alone (n = 5; 25%), steroids alone (n = 5; 25%), hydroxychloroquine (n = 2; 20%), methotrexate (n = 3; 15%), and TNF inhibitors (n = 2; 10%). A complete/partial joint response was noted in 14 (70%) cases with a DAS44-CRP reduction of 2.07 [1.85–2.44] (from 3.13 [2.76–3.42] to 1.06 [0.9–1.17]; p < 0.05).Conclusion: Sarcoid arthropathies have different clinical phenotypes in acute and chronic forms and various treatment regimens such as hydroxychloroquine and methotrexate could be used in chronic forms.
Published: 2020
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12. The neglected association of crystalline silica exposure and systemic sclerosis

Author: Paul-André Rosental, Catherine Cavalin, Nicolas Belhomme, Patrick Jego, Stéphane Jouneau, Alain Lescoat, Claire Cazalets, Christophe Paris, Alfredo Menéndez-Navarro, Alice Ballerie, Valérie Lecureur, CHU Pontchaillou [Rennes], Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), History of Science Department, University of Granada [Granada], Centre d'histoire de Sciences Po (Sciences Po) (CHSP), Sciences Po (Sciences Po), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Centre d'histoire de Sciences Po (CHSP), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), and Universidad de Granada = University of Granada (UGR)
Subjects: 0303 health sciences, medicine.medical_specialty, Scleroderma, Systemic, business.industry, Australia, Silica, Silicon Dioxide, Dermatology, SILICA EXPOSURE, Dust exposure, 3. Good health, [SHS]Humanities and Social Sciences, Occupational Diseases, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Rheumatology, Occupational Exposure, medicine, Systemic sclerosis, Humans, Pharmacology (medical), business, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology
Abstract: International audience
Published: 2020
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13. Elucidating in utero fetal demise time to reassemble the pieces of the puzzle?

Author: Philippe Loget, Gwenaelle Le Bouar, Patrick Jego, Florence Rouget, Alain Lescoat, Leïla Caillault, Alice Ballerie, Nicolas Belhomme, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Chard-Hutchinson, Xavier, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA)
Subjects: 030203 arthritis & rheumatology, 030219 obstetrics & reproductive medicine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Obstetrics and Gynecology, 03 medical and health sciences, 0302 clinical medicine, In utero, Pediatrics, Perinatology and Child Health, Medicine, Fetal Demise, business, Neuroscience, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2020
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14. Association of silica exposure with chest HRCT and clinical characteristics in systemic sclerosis

Author: Alain Lescoat, Mathieu Lederlin, Patrick Jego, Catherine Cavalin, Claire Cazalets, Amélie Nicolas, Paul-André Rosental, Ronan Garlantézec, Christophe Paris, Stéphane Jouneau, Nicolas Belhomme, Alice Ballerie, Valérie Lecureur, Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), CHU Pontchaillou [Rennes], Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Radiologie [CHU de Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Centre d'études européennes et de politique comparée (CEE), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), CCSD, Accord Elsevier, Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Rennes, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre d'études européennes et de politique comparée (Sciences Po, CNRS) (CEE)
Subjects: Male, medicine.medical_specialty, Population, Context (language use), Interstitial lung disease, SILICA EXPOSURE, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, medicine, Humans, In patient, 030212 general & internal medicine, Risk factor, education, 030203 arthritis & rheumatology, Thoracic lymph node, education.field_of_study, Univariate analysis, Scleroderma, Systemic, business.industry, Silica, respiratory system, Silicon Dioxide, medicine.disease, Dust exposure, 3. Good health, respiratory tract diseases, Anesthesiology and Pain Medicine, Erasmus syndrome, Systemic sclerosis, Radiology, [SHS] Humanities and Social Sciences, Lung Diseases, Interstitial, Tomography, X-Ray Computed, business
Abstract: International audience; Context - Thoracic lymphadenopathy (LA) has been identified as a key prognostic factor in interstitial lung disease (ILD) of all-cause. Crystalline silica is a risk factor of systemic sclerosis (SSc). The association of a history of crystalline silica exposure with chest high-resolution computed tomography (HRCT) features and thoracic LA are still to be determined in SSc patients. Objectives - We performed an observational study to assess the association of lifetime exposure to silica, with chest HRCT characteristics in a population of SSc patients fulfilling the 2013 ACR/EULAR classification criteria for SSc. Methods - A specific questionnaire based on a multidisciplinary approach was used to assess occupational and non-occupational exposure to silica in 100 consecutive SSc patients. Clinical characteristics and chest HRCT at diagnosis and at the latest visit were evaluated to assess the association of silica exposure with disease characteristics. Results - 16% of the overall population and 58% of men had an occupation with specific high silica exposure. A higher silica exposure score was associated with the combination of mediastinal and hilar LA on HRCT (OR=8.09, 95%CI=2.01-32.52, P = 0.002). More than 12% of the patients had a combination of mediastinal and hilar LA on HRCT. This marker of silica exposure was predictive of worsening of pulmonary involvement in univariate analysis (OR=5.86, 95%CI=1.64-20.89, P = 0.007) and multivariate analysis (OR=4.57, 95%CI =1.12-18.60, P = 0.034). Conclusions - In patients with SSc, the combination of mediastinal and hilar LA on HRCT was associated with exposure to silica and was also significantly associated with a more severe evolution of ILD.
Published: 2020
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15. Correspondence on 'Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis'

Author: Julien Haroche, Grégory Pugnet, Isabella Annesi-Maesano, Nathalie Freymond, Robin Dhote, Fleur Cohen-Aubart, Hilario Nunes, Nathalie Saindenberg, Aurélien Justet, Nicolas Belhomme, Yurdagul Uzunhan, Abdellatif Tazi, P. Gazengel, Alexis Mathian, Florence Jeny, Raphael Lhote, Stéphane Jouneau, Baptiste Hervier, Yacine Tandjaoui-Lambiotte, Emmanuel Bergot, Dominique Valeyre, Arsène Mekinian, Raphael Borie, Zahir Amoura, Gwenaël Lorillon, Jérôme Le Pavec, Miguel Hie, T. Chazal, and Dov Taieb
Subjects: medicine.medical_specialty, Sarcoidosis, medicine.medical_treatment, Immunology, General Biochemistry, Genetics and Molecular Biology, Pulmonary function testing, Rheumatology, Recurrence, Internal medicine, Diabetes mellitus, medicine, Immunology and Allergy, Humans, Respiratory system, Glucocorticoids, Lung, business.industry, Interstitial lung disease, COVID-19, Immunosuppression, medicine.disease, medicine.anatomical_structure, business, Glucocorticoid, medicine.drug
Abstract: Patients with interstitial lung disease have been considered at high risk of complications of COVID-19 because of their underlying lung disease and use of immunosuppressive agents.1 However, data on COVID-19 in patients with sarcoidosis are scarce.2–4 Several reasons for an increased risk of severe forms of COVID-19 among sarcoidosis patients have been hypothesised: the involvement of the lung in almost 90% of patients with COVID-19, some of whom have reduced pulmonary function and comorbidities such as diabetes or hypertension, which are largely associated with the use of glucocorticosteroids for treating sarcoidosis; and the use of immunosuppressive agents in a subset of these patients.5 Recently, Gyorfi et al 6 described the case of a patient with sarcoidosis who experienced a symptomatic SARS-CoV-2 infection with spontaneous clinical improvement, and a virological relapse after steroids treatment. This case illustrated the fact that immunosuppression with glucocorticoids may induce relapse of COVID-19 in patients with sarcoidosis. However, we lack data on the outcomes of patients with sarcoidosis affected by COVID-19. We retrospectively collected data for all patients with sarcoidosis and SARS-CoV-2 infection seen among 15 French centres between 1 March and 20 May 2020. The inclusion criteria were a sarcoidosis diagnosis based on the American Thoracic Society/European Respiratory Society/World Association for Sarcoidosis and other granulomatous diseases …
Published: 2020

16. High Cycle Fatigue strength evaluation of welded joints in handling equipment

Author: Camille Robert, Charles Mareau, Nicolas Belhomme, Franck Morel, Jean-Yves Auge, Daniel Bellett, Hugo Heyraud, Olivier Dore, Laboratoire Angevin de Mécanique, Procédés et InnovAtion (LAMPA), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Centre National de la Recherche Scientifique (CNRS)-Arts et Métiers Sciences et Technologies, and HESAM Université (HESAM)-HESAM Université (HESAM)-Institut Polytechnique de Bordeaux-Université de Bordeaux (UB)
Subjects: 0209 industrial biotechnology, Chassis, business.industry, Computer science, Work (physics), Shell (structure), Stiffness, 02 engineering and technology, Structural engineering, Welding, Finite element method, law.invention, [SPI]Engineering Sciences [physics], Matrix (mathematics), 020303 mechanical engineering & transports, 020901 industrial engineering & automation, 0203 mechanical engineering, law, medicine, medicine.symptom, Design methods, business, Earth-Surface Processes
Abstract: This study falls within the scope of the fatigue design of handling machines manufactured by the Manitou Group, which are usually composed of a chassis and a boom. These welded assemblies are subjected to fatigue loading conditions and include highly stressed zones acting as crack initiation sites. In view of the geometrical complexity of the structures, the degree of conservatism incorporated in design methods based on the usual international standards is difficult to evaluate. Alternative design approaches based on the structural stress are being developed and used by other companies such as PSA and LOHR. The present work focuses on developing a numerical approach to take into account the local stiffness of welds. The proposed strategy is based on shell finite element modelling of the assembly and an equivalent stiffness matrix for welds. This makes it possible to describe the local mechanical behaviour of seam welds with the computational cost of a shell element based model. To validate the proposed approach, a comparison in terms of stiffness is undertaken for three welded structures using solid finite element models as a reference. The proposed approach is also compared to the Manitou, Fayard and Lohr approaches.
Published: 2019
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17. Silica Exposure and Scleroderma: More Bridges and Collaboration Between Disciplines Are Needed

Author: Mathieu Lederlin, Catherine Cavalin, Valérie Lecureur, Alain Lescoat, Alice Ballerie, Nicolas Belhomme, Christophe Paris, Ronan Garlantézec, Lucile Sesé, Guillaume Coiffier, Claire Cazalets, Stéphane Jouneau, Patrick Jego, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 Pontchaillou [Rennes], Laboratoire interdisciplinaire d'évaluation des politiques publiques [Sciences Po] (LIEPP), Sciences Po (Sciences Po), Centre d'études de l'emploi et du travail (CEET), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.)-Ministère du Travail, de l'Emploi et de la Santé, Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), École des Hautes Études en Santé Publique [EHESP] (EHESP), Université Paris Dauphine-PSL-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Jonchère, Laurent, Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 interdisciplinaire d'évaluation des politiques publiques (Sciences Po) (LIEPP), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.)-Ministère du Travail, de l'Emploi et de la Santé, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, systemic sclerosis, crystalline silica, Critical Care and Intensive Care Medicine, SILICA EXPOSURE, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Scleroderma, 03 medical and health sciences, 0302 clinical medicine, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, Medicine, scleroderma, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, medicine.disease, Dermatology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, silica, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, artificial stone
Abstract: International audience
Published: 2020
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18. Aspirine : indications et utilisation durant la grossesse

Author: Nicolas Belhomme, E. Polard, Patrick Jego, H. Isly, B. Henriot, and C. Doudnikoff
Subjects: Aspirin, medicine.medical_specialty, Pregnancy, 030219 obstetrics & reproductive medicine, Fetal death, business.industry, Gastroenterology, Disease, Placental insufficiency, Placental disease, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Fetal growth, 030212 general & internal medicine, Cyclo-oxygenase, business, medicine.drug
Abstract: Aspirin (acetylsalicylic acid) has been used ever since the Antiquity for its painkilling and anti-inflammatory effects. Its antiplatelet properties have then extended its indications to the field of coronaropathy and vascular cerebral disease, and finally to vascular placental disease. Aspirin has been widely prescribed since the 1980's to prevent pre-eclampsia, intra-uterine growth retardation and fetal death of vascular origin. It has also been proposed to prevent unexplained recurrent miscarriages. Its use during pregnancy is considered as safe, provided the daily doses do not exceed 100mg. Aspirin has been proven efficient to prevent pre-eclampsia and fetal growth restriction in high-risk patients. The benefits of prescribing aspirin have been demonstrated neither for vascular placental disease prevention in low risk patients, nor in cases of unexplained recurrent miscarriages.
Published: 2017
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19. Drug-induced granulomatosis: is dupilumab the new kid on the block?

Author: Valérie Lecureur, B. Cador, S. Cadiou, E. Polard, T. Gaignon, Alain Lescoat, Laurent Misery, Alice Ballerie, Patrick Jego, Nicolas Belhomme, S. Mensi, Stéphane Jouneau, C. Abasq-Thomas, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), and Chard-Hutchinson, Xavier
Subjects: Drug, 0303 health sciences, business.industry, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Dermatology, Pharmacology, [SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology, Antibodies, Monoclonal, Humanized, Dupilumab, 3. Good health, Dermatitis, Atopic, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Pharmaceutical Preparations, 030220 oncology & carcinogenesis, Block (telecommunications), Medicine, Humans, business, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology, 030304 developmental biology, media_common
Abstract: International audience; Dupilumab is an IgG4 antibody directed toward IL-4 and IL-13, two major effectors of the Th2 immunity response. It was originally developed for severe and/or refractory atopic dermatitis, nevertheless its use has secondarily been broadened to severe asthma . We report herein the case a 28-year-old, non-smoker male who presented to the emergency department with confusion, headaches, emesis and photophobia. His medical history included only a severe atopic dermatitis leading to dupilumab initation 4 months earlier. Physical examination revealed a meningoencephalitis syndrome, and a bilateral parotidomegaly.
Published: 2020
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20. Spondyloarthritis and sarcoidosis: Related or fake friends? A systematic literature review

Author: Aleth Perdriger, Stéphane Jouneau, S. Cadiou, Guillaume Coiffier, Nicolas Belhomme, Pascal Guggenbuhl, Raphaël Guillin, François Robin, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre Hospitalier Universitaire [Rennes], Aucun soutien financier ni autre avantage provenant de sources commerciales n’a été fourni pour ce travail., Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Jonchère, Laurent
Subjects: musculoskeletal diseases, medicine.medical_specialty, Sarcoidosis, [SDV]Life Sciences [q-bio], Os, Friends, Granulomatous, Sacroiliac joint, Cochrane Library, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Spondylarthritis, Spondyloarthritis, medicine, Humans, In patient, 030212 general & internal medicine, Sacroiliitis, Bone, 030203 arthritis & rheumatology, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, HLA-B27, medicine.diagnostic_test, business.industry, Granulome, Sacro-iliite, Magnetic resonance imaging, Articulation sacro-iliaque, medicine.disease, Sarcoïdose, Dermatology, Magnetic Resonance Imaging, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Systematic review, Cross-Sectional Studies, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Back Pain, business, Spondyloarthrite
Abstract: National audience; Contexte: Sarcoïdose et spondyloarthrite (SpA) sont fréquemment associées, et des granulomes ont été décrits au niveau des os iliaques. Nous proposons ici une revue systématique de la littérature sur les manifestations rhumatologiques axiales de la sarcoïdose. Méthodes: Cette revue systématique de la littérature a été réalisée dans les bases de données PubMed et Cochrane Library. Les recommandations PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) ont été appliquées pour l'examen des rapports de cas et des études transversales. Résultats Au total, 41 articles remplissaient les critères définis. Trois études transversales sur l'association SpA-sarcoïdose ont montré une prévalence de sacro-iliite et de SpA de 12,9 à 44,8 % et de 12,9 à 48,3 %, respectivement, dans les sous-groupes de lombalgie inflammatoire (LI). Cependant, les définitions de la LI et les modalités d'imagerie de l'articulation sacro-iliaque (ASI) étaient hétérogènes (radiographie ou imagerie par résonance magnétique), la radiographie étant la principale technique (78 % des cas) employée pour diagnostiquer la sacro-iliite. Trente-et-un rapports de cas sur l'association sarcoïdose-sacro-iliite ont été identifiés, représentant 35 patients. Les critères de l'ASAS pour la SpA étaient remplis dans la moitié des cas (16/32), et le HLA-B27 était positif dans 46 % des cas (12/26). La sarcoïdose est apparue postérieurement aux symptômes sacro-iliaques chez 47 % des patients. L'atteinte unilatérale était significativement plus fréquente dans les sept cas de granulome des os sacro-iliaques que dans le groupe sarcoïdose-sacro-iliite (p < 0,001). Conclusion: L'analyse de la littérature a démontré de façon probante l'existence d'une association SpA-sarcoïdose, ce qui incite à accorder une attention particulière aux patients atteints de sarcoïdose et faisant état d'une LI. La présence d'une sacro-iliite unilatérale devrait faire suspecter une atteinte osseuse granulomateuse distincte de la sacro-iliite. Les modalités d'imagerie mises en Œuvre pour étudier l'ASI chez les patients présentant une sarcoïdose étaient hétérogènes et des études supplémentaires sont nécessaires.
Published: 2020
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21. Eosinophilic Fasciitis Triggered by Nivolumab: A Remarkable Efficacy of the mTOR Inhibitor Sirolimus

Author: B. Cador, Céleste Lebbé, Erwan Le Tallec, Nicolas Belhomme, Hervé Lena, Alain Lescoat, Sène Damien, Alice Ballerie, Charles Ricordel, Patrick Jego, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Cochin [AP-HP], Immunologie humaine, physiopathologie & immunithérapie (HIPI (UMR_S_976 / U976)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth,NJ, USA., Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976))
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, Lung Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Pembrolizumab, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Eosinophilia, medicine, Humans, Fasciitis, ComputingMilieux_MISCELLANEOUS, Sirolimus, business.industry, TOR Serine-Threonine Kinases, Discovery and development of mTOR inhibitors, medicine.disease, Eosinophilic fasciitis, 3. Good health, Safety profile, Nivolumab, 030104 developmental biology, 030220 oncology & carcinogenesis, business, medicine.drug
Abstract: International audience; The global, randomized, double-blind, phase 3 KEYNOTE-189 study(NCT02578680) showed significantly improved OS and PFS with pembrolizumab(pembro)þpemetrexed (pem)þplatinum compared with placeboþpemþplatinumwith a manageable safety profile in pts with previously untreated metastatic nonsqua-mous NSCLC without targetable EGFR/ALK aberrationsj. We present safety and toler-ability data from Japanese pts enrolled in KEYNOTE-189
Published: 2020
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22. The nosology of systemic sclerosis: how lessons from the past offer new challenges in reframing an idiopathic rheumatological disorder

Author: Rodney Ehrlich, Catherine Cavalin, Marine de Saint Riquier, Vincent Sobanski, Guillaume Coiffier, Alice Ballerie, Patrick Jego, A. Lescoat, Claire Cazalets, Paul-André Rosental, Nicolas Belhomme, Eric Hachulla, Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), CHU Pontchaillou [Rennes], Laboratoire interdisciplinaire d'évaluation des politiques publiques [Sciences Po] (LIEPP), Sciences Po (Sciences Po), University of Cape Town, Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'histoire de Sciences Po (CHSP), Lille Inflammation Research International Center - U 995 (LIRIC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre de référence des maladies auto-immunes systémiques rares du Nord et Nord Ouest [CHRU Lille], Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département de Médecine interne et d'Immunologie clinique [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Our contract grant sponsor is the ERC and Silicosis Project, 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)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire [Rennes], Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Institut National de la Recherche Agronomique (INRA)-Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), University of Stellenbosch Business School [Cape Town] (USB ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Rennes (UR), Centre d'histoire de Sciences Po (Sciences Po) (CHSP), European Project: 295817,EC:FP7:ERC,ERC-2011-ADG_20110406,SILICOSIS(2012), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 interdisciplinaire d'évaluation des politiques publiques (Sciences Po) (LIEPP), and Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Nosology, medicine.medical_specialty, systemic sclerosis, Immunology, Disease, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, medicine, Immunology and Allergy, 030212 general & internal medicine, Intensive care medicine, 030203 arthritis & rheumatology, business.industry, Cognitive reframing, medicine.disease, Connective tissue disease, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, pathophysiological features, Etiology, Systemic sclerosis, business, nosological debates, Rheumatism, American College of Rheumatology and European League Against Rheumatism (ACR/EULAR
Abstract: International audience; Systemic sclerosis is a rare connective tissue disease characterised by a wide range of clinical manifestations. Compared with previous sets of criteria, the 2013 American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) classification of systemic sclerosis encompasses a broader and more relevant spectrum of the condition. Nonetheless, clinical and prognostic heterogeneity persists among patients fulfilling these criteria. The next task in the classification of systemic sclerosis is the development of new subset criteria that can successfully identify subgroups of patients with distinct prognostic or pathophysiological features. In this Viewpoint we describe the history of systemic sclerosis over the past century with the objective of highlighting the effect of previous nosological debates on efforts to understand and manage this disorder. Rather than seeking to present a systematic review of possible subgrouping for systemic sclerosis in relation to prognosis, we aim to clarify how nosological considerations have influenced our understanding of the cause and prognosis of this so-called idiopathic rheumatological disorder and how aetiological, prognostic, and pathophysiological hypotheses have helped to describe clusters within the disease. By reflecting on past nosological debates and endeavours, we identify challenges for the current initiative to develop a new subgrouping of systemic sclerosis.
Published: 2019
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23. Ulnar Artery Occlusion and severity markers of vasculopathy in Systemic sclerosis a multicenter cross-sectional study

Author: Matthieu Wargny, Pierre-Yves Hatron, Alice Ballerie, Aleth Perdriger, Nicolas Belhomme, Patrick Jego, Cécile Yelnik, Eric Hachulla, C. Lamotte, Claire Cazalets, David Launay, Alain Lescoat, Vincent Sobanski, Guillaume Coiffier, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Immunology, Arterial Occlusive Diseases, Severity of Illness Index, Scleroderma, Fingers, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, DLCO, Diffusing capacity, Internal medicine, Severity of illness, Skin Ulcer, medicine, Odds Ratio, Immunology and Allergy, Humans, Telangiectasis, Telangiectasia, Ulnar artery, vasculopathy, Aged, 030203 arthritis & rheumatology, Scleroderma, Systemic, Digital Ulcers, business.industry, Ultrasonography, Doppler, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Tricuspid Valve Insufficiency, 3. Good health, 030104 developmental biology, Cross-Sectional Studies, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antibodies, Antinuclear, Pulmonary Diffusing Capacity, Systemic sclerosis, Female, medicine.symptom, business, Lung Diseases, Interstitial, Rheumatism
Abstract: International audience; Objective - To evaluate the association of ulnar artery occlusion (UAO) assessed using Doppler ultrasound (DUS) with the severity markers of systemic sclerosis (SSc). Methods - Two hundred four unselected patients fulfilling the American College of Rheumatology/European League Against Rheumatism 2013 classification criteria for SSc were included in this cross-sectional multicenter study. All patients underwent bilateral hand DUS to evaluate the presence of UAO and clinical/paraclinical visceral evaluation according to current guidelines. Univariable and multivariable ordinal regression models were applied, grading the severity of UAO as "no UAO," "only one UAO," and "UAO on both hands," and assessing its association with clinical features of SSc. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results - UAO was found in 76 patients (37.3%) and was bilateral in 49 patients (24%). UAO as an ordinal event was significantly associated with disease duration, history of fingertip ulcers, telangiectasia, higher modified Rodnan skin thickness score (MRSS), worse diffusing capacity for carbon monoxide (DLco) values, higher tricuspid jet velocity, late capillaroscopic pattern, and positivity for anticentromere antibodies (ACAs) (univariable analysis). In the adjusted multivariable ordinal model, UAO was less frequent in women (OR 0.35 [95% CI 0.15-0.83], P = 0.017) and in patients receiving steroids (OR 0.24 [95% CI 0.09-0.62], P = 0.0034). In multivariable analyses, significant association with UAO was retained for history of fingertip ulcers (OR 2.55 [95% CI 1.24-5.21], P = 0.011), higher MRSS (OR 1.65 [95% CI 1.06-2.56], P =0.025), lower DLco values (OR 0.85 [95% CI 0.78-0.94], P = 0.0015), and ACA positivity (OR 2.89 [95% CI 1.36-6.11], P = 0.0056). Conclusion - UAO may represent a relevant severity marker of vasculopathy in SSc. Its predictive value for the onset of severe vascular manifestations such as pulmonary arterial hypertension, and its association with mortality, remain to be determined in longitudinal studies.
Published: 2019
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24. FRI0331 HISTORY OF SILICA DUST EXPOSURES AND ASSOCIATION WITH CHEST HRCT AND CLINICAL CHARACTERISTICS IN SYSTEMIC SCLEROSIS

Author: Ronan Garlantézec, Patrick Jego, Lescoat Alain, Stéphane Jouneau, Claire Cazalets, Erc Advanced Grant Silicosis project, Amélie Nicolas, Paul-André Rosental, Alice Ballerie, Mathieu Lederlin, Nicolas Belhomme, and Catherine Cavalin
Subjects: 030203 arthritis & rheumatology, 0301 basic medicine, medicine.medical_specialty, Lung, business.industry, Pneumoconiosis, Interstitial lung disease, respiratory system, medicine.disease, Occupational safety and health, respiratory tract diseases, 3. Good health, 03 medical and health sciences, Silica dust, 030104 developmental biology, 0302 clinical medicine, medicine.anatomical_structure, Mediastinal lymph node, Internal medicine, Epidemiology, medicine, business, Cohort study
Abstract: Background The association of a history of silica exposure with precise chest high-resolution computed tomography (HRCT) features are still to be determined in SSc patients fulfilling the 2013 EULAR/ACR classification criteria. A recent study highlighted that mediastinal lymph nodes were associated with worse prognosis in all-cause interstitial lung diseases (ILD) (1). Nonetheless, the links between mediastinal lymphadenopathies (LA) and silica exposure in SSc patients have never been studied to date. Objectives The aim of this study was to assess the association of exposures to inorganic particles on the whole life course, with the HRCT characteristics in an unselected population of SSc patients. Methods A specific questionnaire based on a multidisciplinary approach (social sciences, epidemiology, occupational health and medicine) was used to assess occupational and non-occupational exposures to inorganic particles, with a specific interest on silica exposures in 100 SSc patients fulfilling the 2013 EULAR/ACR classification criteria. Clinical characteristics and chest HRCT at diagnosis were evaluated to assess the association of dust exposure with disease characteristics. The most recent chest HRCT was also evaluated and compared to HRCT at diagnosis to assess pulmonary evolution. All HRCT were evaluated by 3 experts, blinded for the results form dust exposure questionnaire. Results Men had significantly higher global and occupational dust-exposure scores than women. Sixty-five percent of men with SSc (n=17) had an occupational exposure to silica. Thirty-five percent of patients had thoracic LA and 12% an association of mediastinal and hilar LA. Male gender, history of tobacco use, dcSSc, positivity for ATA, thoracic LA and pneumoconiosis were significantly associated with occupational exposure to silica (p Conclusion By using a dedicated highly detailed questionnaire, this study underscores the high prevalence of silica exposure in SSc patients, especially in men. Mediastinal and hilar LA, considered as a bad prognostic factor in ILD, were frequent and associated with silica exposure. References [1] Adegunsoye A, et al. Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment: An Observational Cohort Study with Independent Validation. Am J Respir Crit Care Med. 2018Sep14. Disclosure of Interests None declared
Published: 2019
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25. Beyond silicosis, is the world failing on silica hazards ?

Author: Catherine Cavalin, Alice Ballerie, Patrick Jego, Valérie Lecureur, Nicolas Belhomme, Christophe Paris, Paul-André Rosental, Alain Lescoat, Mathieu Lederlin, Stéphane Jouneau, Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Institut National de la Recherche Agronomique (INRA)-Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Service de pneumologie, CHU Pontchaillou [Rennes], Département de Radiologie [CHU de Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'histoire de Sciences Po (CHSP), Sciences Po (Sciences Po), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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), Centre d'histoire de Sciences Po (Sciences Po) (CHSP), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), and Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Paris Dauphine-PSL
Subjects: Pulmonary and Respiratory Medicine, business.industry, sociologie, Silicosis, education, Criminology, Silicon Dioxide, medicine.disease, SILICA EXPOSURE, 3. Good health, [SHS]Humanities and Social Sciences, Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Occupational Exposure, Humans, Medicine, 030212 general & internal medicine, business, médecine, santé
Abstract: International audience; Collis and Yule 1 stated in 1933, that “silica is such a body poison as is lead, even though it exerts its maleficent influence, especially with regard to tuberculosis, mainly on the respiratory organs, through which it gains access to the body”. This statement invites us to question the editorial 2 entitled “The world is failing on silicosis” in The Lancet Respiratory Medicine. As clinicians, radiologists, toxicologists, and social scientists working on health hazards related to crystalline silica exposure, we delve beyond silicosis, to learn of other dangers associated with silica.
Published: 2019
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26. THU0352 DIAGNOSTIC PERFORMANCES OF HAND ULTRASOUND PARAMETERS AND THEIR IMPACT ON THE 2013 ACR/EULAR CLASSIFICATION CRITERIA FOR SYSTEMIC SCLEROSIS

Author: Cécile Yelnik, M. De Saint Riquier, Vincent Sobanski, Guillaume Coiffier, Eric Hachulla, François Robin, Claire Cazalets, Patrick Jego, Catherine Droitcourt, Nicolas Belhomme, Alain Lescoat, Aleth Perdriger, and Alice Ballerie
Subjects: medicine.medical_specialty, Tenosynovitis, business.industry, Immunology, Diagnostic strategy, medicine.disease, General Biochemistry, Genetics and Molecular Biology, 3. Good health, Power doppler, Rheumatology, Internal medicine, medicine, Immunology and Allergy, business
Abstract: Background:Recent studies have highlighted that ultrasound (US) examination could offer a better assessment of hand manifestations of systemic sclerosis (SSc). Indeed, US allows a simultaneous evaluation of vascular, fibrotic and inflammatory hand features of the disease. Power Doppler US can especially explore macrovascular involvement characterized by an obliteration of digital arteries or ulnar arteries. Ulnar artery occlusion (UAO) is especially frequent in SSc patients and could be a relevant marker of the severity of SSc-associated vasculopathy. Among other hand manifestations of SSc, US evaluation can notably explore tenosynovial involvement such as fibrotic tenosynovitis (TS), which is considered to be SSc-specific.Objectives:This study aims to assess the diagnostic performances of these hand US parameters for the diagnosis of SSc.Methods:244 patients with suspected SSc were consecutively included. They all had US evaluation assessing the presence of fibrotic TS and UAO. The final diagnosis of SSc was based on the evaluation of an expert, independently from US results and from any pre-established classification criteria.Results:166 patients were finally diagnosed as SSc. 62 SSc and 8 non-SSc patients had UAO (uni or bilateral) (p=0.001). 23 SSc patients and 1 non-SSc patient had US fibrotic TS (p=0.007). A US SSc-pattern (presence of UAO and/or fibrotic TS) was reported in 73 SSc patients and 9 non-SSc patients (pConclusion:The use of hand US parameters may help to refine the diagnostic strategy of SSc and their inclusion in addition with the items of the ACR/EULAR classification could be discussed.Disclosure of Interests:Marine de Saint Riquier: None declared, Alice Ballerie: None declared, François ROBIN: None declared, Nicolas Belhomme: None declared, Claire Cazalets: None declared, Catherine Droitcourt: None declared, Aleth Perdriger: None declared, Cécile Marie Yelnik: None declared, Eric Hachulla Speakers bureau: speaking fees from Actelion Pharmaceuticals,GlaxoSmithKline, and Bayer outside of the current study, Vincent Sobanski: None declared, Patrick Jégo: None declared, Guillaume Coiffier: None declared, Alain LESCOAT: None declared
Published: 2020
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27. Interstitial Lung Disease and Mediastinal Lymph Nodes: A Computed Tomography-based Biomarker beyond Nosological and Etiological Borders?

Author: Patrick Jego, Catherine Cavalin, Alain Lescoat, Alice Ballerie, Mathieu Lederlin, Stéphane Jouneau, Nicolas Belhomme, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Institut National de la Recherche Agronomique (INRA)-Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po) (LIEPP), Sciences Po (Sciences Po), Centre d'études de l'emploi et du travail (CEET), Conservatoire National des Arts et Métiers [CNAM] (CNAM), and 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)-Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.)-Ministère du Travail, de l'Emploi et de la Santé
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, pneumoconiosis, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, heart failure, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, lymphadenopathy, Correspondence, medicine, Humans, Dust exposure, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, interstitial lung disease, business.industry, Interstitial lung disease, Mediastinum, medicine.disease, dust exposure, 030228 respiratory system, Etiology, Biomarker (medicine), Lymph, Radiology, Lymph Nodes, business, Lung Diseases, Interstitial, Biomarkers
Abstract: International audience
Published: 2019
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28. An Original Case of an Association of Eosinophilic Fasciitis with Cholangitis Induced by Nivolumab

Author: Patrick Jego, Erwan Le Tallec, Hervé Lena, Nicolas Belhomme, Pascale Marcorelles, Arnaud Deniel, Louise Triquet, Charles Ricordel, CHU Pontchaillou [Rennes], Laboratoire de Neurosciences de Brest (LNB), Université de Brest (UBO), CHRU Brest, Pôle de Biologie Pathologie (CHU - BREST - Biologie pathologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Eugène Marquis (CRLCC), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 )
Subjects: 030203 arthritis & rheumatology, Pulmonary and Respiratory Medicine, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, medicine.medical_specialty, business.industry, MEDLINE, medicine.disease, Dermatology, Eosinophilic fasciitis, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Medicine, Nivolumab, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019
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29. Synovial involvement assessed by power Doppler ultra-sonography in systemic sclerosis: results of a cross-sectional study

Author: Guillaume Coiffier, A. Lescoat, Marine de Carlan, Catherine Droitcourt, Claire Cazalets, Aleth Perdriger, Alice Ballerie, Patrick Jego, Nicolas Belhomme, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 Pontchaillou [Rennes], Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, Wrist Joint, medicine.medical_specialty, systemic sclerosis, Cross-sectional study, Hand Joints, Wrist, Systemic scleroderma, Gastroenterology, Severity of Illness Index, 03 medical and health sciences, Pericarditis, 0302 clinical medicine, Rheumatology, Internal medicine, Synovitis, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Aged, power Doppler ultrasonography, 030203 arthritis & rheumatology, Tenosynovitis, Scleroderma, Systemic, business.industry, Synovial Membrane, Ultrasonography, Doppler, Odds ratio, Middle Aged, medicine.disease, medicine.anatomical_structure, Cross-Sectional Studies, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business, tendon friction rubs
Abstract: International audience; Objectives - To characterize hand synovial manifestations assessed by power Doppler ultrasonography (PDUS) in a cohort of unselected patients fulfilling the 2013 ACR/EULAR classification criteria for SSc and to evaluate the associations of these synovial manifestations with the main general clinical and biological features of SSc. Methods - One hundred and three SSc patients were consecutively included and underwent PDUS evaluation of both hands assessing synovial and tenosynovial manifestations according to the OMERACT definitions. Clinical, biological and immunological SSc characteristics were recorded at the same time. Results - Thirty-three patients (32%) had ultrasonographic synovial/tenosynovial involvement. The two main PDUS features were Doppler-positive/inflammatory synovitis (n = 18, 17.5%) and sclerosing tenosynovitis (TS) (n = 19, 18.4%). Inflammatory synovitis was more frequent in the wrist and MCP joints. Sclerosing TS was more frequent in men [odds ratio (OR) = 6.32, 95% CI: 2.17, 18.41; P = 0.001] and was associated with anti-RNA polymerase III antibodies (OR = 10.93, 95% CI: 1.84, 65.12; P = 0.01), diffuse SSc (OR = 18.24, 95% CI: 4.80, 69.32; P < 0.0001), interstitial lung disease (OR = 6.09, 95% CI: 1.86, 19.98; P = 0.001) and inflammatory arthralgia (OR = 14.64, 95% CI: 2.58, 83.10; P = 0.002). Inflammatory TS or synovitis were associated with CRP levels >5 mg/l (OR = 5.50, 95% CI: 1.81, 16.70; P = 0.001), pericarditis (OR = 7.81, 95% CI: 1.58, 38.71; P = 0.017) and inflammatory arthralgia (OR = 15.96, 95% CI: 2.80, 91.02; P = 0.002). Inflammatory synovitis and sclerosing TS were not significantly associated within an individual patient (OR = 2.77, 95% CI: 0.88, 8.70; P > 0.05). Conclusions - Ultrasonographic synovial involvement is frequent in patients fulfilling the 2013 ACR/EULAR classification criteria and PDUS may have a part to play in a more accurate and precise description of musculoskeletal manifestations of the disease, especially as the question of a treat-to-target approach is arising for SSc.
Published: 2018
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30. Investigating in utero fetal death: outcome of internal medicine consultation

Author: Thomas Le Gallou, Nicolas Belhomme, Patrick Jego, Florence Rouget, Philippe Loget, Marine de Carlan, A. Lescoat, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 )
Subjects: placental pathology, Placenta Diseases, Epidemiology, Placenta, 030204 cardiovascular system & hematology, Hospitals, University, Drug treatment, 0302 clinical medicine, Pregnancy, Risk Factors, Prevalence, Referral and Consultation, 030219 obstetrics & reproductive medicine, Fetal death, Obstetrics, Clinical aspects, Gestational age, Stillbirth, Antiphospholipid Syndrome, Thrombosis, Pathophysiology, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, In utero, Infarction, Antibodies, Antiphospholipid, Female, France, Adult, medicine.medical_specialty, placental vascular disorders, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, Young Adult, Rheumatology, Internal medicine, medicine, Internal Medicine, Humans, Pathological, Fetal Death, Retrospective Studies, business.industry, antiphospholipid antibodies syndrome, medicine.disease, Etiology, in utero fetal death, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Biomarkers
Abstract: International audience; Aim: The objectives were to determine the frequency of in utero fetal death (IUFD) related to placental disorders and to assess the frequency of antiphospholipid antibodies syndrome (APS) among women referred to the internal medicine department.Methodology: A retrospective clinical study conducted in Rennes University Hospital, France. From January 2007 to December 2014, 53 women who presented an IUFD at 14 weeks or more of gestational age were included. The main cause for each IUFD was determined by expert agreement. Primary outcome was to analyze the final etiologies diagnosed and the prevalence of IUFD related to placental disorders. Secondary outcomes included the frequency of APS among patients with IUFD of placental origin and the pathological and clinical features associated with APS.Results: IUFD resulted from placental disorders in 36/53 (68%) patients, and remained unexplained in 11 cases (20.8%). Among the 36 patients with placental disorders, APS was diagnosed in five (13.9%) cases, and four (11.1%) patients were considered as having 'non-criteria' APS. History of thrombosis (P = 0.001) and placental infarcts (P = 0.047) were significantly associated with APS.Conclusion: Placental disorders were the major cause for IUFD in patients who were referred to internal medicine specialists. Importantly, APS was seldom found in patients with placental disorders. Venous thromboembolism history and placental infarcts were both significantly associated with APS. Further studies are needed in order to deepen our understanding of the physiopathology of placental disorders and its underlying causes among non-APS women, and to determine the best treatment regimen for future pregnancies.
Published: 2017
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31. Rare myopathy associated to MGUS, causing heart failure and responding to chemotherapy

Author: Olivier Decaux, Thomas Le Gallou, Nicolas Belhomme, Olivier Benveniste, Alain Lescoat, Sarah Leonard-Louis, Yves Le Tulzo, Nicolas Champtiaux, Antoine Larralde, Marie-Christine Minot-Myhié, Adel Maamar, CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), and Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière]
Subjects: medicine.medical_specialty, Pathology, medicine.medical_treatment, Monoclonal gammopathy of unknown significance, Late onset, Heart failure, macromolecular substances, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Nemaline myopathy, immune system diseases, Internal medicine, hemic and lymphatic diseases, medicine, Electron microscopy, Chemotherapy, Myopathy, Nemaline myopathy related cardiomyopathy, Hematology, business.industry, Sporadic late onset nemaline myopathy, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, General Medicine, medicine.disease, 3. Good health, Monoclonal gammopathy, 030220 oncology & carcinogenesis, Sarcoplasmic rods, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: International audience; Monoclonal gammopathy of unknow significance (MGUS) has recently been described as a possible cause of sporadic late onset nemaline myopathy (SLONM), which can lead to severe muscle impairment and respiratory insufficiency. We report the case of a man presenting a MGUS related SLONM, whose singularity was a severe heart involvement...
Published: 2017
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32. Atypical bortezomib-induced neutrophilic dermatosis

Author: Catherine Droitcourt, A. Lescoat, Nathalie Stock, Patrick Jego, Alain Dupuy, Nicolas Belhomme, Olivier Decaux, Martine Sebillot, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, medicine.medical_specialty, Hematology, business.industry, Bortezomib, [SDV]Life Sciences [q-bio], 030106 microbiology, General Medicine, 030204 cardiovascular system & hematology, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Neutrophilic dermatosis, Internal medicine, Medicine, business, ComputingMilieux_MISCELLANEOUS, medicine.drug
Abstract: International audience
Published: 2018
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32 results on '"Nicolas, Belhomme"'

1. Efficacy of valaciclovir in preventing herpes zoster in patients receiving anifrolumab

2. Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome in the intensive care unit: a case report

3. History of pre-eclampsia does not appear to be a risk factor for vascular phenotype in women with systemic sclerosis

4. Role of serum immunoglobulins for predicting sarcoidosis outcome: A cohort study.

5. Libman-Sacks endocarditis under apixaban in a patient with a high-risk profile venous antiphospholipid syndrome

6. Ultrasound classification of finger pulp blood flow in patients with systemic sclerosis: A pilot study

7. Impact of Three Different Algorithms for the Screening of SSc-PAH and Comparison with the Decisions of a Multidisciplinary Team

8. Apixaban and rivaroxaban in obese patients treated for venous thromboembolism: Drug levels and clinical outcomes

9. Bone mineral density and trabecular bone score assessment in systemic sclerosis: A cross-sectional study

10. Sacroiliac joint in sarcoidosis on computed tomography: a monocentric retrospective study (SISTER)

11. Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study

12. The neglected association of crystalline silica exposure and systemic sclerosis

13. Elucidating in utero fetal demise time to reassemble the pieces of the puzzle?

14. Association of silica exposure with chest HRCT and clinical characteristics in systemic sclerosis

15. Correspondence on 'Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis'

16. High Cycle Fatigue strength evaluation of welded joints in handling equipment

17. Silica Exposure and Scleroderma: More Bridges and Collaboration Between Disciplines Are Needed

18. Aspirine : indications et utilisation durant la grossesse

19. Drug-induced granulomatosis: is dupilumab the new kid on the block?

20. Spondyloarthritis and sarcoidosis: Related or fake friends? A systematic literature review

21. Eosinophilic Fasciitis Triggered by Nivolumab: A Remarkable Efficacy of the mTOR Inhibitor Sirolimus

22. The nosology of systemic sclerosis: how lessons from the past offer new challenges in reframing an idiopathic rheumatological disorder

23. Ulnar Artery Occlusion and severity markers of vasculopathy in Systemic sclerosis a multicenter cross-sectional study

24. FRI0331 HISTORY OF SILICA DUST EXPOSURES AND ASSOCIATION WITH CHEST HRCT AND CLINICAL CHARACTERISTICS IN SYSTEMIC SCLEROSIS

25. Beyond silicosis, is the world failing on silica hazards ?

26. THU0352 DIAGNOSTIC PERFORMANCES OF HAND ULTRASOUND PARAMETERS AND THEIR IMPACT ON THE 2013 ACR/EULAR CLASSIFICATION CRITERIA FOR SYSTEMIC SCLEROSIS

27. Interstitial Lung Disease and Mediastinal Lymph Nodes: A Computed Tomography-based Biomarker beyond Nosological and Etiological Borders?

28. An Original Case of an Association of Eosinophilic Fasciitis with Cholangitis Induced by Nivolumab

29. Synovial involvement assessed by power Doppler ultra-sonography in systemic sclerosis: results of a cross-sectional study

30. Investigating in utero fetal death: outcome of internal medicine consultation

31. Rare myopathy associated to MGUS, causing heart failure and responding to chemotherapy

32. Atypical bortezomib-induced neutrophilic dermatosis

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